MANAGING ANXIETY DURING THE CORONAVIRUS OUTBREAK

> GOOD EVENING AND WELCOME TO 'METROFOCUS.'

I'M MADDIE ORTON.

AS YOU CAN SEE LIKE MANY OF YOU, I'M WORKING FROM HOME.

THIS PERIOD OF SELF-ISOLATION DURING THE CORONAVIRUS HEATH CRISIS IS AN ANXIETY-PROVOKING ONE.

A ROGUE COUGH THAT MIGHT OTHERWISE GO UNNOTICED CAN CAUSE TREMENDOUS CONCERN AND IT'S EASY TO GET PANICKY.

THAT'S WHY I'M SPEAKING WITH A PROFESSOR OF PSYCHIATRY AT COLUMBIA UNIVERSITY, IRVING MEDICAL CENTER, WITH AN EXPERTISE IN ILLNESS ANXIETY AND HYPOCHONDRIA.

THANKS FOR YOUR TIME.

MY PLEASURE.

CAN YOU TELL ME A LITTLE BIT ABOUT HOW THE BRAIN WORKS UNDER A CIRCUMSTANCE LIKE THIS?

THERE'S A PANDEMIC.

YOU HEAR THINGS ALL OVER THE PLACE, AND IT DOES MAKE YOU ANXIOUS.

LET ME SAY A FEW THINGS JUST TO START.

SURE.

I THINK IT'S TOTALLY GOOD THAT PEOPLE ARE ANXIOUS RIGHT NOW.

THEY SHOULD BE ANXIOUS.

WE'RE FACING A VERY SERIOUS PANDEMIC AROUND THE WORLD.

THIS IS A VERY SERIOUS INFECTION, AND I'M ACTUALLY QUITE HAPPY THAT THERE ARE A LOT OF PEOPLE OUT THERE VERY ANXIOUS AND PANICKING SOMEWHAT.

AND GOVERNOR CUOMO IN NEW YORK HAS DONE QUITE A GOOD JOB CONVEYING HOW SERIOUS THAT WE HAVE TO TAKE THIS.

AND IF WE DON'T TAKE IT SERIOUSLY, WE'RE GOING TO -- WE ALREADY HAVE A MAJOR PUBLIC HEALTH CRISIS, BUT IT'S GOING TO GET DRAMATICALLY WORSE.

SO WHAT I'M SAYING RIGHT NOW IS NOT TO REDUCE ANXIETY BECAUSE PEOPLE SHOULD BE ANXIOUS.

THAT'S A GOOD RESPONSE TO A SERIOUS INFECTIOUS DISEASE AND EPIDEMIC.

SURE.

PEOPLE HAVE TO TAKE IT SER SERIOUSLY.

SO THE FIRST WAY YOU REDUCE ANXIETY IS TO UNDERSTAND SOMETHING ABOUT THIS ILLNESS.

SO WHAT WE UNDERSTAND IS THAT IT'S RAPIDLY SPREAD AMONG INDIVIDUALS, AND THEREFORE IT'S IMPORTANT TO AVOID CONTAGION.

IT'S IMPORTANT TO AVOID EXPOSURE TO PEOPLE WHO MIGHT BE INFECTED.

WE KNOW THAT RIGHT NOW WE DON'T KNOW WHO IS INFECTED AND WHO ISN'T INFECTED BECAUSE PEOPLE MIGHT HAVE INFECTION AND HAVE NO SYMPTOMS AT THAT PARTICULAR TIME.

SO THAT CREATES A LEVEL OF AN UNCERTAINTY THAT'S QUITE HIGH.

WHO HAS THE INFECTION, AND WHO DOESN'T?

AND AT THIS POINT WE DON'T KNOW.

SO YOU DO HAVE TO ASSUME THAT YOU MIGHT BE A CARRIER, I MIGHT BE A CARRIER.

WE JUST DON'T KNOW.

SO WHAT DOES THAT MEAN?

THAT MEANS THAT WE HAVE TO ENGAGE IN PERSONAL PRACTICES THAT ARE VERY IMPORTANT TO PRESERVING THE HEALTH CARE OF OTHERS AS WELL AS OURSELVES.

THAT INCLUDES HAND-WASHING.

THAT INCLUDES SOCIAL DISTANCING.

THAT DOESN'T MEAN SOCIAL ISOLATION, BUT IT MEANS KEEPING YOURSELF AT A DISTANCE FROM ONE ANOTHER.

AND EVEN THOUGH IT'S NOT PLEASANT TO DO THAT, WE HAVE TO DO THAT.

SO THAT'S VERY IMPORTANT BECAUSE EVEN THOUGH I AN EXPERT AND HYPOCHONDRIA AND ANXIETY, I ALSO HAVE AN EXPERTISE IN INFECTIOUS DISEASE, PARTICULARLY LYME DISEASE, WHICH I ALSO TAKE SERIOUSLY.

SO I THINK IT'S IMPORTANT TO UNDERSTAND THE IMPORTANCE OF ALL THE PUBLIC HEALTH MESSAGES THAT ARE OUT THERE.

ABSOLUTELY.

YOU BRING UP AN INTERESTING POINT, WHICH IS THAT IT IS A VERY REAL CIRCUMSTANCE, BUT IT ALSO DOES PLAY ON ANXIETY, PARTICULARLY PEOPLE WHO ARE PREDISPOSED TO EITHER OBSESSIVE COMPULSIVE DISORDER, ANXIETY DISORDER, HYPOCHONDRIA.

SO HOW DO YOU WALK THAT LINE OF DOING WHAT'S RIGHT FOR YOU AND FOR THE COMMUNITY BUT ALSO NOT GOING TOO CRAZY WHILE YOU'RE IN ISOLATION?

YEAH, I THINK THAT'S REALLY IMPORTANT.

SO ISOLATION IS VERY DIFFICULT FOR PEOPLE.

SO THERE IS A TREMENDOUS AMOUNT THAT CAN BE DONE TO REDUCE PERSONAL ANXIETY.

NUMBER ONE, AVOID CHECKING.

AVOID CHECKING THE NEWS OVER AND OVER AGAIN, AND WE'VE ACTUALLY DONE STUDIES IN THE CONTEXT OF ILLNESS AND ANXIETY TO TEST DO PEOPLE WHO CHECK THE INTERNET, DO THEY HAVE MORE ANXIETY AFTERWARDS OR LESS ANXIETY?

IF YOU'RE A PERSON WHO DOESN'T HAVE AN ANXIETY DISORDER, SOMETIMES HAVING THAT INFORMATION CAN BE HELPFUL AND IT REDUCES YOUR ANXIETY.

ON THE OTHER HAND, IF YOU'RE SOMEONE WITH A PRE-EXISTING ANXIETY PROBLEM SUCH AS GENERALIZED ANXIETY OR OCD OR A PANIC DISORDER, IT WILL DRAMATICALLY INCREASE YOUR ANXIETY, AND YOU'LL FEEL THAT YOU HAVE TO KNOW MORE AND MORE.

SO YOU'LL BE CHECKING THE INTERNET OVER AND OVER AGAIN, AND YOU'LL BE HEARING ALL OF THESE SCARY STORIES, AND IT WILL LEAD YOU INTO A RABBIT HOLE OF PANIC.

SO IT'S VERY IMPORTANT TO LIMIT THE AMOUNT OF INFORMATION THAT YOU'RE GETTING, ESPECIALLY IF YOU HAVE A PRE-EXISTING ANXIETY PROBLEM.

IF YOU HAVE SERIOUS MOOD DISORDER OR AN ANXIETY DISORDER AND YOU'RE NOT GETTING HELP, WELL THEN YOU SHOULD GET HELP.

THERE'S SOME WONDERFUL TELEPSYCHIATRY AVAILABLE IN THE GREATER NEW YORK AREA AND AROUND THE COUNTRY.

IT'S VERY EASY TO ACCESS, AND YOU CAN GET A LOT OF HELP FROM MENTAL HEALTH PROFESSIONALS AND TIPS ON HOW TO REDUCE ANXIETY.

SO WHY IS IT THAT I CAN BE ON VACATION AND GET A COUGH, AND I THINK, OH, I HAVE A LITTLE TICKLE IN MY THROAT, AND RIGHT NOW I GET A COUGH AND I THINK, OH, MY GOODNESS, THIS IS TERRIBLE?

THIS COULD BE THE CORONAVIRUS.

THAT'S A REALLY GREAT QUESTION.

ONE THING WE KNOW IS THAT CONTEXT IS SUPER IMPORTANT.

JUST AS YOU SAID, IF YOU'RE OUT SKIING ON A SLOPE AND YOU BANG YOUR LEG, YOU PAY ABSOLUTELY NO ATTENTION TO IT.

BUT IF YOU'RE AT WORK, AT HOME OR EVEN IN YOUR OFFICE AND YOU BANG YOUR LEG, YOU MIGHT SUDDENLY START PAYING ATTENTION TO IT BECAUSE OF THE CONTEXT, WHICH IS THAT YOU HAVE TIME TO THINK ABOUT IT, AND IT'S CAUSING A LOT OF DISTURBANCE BECAUSE YOU'RE FOCUSING.

SO IT'S BEEN WELL KNOWN FROM MULTIPLE STUDIES THAT THE MORE YOU ATTEND TO YOUR SYMPTOMS, THE WORST IT WILL BE.

AND IN THE CONTEXT OF THIS VIRUS THAT'S GOING AROUND, IT DOES MAKE SENSE TO ATTEND TO YOUR SYMPTOMS TO A CERTAIN EXTENT, BUT BE CAREFUL NOT TO CA TASS TRO FIEZ.

EVERYONE HAS UNEXPLAINED PHYSICAL SYMPTOMS.

EVERY WEEK WE HAVE THOSE.

SO IF YOU TAKE EVERY SYMPTOM SERIOUSLY, YOU'RE GOING TO GO PACK AT EVERY LITTLE SIGN.

THERE'S A CLUSTER OF SYMPTOMS THAT ARE SIMPLE.

GRADUALLY INCREASING FEVER, COUGH, RESPIRATORY PROBLEM THAT ARE CERTAINLY THE KNOWN SIGNS OF CORONAVIRUS.

IF YOU DON'T HAVE THOSE, IT'S MUCH LESS LIKELY.

FOR EXAMPLE, IF YOU'RE SO ANXIOUS THAT YOU'RE NOT SLEEPING, THEN YOU'RE GOING TO WAKE UP FATIGUED.

YOU'RE GOING TO WAKE UP PERHAPS WITH HEADACHES, PERHAPS WITH MUSCLE PAIN.

YOU'RE GOING TO THINK, OH, MY GOD, I'M GETTING A VIRUS.

SO YOU JUST NEED TO RATION THE AMOUNT OF MEDIA THAT YOU EXPOSE YOURSELF TO AND BE REALISTIC IN THE ASSESSMENT OF RISK.

WE KNOW, FOR EXAMPLE, THAT YOUNGER PEOPLE ARE LESS AT RISK THAN OLDER PEOPLE.

THAT DOESN'T MEAN YOUNGER PEOPLE AREN'T AT RISK.

THEY ARE.

BUT THE RISK OF GETTING A SERIOUS ILLNESS IS LESS THAN WITH OLDER PEOPLE.

SO YOU NEED TO ASSESS THE RISK REALISTICALLY.

EVEN THE NUMBER OF CASES ARE STEADILY INCREASING AND THEY WILL DEFINITELY DRAMATICALLY INCREASE OVER THE NEXT SEVERAL WEEKS AS THE TESTING IS MUCH MORE WIDELY AVAILABLE, THE RISK IS NOT EVERYBODY GETTING INFECTED AT THIS POINT AND EVERYBODY DYING.

THAT'S JUST NOT THE CASE.

THE MORTALITY RATE FROM THIS INFECTION IS NOT KNOWN CLEARLY EXACTLY WHAT IT IS, BUT IT'S ROUGHLY AROUND 1% FOR PEOPLE LESS THAN AGE 60.

FOR PEOPLE ABOVE AGE 60, IT GETS HIGHER.

WE SHOULD AVOID FORECASTING INTO THE FUTURE.

SO, FOR EXAMPLE, PEOPLE -- SOME PEOPLE WITH HIGH ANXIETY WILL START THINKING, WHAT'S IT GOING TO BE LIKE TWO WEEKS FROM NOW?

WHAT'S IT GOING TO BE LIKE TWO MONTHS FROM NOW?

OH, MY GOD, IT'S GOING BE A TOTAL DISASTER AND THE WORLD IS GOING TO FALL APART.

THE TRUTH IS WE DON'T KNOW WHAT IT'S GOING TO BE LIKE IN FOUR WEEKS OR EIGHT WEEKS, BUT WE KNOW WE CAN DO THINGS RIGHT NOW TO HELP REDUCE THE SPREAD OF THIS INFECTION.

THAT'S REALLY NICE BECAUSE WE ALL NEED PERSONAL CONTROL.

SO THE CONTROL THAT WE CAN EXERT IS BY TAKING ALL THOSE MITIGATION STEPS TO REDUCE THE SPREAD OF THIS INFECTION.

THAT MEANS STAYING AT HOME, NOT GOING INTO CROWDED PLACES, SOCIAL DISTANCING, HAND-WASHING AND THOSE ARE ALL WAYS TO HELP OURSELVES AS WELL AS TO SHOW COMPASSION TO OTHERS IN OUR POPULATION.

IT'S NOT A COURAGEOUS THING TO BE BRAVE RIGHT NOW IN THE FACE OF ADVERSITY.

WHAT'S APPROPRIATE RIGHT NOW IS TO BE COMPASSIONATE IN THE FACE OF ADVERSITY TO OUR NEIGHBORS AS WELL AS TO OURSELVES.

AND THAT COMPASSION MEANS NOT SHAKING HANDS, NOT TOUCHING OTHER PEOPLE.

BUT IT DOES MEAN -- COMPASSION DOES MEAN REACHING OUT TO OTHER PEOPLE, CALLING UP YOUR RELATIVES, CALLING UP YOUR FRIENDS, CALLING UP THE ELDERLY NEIGHBOR ACROSS THE STREET.

IF SOMEONE CAN'T GET FOOD BECAUSE THEY'RE TOO INFIRM TO GET FOOD, FIND A WAY TO HAVE FOOD DELIVERED TO THEM.

SO THERE ARE LOTS OF THINGS THAT WE CAN DO THAT WILL HELP US FEEL BETTER BECAUSE WE'RE HELPING SOMEONE ELSE.

ANOTHER THING ABOUT PEOPLE WHO ARE ANXIOUS IS THAT THEY TEND TO FOCUS VERY MUCH ON THEMSELVES.

SO THE MORE YOU CAN FOCUS ON OTHER PEOPLE AND GET THE BENEFIT ACTUALLY OF DOING THAT BECAUSE IT MAKES YOU FEEL GOOD, THE BETTER.

DISTRACTION TECHNIQUES ARE ANOTHER IMPORTANT WAY OF REDUCING ANXIETY, AND THAT MEANS TURNING OFF YOUR PHONE OR TV.

IT MEANS ENGAGING IN PLEASURABLE ACTIVITIES.

IT MIGHT MEAN STARTING UP A NEW LEARNING ADVENTURE.

SO, FOR EXAMPLE, THERE ARE LOTS OF LEARNING OPPORTUNITIES ONLINE, ON YOUTUBE THAT ARE FREE.

YOU CAN LEARN HOW TO PLAY THE GUITAR OR TAKE A COURSE.

THERE'S OPPORTUNITIES OUT THERE FOR YOU TO USE THIS TIME IF YOU'RE STUCK AT HOME IN A PRODUCTIVE WAY.

MOST CHILDREN RIGHT NOW ARE HOME FROM SCHOOL.

SPEND TIME WITH YOUR CHILDREN AND PLAY SOME MONSTER AWFUL JIGSAW PUZZLE THAT HAS 3,000 PIECES.

THAT'S RIGHT.

YOU'LL HAVE TIME TO FINISH IT.

FOR THOSE WHO ARE ALREADY SORT OF CYCLING AND THINKING ABOUT THE POSSIBLE THINGS THAT CAN HAPPEN OR FOR THOSE WHO FEEL THEMSELVES GOING INTO A BIT OF A PANIC, WHAT ARE SOME ANXIETY MANAGEMENT STRATEGIES THAT YOU WOULD RECOMMEND IN ADDITION TO TELECONFERENCING A PROFESSIONAL?

SURE.

ALL THE GOOD PERSONAL SELF-HELP CARE MEASURES ARE IMPORTANT.

SO EXERCISE IS REALLY IMPORTANT.

MEDITATION OBVIOUSLY IS VERY VALUABLE.

THERE ARE LOTS OF GOOD MEDITATION PROGRAMS ONLINE THAT CAN HELP YOU.

HEADSPACE, FOR EXAMPLE.

JOURNEY IS ANOTHER ONE.

THERE'S A WHOLE BUNCH OF GOOD ONES.

YOGA, YOU SHOULD CONTINUE GOOD HEALTH STRATEGY IN TERMS OF FOOD, IN TERMS OF SLEEP.

ALL THOSE ARE KEY.

SPIRITUAL SUPPORT FROM YOUR FAITH-BASED COMMUNITIES CAN BE VERY HELPFUL.

EVEN THOUGH YOU CAN'T GO TO THEM BECAUSE SO MANY OF THEM ARE CLOSED AT THIS POINT AND YOU DON'T WANT TO GO TO THEM BECAUSE THOSE ARE PLACES WHERE PEOPLE ARE GATHERING IN MASSES, OFTENTIMES YOUR SPIRITUAL COMMUNITY MIGHT HAVE SOMETHING ONLINE THAT YOU CAN ATTEND.

OR YOU CAN CONNECT WITH YOUR FAMILY AND FRIENDS AND HAVE -- SAY, OKAY AT 9:00 THIS EVENING, WE'RE ALL GOING TO PRAY AT THE SAME TIME.

YOU DON'T HAVE TO BE IN THE SAME ROOM, BUT CAN BE PRAYING FOR ONE ANOTHER, AND THAT'S WHAT I'VE HEARD SOME PEOPLE DOING.

SO THOSE ARE ALL IMPORTANT STEPS THAT YOU CAN TAKE.

AND BASICALLY COGNITIVELY REFRAME WHAT'S GOING ON.

SO JUST TRY TO THINK OF A POSITIVE ASPECT OF WHAT'S GOING ON RATHER THAN ALWAYS FOCUSING ON THE NEGATIVES.

DOCTOR, THANK YOU SO MUCH FOR YOUR TIME.

I REALLY APPRECIATE IT.

STAY SAFE OUT THERE.

THANK YOU.

SAME TO YOU.