Managing worry in these uncertain times
HLN's resident therapist, Sian Barnard, gives an insight into exactly what worry is, as well as practical advice on how to manage worry and look after our wellbeing.
By Sian Barnard
What is worry?
Human beings have the amazing ability to think about future events. ‘Thinking ahead’ means that we can anticipate obstacles or problems and gives us the opportunity to plan solutions. When it helps us to achieve our goals, ‘thinking ahead’ can be helpful. For example, hand washing and social distancing are helpful things that we can decide to do in order to prevent the spread of the virus. This is just basic planning.
However, worrying is another way of ‘thinking ahead’ that often leaves us feeling anxious or apprehensive. When we worry excessively, we often think about worst-case scenarios and feel that we won’t be able to cope.
What does worry feel like?
When we worry it can feel like a chain of thoughts and images which can progress in increasingly catastrophic and unlikely directions. For example, when we watch horror movies, we feel fear – we watch comedies and we feel happy. If you run a mental movie in your head and it is frightening, you will generate anxiety.
Some people feel that worry is uncontrollable – it seems to take on a life of its own. It is natural that many of us may have recently noticed ourselves thinking about worst-case scenarios. The example below illustrates how worries can escalate quickly even from something relatively minor. Have you noticed any thoughts like this? (confession: I have!)
I have a headache…What if Its Corona?… Maybe I passed it on to everyone at work yesterday…Everyone will pass it on and die.
This is imagining an apocalypse and losing everyone who I know and love.
Worry isn’t just in our heads. When it becomes excessive, we feel it as anxiety in our bodies too. Physical symptoms of worry and anxiety include:
- Muscle tension or aches and pains (tight chest)
- Restlessness and an inability to relax
- Difficulty sleeping
- Feeling easily fatigued
- Difficulty in concentration
What triggers worry and anxiety?
Anything can be a trigger for worry. Even when things go right, you might manage to think to yourself “but what if it all falls apart?”. There are particular situations where worry becomes even more common, though. Strong triggers for worry are situations that are:
Ambiguous – open to different interpretations.
Novel and new – so we don’t have any experience to fall back on.
Unpredictable – unclear how things will turn out.
Does any of this sound familiar at the moment? The current worldwide health situation ticks all of these boxes, and so it makes sense that people are experiencing a lot of worries. It is an unusual situation with much uncertainty, which can naturally lead us to worry and feel anxious.
It’s also important to remember that anxiety can produce similar symptoms to the coronavirus. When we are anxious and panicky our muscles tense and can cause knots and tension headaches, we can get a shortness of breath, upset tummies, pains in our chest, sweats and shakes.
Are there different types of worry?
Worry can be either helpful or unhelpful, I tend to distinguish between worries concerning ‘real problems’ vs. ‘hypothetical problems’
Real problem worries are about actual problems that need solutions right now. For example, given the very real concern about the virus at the moment, there are helpful solutions which include regular handwashing, physical distancing, and physical isolation if you have symptoms.
Hypothetical worries about the current health crisis might include thinking about worst-case scenarios (what we call catastrophising). For example, imagining worst-case scenarios such as most people dying, the NHS collapsing, running out of food.
When does worry become a problem? Everyone worries to some degree, and some thinking ahead is useful to help us to plan and cope. There is no ‘right’ amount of worry, but we say that worry becomes a problem when it stops you from living the life you want to live, or if it leaves you feeling demoralised and exhausted.
What can I do about worry?
It is natural for you to worry at the moment, but if you feel that it’s becoming excessive and taking over your life – for example, if it’s making you anxious, or if you’re struggling to sleep – then it might be worth trying to find ways to limit the time you spend worrying and taking steps to manage your well-being.
We now believe that maintaining balance in your life creates wellbeing and that balance comes from living a life with a range of activities that give you feelings of pleasure, achievement, and closeness. Certain activities can ward off worry and even depression.
Wellbeing is maintained by following activities that encompass ACE (achievements, closeness and enjoyment), which leads to interaction and engagement with the world. This then raises your mood and feelings of wellbeing and makes you want to do more stuff.
When we make plans or set goals and achieve them, we release a neurochemical in our brain called serotonin that gives us that feeling of satisfaction and that all is well. It uplifts our mood. When we are spending time with people we like, love and trust, we release oxytocin, another chemical that makes us feel good and like we belong. When we are doing something that we enjoy, whether it’s sport or knitting, we release dopamine which is our pleasure chemical.
Look after your wellbeing by finding balance between these activities
With the current health situation, many of our normal routines and daily activities are changing. Naturally, this can be unsettling, and the things we usually did to look after our well-being have become difficult. Whether you are working from home, or in some form of physical isolation or distancing, it can be helpful to organise a daily routine that involves a balance between activities that:
Give you a sense of achievement
Help you feel close and connected with others
Activities that you can do just for pleasure
When we are struggling with anxiety and worry, we can lose touch with things that used to give us pleasure. Plan to do some activities each day that are pleasurable and make you feel joyful. For example, reading a good book, watching a comedy, dancing or singing to your favourite songs, taking a relaxing bath, or eating your favourite food. We feel good when we have achieved or accomplished something, so it’s helpful to include activities each day that give you a sense of achievement. For example, doing some housework, decorating, gardening, a work task, cooking a new recipe, completing an exercise routine, or completing ‘life admin’ such as paying a bill.
We are social animals, so we need and naturally crave closeness and connection with other people.
With the current health crisis, many of us may be physically isolated or distant from others, so it’s important that we consider creative ways to connect in order that we don’t become socially isolated and lonely. How can you continue to connect with family and friends and have social time in a virtual way?
I like to call it physical distancing, not social distancing. Using social media, phone and video calls are ideal to set up shared online activities such as a virtual book or film club. You could also explore local online neighbourhood groups and see if there are ways to be involved in helping your local community. An imbalance of pleasure, achievement, and closeness can lower our mood.
Be aware that imbalance can also happen. If your stay in your pyjamas all day and eat chocolate and watch every series of Game of Thrones, with no exercise and no mental stimulation, or you keep staring inside the fridge and spend 12 hours on the Xbox, then you will have a low mood as there will be no sense of achievement.
At the end of each day, check-in with yourself and ask ‘what did I do today that gave me a sense of achievement? Pleasure? Closeness with others? Did I get a good balance, and if not, what can I do differently tomorrow?’
Speak to yourself with compassion
Worry can come from a place of concern. A traditional cognitive behavioural therapy technique for working with negative, anxious, or upsetting thoughts is to write them down and find a different way of responding to them.
Learning and practicing mindfulness can help us to let go of worries and bring ourselves back to the present moment. For example, focusing on the gentle movement of your breath or the sounds you hear around you can serve as helpful ‘anchors’ to help bring you back to the present moment and let go of worries.
Another technique is to practise postponing your worry or creating a “worry time”
Worry is insistent – it can make you feel as though you have to engage with it right now or your world will fall apart. But you can experiment with postponing hypothetical worry, and many people find that this allows them to have a different relationship with their worries. In practice, this means deliberately setting aside time each day to let yourself worry (e.g. 30 minutes at the end of each day). It can feel like an odd thing to do at first! It also means that for the other 23.5 hours in the day you try to let go of the worry until you get to your ‘worry time’.
People who are bothered by worry often experience it as uncontrollable, time-consuming, and sometimes believe that it is beneficial to engage in worry when it occurs. Experimenting with postponing your worries is a helpful way of exploring your relationship with worry. Follow the steps below for at least one week.
Step 1: Preparation – Decide when your worry time will be and how long it will be for.
Step 2: Worry postponement – try to avoid thinking about it until your designated time
Step 3: Worry time – Use your dedicated worry time for worrying. Consider writing down any of the hypothetical worries that you remember having throughout the day. How concerning are they to you now? Are any of them the kinds of worries that can lead you to take practical actions?
Some things to consider:
What time of day do you think you will be in the best frame of mind to attend to your worries?
When are you unlikely to be disturbed? (If you are unsure, 15 to 30 minutes every day at around 7:00 pm is often a good starting point.)
When you catch yourself worrying, think to yourself ‘is this a ‘real problem’ worry that I can do something about right now?’ If yes, take action now. If not, postpone thinking about it until worry time.
Now redirect your attention to the present by becoming mindful of the present moment. Do this by using your senses (sight, sound, touch, smell, taste) and try to focus your attention externally rather than internally.
Say to yourself “I’m not going to engage in this worry now, I will engage in this worry later”. During the day, decide whether worries that surface are ‘real problem’ worries you can act on now, or whether they are hypothetical worries that need to be postponed.
Some final tips
Set a routine. If you are spending more time at home, it is important to continue with a regular routine. Maintain a regular time for waking up and going to bed, eating at regular times, and getting ready and dressed each morning. You could use a timetable to give structure to your day.
Stay mentally and physically active. When you plan your daily timetable, have a go at including activities that keep both your mind active. For example, you could try learning something new with an online course or challenge yourself to learn a new language. It’s also important to keep physically active. Try doing rigorous housework for 30 minutes, or an online exercise video.
Practice gratitude. At times of uncertainty, developing a gratitude practice can help you to connect with moments of joy, aliveness, and pleasure. It has been a part of major religions for centuries, but modern neuroscience finds that gratitude releases serotonin. At the end of each day, take time to reflect on what you are thankful for today. Try and be specific and notice new things each day, for example ‘I am grateful that it was sunny at lunchtime so I could sit in the garden’. You could start a gratitude journal or keep notes in a gratitude jar. Encourage other people in your home to get involved too.
Notice and limit worry triggers. As the health situation develops it can feel like we need to constantly follow the news or check social media for updates. However, you might notice this also triggers your worry and anxiety. Try to limit the time that you are exposed to worry triggers each day. You might choose to listen to the news at a set time each day, or you could limit the amount of time you spend on social media for news checking. I personally watch the news briefly every four or five days.
Rely on reputable news sources. It can also help to be mindful of where you are obtaining news and information. Be careful to choose reputable sources such as The World Health Organisation.
About the Author:
Sian Barnard is a cognitive behaviour psychotherapist and hypnotherapist based in Newcastle Upon Tyne, currently working via Zoom, Skype and other online platforms to deliver effective personal therapy and corporate training.https://peacefulminds.org.uk