What Is COVID-19 Anxiety?

Experiencing anxiety related to COVID-19 is a normal response to the various challenges and uncertainties brought about by the pandemic. The disruptions in daily life, social isolation, and concerns about the health and well-being of oneself and loved ones can trigger feelings of anxiety and stress.

The COVID-19 pandemic has had a profound impact on society since its onset in March 2020. The highly contagious nature of the SARS-CoV-2 virus has necessitated significant changes in how people interact, work, and travel. The widespread transmission of the virus has placed a strain on healthcare systems, leading to overwhelmed hospitals and increased anxiety in the population.1

The mental health implications of the pandemic are substantial. From March 2020 to January 2021, an estimated 76 million people were diagnosed with anxiety, representing a 25% increase compared to the period from 2010 to 2019 when 30 million people were diagnosed. These statistics highlight the significant impact of the pandemic on mental well-being and the prevalence of anxiety-related concerns.

COVID-19 Anxiety Symptoms

Anxiety is a prevalent mental health condition characterized by intense feelings of fear and apprehension in response to perceived threats. There are various types of anxiety disorders, including phobias, generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder. Despite their distinct features, these disorders often share common symptoms and manifestations.3

Individuals with anxiety disorders commonly experience symptoms such as:

• uncontrollable anxious thoughts that progressively worsen
• a rapid heartbeat muscle tension and aches
• Dizziness
• difficulty breathing

Additionally, anxiety can lead to the avoidance of situations or activities that were once enjoyable or deemed as safe. These symptoms can significantly impact an individual’s daily functioning and overall quality of life.3

What Causes COVID-19 Anxiety?

The ongoing COVID-19 pandemic has had a significant impact on mental health, leading to the development or exacerbation of anxiety symptoms in many individuals. Various factors related to the pandemic have contributed to heightened anxiety levels among the population.

One prominent factor is the pervasive uncertainty surrounding the virus itself. During the early stages of the pandemic, there was limited knowledge about the novel coronavirus, including its transmission, treatment, and long-term effects. The uncertainty surrounding these aspects created a sense of fear and concern among individuals, leading to increased anxiety.

Social isolation and disrupted daily routines have also played a significant role in anxiety development. The necessary measures to contain the spread of the virus, such as lockdowns and physical distancing, resulted in limited social interactions and disrupted regular activities. The prolonged periods of isolation and the loss of familiar routines have contributed to feelings of loneliness, distress, and heightened anxiety.

Financial worries have been another significant stressor for many individuals during the pandemic. The economic impact of the crisis, including job losses, reduced income, and financial instability, has caused significant distress and anxiety for individuals and families. The uncertainty surrounding employment and financial security has added an additional layer of anxiety to the already challenging circumstances.

Healthcare providers and frontline workers have faced immense stress and anxiety throughout the pandemic. Overwhelmed healthcare systems, increased workload, and the risk of exposure to the virus have taken a toll on the mental health of these individuals. The constant pressure and demands placed on healthcare professionals have contributed to heightened anxiety levels.

While the availability of COVID-19 vaccines and improved treatment options may have alleviated some of the initial uncertainties and stress, new variants such as Delta and Omicron have introduced new concerns and anxieties. The ever-evolving nature of the virus and its potential impact on public health can contribute to ongoing anxiety among individuals.

Risk Factors

Certain factors can increase an individual’s vulnerability to developing anxiety in response to the COVID-19 pandemic. Understanding these risk factors can help identify individuals who may require additional support and intervention. Some key risk factors include:

• Gender: Research has shown that women are more likely to develop anxiety compared to men. Hormonal and sociocultural factors may contribute to this gender difference.
• Health conditions: Individuals with pre-existing health conditions such as asthma, cardiovascular disease (CVD), cancer, or other illnesses that may increase the risk of complications from COVID-19 may experience heightened anxiety. The fear of contracting the virus and the potential impact on their health can contribute to increased anxiety levels.
• Pre-existing mental health condition: Individuals who had pre-existing anxiety before the pandemic are at a higher risk of experiencing worsened symptoms. People with severe mental health disorders, such as schizophrenia, may also be more vulnerable to heightened anxiety due to the pandemic’s impact on their routine and access to support services.
• Career: Healthcare providers, including doctors, nurses, and other frontline workers, are at an increased risk of developing anxiety. The demands of their work, exposure to high levels of stress, and the potential risk of contracting the virus can contribute to heightened anxiety levels among healthcare professionals.
• Low socioeconomic status: Financial stressors associated with low socioeconomic status can contribute to the development or exacerbation of anxiety symptoms. Economic uncertainties, job loss, and financial instability can significantly impact mental health and increase anxiety levels.

How Is COVID-19 Anxiety Diagnosed?

Healthcare providers play a crucial role in identifying and assessing anxiety disorders. During a screening or evaluation, they may employ various methods to gather information and determine the presence of anxiety. Here is a general outline of the process:

1. Questionnaires and Interviews: Healthcare providers may administer standardized questionnaires or conduct interviews to assess your symptoms and their impact on your daily life. These may include questions about your mood, sleep patterns, appetite, concentration, and overall well-being.
2. Symptom Assessment: Based on your responses, the healthcare provider will evaluate the nature, duration, and severity of your symptoms. They may ask about the specific triggers or situations that elicit anxiety and how it affects your ability to function in different areas of life.
3. Physical Examination and Lab Tests: To rule out any underlying medical conditions that could contribute to anxiety symptoms, a physical examination may be conducted. Additionally, lab tests, such as blood tests, might be ordered to investigate potential physiological causes or to exclude other conditions that may mimic anxiety symptoms.
4. Referral to a Mental Health Professional: If anxiety is suspected, the healthcare provider may refer you to a licensed therapist or psychiatrist for further assessment and specialized treatment. Mental health professionals are trained in diagnosing and treating anxiety disorders and can provide appropriate interventions, such as therapy and medication if necessary.

Treatments for COVID-19 Anxiety

Treating anxiety often involves an interdisciplinary approach. For example, a healthcare provider may advise a mix of psychotherapy, medication, support groups, or stress management techniques.

Psychotherapy

Psychotherapy, or talk therapy, is an effective treatment option for addressing anxiety related to COVID-19 and other concerns. Here are some common types of psychotherapy used to alleviate anxiety:

• Cognitive Behavioral Therapy (CBT): CBT focuses on identifying and changing negative thought patterns and behaviors that contribute to anxiety. A mental healthcare provider helps you challenge and reframe irrational or distorted thoughts about COVID-19, develop coping strategies, and engage in gradual exposure to anxiety-provoking situations in a safe and controlled manner.
• Exposure Therapy: Exposure therapy involves gradually and systematically exposing yourself to feared situations or triggers to reduce anxiety. However, in the context of COVID-19, direct exposure to the virus is not recommended. Instead, a mental healthcare provider may guide you in safely navigating public spaces while following recommended precautions such as wearing masks and practicing social distancing.
• Acceptance and Commitment Therapy (ACT): ACT aims to help individuals accept their anxious thoughts and emotions while focusing on taking valued actions in line with their goals and values. A mental healthcare provider may teach mindfulness techniques to help you observe and accept anxious thoughts related to COVID-19 while actively engaging in behaviors that promote well-being and safety.

Medication

Medications can be a valuable tool in managing anxiety symptoms, although they do not provide a cure for anxiety. Here are some classes of medications commonly prescribed for anxiety:

• Anti-anxiety Medications: These medications are designed to relieve feelings of anxiety and fear. Benzodiazepines, such as diazepam (Valium) and alprazolam (Xanax), are commonly prescribed for short-term relief of anxiety symptoms. They work by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which helps to calm the nervous system.
• Antidepressants: While primarily used to treat depression, certain antidepressant medications can also be effective in reducing anxiety symptoms. Selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft) and escitalopram (Lexapro), are commonly prescribed for generalized anxiety disorder (GAD) and other anxiety disorders. These medications work by increasing the availability of serotonin, a neurotransmitter that helps regulate mood.
• Beta-blockers: Beta-blockers are typically used to treat high blood pressure and heart conditions, but they can also be helpful in managing the physical symptoms of anxiety, such as rapid heartbeat, trembling, and sweating. They work by blocking the effects of adrenaline, reducing the physiological response to anxiety-inducing situations. Beta-blockers are often used on an as-needed basis for specific anxiety-provoking situations, such as public speaking or performance anxiety.

Support Groups

Support groups can be a valuable resource for individuals with anxiety. Connecting with others who share similar experiences and concerns can provide a sense of belonging, validation, and support. Here are some key benefits of joining a support group:

• Shared Understanding: Being in a support group allows you to interact with individuals who can relate to your anxiety symptoms and understand the challenges you face. This shared understanding can help alleviate feelings of isolation and provide a sense of camaraderie.
• Emotional Support: Support groups provide a safe space for you to express your thoughts, fears, and emotions openly without judgment. Sharing your experiences with others who have similar struggles can help validate your feelings and provide emotional support.
• Peer Learning: Support groups offer an opportunity to learn from the experiences and coping strategies of others. You can gain insights and practical advice from group members who may have found effective ways to manage their anxiety. This peer learning can provide new perspectives and strategies for dealing with your own anxiety symptoms.
• Encouragement and Motivation: Support groups can be a source of encouragement and motivation. Group members can provide support and celebrate your achievements, both big and small. This positive reinforcement can boost your self-esteem and inspire you to continue working towards your goals.
• Access to Resources: Support groups often provide access to valuable resources, information, and referrals to mental health professionals, treatment options, or additional support services. Group members may share helpful resources, recommended books, apps, or websites that can assist in your journey towards managing anxiety.

In addition to in-person support groups, many organizations offer virtual support groups, especially during the COVID-19 pandemic. Online support groups can provide a convenient and accessible way to connect with others, particularly for individuals who may have limited access to local support groups or prefer the anonymity of virtual interactions.

The Anxiety & Depression Association of America (ADAA) is a reputable resource that offers a directory of support groups, both in-person and online. Exploring their directory or reaching out to mental health organizations in your area can help you find a support group that aligns with your needs and preferences.

Stress Management Techniques

Stress management techniques are valuable tools for reducing anxiety and promoting overall well-being. Here are some commonly recommended techniques that can help alleviate stress:

• Physical Activity: Engaging in regular physical exercise, such as walking, jogging, or engaging in a sport, can help reduce anxiety and improve mood. Physical activity releases endorphins, which are natural mood-boosting chemicals in the brain.
• Mindfulness and Meditation: Practices like mindfulness meditation, deep breathing exercises, or guided imagery can help calm the mind and promote relaxation. These techniques encourage focusing on the present moment, letting go of worries and anxieties, and cultivating a sense of peace and tranquility.
• Progressive Muscle Relaxation (PMR): PMR involves systematically tensing and relaxing different muscle groups in the body. This technique helps relieve muscle tension and promotes a deep sense of relaxation. By intentionally tensing and releasing muscles, you can become more aware of the sensations in your body and experience a release of physical and mental stress.
• Self-Care Activities: Engaging in activities that bring you joy and relaxation can significantly reduce stress. This can include hobbies, such as painting, gardening, playing music, or reading a book. Taking time for self-care, such as taking a bath, practicing self-reflection, or engaging in activities that promote self-compassion and self-care, can also be beneficial.
• Social Support: Connecting with supportive friends, family members, or participating in support groups can help alleviate stress. Sharing your concerns and feelings with trusted individuals can provide emotional support, different perspectives, and a sense of belonging.
• Healthy Lifestyle Habits: Maintaining a balanced and nutritious diet, getting sufficient sleep, and managing time effectively can contribute to overall stress reduction. It’s important to prioritize self-care and establish healthy habits that support your mental and physical well-being.

How To Prevent COVID-19 Anxiety

Taking proactive steps to prevent stress and fear related to COVID-19 can be empowering and help alleviate anxiety. Here are some precautions you can take:

Assess Your Risk

Assessing your risk of contracting COVID-19 can indeed empower you and help alleviate anxiety. Here are some steps you can take to determine your risk:

1. Stay Informed: Stay updated on the COVID-19 situation in your community by following reliable sources such as local health authorities and reputable news outlets. Understand the number of confirmed or presumptive positive cases in your area and any relevant information about the spread of the virus.
2. Evaluate Personal Exposure: Assess your own exposure to the virus by considering if you have been in close contact with someone who has recently been sick or tested positive for COVID-19. Take into account any interactions you’ve had with individuals who may have been exposed to the virus.
3. Consider Vulnerabilities: Take stock of any underlying health conditions or risk factors that could potentially increase your vulnerability to COVID-19. This includes conditions such as a weak immune system or respiratory issues that may make you more susceptible to complications if you were to contract the virus.
4. Consult Healthcare Professionals: If you have concerns about your specific health situation and its relation to COVID-19, reach out to healthcare professionals such as your primary care physician or specialist. They can provide personalized guidance and help you understand your individual risk factors.

Remember that assessing risk is about gaining a sense of control and making informed decisions rather than increasing anxiety. By actively engaging in this process, you can take steps to protect yourself and make choices that align with your specific circumstances and health needs.

Limit Your News Consumption

Staying informed about the COVID-19 pandemic is important, but it’s equally crucial to manage your news consumption to prevent excessive anxiety. Here are some tips to find a balance:

• Set Boundaries: Establish specific times during the day to catch up on the news, and limit your overall news intake. Constantly checking for updates can contribute to heightened anxiety. Choose a reliable news source and avoid constantly refreshing social media feeds or exposing yourself to sensationalized or unreliable information.
• Reputable Sources: Rely on trusted sources such as the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and your local public health department. These organizations provide accurate and up-to-date information on COVID-19. Be cautious of misinformation and avoid sharing unverified news or rumors.
• Mindful Consumption: Be mindful of how consuming news affects your mental and emotional well-being. If you notice that news consumption significantly increases your anxiety or stress levels, consider scaling back or taking breaks. Engage in activities that help you relax and divert your attention from the news, such as hobbies, exercise, or spending time with loved ones.
• Seek Balance: Strike a balance between staying informed and taking care of your mental health. It’s important to stay aware of important updates and guidelines related to COVID-19, but also prioritize self-care and engage in activities that bring you joy and promote well-being.

Remember, being selective about your news intake and maintaining a healthy balance can help you stay informed without overwhelming yourself with anxiety-provoking information.

Take Precautions Against COVID-19 Infection

Taking standard precautions is crucial in preventing the spread of COVID-19. Here are some additional measures you can take to protect yourself and others:

• Follow Local Guidelines: Stay updated on the guidelines and recommendations provided by your local health authorities or government. Adhere to any restrictions or guidelines regarding gatherings, travel, and public spaces.
• Practice Good Respiratory Hygiene: Cover your mouth and nose with a tissue or your elbow when coughing or sneezing. Dispose of used tissues properly and wash your hands immediately afterward.
• Clean and Disinfect: Regularly clean and disinfect frequently touched surfaces, such as doorknobs, light switches, and electronics. Use EPA-approved disinfectants or household cleaners that are effective against COVID-19.
• Stay Home When Sick: If you are experiencing symptoms of COVID-19 or feeling unwell, it’s important to stay home and avoid close contact with others. Follow the guidance of healthcare professionals and get tested if necessary.
• Vaccination: Get vaccinated against COVID-19 as soon as you are eligible and follow the recommended vaccination schedule. Vaccines have been proven effective in reducing the severity of the illness and preventing hospitalizations and deaths.
• Stay Informed: Stay updated on the latest information regarding COVID-19, including new variants, vaccine updates, and recommendations from reputable sources. This can help you make informed decisions and adapt your precautions as needed.

Know That You’re Doing Your Best

Grounding techniques can be helpful in managing anxiety and regaining a sense of control. Here are some additional grounding techniques you can try:

• 5-4-3-2-1 Technique: Take a moment to notice and name five things you can see, four things you can touch, three things you can hear, two things you can smell, and one thing you can taste. This technique helps redirect your focus to the present moment and engage your senses.
• Deep Breathing: Practice deep breathing exercises by taking slow, deep breaths in through your nose, holding for a few seconds, and exhaling slowly through your mouth. Pay attention to the sensation of your breath filling and leaving your body, which can help calm your nervous system.
• Grounding Objects: Carry a small object with you, such as a smooth stone, stress ball, or keychain, that you can hold and focus on when you feel anxious. The tactile sensation and presence of the object can provide a sense of stability and grounding.
• Body Scan: Close your eyes and mentally scan your body from head to toe, paying attention to any areas of tension or discomfort. Take slow breaths and consciously relax each part of your body, releasing tension as you exhale.
• Engage Your Senses: Engage your senses by focusing on the details of your surroundings. Notice the colors, textures, sounds, and smells around you. Engaging with your senses can help shift your attention away from anxious thoughts and into the present moment.
• Positive Affirmations: Repeat positive affirmations or mantras to yourself, such as "I am safe," "I am capable," or "I can handle this." Remind yourself of your strengths and resilience, reinforcing a positive mindset.

Remember, everyone responds differently to grounding techniques, so find the ones that work best for you. Practice them regularly, even when you’re not feeling particularly anxious, to build resilience and create a foundation of emotional well-being.

Comorbid Conditions

Unchecked anxiety can indeed have various physical and mental health effects. Prolonged or chronic anxiety can lead to increased stress hormone release, which can have detrimental effects on the body and mind. Here are some examples of how anxiety can impact health:

• Digestive Issues: Anxiety can contribute to gastrointestinal problems such as ulcers, irritable bowel syndrome (IBS), and acid reflux. Stress hormones can affect digestion, leading to symptoms like abdominal pain, bloating, and changes in bowel movements.
• Musculoskeletal Problems: Anxiety and chronic stress can cause muscle tension and tightness, leading to conditions such as back pain, tension headaches, and jaw pain (temporomandibular joint disorder or TMJ). Muscle tension can also increase the risk of developing musculoskeletal disorders over time.
• Cardiovascular Health: Prolonged anxiety can strain the cardiovascular system. Increased levels of stress hormones may contribute to high blood pressure, irregular heart rhythms, and an increased risk of cardiovascular disease (CVD). Chronic anxiety may also lead to unhealthy lifestyle habits such as smoking, poor diet, and lack of exercise, further affecting heart health.
• Respiratory Issues: Anxiety can exacerbate respiratory conditions such as asthma. Stress and anxiety can trigger or worsen asthma symptoms, making it more challenging to manage the condition effectively.
• Mental Health Conditions: Anxiety often coexists with other mental health disorders, such as depression. The chronic activation of the stress response and the persistent worry associated with anxiety can contribute to the development or exacerbation of depressive symptoms.

It’s important to address anxiety and seek appropriate treatment to minimize its impact on physical and mental well-being. Seeking professional help from a healthcare provider or mental health professional can provide guidance and support in managing anxiety and its potential health consequences.

When To See a Healthcare Provider

Seeking help from a mental healthcare provider is crucial if anxiety significantly impacts your daily life or if you experience symptoms that indicate a more severe condition. Anxiety disorders are often associated with co-occurring disorders such as substance abuse, alcohol use disorder, and suicidal ideation. Therefore, it is vital to address and manage anxiety to safeguard your overall well-being.

If your COVID-19 anxiety leads to persistent symptoms that affect your mental health, consider consulting a healthcare provider. Some symptoms to watch for include:

1. Persistent feelings of sadness or emptiness.
2. Hopelessness or excessive guilt.
3. Irritability or anger.
4. Loss of interest in previously enjoyable activities.
5. Fatigue or low energy levels.
6. Restlessness or difficulty sitting still.
7. Trouble concentrating or focusing.
8. Changes in sleep patterns, such as insomnia or excessive sleep.
9. Physical symptoms like headaches or gastrointestinal issues.
10. Thoughts of suicide or self-harm.

Discussing these symptoms with a healthcare provider may feel challenging, but it is an important step in receiving appropriate care and support. To ease the process, consider asking a trusted loved one to accompany you during the visit. They can provide emotional support, take notes, and help ensure that all your concerns are addressed during the appointment. Remember, seeking help is a sign of strength and taking proactive steps towards better mental health.