Fear, Anxiety and Moments of Calm

If you have been feeling scared or anxious, you are not alone. I imagine that most of us, if not all of us, are experiencing unpleasant feelings lately in the form of fear or anxiety or both. This is expected and normal. We are in a place where we are dealing with something none of us have ever had to face before. Fear and anxiety are normal and expected. These are naturally occuring feelings that can provide us with some protection against harm. When they become overwhelming, however, these feelings can become less useful and may get in the way of adapting to what's happening around us.

First, I want to make sure we all understand what we’re talking about here – fear and anxiety. I am using the definitions put forth by the American Psychiatric Association, in the current version of their Diagnostic and Statistical Manual (DSM-5) so you can trust the source.

Fear – the emotional response to real or perceived imminent threat. Fear is more often associated with the increase in the body’s fight or flight response.

Anxiety – anticipation of future threat. Anxiety is more often associated with muscle tension and heightened awareness in preparation for future danger and cautious or avoidant behaviors.

So to simplify, fear is a reaction to a “here and now” threat. Something dangerous or threatening is here right now and we are having an emotional reaction to it. That emotional reaction is often fear. On a positive note, fear can provide us with the energy to act or to the stillness to protect ourselves from an actual threat.

Anxiety is the worry and apprehension about a future or anticipated threat. Anxiety usually has to do with what hasn’t happened yet, but what we are pretty certain is coming (or at least possible).  On the positive side, anxiety can serve to help us prepare for what's to come. For many of us, anxiety is often partnered with our “worst case scenario” thinking. On the other hand, anxiety can leave us stuck in "worry" rather than motivating us toward effective action.

Today, I would guess that most of us are experiencing both fear and anxiety in reaction to the current pandemic. Before I go any further, I want to be sure to clarify that while I am a licensed clinical psychologist, I am providing my personal observations and basic information here. I do not want you to take the information in this article as clinical advice/guidance, individual diagnosis, or a replacement for actual clinical intervention. Those things can only be provided by a licensed clinician following a comprehensive, individualized assessment with you. 

Now that we’ve got that out of the way, I want to present some observations I've had about how we are experiencing fear and anxiety. Please know that these are not "real" categories. They are just my thoughts about the different levels of feelings we may be experiencing. I also believe that most of us likely experience a range of feelings that may cross all of these "categories" at some point or another.

1)  Mild, manageable fear and anxiety. From what I’ve seen, this looks like an increase in stress, mild headache, mild sleep disturbance, distractibility, irritability, and a generalized sense of heightened awareness to our environments and other people. When we feel this way, we may not feel like our coping resources are overwhelmed, but our “coping” activities have increased. There is a real threat out there, so there is reaction to it. It’s fear and it’s expected, given what’s happening. Increased hand-washing, awareness of an increase in personal space, wiping down surfaces, avoiding public places and other activities are practical in the face of the threat. These are positive things we can do for ourselves and our loved ones. There may also be anxiety about what comes next. Worries about how long this will last, concerns about the lack of information about how to prepare and whether or not we will be affected.

2)  Moderate anxiety and fear. This looks like what I’ve described above but with more intensity. When we find ourselves with moderate levels of fear and anxiety, we may find that we are unable to stop thinking about the virus or worrying about what is going to happen next. There may be excessive hand-washing and cleaning. There may be hoarding of “supplies” to prepare for the illness. When we have moderate fear and anxiety, we may be overly restless, feel a sense of fatigue, experience increased muscle tension and have significant sleep disturbance. This level of anxiety and fear may feel less "productive" than the milder versions described above.

3) Serious, severe anxiety and fear.  When we feel anxiety and fear at this level, we feel as if the current events are overwhelming. Our ability to cope is tapped. It feels like “too much” and we may feel like we are at a breaking point. Some of us who feel overwhelmed may already have an underlying mental health condition or anxiety disorder, but this does not have to be the case. Fear and anxiety are excessive, to the point that we can think about little else. There may be a total avoidance of anything seen as a threat, including friends and family. There may a desire to fill ourselves constantly with information about the virus or conversely, to avoid information about the virus altogether. For any of us, at any time, when we find ourselves beyond our ability to cope, we should seek professional help. Mental health professionals are available through an employer’s EAP program, by searching on line through resources such as www.findapsychologist.org, www.psychologytoday.com/us/therapists, locator.apa.org, finder.psychiatry.org, as well as simply searching for psychologists or psychiatrists “near me” in any online search engine.

Also please remember, that any of us at any time, can seek professional help. We don’t have to be “mentally ill” to want or need professional help. We don't have to wait until we are overwhelmed. These are unusual times, full of stress, and talking through our anxieties with a professional can be enormously helpful. It can help keep our fears and anxieties at the mild or moderate level, within the range of our ability to cope. So, please, let's seek out help at any point if we need it. I also want to say clearly that this is not a time to judge ourselves. This is a time for compassion, especially self-compassion. Let's give ourselves permission to ask for help and support whenever we need it.

When I sat down to write, I had two goals in mind – to provide education about fear and anxiety and to provide a simple, basic exercise to assist in providing moments of calm. Hopefully, I’ve achieved the first goal. The second goal follows here, and it’s pretty simple. If you can breathe, you can follow these steps. 

It’s all about focusing on your breathing. There are two reasons that this works. First – deep, slow breath with prolonged exhalation slows our heart rate. It provides an overall sense of relaxation by triggering what is known as our parasympathetic nervous system. This is our “calm down” system.  Second – focusing (and returning to that focus when distracted) trains our brains to be better at problem-solving and helps us to feel less overwhelmed during times of stress. Also, practicing this focus can help us stop ourselves from becoming fixated on worries and things we cannot control.

Here’s the exercise:

Sit comfortably. If you are able, sit with a straight spine, shoulders back and away from the ears, and neck long. You can imagine a very gentle tug at the top of your head, helping it lift up and away from your shoulders and neck. If you feel safe, close your eyes (after you’re done reading this, obviously) or simply soften your focus so that you’re not really looking at anything specifically. Take a deep breath in through your nose, hold it briefly, and then exhale. If you can, cause your exhale to be just a little bit longer than your inhale. Do this for at least three breaths. 

Once you’ve got that down, imagine a soothing color. I tend to use a light color like a pale yellow, a pale pink, or a light blue but use whatever color that you associate with feeling calm. Imagine that color being inhaled through your nostrils and filling your chest and body. Feel it clearing and cleaning the stress and anxiety from your body. When you exhale, imagine that you are breathing out all those “stress and anxiety toxins” and give them a color.  Often, I find this to be a dark color, like black or a thick, dark green. Breathe that all out, get it cleared from your body. Then again, breathe in your soothing color, hold it while it clears and cleans briefly, then let all that dark, stress out. Do this for a while. If you’re so inclined, set a timer on your phone for 5 to 10 minutes and do this until your timer chimes. 

Now, here’s the focus trick. Your mind is going to wander. You are going to have thoughts seep in. “What’s for dinner?” “How long have I been doing this?” “Did I leave the stove on?” etc. When you have those distracted thoughts, simply let them go and return to focusing on your breathing. A mentor of mine says “Oh, well” to herself when her mind wanders and comes back to focusing on the breath. I tend to say to myself, “Back to the breath” and refocus. Here’s the deal – you are going to lose focus. If you’re like me, it’s going to happen a lot during those 5-10 minutes. Sometimes, you may even forget that you’re supposed to be focused on your breathing altogether. That’s ok, just bring it back. Over and over and over again.

That’s it. That’s the exercise. 5 to 10 minutes of breathing colors in and out while you try to focus on nothing else. I’ll let you in on little secret, if you’ve never meditated before, this is one form of meditation. And it takes practice. That’s why it’s called a “meditation practice” because you need to do it over and over and over again. And I’ll let you in on another secret, if you find the time (just a few minutes) every day to do this practice, you will reap benefits including decreased stress and an improved ability to focus. Which means, when you start to feel worry and anxiety during the day, you can say to yourself, “back to the breath” and turn your attention away from your worried thoughts and back to your breath. In these times when we all feel like things are out of our control, having even just a few breaths of control can change a stressful moment into a manageable one.

Look, there are plenty of breathing and relaxation exercises out there, so if this one doesn’t work for you, find one that does. And then, do it. Practice every day. Even if you can only give 2 or 3 minutes, do it. 

And remember, you are not alone. Every single one of us is trying to manage the fear and anxiety of this moment. The whole world is with you. And we will get through this someday, somehow. Hopefully, taking time to focus on your breathing will make it a little easier. Be safe, be compassionate toward yourself and others, and don’t forget to breathe.