Monday March 16. Waitrose, North Finchley. One week before coronavirus lockdown. I am clinging to my shopping trolley, legs turned to jelly, heart racing, palms sweaty, weak and nauseous. I know I am having a panic attack. The rational thinking part of my brain is on hold, I am in fight or flight mode. Surrounded by frantic customers piling their shopping high, grabbing what they can from the half empty shelves, following the crowd of panic buying Londoners. I, and the world around me seem to be in melt down.
I know I am not alone. Many of us have been feeling deeply, sometimes uncontrollably anxious and overwhelmed by our strange, new, coronavirus-induced ‘lifestyle’. Destabilised by daily uncertainty and shifting of goalposts, health worries, work worries, anxious for our loved ones.
Back in Waitrose, I talk myself out of the panic attack and realise that if lockdown is looming I will have to find ways to cope with my mental health.
Emma Citron is a consultant clinical psychologist with a private practice in North West London. She is also a regular media contributor for the British Psychological Society. You may have heard her regularly on the radio. Her voice alone is calming and her knowledge and experience clearly evident.
Citron reassures me that feeling anxious right now is totally normal, although not everyone will respond the same way. “We are all different. We cope in different ways,” she says. “People deal with stressful situations like moving house or divorce differently, and we react differently at different times in our lives. We may be someone who generally copes well with challenges, but finds it harder to cope if four or five come along in close succession.”
Research has shown that there is a genetic predisposition to anxiety and other mental health conditions, making you 50 percentmore likely to experience anxiety, depression or Obsessive Compulsive Disorder if you have a close family member who has suffered from these conditions. But it doesn’t mean it’s not treatable. Citron explains that we can learn tools and strategies to help us cope well.
“Almost everybody feels anxious at points in their life,” says Citron. “And everybody’s triggers for that are somewhat different. Some people find public speaking easy and for others it creates anxiety. It’s the same for coronavirus — some will cope better than others, for example by switching off the news through the day and just checking in once a day for government directives. In fact I would recommend that to anyone as the news doesn’t put you in a good mood.”
Periods of manageable anxiety are part of life, but if you find that you have a high level of anxiety lasting two to three weeks, and it is affecting your appetite, sleep mood or work, or you are more irritable and angry, Citron suggests that you talk to your doctor.
“Most people do not like uncertainty and our current inability to plan,” she explains. “It’s perfectly normal to have these feelings. Recognise it’s an appropriate response in the current climate to feel anxious. Acknowledge you are human, don’t try to be super human. We all feel more in control of ourselves and our environment when we know what’s round the corner. In our normal, day to day lives we know that ‘we are going to get up/ go to work/ come home/ have dinner/ watch TV. But now, we do not know what each day is going to bring. One way to deal with unpleasant uncertainty is to write down what we can be certain about, as much as we have certainty over anything in our lives.”
Citron says a good way to do this is by drawing a circle within a circle on a piece of paper. In the inner circle write all the things you do have control over, such as “I can make a healthy supper for my family, I can do my gym exercises and press ups, I can chose to watch a movie with my family in the evening”. In the outer circle write, in a limited way, what you cannot control. For example, the NHS response to the virus, or whether we will remain employed. This will demonstrate that despite the strangeness of our new way of living, there are still many things we can control.
Supporting an anxious child or teenager when we ourselves are feeling the strain can be challenging. Citron encourages us to follow our instincts. “You know each child best. If they like to watch action movies, let them relax that way. Don’t be too rigid with your children. Try to remain flexible and not to regiment their day, in your effort to gain self control. Instead, talk and communicate with them. Include your children and teens in the discussions. Weave in what they would like to do in the structure of the day, let them feel empowered so they have some sense of control in their day, when the norm that they knew has largely disappeared. We don’t want an unravelling of society and families with this stress.”
Citron suggests the following tools for coping with anxiety, isolation and bringing a sense of calm to our lives.
l Mental health charities such as Anxiety UK and Mind have very good resources as does the NHS website. Mind recommend using the mnemonic APPLE — Acknowledge, Pause, Pull back, Let Go, Explore. CBT (cognitive behavioural therapy) can be an effective way of harnessing our reasoning powers to calm us down.
l Tap into freely available mindfulness apps, such as Calm and Headspace which provide useful mindfulness and relaxation techniques. The app Yoga Studio is great for beginners with 65 ready-made yoga and meditation classes and a library of poses. And don’t forget to take your exercise every day, ideally outside.
l Stick to your normal routine and try to remain adaptable and flexible. Perhaps find areas in the home where we can do different activities. For example, eat in kitchen, keep the living room clutter free for non-stressful activities. Demarcating spaces in your environment can help maintain self-equilibrium and good mental health.
l Look up simple breathing exercises. Slowing down breathing can reduce production of stress hormones in the brain, by which we can reverse some of the feelings of anxiety and decrease the physiological symptoms of anxiety such as rapid heartbeat, sweaty palms, shortness of breath, tightness in the chest and nausea.
lTry not to catastrophise, or engage in doom and gloom thinking. Bring the mind back to the here and now and what you can control in the here and now. Stopping the endless fast forward to Armageddon. Take a breath and look outside at the flowers and trees.
l Keep busy. Pepper the day with activities that could be categorised as pleasurable such as sitting on the patio with a cup of tea, and ‘mastery’ — chores that need doing, attending to business and administration or work. Trying to keep a balance. If you do a mastery item in your day, reward yourself with a pleasurable activity.
l Transfer to online communication and virtual get togethers though social media such as Facetime and Houseparty.
l Reach out and have some online psychology sessions if you feel that would be beneficial.
Two weeks into lockdown and my panic has subsided. Citron’s final words of advice appear to be working as I try to avoid being hard on myself, talk to myself as I would to a dear friend, and to show myself more kindness.
