by Christine MacMillan, MSW, RSW, Clinical Social Worker
We may very well be facing our deepest fears because of the threat of COVID-19. This danger is not only happening in other parts of the world, it has entered our world and causing anxiety to rise to an all-time high. Whenever there is a disruption in our normal schedule and when we perceive we do not have the resources to respond adequately, it usually leads to stress. This is not unlike the experience of grief after the death of a loved one.
Normally, grief after a death is associated with feelings of profound sadness, longing and yearning which causes deep emotional pain. Anxiety is not usually linked to the grief process. It is though, a very normal part of the experience.
To begin with, let’s have a look at what anxiety is. It is an instinctive part of our human response system which ensures we remain safe or adapt. It is more commonly known as the “fight or flight” response which was designed to respond to threats in our environment. When activated, the ‘fight or flight’ response propels us to take action to keep us safe. This remarkable system allowed our ancestors to survive. However, when our fight or flight response is activated now in modern times, it is not typically in response to danger. And when the system becomes hijacked, we may feel threatened or have an underlying feeling of dread when the situation does not warrant this response.
However, when confronted with the COVID-19 virus, the threat to our wellbeing is real. But our neurological system is not familiar with this type of threat. It evolved to specialize in ensuring we had enough food and/or were safe from predators. But we still need to adapt and keep safe from this viral threat.
Anxiety is usually experienced through physical sensations, emotions, behaviour or thoughts which are interconnected. And when this system gets derailed we tend to think and behave irrationally. When our emotions are dysregulated, our higher cognitive functioning (thinking), literally, goes ‘offline’…. And we do not make rational decisions consistent with the threat. For example, many overreacted by stockpiling toilet paper …. thus, giving them the illusion that they have some type of control by being proactive.
But anxiety can also be used to our advantage. It is a great motivator…it can motivate us to act in ways which allow us to operate in a functional but not in a frantic state. In the case of COVID-19, we can keep informed of current guidelines based on facts and ensure we practice those guidelines to keep us, our loved ones, and others safe. These are the things within our control. However, we must also come to terms with the fact doing everything within our control does not guarantee us a favorable outcome either. Taking precautions can reduce the likelihood of falling ill but cannot guarantee it. And this is unsettling because anxiety craves certainty. We need to remember that there will always be things beyond our control.
However, one of the certainties of life is that things will always change and end. In the case of the virus, we can do what is within our control, practice patience, settle into the uncertainty and wait, for this too will end. However, with grief an ‘end’ brings emotional pain and perhaps a heightened need for closeness when it’s not possible because of physical distancing. This will add distress to the complexity of your grief experience.
After the death of a loved, we essentially experience ‘separation anxiety’. The term is usually associated with children, but adults also experience this. This anxiety stems from feelings which arise after the death of a person who provided either comfort, security, a safe haven or protection from threat. So, when we think back to the evolutionary role of anxiety we can understand why feelings of anxiety or apprehension are heightened when this person has died. Although we are not in physical danger after a death, we do feel emotionally unsafe…. the world as we know it has changed and now we don’t feel safe without our loved one. This leads to searching and yearning behaviours early in the process when the loss is believed to be temporary. But as time passes, and the reality of the permanence becomes more “real” (because our searching and yearning has not resulted in the return of our loved one), our responses change to profound sadness and pain.
Part of the reason that grief is so painful is that we must learn how to let go of our physical attachment to our loved one after their death. Our attachment to people who bring meaning to our life do continue to exist in their absence regardless of our protest to the separation. Eventually, when our protests do not ‘bring back’ our loved one, we work on transforming our physical attachment to our loved one to an inner relationship with them called a ‘continuing bond’. We continue to have a relationship with them, albeit not in a physical sense.
Our grief anxiety can also be related to being confronted with our mortality, apprehension about the health of other loved ones, internalizing myths of the grief process, anxiety about being changed and different than before. Additionally, pre-existing anxiety will be exacerbated during the grief process. So, while there is ‘no right way to grieve’ or a ‘one size fits all’ answer to grief, be comforted if you have experienced anxiety, that you are ‘normal’.
Anxiety due to grief or COVID-19 can manifest itself in the following ways: Physically (increased heart rate, tightness in chest, shallow breathing, tightness or knots in the stomach), Cognitively (ruminating/obsessing, scanning the environment for threat, “what if” scenarios), Behaviourially (avoiding or repeating behaviours, withdrawing, quickened speech, agitation), and Emotionally (worry, apprehension, fear, dread). While these symptoms are uncomfortable, they are signals we need to pay attention to so that we can act. If you still experience anxiety symptoms after you have done things within your control, try some or all the following:
1. Practice deep or square breathing. As you focus on your breath in for a count of 4 and out slowly for a count of 4, soften your muscles and release the tension. This will manage and slow down the fight or flight response to allow us to move into a state of calm.
2. Practice mindfulness. This means being aware of our present, either our actions or feelings (even if uncomfortable and painful) without judgement or criticism. Being mindful or totally engaged in our present moves us away from our anxiety about the future. When we stay in the present we are less likely to concern ourselves with the ‘worst’ which our minds think might happen in the future.
3. Engage in some form of physical activity. You may have to become creative if your normal form of physical outlet (gyms, classes, team sports) is not available to you.
4. Find creative ways to connect with important people in your life while sheltering in place. How do you remain ‘close” with physical distancing in place?
5. Refrain from getting trapped in believing you can control everything and practice becoming comfortable with living with uncertainty. Practicing any new behaviour will initially be uncomfortable and will likely intensify anxiety. But with practice it can become more natural. Remember, it is an illusion that we have control over a lot of things. Letting go of our need to control liberates us from our fears.
6. Believe in your capacity to handle whatever happens. Whether this means we reach out and ask for help or we manage on our own, it is a testament to our ability to problem solve and build resilience.
7. Reach out to someone in need. This will help to shift the focus from your fears (future oriented) to someone else (present oriented).
8. When you find your anxiety increasing and you are engrossed in your fears, try changing your “what if” thoughts; distract yourself with a ‘here and now’ manageable task.
9. Manage your media exposure in the case of COVID-19 and rely on trusted resources and experts with respect to your grief.
10. Practice self-compassion; in times of stress and anxiety, we can become critical of ourselves because of our vulnerabilities, failures, and inadequacies. Instead, accept your fears with compassion, acknowledge your humanity with its frailties and treat yourself with kindness and empathy as you would a friend.
About Chrisitine:
Christine MacMillan, MSW, RSW is a clinical social worker, therapist, and owner of MacMillan Counselling and Consulting, Windsor. She provides counselling in the areas of bereavement, grief/loss, depression, anxiety, adjustment to injury or illness and trauma. Christine is a frequent speaker in the community on grief and loss and is the presenter for Grieving Hearts program. She continues to offer support during this period of isolation through video, phone or email.
Christine can be reached through her website, macmillancounselling.ca, by email at christine@macmillancounselling.ca
or at 519-995-9052.