Editor’s Note: Ford Vox is a physician specializing in rehabilitation medicine and a journalist who contributes frequently to CNN Opinion. Follow him on Twitter @FordVox. The views expressed in this commentary belong to the author. View more opinion at CNN.
Death lies ahead for all of us, preceded by a catastrophe or two along the way for many of us. Close calls can put the fragility of our lives into high relief, making our daily existence all the more meaningful. But this grueling slog of a pandemic strains the limits of normal resilience. And allowing your anxiety to peak can result in serious health consequences.
The novel coronavirus pandemic can make it seem impossible to look away from the storm on the horizon. And what a monster it is: Covid-19’s first wave is building into a tsunami threatening a growing number of states.
Dr. Anthony Fauci, the top infectious disease expert in the nation, says we could reach 100,000 cases daily nationwide. In these circumstances, rising stress levels are inevitable. Covid-19 has already “infected” our minds whether or not it ever enters our bodies. Now’s the time to work methodically on treating your pandemic brain.
The onrush of critical Covid-19 cases into our hospitals is of course the biggest single problem the nation faces. But for many individuals with no trace of the virus in their bodies, pandemic stress reactions are also tipping the scales toward medical catastrophe.
I’m a doctor who deals exclusively in the world of life-changing injuries, working at a large Atlanta hospital treating patients from throughout the southeastern US and beyond.
It’s not uncommon that headlines in the news are soon reflected in the folks coming through our doors, whether a scooter craze resulting in head injuries, or a mass shooting’s victims or, certainly, a rapidly spreading infectious disease. But it takes a global event like this to land such a collection of stress-related consequences at one particular hospital or with one particular doctor.
I’m used to patients reporting particularly stressful events happening at the time of the heart attacks or strokes that land them in my care. We know there’s a clear link between stress, anxiety and your cardiovascular health. Now they’re reporting business closures.
I’m seeing anxiety managed with alcohol or drugs become cardiac arrest. I’m also seeing delayed medical care with disabling consequences and reckless behaviors (another unhealthy response to stress) resulting in life-altering injury.
For every person whose stress rises to the level that they’ve suffered a heart attack or stroke, there are many more people who simply experience a barely perceptible sustained increase in blood pressure or a tiny uptick in inflammatory biomarkers circulating in the bloodstream. In time, there may be consequences.
I can’t imagine a set of prior life experiences that could fully inoculate one from worry. In any given week I see families through a loved one’s twilight states of unconsciousness and semiconsciousness, facilitating deliberations over when to push forward and when it may be time to let go.
After being saturated with such problems daily for a decade now, you might assume a global pandemic couldn’t rock my psyche much in the way of life or death fear. You’d be wrong. None of us were ready for this.
Anxiety is natural, but keeping your brain constantly plugged into a smartphone – a handheld conduit to all the world’s problems – is decidedly unnatural. “Doomscrolling” makes 2020’s anxieties synthetically supercharged.
Even with mask-wearing and avoiding crowds it’s not fully in our control when we will contract Covid-19. It’s certainly not up to us how we will fare when it takes hold.
But we have a level of control over the way we react to this new reality, where we direct our attention and for how long, and how deliberately we manage our moments. Of course, it doesn’t help that just as anxiety and depression are spiking, professional help is harder than ever to access. (Though the national suicide prevention lifeline is always available to connect people to the care they need. If you need this service, call 1-800-273-8255).
Now don’t get me wrong, just because you worry about Covid-19 does not mean you have a stroke coming around the corner. Underlying risk factors are typically required to see stress translate into a major cardiovascular event. At the same time, many adults do have some risk factors, often unbeknownst to them.
Situational factors – say the events of a pandemic or world war – are often going to be at play in whether any particular person’s stroke or heart attack happens on one given day versus another. And we’re seeing a whole lot more of these health incidents now because of the pandemic.
Washington Post data analysts pored over three months of pandemic data from five states to determine that there were 8,300 more cardiovascular disease related deaths than expected in those states.
The deaths aren’t from Covid-19 directly, but many were likely due to delayed care, and perhaps in some cases, they were the result of pandemic stress, similar to my own clinical observations.
Last week the Journal of the American Medical Association also published a data analysis suggesting that Covid-19 death counts significantly underreport the true number of deaths related to the pandemic through health impacts like these.
For every pandemic-stress related death, there are many more survivors with near-death experiences, like the patients I treat.
No doctor can prescribe that your business will breeze through what’s happening, or that you don’t lose your insurance or fall victim to the many other of the factors making lives go haywire right now. I can’t tell you to make sure no one in your family ends up in the hospital for weeks, separated and suffering.
Still, there are some things we can do to try to maintain our physical and mental well-being while accepting that no, everything isn’t alright. Doing what we can to manage our personal pandemic stress reactions, while accepting more of what we can’t change, will be one key to our survival.
The treatment I’d prescribe calls for conscious disconnection, then elective reconnection to what’s really important in your life. Manage untoward events where you realistically can do so. Let the rest wash overboard. Go data dry for a day. Build from there.
As everything moves online – our work lives, social lives, and more of our basic services, including our health care – this may seem like an impossible goal. Use some of the growing assortment of tools to help you lessen your screen time and protect all the screen-free time you can wring out of your days and weeks.
I’m trying to stick to the prescription myself, increasingly disconnecting for much of the day during weekends and hoping to continue.
Does it sound trite to recommend a hobby too? Doesn’t it also sound a little underwhelming to recommend exercise and a heart-healthy diet – especially following a heart attack?
The treatment works, however low-tech it may be. The same exercise and diet that can help your heart can also help calm your pandemic brain.
Manage your consumption of 2020’s malignant political scene in the same way that you attempt to limit your dessert intake. We can’t turn away from our democracy at these critical moments. But engage judiciously. I teach families that they have to take time for and care for themselves in order to care for their loved one. The same can be said when caring for our troubled democracy.
It’s appropriate to grieve the world and the innocence we’ve lost. And we should not underestimate the lasting effects of this stress on our health. The ripple effects here aren’t a mere “butterfly effect.” The pandemic is more of a charging hippopotamus effect. Intentionally coping with and managing the unfortunate reality, while dodging the hippo as best we can, just became part of the job description for every adult.
Survival is in question now, but in reality, that has always been the case. The ways we interact and how we do business are changing, much of it for the long term. But life has always been subject to change. Some degree of acceptance of these facts, if you can muster it, will help lower your anxiety.
Puzzles, painting, hikes, kayaking, adopting a dog, games with friends online – find whatever works to move your gaze off the storm on the horizon. For those who can afford camping trips and are boosting the RV sales around the country, that’s a great response. Same with the home exercise equipment, so long as you use it! You’ve got to be deliberate in adding new social and physical routines to your weekly mix.
What kept you healthy in 2019 won’t be good enough for the rest of 2020. So maybe add in some meditation or try mindfulness exercises. I’m not a practitioner, but agree it sounds like a good idea (I’d rather weed the garden). Whatever new activities you pick, be prepared and willing to change it up. Change is about the only thing we can count on.