LEVELS OF ANXIETY Function of fear

Dalhousie expert on dealing with anxiety amid COVID-19, even as restrictions ease

Over the last three months, we've all worried about what would happen if someone became sick or died while we were all effectively locked down.

Even now, when we've been told it's OK to visit family in the Atlantic Canada bubble, there's the worry about what happens if you get sick or inadvertently pass COVID-19 on to a loved one.

Fear and anxiety have legitimate functions. The world can be dangerous, and it feels more dangerous now. But the world is always a little dangerous, and fear helps alert us to that danger. The tightrope we all walk every day is the line between rational fear and paralyzing anxiety.

Lynne Robinson is an associate professor with Dalhousie's School of Health and Human Performance. She is an expert in anxiety disorders and spoke about how to cope with COVID-19 fears.

WHAT IS THE ROOT OF ANXIETY?

“Anxieties, to a certain extent, have that function of protecting us from things that harm us,” she says.

But COVID-19 has reminded us that sometimes, the bogeyman is real.

“Being anxious about this very serious infection and disease is healthy at this point because this is something that we haven't had to deal with for a long time,” says Robinson.

“The normal anxieties are actually serving a useful purpose again, to the degree that they're not overwhelming us and making it difficult for us to manage.”

Right now, people are trying to manage anxiety about a risk that has changed day-by-day since mid-march. Robinson says it's natural to have trouble unpacking these layers of anxiety, and that properly managed fear is probably what has helped keep us relatively safe so far.

“When we think about risk, there's anxiety for yourself, anxiety for your family, and anxiety for other people. And maybe that element of being concerned for other people in your community, is somewhat more in places like Nova Scotia. We're still a fairly small, close-knit community,” she says.

“Anxiety has benefits."

It likely prompted people to follow health advice to stay at home and not visit family and friends, preventing the spread of COVID-19.

There's a variance in how concerned people are about the virus. Some people are just naturally more anxiously atuned to things that may hurt them in the environment. That's normal, Robinson says, and can even be helpful.

“In some kind of bigger, population-based thinking, that's not necessarily a bad thing to have people with these various capacities and skills in our population. But, for each of us, we have to find a way to carry on living a reasonable, meaningful, relatively satisfying life, even in the midst of this kind of pandemic.”

For those who are still anxious, even as the situation seems less dire, Robinson's first advice is not to ignore or repress the feeling itself.

“There's kind of this North American myth that we should feel good all the time, that we shouldn't have bad feelings, we shouldn't be anxious, we shouldn't be unhappy, and bad things shouldn't happen to us,” she says.

“But the reality is, they do. Bad things happen to people even without COVID-19. People have bad days."

She suggests spending time breathing through that and accepting it as the reality of the current situation.

For Robinson, the first step is accepting the anxious feelings and identifying the factors in and out of our control - something that isn't easy due to the uncertainty around the situation. She suggests weighing risks.

"Do what you can to figure out how much at risk you are and then come up with a plan that makes sense to you. Make a plan for what you can change, and as the old saying goes, accept the things that you can't change and you can't know.”

How can the more anxious among us continue to live our lives in the face of the pandemic?

First, Robinson says, dispense of the notion that dealing with mental health is about some nebulous concept of “will" - a word she describes as "fraught with nuances that don't make any real sense."

"And there's this whole history of people being told ‘Well, you can stop being depressed, you just need to do it'," she says. “At the same time, that doesn't mean that people are without capacity to build their own resilience. It's not easy, it takes time, and we need to work at it. And we do it better if we have help from others, whether it's professional help, or friends or family.”

TIME AND CARE

Sometimes, it's tempting to shut your eyes and try to ride the pandemic out. But that brings with it further worries about wasting time or missing out on things that are important. There can also be fears that by indulging in recreational activities, you're somehow not focused enough on the pandemic.

But, she says, not every moment of this pandemic will be hard, and the best way to prepare for the most acute difficulties is to give yourself a break when you can. Stay informed, but don't wallow.

“It's important to focus on the good things in your life," Robinson says. She suggests checking reliable sources, like government-run coronavirus sites, to make sure you have accurate information and can make the best choices for your situation.

“But beyond that, it's really important to remind yourself that no matter what else is happening, you have real value and importance, and to take time to do the things that help you to feel better," she says.

"Not denying what's going on, but distancing yourself from it, distracting yourself from it quite regularly in whatever way works for you, whether it's working in your garden or watching a show on TV or reading a book or listening to music. Those are important for us to do at any time to help maintain our mental health. But even more so now.”

Our fears didn't begin with COVID19 and won't end with it, she adds.

“In this time, just as in any time, people have to actually practice good mental health. It's just easier right now to lose track of those skills if you've developed them," Robinson says.

"Or, if you haven't developed them, it can be more challenging to start to build those skills in."

And for people already dealing with serious anxiety challenges, it's a particularly difficult time.

“They shouldn't be ashamed; they shouldn't feel bad. They should persist, even under these circumstances where I know it has been difficult for people to get help.”

WHAT ABOUT KIDS?

For people who work with children and parents, this pandemic has introduced another level of challenge to the already-complex task of teaching kids of all ages how to navigate the world. Robinson says the key is in how much you share and if it's done in an honest way, without burdening children with responsibility for adult worries.

“You should never lie to kids. It's actually much the same way as helping people to manage their own anxieties," she said.

The word kids could describe anyone from a teen to a toddler, she points out.

“People also know their own child. They know how anxious their own child is. (Parents) shouldn't pretend this isn't happening, because kids aren't stupid," she said.

"It's important to talk to your kids about this, but to manage your own anxiety."

That means parents must try to control their own anxiety when talking with kids so they're not sharing a fear that children don't need to have.

Given the amount of information out there, Robinson advises an exploratory conversation to start.

“Have they heard about COVID19, or whatever the term is that you would use in your family? Do they have any questions about it as a starting place?"

Get a sense of what they know. "You might find out that they have some odd ideas," Robinson says, or they may not have much knowledge at all.

With so much unknown, it's tempting to tell children that things will be OK. Given the uncertainties around COVID-19, that isn't always true. In the spirit of age-appropriate honesty, Robinson suggests it's better to assure kids that they are loved and supported regardless of what is happening in the world.

“You can reassure them that, to the degree that their family, the people around them, are doing everything they can to stay safe themselves and to protect the child. You want to check if they're worried about someone else that they're not seeing, like Grandma and Grandpa or friends. Thank goodness right now there's lots of ways you can connect with people so they can talk to them, too.”

RESOURCES

If you feel like you'd like some help dealing with anxiety, whether it's caused by, intensified by, or unrelated to, COVID-19, Robinson suggests these resources:

• Anxiety Canada is a main Canadian site for dealing with anxiety. The site has a lot of information & resources, including COVID-19 specific content and information for parents/ caregivers. It also offers a free online app: Mindshift CBT Mobile App which can be used both on androids and iphones — anxietycanada.com

• Canadian Mental Health Association (National) COVID-19 resources page at cmha.ca

• Vancouver's Fraser Health Unit has a nice poster with a short list of good tips for talking to kids about covid.

RESOURCES AVAILABLE BY PHONE:

• Mental Health Mobile Crisis Team – 902-429-8167 or 1-888-4298167

• Mental Health and Addictions Intake Service – 1-855-922-1122

• Healthy Minds Patient Navigator – 902-404-3504 (9 a.m.-5 p.m. Monday-friday)

• Strongest Families (Anxiety) – 1-866-470-7111.

• Canadian Mental Health Association, Nova Scotia – 1-877-466-6606

• Kids Help Phone - 1-800-6686868 or text CONNECT to 686868

1223RF Feeling anxiety about COVID-19 is normal, but it's important to find ways to cope.

1223RF It's natural to have trouble with Covid-19-related anxiety, and that properly managed fear is probably what has helped keep us relatively safe so far.