How can we prevent the spread of fear and anxiety while we also try to prevent the spread of COVID-19? With the pandemic showing no signs of stopping, demand for anxiety therapy is continuing to rise, as more people seek out solutions to their mental health struggles. CBT and mindfulness skills are great tools for helping us to manage anxiety. Since the beginning of the pandemic, we have come to appreciate the public health efforts to control a deadly virus. It has taken a huge effort to get the population on board with simple behaviours like social distancing, wearing a mask, and monitoring  symptoms..In the same way, we can take a public health approach using evidence based CBT skills to controlling the spread of mental health problems in our society.  Here's some tips from the therapy room.

A New Kind of Fear

With COVID-19, we are facing  a new kind of fear that many of us did not realize existed: the fear of an enemy that we cannot see in our own bodies.  Everyday experiences like riding the subway, shopping, and now going back to school become fraught with worries that were never there before. For this reason, it is important that we both understand anxiety and take a proactive approach to learning self management tools.   The anxiety equation is a useful tool we use for teaching CBT and mindfulness skills in therapy.  

Understanding Anxiety

Anxiety is a natural response to what we cannot control. To a certain degree, it is healthy to be wary of what can be potentially harmful. Anxiety keeps us alert and motivates us to seek effective coping strategies that build our confidence and resilience.  However, when people suffer from the debilitating effects of anxiety, they overestimate the likelihood of the danger, the effects, or their own ability to cope. A helpful way of thinking about anxiety is the anxiety equation: Our goal in managing anxiety is not to eliminate it but to decrease its intensity. We can decrease anxiety with the following strategies specific to managing COVID-19 anxiety:

1) Decrease the estimation of danger by: 

1. a) Taking precautions to minimize risks like wearing a mask and social distancing.

2. b) Staying informed about risks from reliable sources and minimize social media consumption.

3. c) Using cognitive strategies and self-talk to evaluate the accuracy of our beliefs related to the fear.

2) Increase our capacity to cope by:

1. Using mindfulness skills to be with the anxiety as it arises.  With mindfulness, we can learn to recognize and accept the anxiety as it occurs and be with it in a receptive way.  This allows us to make skillful choices rather than avoid or try to get rid of anxiety, which never works effectively.

2. Embrace stressful situations that are unavoidable and create exposure opportunities to build confidence to be out in safe public settings like shops or parks

Don’t Try to Control Anxiety— or Avoid It

Two of the biggest pitfalls people face when managing anxiety are either fixing it or avoiding it. When we try to fix anxiety, we get stuck either seeking solutions that never bring relief or obsessively checking to see if we are okay.  Another flawed strategy is avoiding situations that are necessary or minimizing the risks. These strategies work in the short term but perpetuate the problem of anxiety. Mindfulness strategies provide the middle ground we need to manage anxiety. With mindful awareness, we learn to turn toward anxiety and be aware of the thoughts and feelings associated with the experience. This allows us to tolerate the emotions that are there and make skillful choices to manage the anxiety.

Mindfulness Practices for Working with Anxiety

What would a public health initiative for mental health look like?  First, we would need to emphasize the importance of taking time out to recognize the experience of fear and anxiety. We can then use the anxiety equation to ask ourselves how we decrease the size of the anxiety rather than eliminate it.  We can do this by decreasing the estimation of coping, but this is not enough.  We also need to increase our coping skills, and mindfulness practices help us do that.  For more mindfulness tools on managing difficult emotions and regulating anxiety, check out our free downloadable handouts and guided meditations. Click here to access our resources.