The recent reported outbreaks and fatalities of the COVID-19 disease may impact mental health by elevating anxiety worldwide. COVID-19 is the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A quick query on Google for COVID-19 returns well over half a billion results.
Before the emergence of COVID-19, anxiety disorders already rank as one of the most common mental health problems globally. According to University of Oxford research, anxiety disorders, the most widespread of mental health disorders, impacted an estimated 284 million people in 2017 worldwide. In the U.S. alone, anxiety disorders affect an estimated 40 million adults according to the Anxiety and Depression Association of America.
Environmental factors that may increase the risk of anxiety disorders include early childhood trauma and life experiences. There may be a genetic component to anxiety disorders. A research study published in Psychiatry and Clinical Neuroscience in 2015, attributes 30 to 50 percent to heritability for anxiety disorders.
The neuroanatomy of fear many involve many regions of the brain, including the amygdala, ventromedial hypothalamus, hippocampus, nucleus accumbens, BNST (bed nucleus of stria terminalis), the inframlimic cortex (among various parts of the prefrontal cortex), insular cortex, and other brain regions based on various neuroscience research with animal models.
The amygdala (named after the Greek word for almond—“amygdale”), an almond-shaped set of neurons in the medial temporal lobe, is part of the limbic system. It is the neural network that mediates emotional learning and behavior. It plays a major role in mediating fear and other emotions.
Anxiety disorders impact children and adults and may be manifested by excessive fear and avoidance. Examples of anxiety disorders include panic disorder, generalized anxiety disorder, substance or medication-induced anxiety disorder, separation anxiety disorder, social anxiety disorder, anxiety disorder due to medical condition, specific phobia, agoraphobia, and selective mutism, according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association (APA). Posttraumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD) are closely related to anxiety disorders but have different DSM-5 categories.
According to the Mayo Clinic, common symptoms of anxiety include sleep issues, challenges on thinking or focusing on topics other than what is triggering the worrying, sweating, trembling, restlessness, tension, nervousness, hyperventilation, challenges controlling worrying, avoiding anxiety triggers, increased heart rate, gastrointestinal issues, and a sense of impending doom, danger or panic.
To manage normal anxiety, there are many steps that people can take such as getting adequate sleep, proper nutrition, and regular exercise. Make time for fun and relaxation, such as hobbies, meditation, yoga, or even listening to music to redirect the mind and calm the body. Above all, it is important to identify what is triggering the feelings of apprehension and create a plan.
If COVID-19 is elevating anxiety, create a plan, do not panic. Practice good hygiene by washing hands often for at least 20 seconds with soap, avoiding touching the face with hands (especially the eyes, nose, and mouth), covering coughs with the elbow or tissue, and staying at home if sick. Stock supplies (food, medications, hygiene products, etc.) in the case of a 14-day or longer quarantine. Get a seasonal flu shot. Postpone nonessential travel, especially to areas with active outbreaks. Employers and education institutions can set up virtual classrooms, use remote (video, Web, telecommunications) conferencing for meetings, allow working from home, postpone large gatherings, and encourage staying at home if sick.
Mental health professionals such as psychiatrists and psychologists may assist in determining anxiety disorders that are not due to medical conditions. Anxiety disorders are treatable. Depending on the anxiety disorder, treatment may include medications (e.g. anti-anxiety, antidepressants, and beta-blockers), managing the symptoms, cognitive behavioral therapy, and psychotherapy.
Experiencing anxiety now and then is a normal part of life. It is not unusual to temporarily feel anxious when facing stressful situations, uncertainty, or extreme challenges. The emotions of anxiety and fear in confronting a real threat are part of the survival instinct.
Anxiety might become problematic when it becomes persistent or impairs day-to-day tasks, performing at work or school, rational decision-making, and maintaining healthy relationships. In those cases, there is no stigma in seeking out professional assistance—mental health is as important as physical health.