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Of course you are. Almost everyone is concerned, and some people are avoiding everyday activities that seemed safe a few weeks ago.
My view is that we need to take this very seriously, try the best we can to contain the spread, follow the CDC guidelines about hygiene (handwashing, disinfectants, distancing) and travel warnings. We don’t want to make believe that this is entirely in our imagination. This is not “the common cold” and we need to do what we can to reduce the risk.
But even when you are following all of these guidelines, you may still be very worried. In fact, some people are living in dread. Some people think that it is imminent—that they are doomed—that there is no escape. You may find yourself bombarded by worried thoughts: “What if someone sneezes on me?”; “What if I get quarantined?”; or “What if I die from this?” These thoughts may haunt you day and night and keep you from getting sleep as you wake up in the middle of the night in a sense of terror.
What should you do? Should you not worry at all? Should you just think positively?
No, you are entitled to worry, you have a right to feel anxious, and you are not alone. The question to examine is how much and how frequently should you get caught up in your worries? How much danger should you think you are facing?
1. Validate Your Anxiety. It is a difficult time for millions of people concerned about the risk of infection. Validate your right to feel anxious, normalize that this is a human response, and don’t put yourself down for being afraid. This is a natural response to a real threat that we face. But just as you have a right to feel anxious, you also have a right to put things in perspective.
2. Distinguish Between Productive and Unproductive Worry. Productive worry leads to productive action today. It is your to-do list that helps you cope with a problem. For example, it is productive today to wash your hands, use sanitizer, use the elbow bump rather than the handshake, cover your face if you cough and—if you are in a high-risk group—avoid unnecessary travel and crowded places. That makes sense. But unproductive worry involves those repetitive negative thoughts about “what if?”—about which you have no answers. Unproductive worry involves thoughts like, “What if someone coughs on me?” or “What if I have the virus?” There is no to-do list today that will help you. So, if you are plagued with unproductive worry you need to go to the next step—acceptance.
3. Accept Uncertainty and What You Cannot Control. A central part of worry is the intolerance of uncertainty. We often equate uncertainty with a bad outcome—in this case, a terrible outcome. But uncertainty is neutral about the outcome. You already accept uncertainty eating food, crossing the street, driving a car. And we cannot control everything—but this does not mean we are in greater danger. You actually can control many of the risk factors—such as hygiene, distancing, and travel to riskier places.
4. Look at Probability Not Possibility. When we are anxious we often think, “But I could be the one.” That is always true. But the relevant question is, “What is the probability that I will die from this?” That’s why it is important to look at the actual numbers. According to the CDC today, March 10, there are 647 cases and 25 deaths in the United States.
5. Avoid Google-itis. When we worry about something we often Google the worst-case outcome. So, if you are worried about a headache as a sign of brain cancer you selectively google, “Brain cancer-Headache.” That links me to 44,200,000 websites. Hmm. Sounds pretty bad. But according to the World Health Organization almost everyone has headaches at some time. Again, let’s not confuse possibility with probability. Don’t confuse coming across stories on Google with the probability of something happening to you. The nature of Google-itis is that you spend a lot of time in negative territory and you are likely to find bad news there. You will never see a headline in the newspaper that reads, “Nothing happened.” It's hard to picture nothing happening. So, my advice is to cut back on googling.
6. Set Aside Worry Time. I see patients every day and every patient has an appointment. You can do the same with your virus worries. Set aside 15 minutes every day to worry about it—say, 3:30 in the afternoon. During the rest of the day or night write down your worries and set them aside to their appointment time. Then, when you get to the worry time later, ask yourself, “Is this productive or unproductive?”; “Is there a to-do list that will help me make progress right now?”; “What if I accepted uncertainty?”; and “What is the probability?”
7. Have Daily Goals. Worry takes up a lot of time and energy and seldom leads to anything productive. Keep yourself busy with positive goals like exercise, seeing friends, getting work done, pursuing valued action. While you focus your attention on these positive daily goals, recognize that your mind might drift off to worry. Accept that, notice that, and put that worry on the appointment calendar—for later. You are too busy with positive goals right now to distract yourself with worry.
