Living in the place where uncertainty meets worry (and learning how to manage it)
Is there actually something to the phrase “go with the flow”? Here’s what you need to know about the difference between worry, stress and anxiety
SALT LAKE CITY — Author, inventor and innovation keynoter Julie Austin worries about the pieces of her career that rely on interacting with a live audience just when “in-person” is out of the question. This coronavirus pandemic has sent millions home from work and school, forced weddings and baptisms online, closed malls and cleared city streets. Live shows are temporarily halted.
Then her worries broaden. “I’m also worried about us losing social contact with others. I’ll be very happy if hand-shaking goes out of favor, but I like the closeness of meeting other people and being social. Right now, when people cross the street to avoid being near you, it feels weird and lonely,” said Austin, of Los Angeles.
Most adults easily list COVID-19 worries, from losing a loved one to losing a job. Some worry about being quarantined alone, while others fear being cooped up amid strained relationships. Loss of money, autonomy and adequate health care all make worry lists.
“Worry can have many targets,” says Kate Sweeny, a professor of psychology at University of California, Riverside and a national expert on worry. “Worry is pretty specific — and this is a worrisome time.”
Understanding the difference between worry, stress and anxiety.
It’s not easy to sort out the difference between worry, stress and anxiety, and some people use the words nearly interchangeably, which isn’t quite right. There are differences, though different experts sort them in various ways and they often travel together. You can be stressed, worried and anxious all at once.
“Worry” is a mental process, including repetitive, nagging thoughts. Worry is sometimes obsessive and usually focused on a specific target, like losing a job or wondering if you’ll get sick.
“Stress” is a physical body response to something external — usually something that’s already happening or well-defined, like a dreaded medical test or job performance evaluation. Melanie Greenberg, a clinical psychologist in Mill Valley, California, who wrote “The Stress-Proof Brain, told The New York Times that stress is a “reaction to environmental changes or forces that exceed the individual’s resources.”
“Anxiety” involves body and mind and can be serious enough to qualify as a mental disorder. Anxiety disorder can combine stress, fear and anxiety in ways that interfere with life.
The Deseret News recently explored anxiety and the terrible toll it takes on young people — in a yearlong series that was honored by Mental Health America, among others. You can read it here: Generation Vexed.
A recent Pew Research Center survey found 9 in 10 adults changed their public activities and personal lives due to worries about the pandemic, especially in states with lots of illness.
Sweeny’s research typically looks at the kind of worry that has an end date, like worrying about biopsy results one expects to get Friday or whether that coveted job will go to someone else.
COVID-19 has thrust much of the world into what Sweeny describes as “this sort of bizarre time that we’re living in — a particularly challenging kind of uncertainty.”
Not only do friends and colleagues tell her they don’t know how it will end, but it’s unclear when it will end. “There is this overwhelming, free-floating sense things are not right and I don’t know when they will be and that throws everyone off,” Sweeny said.
Nor is the worry uniquely American. “Trying to analyze what I’m worrying about at the moment is like peeling an onion. There are many layers,” Ben Taylor said in an email from England, where he runs an advice portal for aspiring remote workers. His worries include the mental toll if the pandemic drags on.
Lynell Ross suspects being a long-time worrier gives her an advantage of sorts during this profoundly challenging period. “I used to worry about everything,” said Ross, founder of an education advocacy website and a certified health and wellness coach in Auburn, California. “Had I not prepared myself and learned about stress, worry and anxiety, my worrying would be out of control right now.”
Those who aren’t used to coping with crisis can learn to handle their worries, experts told Deseret News.
Adding, subtracting from life
“It’s pretty normal to be worried right now; it’s not even necessarily bad,” said Dr. Gail Saltz, associate professor of psychiatry at the New York Presbyterian Hospital Weill-Cornell School of Medicine and host of the “Personology” podcast. “Worry is the human danger signal to tell you there’s something to do to avoid danger. It is appropriate to worry inasmuch as it keeps you washing your hands, not touching your face, wearing a mask if that’s appropriate, not taking unnecessary risks, giving thought to how you’ll problem-solve around your house and manage your relationships, create structure, create space, do all those things.”
She calls that worry productive. Not all worry is. Saltz said some kicks off harmful “stress-mediated behaviors” like domestic violence and obesity. And Sweeny notes just being worried “deteriorates your ability to regulate your behavior optimally the way you might want.”
For example, “there’s a pretty reliable connection between worry and other negative emotions and drinking too much, not exercising, not eating as well as you should. I am seeing this now anecdotally on Twitter and among friends,” Sweeny said, noting people joke that when social distancing ends, they’ll either be a master chef or alcoholic.
Worrying may have evolved alongside intelligence as a beneficial trait that helped people survive, said a recent study led by scientists at State University of New York Downstate Medical Center. Dr. Jeremy Coplan, professor of psychiatry, said both high intelligence and worry correlate with brain activity that metabolizes the nutrient choline in the brain’s subcortical white matter. That’s why researchers believe intelligence and worry developed together in humans.
“While excessive worry is generally seen as a negative trait and high intelligence as a positive one, worry may cause our species to avoid dangerous situations, regardless of how remote a possibility they may be,” said Coplan of the study, published in Frontiers in Evolutionary Neuroscience. “... Thus, like intelligence, worry may confer a benefit.”
The National Institutes of Health’s Director’s Blog, by Dr. Francis Collins, recently featured a conversation about worry with National Institute of Mental Health’s director Dr. Joshua Gordon. Gordon said to focus on facts. “There’s a lot of rumor, there’s a lot of hyperbole out there, and there’s a lot of, frankly, uncertainty. To the extent that you can, learn and share the facts about the virus. If you know what’s happening, it reduces the uncertainty.”
He warned against turning fact-finding into overconsuming COVID-19 news. “It’s really important to set aside periods of each day where you turn off social media, you turn off the TV, turn off the news, and do something that you enjoy.”
Sweeny suggests worried people “ask yourself if there’s anything you could be doing to make the situation better that you haven’t tried.” Are you tuned into news enough to know if circumstances change drastically? Are you washing your hands and staying quarantined? What else might you do to make your circumstance better?
If you’ve done items on your personalized list to reduce risks, it’s probably time to turn the volume down on worry, she said. “It’s not useful at that point.”
That’s something David Bakke, of Atlanta, Georgia, decided. “To manage my worries, I’ve made a conscious effort to ignore the seemingly daily if not hourly updates on the virus and its spread. It’s just too much for me. At this point, I will probably start to check in less regularly until I hear at least some bit of good news.”
He added, “I’ve also increased communication with friends and family members for reassurance and advice during these troubling times. I think we’re going to get through this, but at this point, I just don’t know. I’m hoping things will end well.”
Paige Arnof-Fenn runs a marketing company in Cambridge, Massachusetts, and usually worries about client needs. COVID-19 has stretched her worries to people she will never know, including “all the people who will fall through the cracks,” like the elderly, retirees who lost savings, people with compromised immune systems, kids in low-income families struggling with online learning, limited-skill restaurant workers whose jobs may not return and small businesses that may founder. She fears for front-line health care workers and wonders about “the entire generation of young people today whose lives had barely launched who will probably suffer from PTSD for decades.”
To keep worry from becoming overwhelming, some experts say to schedule a short block of worry time daily — and use that time specifically for worry, so it doesn’t encroach on everything else.
Exercise it out
When a news alert pings or someone has a scratchy throat, there’s a degree of worry, which “drives up” the sympathetic nervous system, responsible for human fight or flight response, Saltz said. People need to counter with actions that bring the parasympathetic system online: Things that calm mind and body like a half-hour of daily exercise.
NIH’s Gordon points to yoga, exercise, resting and regular meals as part of coping. He advised against using alcohol as “an escape mechanism when you’re feeling stressed.”
He also emphasized connecting. He prefers “physical distancing” to “social distancing,” he told Collins, because “I think we can be socially intimate and physically distant. So, connect with others, reach out to people, use digital tools, use telephones, use email and text, write a letter.”
Exercise can create calm, but so can being still. Saltz advocates taking slow, deep breaths several times a day to turn down the sympathetic system and turn up the parasympathetic. Squeezing muscle groups to a five count and releasing them to a five count calms. Picturing a place you find relaxing and beautiful while deep breathing can enhance the effects.
Ross believes those who are worried should talk to someone they trust to help calm thoughts and focus on what can be controlled. Some may need a therapist’s help, she added.
Go with the flow
Sweeny has been studying the value of “flow states” for enduring waiting periods and called findings “very exciting.” Flow states happen when something entirely captivates attention. “It is absorbing, challenging and you’re in it and you lose yourself, you lose track of time,” Sweeny said.
Research suggests that “if you are experiencing a lot of flow, whether you’re in quarantine or you’re not, your well-being is about the same,” she said.
There’s a caveat: Thoroughly enjoying a movie or TV show, however absorbing, is not the same. Research suggests chilling out isn’t as beneficial as doing something challenging, like learning a language or creating something, she added.
Being in the flow shares traits and benefits of another calming tool, mindfulness.
A study from North Carolina State University in the journal Personality and Individual Differences found balancing living in the moment with planning for the future helps people manage daily stress and not give in to negativity.
They looked at the interplay of mindfulness and proactive coping, which corresponding author Shevaun Neupert, a psychology professor, described as “when people engage in planning to reduce the likelihood of future stress.”
Findings are applicable to the pandemic. Proactive coping helped limit the impact of daily stressors — but not on days when participants reported low mindfulness.
”Interventions targeting daily fluctuations in mindfulness may be especially helpful for those who are high in proactive coping and may be more inclined to think ahead to the future at the expense of remaining in the present,” the researchers wrote.
Rooted in now
People get tired of hearing about mindfulness, Sweeney said. Still, it works. “It doesn’t have to be some formal meditation practice. It can be as simple as taking a walk without a podcast going. Walk in silence. Ground yourself into the moment, terrifying as it is.”
A too-wistful longing for days gone by isn’t helpful. Nor is overthinking the future.
“Mental time travel can be very detrimental,’ Sweeny said. Mindfulness focuses on the present moment.
A new study in the journal Aging and Mental Health says evidence life gets better with age happens partly because older people “have the wisdom and time” to employ mindfulness practices in ways that improves well-being.
Social distancing provides others time to use it, too.
Mindfulness refers to the natural human ability to be aware of one’s experiences and to pay attention to the present moment in a purposeful, receptive and nonjudgmental way. Using mindful techniques can help reduce stress and boost positive psychological outcomes.
Apps and books teach mindful techniques. Saltz said those who aren’t tech savvy can learn to use them.
Tips for being mindful include:
- Recognize thoughts are passing through and feelings won’t last. That boosts resilience in crisis and increases optimism — even about COVID-19.
- Stay in the moment, acknowledging thoughts and surroundings, without being judgmental.
- Check out a mindfulness app. Some popular ones are Calm, Headspace, Insight Timer, Smiling Mind, and Stop, Breathe & Think. They can guide you into mindfulness.
Arnof-Fenn, despite her many worries, believes some good will come of all the hours on Zoom and Skype. She’s found routines and things she can control, easing her worries. “Maybe the silver lining is that this crisis reminds us technology does not have to be isolating; it can be used to build our real-world communities and relationships, too,” she said.
NIH’s Collins thinks that, too. On the blog, he said, “I’d predict that all of us who are living through this COVID-19 experience will look back on it as a time of special significance in terms of what we learned about ourselves and about the perspective of what really matters in this world. So, yes, it’s stressful, it’s full of grief and sorrow, but maybe it’s a way in which you can gain something to carry forward.”