Managing Anxiety when your fear is real
May 23, 2020 2:11 AM   Subscribe

So things are looking very rough here in South Africa re covid 19. I'm personally fairly safe at the moment but feeling completely overwhelmed by my knowledge that things are spiralling out of control all around me, and that my husband will be having to go work in an unsafe environment from next week. I need to find tools to manage my anxiety.

I'd prefer not to have to spend money as financial situation is unsure, but I can probably afford small expense on mental health support. I have never been in therapy but I've worked through online courses on Cognitive Behavioural Therapy. I have found some solace in CBT apps like Woebot but I find they have a limit as a lot of CBT assumes that your anxiety is based on cognitive distortions. And while that's certainly true to some extent, even when I remove cognitive distortions from my thinking, the realistic view from here is still grim and terrifying. How do I navigate my way through this?

My question is whether there are tools I can use to keep myself together enough emotionally so that I can not be a burden on the people around me. I would like to ask if there's a way to not feel so terrible all the time but I think part of the solution is to just accept that I'm going to feel terrible a lot of the time and that is somehow ok.

By tools I mean all kinds of things - for example, I have found the Woebot app to be helpful in centering myself and calming down. Are there any other similar apps or online interactive tools I can use?

Exercise helps a bit. So does meditation. I am writing a book and when I can get my mind into that, it helps. But things that have really helped me is to think of this as that I'm grieving, and that the pain isn't a sign that there is something wrong, but just something I have to live through. My stomach really hurts all the time now and I struggle to eat, and when that happens I feel trapped and as if there's something wrong with me. I'm trying to think of it as just a symptom, as if I have a tummy bug, not as "THIS IS TERROR OMG WHAT SHOULD I DO". Does that sound reasonable?

That "this too shall pass" and whatever happens, things will change. Being mindful of a good moment when it happens, that I'm "safe right now".

What also helps is doing stuff that might make a difference to other people e.g. making masks for the community groups in our area (there's a soup kitchen nearby that's not allowed to give food to people if they don't have masks, so I'm making masks for them to hand out) and maybe also knitting beanies (winter is nearly here and people are going to need them).

I've even tried praying, even though I am an atheist. I just pray for strength and that helps a little.

I do a little bit of chatting via text with family and friends but I try to keep it light as I know everyone is in a pretty bad place right now. I want to phone my father but I know I'll cry and I don't want that to happen.

From next week my husband will be going to work during the day so I'm going to be alone a lot. Any techniques you have for staying centered will be very much appreciated.

So sorry this turned into a long ramble - my specific question is whether there are any online tools like apps that could help me with managing my anxiety, possibly something other than CBT. I guess books would also be helpful, if you can recommend any.
posted by Zumbador to Health & Fitness (10 answers total) 3 users marked this as a favorite
 
Not a specific app, but in terms of a general approach, tools based on "Acceptance & Commitment Therapy" might be useful - I've found it helps with situations where the cause of my distress is a genuinely bad situation, rather than cognitive distortions.
posted by Mauve at 2:18 AM on May 23 [4 favorites]


If you think guided meditations might be helpful, I know apps like Insight Timer and Headspace have been putting together some Covid-related material.

I'm not great at sticking with meditation but during the periods when I do more or less regular meditation or exercises (like yoga) with a focus on deep breathing, I find that I can take a deep breath or two at random times when panicking and my body relaxes automatically and it helps with the centering you mentioned.

My stomach really hurts all the time now and I struggle to eat, and when that happens I feel trapped and as if there's something wrong with me. I'm trying to think of it as just a symptom, as if I have a tummy bug, not as "THIS IS TERROR OMG WHAT SHOULD I DO".

Also I hope this doesn't sound trivializing - I also get anxiety stomach aches and nausea and though weirdly it took me a long time to connect that to the stomach aches that Chidi always gets on The Good Place, once I did it kind of helped me move more fully into the "it's just a symptom" mode, and even see it as a slightly lovable symptom.

posted by trig at 4:18 AM on May 23 [3 favorites]


It sounds like you are doing a lot of great things to take care of yourself in a really stressful time.

IME having a big cry can really help. For me, when the anxiety just keeps piling on, at some point I cry until all the tension seems to be released.

Having someone to talk with is good. I don't think of this as burdensome as long as I listen to them in return, respect their boundaries and make sure they have the bandwidth to listen. And I don't necessarily need to talk about all the things worrying me, sometimes just seeing a friend's face on Skype, or hearing their voice, can help me feel better.

Teletherapy can help, if you have access to it.

Some locales have help lines specifically for covid-related anxiety/mental health concerns. I found this list; there may be others.

And yoga and meditation always help.

I hope you get some strategies that work for you. Internet hugs if you want them.
posted by bunderful at 4:53 AM on May 23 [1 favorite]


I agree with Mauve that ACT is very helpful for this, in my experience far more so than CBT. I’m reading The Happiness Trap and finding it helpful (and I usually loathe self-help books).
posted by shb at 4:56 AM on May 23 [1 favorite]


I think it sounds like you're doing really well and have identified some really useful strategies to help you through this difficult time.

However I'd say you're a little misguided in not wanting to talk about stuff with those close to you. They love you and want to support you. There's a mental pressure of "not being a burden" but that's not really how care looks like to the person who is doing the caring. Most people WANT their loved ones to talk to them and turn to them for solace. Plus, I'm sure there are others you know who feel equally as bad as you and being able to share that together would be a blessing.
Basically if you're not phoning every day and sobbing for hours at a time, I think phonecalls in which you express your distress and use your relationships for comfort, would be a good thing.

It might not work for everyone but for me, thinking about the inevitability of death and the fact that a lot of people have been through terrible stressful chaotic things in this world, help me to accept my own fear of danger/death and my own sense of stress. It's ok that it feels bad. You are strong enough to live through it. And death is the end of all things anyway, so we can feel peaceful about events- a version of "this too will pass"
posted by Balthamos at 5:02 AM on May 23 [2 favorites]


Also I've found it helpful when in an anxiety attack just to write a note about how I'm feeling and what I'm worried about, whether in a notebook or a plain text file or something, as long or as short as I feel like in the moment.
posted by trig at 5:26 AM on May 23 [2 favorites]


More guided meditation links: There are some free guided meditation .mp3s at UCLA's Mindful Awareness Research Center (marc.ucla.edu) ranging from 3 to 20 minutes in length. UCSD's School of Medicine has some longer and more varied guided meditations here, hosted on SoundCloud.

Or skip about 23 minutes into the Youtube video in this decade-old FPP for another ~20-minute-long session with more exposition which I like very much, led by Jon Kabat-Zinn (a medical stress reduction researcher) at Google. (And you can listen to the rest of his hour-plus presentation, too, but the chunk starting at 23 minutes is the guided meditation portion.)
posted by XMLicious at 8:17 AM on May 23 [1 favorite]


I do a little bit of chatting via text with family and friends but I try to keep it light as I know everyone is in a pretty bad place right now. I want to phone my father but I know I'll cry and I don't want that to happen.

Honestly, if I were you, I'd just pick up the phone, talk to him, and have a big old cry. Crying is a huge reliever of stress in itself, as is saying aloud to someone the things you're scared of, as is knowing that someone who loves you, knows how you're feeling. If you don't want to do it because you don't want to worry him, you can always text him after and say "Thank you for listening, I feel so much better for having had a good cry, that was just what I needed today :) "

(Obvs this doesn't work if there are specific reasons you've not gone into for you not wanting to cry to your father.)
posted by penguin pie at 10:54 AM on May 23 [1 favorite]


My question is whether there are tools I can use to keep myself together enough emotionally so that I can not be a burden on the people around me.

This AskMefi question may be useful..
posted by WCityMike at 11:19 AM on May 23 [1 favorite]


My wife uses the Calm app (subscription, not free) and absolutely loves it. It helps her relax at night before sleep, and if she ever gets to the point during a day when she's feeling overwhelmed or stressed, she'll spend a half hour or so with the app and it helps bring her back to a more centered place.
posted by pdb at 3:45 PM on May 24 [1 favorite]


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