As death tolls rise from the global spread of a novel coronavirus, I have observed an increase in anxiety among my patients. I am writing this article to provide physicians with tips on how to help their patients cope with anxiety from the coronavirus. 1. Validate their anxiety To some degree, an increase in anxiety is appropriate under the current circumstances. Anxiety increases when we are confronted with threats to our wellbeing. The coronavirus constitutes such a threat. From an evolutionary standpoint, the human brain is not designed to make us happy. It is designed to protect us by looking for threats. The brain keeps us on guard by creating “what if” hypothetical scenarios and anticipating negative outcomes. This is how we survived as a species. Patients find it helpful when I validate their emotional experience to the current pandemic. Validation conveys the message that “You are not alone. It is OK to have a spike in anxiety.” 2. Employ empathy Empathy is the ability to stand side by side with your patients and understand their concerns from their point of view. Feeling understood is therapeutic. It allows people to open up, be authentic, and trust you with their concerns. In order to understand a patient’s perspective, I like to ask, “What do you find most worrisome about the current situation?” The list of responses is endless. Some of my patients are most worried about being infected and dying from the virus. Some are worried about the wellbeing of their loved ones and have an intense desire to protect them. Many are worried about losing their jobs and financial catastrophe. I have had patients express fear that there will be a national food shortage. Remember that patients may have different worries about the pandemic. It is important to understand their individual concerns. 3. Reduce uncertainty Patients often experience spikes in anxiety when they are uncertain about the likelihood of a potential outcome. Anxiety can be reduced if they understand the odds that their fear will become reality. For example, let’s imagine that you identify a lump on a patient. They will experience a different level of anxiety if you reassure them that the mass has a 1 percent probability of being cancer compared to telling them there is a 90 percent probability that the mass is cancer. The CDC has published a study that shows the outcomes among patients infected with the coronavirus. Patients find it helpful when I share data on the risk of mortality or hospitalization. 4. Focus within their sphere of control The continued coverage over the spreading coronavirus can make patients feel helpless and powerless. They may feel that taking any action is futile because life is out of control. Help patients focus on taking action within their sphere of control. For example, they can focus on taking the necessary precautions to promote their safety and protect their loved ones. Taking such precautions does not only lower their odds of infection. It can also give them a sense of control over the potential threat. Some of my patients have made cloth face coverings to help reduce the spread of the coronavirus. This is a great example of focusing on one’s sphere of control while making a positive contribution to the greater community. 5. Increase “the dose” of their coping skills As physicians, our intent is to reduce suffering. We are accustomed to taking action, such as increasing the dose of a medication to treat physical or mental health symptoms. Let us use the same mindset and encourage our patients to increase the dose of their coping during this challenging period. For example, if your patient typically exercises three times per week, you may encourage them to exercise an extra day to better cope with anxiety. If they normally practice deep breathing exercises in the morning and at night, they may consider adding a third session during lunch. 6. Limit media consumption Remind your patients that the media is in the business of making money. Their goal is to earn ratings. The media may not always present the news objectively but in a manner that elicits an emotional reaction. As the saying goes, “Sensationalism Sells.” Encourage your patients to follow credible sources such as the CDC or their health care provider. Finally, if their anxiety symptoms are interfering with their daily functioning, you may consider making a referral to a local mental health provider. We are here to help. Dimitrios Tsatiris is a psychiatrist and can be reached on Twitter @DrDimitriosMD. Source
