There is so much uncertainty right now because the COVID-19 pandemic is completely unprecedented here in the U.S. Local and state health officials are working to strike a balance between what is known, unknown and calming fears. But the constant stream of information and rising case counts of the new coronavirus are fueling our collective anxieties.
Spectrum News National Health Reporter Erin Billups sat down with Columbia University Clinical Psychologist Anne Marie Albano, PhD, who is also the co-clinical director of the University’s Youth Anxiety Clinic. Dr. Albano shares some thoughts and expert advice on how to cope in the midst of an unprecedented global health crisis.
Q. I think everybody is feeling a certain level of anxiety.
A. The thing we need to know, first of all, is anxiety is a normal emotion. Anxiety heightens when we are faced with uncertainty, unpredictability and the feeling of not being able to control our circumstances. So a virus outbreak certainly is going to stoke all of that. Right? We don't know who's affected and who isn't.
Q. So just give us the basics. What are some coping mechanisms, some tools that people can use moving forward?
A. The best coping mechanism is to restrict your viewing of information, to the experts. The Centers for Disease Control, for example, or your local physician that you might have a relationship with. But don't go searching the web for any and every kind of story. One of the things anxiety tends to do to us is it makes us seek out information to confirm our fears. So you don't want to do that. And we also don't want misinformation. The second thing would be to limit how often you do that. Once a day, looking at the CDC website should be enough for you. The next thing to do is recognize what is in your control. You can control washing your hands. You can control touching your face. And you can distance, in a healthy way. If you can work from home, you work from home. If you have family members and friends who are coming by and visiting, that's wonderful, but pay mind to how old you are, how old they are. Elderly parents, for example, or grandparents, we've got to protect them. So stay in touch in a safe way.
Q. Which leads to my next question, many older Americans are already isolated at home and now the advice, is for younger people to stay away from the elderly to keep them safe. That creates a greater degree of isolation, which is also unhealthy. How do we strike a balance?
A. So I would say family members and friends need to be smart. Number one is we don't want to leave them alone. We want to want them to know we care. We're worried. We're concerned. And we want to see them. So definitely folks should be thinking about checking in by phone number one. But the second thing is get together as family and friends and say, who is feeling fine, who doesn't have a lot of little kids running around who may be little germ vectors just in general. Set up a schedule of who's going to visit and make sure they're OK, bring them things they need. If they're in a nursing home, for example, work with the folks in the nursing home or the facility to understand when they can visit safely.
Q. Schools are closing, how do parents and loved ones talk to their young children and help minimize their fears and anxiety?
A. The best thing again for working with children around the virus issue is to be honest and to give information that they can understand. There is an illness that's going around that makes people very sick like the flu, but sometimes even worse. And it mostly gets people who are older, who have been ill. So you're lucky that it doesn't affect children as much, but that's still you've got to be safe. So we want you not to put things in your mouth, you know? You know, not to share food with your friends or drinks with your friends right now.
I'd give kids things to do during the day from art activities to play in addition to keeping up with their work. But what are things that as a family you could do together? If someone is stuck at home with the kids, think about things to do with them that they will enjoy, and that will occupy them, to prevent the feeling of time passing very, very slowly, which puts everybody on edge.
A big thing we know is, that kids resonate with the emotions of the adults who are taking care of them. So we ask parents, check your own anxiety, check your own frustration, check your own discomfort. Leave that at the front door, because when you're with your kids, you have to be all present for them and you've got to be the calm and the informed person who's going to present to them, that this [crisis] is going to be managed, that we're okay and if anyone gets sick, we'll get help.
Q. What's the best advice for teenagers who might be stuck at home?
A. Remember, teenagers can think very complex, in complex ways and they also can take a long view. So, first parents should give them accurate information. And if they want more information, sitting with them in front of the CDC Web site and explaining things to them is important. And if they don't understand it and if it's too much for you, too, OK, then who can you get on the phone? Like, a family doctor or someone who's with the local medical association to talk to you about it and explain it to your kids and answer questions.
At the same time, teenagers want to be with their friends, they don't want to be stuck in a house. We need to think how to help them have contact that’s safe with their friends. Parents organize small get-togethers that make sense and are safe for everyone, because otherwise those kids are going to go stir crazy.
I would also ask parents to talk their teens about limiting time on social media. Again, talking to teenagers about what is hyped up fear and misinformation versus doing things with social media that is more uplifting and reasonable.
Q. Can too much anxiety make you sick or more prone to illness?
A. Well, one of the things we know is that individuals who are compromised in terms of their immune system, because they've suffered from serious physical illnesses, are more at risk. Sustained levels of anxiety increases your overall stress. If you're losing sleep over this, if you're not eating well, if you're not getting exercise, you're going to be putting yourself into a state of more heightened stress and you're reducing your just defensiveness, against everyday stuff. It's not that, that will make you more likely to contract the coronavirus by any means, but you want to keep yourself healthy. We don't want people sitting at home locked in and afraid. Get out and walk and take a run, do your usual exercise activities, definitely eat well. And then you've got to do something to reduce your worry at night, whether it's meditation and mindfulness, reading something that's for fun and relaxing, turning off the screens so that you get a good night's sleep. These are all things that will help you.
Q. Is there anything within the world of psychiatry, psychology that you can point to from history that informs how to handle this kind of unprecedented shift in social behavior due to, a pandemic or another crisis, that we can look back to and glean hope from?
A. I think one of the most recent and best examples of the way that large groups come together in crises is the way, for example, the U.S. responded after the terrorist 9/11 attacks. The first thing we know is our leaders at the time gave us accurate information and they did it consistently through the aftermath. So we need that. Look to your local leaders; look to your state leaders and hopefully to the government. And there is where the CDC comes in.
The second thing is that communities, again, they banded together. There is a united understanding that in this situation with the virus, it's everywhere and it's everybody in the sense that it's not discriminatory. It doesn't have an agenda of politics or religion or what have you, it's just a virus. So how can we band together? That is important.
Q. What do you do, though, when you don’t trust the government? Because there's a lot of that, and it is adding to public stress and anxiety.
A. So when you're not trusting the government, this again, is where you should think about who are the experts in infectious disease. The experts in infectious disease are the physicians and epidemiologists, scientists who are at the CDC or who are working in your local community through your medical associations. These are the people to turn to and to listen to.
- Try limiting your COVID-19 updates from trusted news sources to once or twice a day.
- Try deep breathing or mediation before you get that daily situation update.
- Talk to people you trust when you’re starting to feel overwhelmed, like friends and family.
- Contact your local health department, doctor or insurance company for referrals if your stress and anxiety are interfering with your daily activities for several days in a row. There are tele-psychiatry and psychology services available if you are quarantined and cannot leave your home.
- Try and keep children close to parents and family. If separation is necessary because of health issues or a parents’ need to work- make time for regular contact.