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Coping with coronavirus

Dr. Susan Heitler

Let’s face it — the last couple of weeks have been rough.

The coronavirus pandemic has triggered an avalanche of ominous and downright bad news covering an almost universal range of woes — rising death tolls and infection rates, locally, nationally and abroad; reports of inadequate testing capacity and insufficient hospital beds; warnings about social distancing and rigorous hygiene practices; fears of civil unrest; devastating losses in the stock market; huge sectors of the workforce forced to remain idle.

Such news and uncertainty are hardly soothing to our individual and collective psyches, which is why the Intermountain Jewish News this week sought an expert capable of putting all this chaos into some sort of emotional and psychological context and — perhaps — providing a measure of comfort in the midst of the pandemic.

Our search led us to a well-known member of the Denver Jewish community, clinical psych- ologist Susan Heitler, PhD, author of several books including her latest, Prescriptions Without Pills, which she says is designed to help “individuals and couples who feel distressed to feel happier and live more gratifying lives.”

That sounds like a perfect prescription for what ails us in such troubling times.

Heitler responded to our questions from Raanana, Israel, where she is visiting her family.

“So glad to be close to family while we’re riding this thing out,” she writes.

Are you seeing growing numbers of patients experiencing increased levels of anxiety or depression as a result of the coronavirus?

All of us are likely to experience at least some anxiety. It’s normal and even helpful for anxiety to be triggered by health, economic, social isolation and other potentially negative circumstances.

At the same time, many folks who are prone to react to life bumps with more intense levels of anxiety, are doing so especially now.

Depression so far appears to be less of an issue, unless serious losses occur.

In your view, how rational — that is, based on justifiable fears and uncertainty — are these reactions?

Some anxiety is totally realistic and even helpful. When dangers appear ahead, anxiety alerts us to pay attention, gather information and map a plan of action.

At the same time, a hyper-focus on worst-case, what-if scenarios can exacerbate anxiety intensity. So can what therapists call “catastrophizing,” that is, viewing situations as more dangerous than they are.

For sure, change is happening. Does change have to imply catastrophe? No. Change in fact is often an equal opportunity phenomenon: along with potential dangers and losses, it offers opportunities for new blessings.

Being on the alert for changes’ upsides mitigates anxiety while it maximizes the likelihood of positive outcomes. The kids have no school? OK, now we finally have time for the family to sing together, to learn a new language, to read more, to feel less time pressure, to teach everyone to cook, to exercise together, to laugh . . .

How much do uncertainty or fear of the unknown have to do with these reactions?

Yes, uncertainty fuels anxiety. For that reason, one of the best antidotes to anxiety is information. With information, we can figure out how best to respond to each of the new situations that now face us.

Is the coronavirus pandemic, and the media coverage of it, particularly dangerous for individuals who already have issues with anxiety?

Not necessarily. In some cases, for instance, a person with obsessive fears of germs or dirt who does compulsive hand-washing may actually feel a gratifying “I told you so!” sense of relief.

The main challenge for people who are anxiety-prone is to remember that their amygdala, the brain’s danger-alert mechanism, is most likely giving them excessively frequent and overly intense danger readings.

In addition to excessive emotional reactivity, cognitive rigidity, that is, difficulty seeing things in new ways, can be problematic in times of change. So is a habit of focusing too much on the dark side, on what is lost or wrong.

By contrast, a positive sense of humor, flexible thinking and collaborative problem-solving dialogue with friends and family members facilitate adaptation to a new normal.

Over and above medical and hygiene recommendations, what general advice would you provide for those individuals suffering psychological effects such as these?

First and foremost, to end anxiety, convert your worrying to thinking:

Begin by sitting down.

Take a deep breath or two, consciously relaxing your body to lower your immediate anxiety level.

Then write a list of all of your specific anxious thoughts, numbering them as you write.

Lastly, circle back to address each item on the list one by one. For each concern, devise a plan of action.

A problem-solving pathway leads back to full calm.

Once you have listed and addressed the problems that have triggered your anxiety, you can add any or all the following options:

• Talk with friends and family members who are adapting more easily. Learn from them to reframe problems so they look less dire.

• Take action: Instead of worrying, do something, anything, that moves you in the direction of solving problems. As one anxious person said to me, “I was so anxious about food shortages I was shaking. Then as soon as a friend and I started driving to the grocery store to stock up, the shaking disappeared.”

• Go outside and enjoy nature’s healing sunshine, greenery and blue skies.

• Enjoy music: music has great power to calm the soul and also to pump up your energies if you are feeling down.

• Exercise, eat well and sleep lots to stay in maximal physical condition.

• Treasure your family and friends. Refrain from anger. Rejoice in this chance to spend more time together.

• Look for opportunities to express gratitude and appreciation.

• Practice altruism. Anything you do that helps others will result in your feeling better as well.

Would you suggest that people minimize, or avoid altogether, news coverage of the pandemic?

In general, information eases anxiety. At the same time, balance information-seeking with enjoying your life. Do things you always wished you had time to do. Launch projects that give you a sense of purpose. Focus primarily on what makes life worth living for you.

Do you think that some of these effects, such as anxiety or depression, might be experienced by some patients in the long term, or are they more likely to diminish as the medical crisis goes away?

Depression and anxiety in most cases are reactive. That is, hopelessness and fear mainly emerge in response to real situations. As situations change, the feelings generally change as well.

To be sure that you will feel better as the coronavirus crisis passes, take the current “novel” situation as a series of opportunities to learn to adapt to changes with ever-growing relaxed creativity.

Wouldn’t it be lovely if the result of these anxious times were to be that you have learned to enjoy a less emotionally over-reactive and consistently more loving lifestyle?

Are there are effects that Jewish individuals might experience that are distinct from those of the general population?

Jews have wisdom texts. Check out, for example, the book of Kohelet. Written by King Solomon many centuries ago, the messages feel particularly timely now. Bruce Heitler’s Kohelet translation, available for free on Sefaria.org, makes Solomon’s wisdom ideas especially accessible.

Jews also have prayer. Open a siddur, a prayer book, to almost any page. Prayer, which so often focuses us on appreciating, has particular potency in challenging times.

Lastly, Jews who do Shabbat have experience in stopping as an opportunity for rejuvenation.

Coronavirus is creating a global grand pause. What would happen if you were to take this situation as an opportunity to reflect and rejoice?

Could it then prepare you for an ever-better way of living when your former life resumes?

Chris Leppek may be reached at [email protected].

Copyright © 2020 by the Intermountain Jewish News



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