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Managing The Anxiety And Grief Of COVID-19


Managing The Anxiety And Grief Of COVID-19

How a global pandemic is a women’s health issue

For the last few months, women have been worrying about the safety of their loved ones and their economic security while navigating new challenges like how to parent while working from home. The pandemic is impacting nearly everything we do (or can’t do anymore) and dominating what we read and watch. We are having to rethink how we celebrate birthdays, weddings and even funerals. Oh, and we are expected to do all of this without being able to hug!

It’s no surprise the coronavirus pandemic is taking a toll on women’s health. Women are already nearly twice as likely as men to be diagnosed with an anxiety disorder in their lifetime. Researchers aren’t sure exactly why, but it likely has to do with all those changes in hormones throughout our reproductive years. Let’s talk through how our bodies and minds are responding to the pandemic and what we can do to manage these feelings.

The differences between worry, stress, and anxiety

We often hear the terms used interchangeably. But what exactly are the differences between worry, stress, and anxiety?

Worry happens in your mind

Worry is something that happens in your mind. It’s the act of dwelling on negative thoughts or uncertain outcomes. Worrying in these times is completely normal and even helpful – it forces your mind to calm down by thinking through what is troubling you and then problem solving.

Stress happens in your body

Stress, on the other hand, is something that happens in your body – it’s a physiological response to some sort of external circumstance. These external stress stimuli are called “stressors” – for example, an argument with a loved one, an upcoming deadline, or a big sports competition. Experiencing these stressors activates your nervous system: your body releases adrenaline and cortisol causing your heart to beat faster and your palms to become sweaty.

This physiological response goes back to prehistoric times. You’ve probably heard of “fight or flight” – the body’s natural response to threats like a rumble in the bushes. The automatic physical response quickly prepares your body to fight or flee an impending threat. This is called “acute stress” because it happens quickly and your body goes back to normal when the threat is over. But when the stressor is something that doesn’t resolve quickly, like, say, a global pandemic, you can experience chronic stress. Chronic stress – when your body lingers in a stage of stress for a long period of time – can lead to a number of health concerns from digestive issues to heart disease to infertility.

Anxiety happens in your mind and body

Anxiety is the culmination of worry and stress. Where worry happens in your mind and stress happens in your body, anxiety includes both the cognitive response and the physiological response. The difference is there is no external stimuli. You often worry that something bad will happen, and you feel the physical symptoms of stress, even when there is no stressor.

If you have ever had a panic attack, you have experienced your body suddenly going into fight or flight mode even though there is no immediate threat. Instead, your body is anticipating a future threat that may or may not happen. Today, that could be a fear of you or your family members becoming infected with the virus or losing jobs – even when that isn’t happening. This combination of worry and the physical symptoms of stress without an actual stressor is anxiety.

The feeling of grief

I read an article in the Harvard Business Review that really captured what many of my colleagues and I have been feeling during the pandemic: grief. It was an interview with David Kessler, one of the world’s top experts on the subject. He co-wrote On Grief and Grieving: Finding the Meaning of Grief through the Five Stages of Loss and its follow-up: Finding Meaning: The Sixth Stage of Grief.

Kessler acknowledged that the pandemic elicits feelings of anticipatory grief – mourning over the impending changes and uncertainty that the future holds. He lists the stages of grief and how we might experience them with respect to the pandemic:

  • Denial: We won’t be affected by the virus.
  • Anger: You’re making me stay home and taking away my activities. 
  • Bargaining: Okay, if I social distance for two weeks everything will be better, right?
  • Sadness: I don’t know when this will end. 
  • Acceptance: This is happening; I have to figure out how to proceed.

These stages don’t always happen in order – you can skip around and go back into different stages at different points in time. As the uncertainty wears on, I’ve found it helpful to try to recognize these different stages as they creep back up, knowing that ultimately peace comes with acceptance.

When grief becomes anxiety

The anticipatory grief that Kessler talked about can play out through anxiety. When anticipatory grief becomes problematic is when the feelings of dread happen so frequently and with such severity that they interfere with our daily activities and overwhelm our abilities to cope. If you find that you can’t shake the uneasiness, you should talk to a physician or a therapist. Many are now offering teletherapy so you don’t have to leave home to have a session.

Ways to cope with these feelings of anticipatory grief, fear, and anxiety

Sorting through these emotions and their physical responses can be difficult, but just recognizing what they are can give you some sense of control and help you feel better. Remind yourself that it is normal to feel each of them. Try to reframe the situation in a way that is manageable, focusing on what you can control. Seek a balance where the feelings of fear and anticipatory grief guide your behavior (like remembering to wear a mask in public and to wash your hands frequently) but don’t dominate or consume you.

Here are some ways of coping:

  • Allow yourself to feel your feelings. When you feel them coming on, give yourself an amount of time, maybe 15-30 minutes, to mourn the important events and physical connections you’re missing out on because of the virus.
  • Then, live in the moment and let go of what you can’t control. Think about the ways you are okay (you can start with having food, shelter, and love) and list the things you can control.
  • Try to get into a good sleep routine. Set a “bedtime alarm” to go to bed at the same time each night, which will make it easier to get it up in the morning. Charge your phone further away than arms reach so you’re not tempted to scroll the night away, or turn on a white noise app to keep your mind from racing as you try to fall asleep.
  • Try mindfulness breathing exercises. Slowly inhale through your nose and slowly exhale through your mouth. Some great apps to help guide you in mindfulness and meditation are Calm, Headspace, and MyLife.
  • Get in some physical exercise daily if you can – even a 10-minute walk is good for anxiety and mental health. Three times a week, try doing 30 minutes of aerobic activity like running, biking or an online class.
  • Eat healthy meals. Limit physiological stimulants like sugar, alcohol and caffeine.
  • Connect with friends and family. Call on the phone, video chat via Facetime or Zoom (for free!), or chat with a neighbor outside, driveway to driveway.
  • Write down what you’re worried about and ways to solve the problem or deal with it.
  • Show compassion. Everyone is learning how to handle this new type of grief and anxiety. Cut people some slack and know that they may be behaving differently than they normally would because they are feeling stressed out.

How VPFW providers are dealing with the stress and grief of the pandemic

In VPFW’s Quarantine Q&A series, our providers were asked about their favorite ways of dealing with the stress and grief of living in quarantine during the pandemic. Personally, I enjoy running – it helps me clear my mind and focus on being present. I loved hearing the variety of ways my colleagues like to decompress:

  • Getting outside
  • Exercising
  • Listening to music
  • Meditating
  • Walking the dogs
  • Cooking
  • Reading
  • Gardening
  • Laughing
  • Spending quality time with family

Dr. Cara Hartle said the main way that she has been dealing with the stress of the current pandemic is to take care of herself. “If I don’t take care of myself, then I won’t be able to take care of my family and my patients. I make sure that I exercise regularly, eat healthy, get enough sleep, and spend some downtime with my husband who is also a physician and experiences a lot of the same stressors as I do. It helps to talk about it because it allows us to reflect and process everything that, otherwise, feels like a whirlwind.”

Dr. Mark Hyde encouraged looking for ways to serve those around you who are impacted more than you. “Sometimes, just a phone call makes a big difference.” Dr. Leslie Davis agreed that “even if they’re all set, it will still make both of you feel better.”

This too shall pass

Whatever you do to manage your mental health during these trying times, know that you are not alone. Most everyone is experiencing these feelings to some degree, so don’t be too hard on yourself. Talk to your loved ones and seek help if you are feeling overwhelmed. And remember that no matter how long it seems, it won’t last forever. We’ll get through it together.

To schedule an appointment with a VPFW provider, you can call us at 804-897-2100 or set an appointment online.

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