Anxiety is a normal part of life; in fact, if we had no mechanism in our brain to make us feel fear when we perceive danger, we wouldn’t live for long.

We are anxious when we feel unable to protect and defend ourselves, when we don’t know how to cope with the situations and stresses in our lives that feel like they put us in danger. Sometimes we are in danger, and sometimes our fears are exaggerated, and dangers are misperceived; either way, we are afraid.

When anxiety becomes chronic and unmanageable, and interferes with our activities and relationships, we have an anxiety disorder, and our catastrophic thoughts and physical symptoms are miserable to endure. The “fight or flight” part of our brain sends chemicals into our body to prepare us for the enemy; but when there is actually no enemy we can fight or flee, the chemicals just make us nervous and restless; our muscles become tense; we develop headaches and other pains; we can suffer nausea, stomach cramps, diarrhea. Sometimes we panic, and feel that we are losing control, and think we will pass out, or even die. Our heart races; we breathe rapidly, and feel like we can’t get our breath; we tremble; we sweat; we feel weak and dizzy. We can’t sleep, and have nightmares; we eat excessively to soothe ourselves, or lose our appetite all together. We have difficulty focusing, thinking clearly, remembering, and problem-solving. Sometimes we develop obsessive or compulsive symptoms in an effort to manage our fears. Usually we do all we can to avoid what is scaring us; and the more we avoid, the smaller our lives become.

The hormones produced in chronic anxiety, combined with its effects on sleep, can create or contribute to multiple physical illnesses, directly or indirectly, through chemical changes that can reduce immune function, increase cardiovascular, respiratory, and gastrointestinal dysfunction, and provoke pain syndromes. Attempts to self-medicate to reduce anxiety are a major cause of substance abuse and addiction.
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Here’s the good news: excessive anxiety is something we know how to treat. Medications can help, but medications can have side effects, and some are addictive and have long-term negative consequences. The best news is that mountains of research and years of clinical experience have demonstrated clearly that cognitive-behavioral therapy is an effective treatment for anxiety disorders. Interventions such as cognitive and imaginative restructuring, behavioral response-prevention, mindfulness and meditation, and bodily focused protocols for breathing, relaxation, exercise, rapid temperature change, and bilateral stimulation can all be effective for both short-term and long-term anxiety management.

Learning to successfully manage anxiety, like all learning, takes time and practice. Today there is a lot of help available, much of it through apps and digital programming, as well as in psychotherapy, and using these easily available resources can greatly speed therapeutic progress. The reward of such therapeutic work and learning is living a life free of chronic fear, free of needless limitations, free of the risks of anxiety-driven illness and substance abuse.

The multiple stresses and consequent anxiety associated with our living through the Covid-19 pandemic have the potential for creating long-term psychological and physical damage in all of us well beyond the disease itself. But knowing how to manage stress and anxiety during this time will provide real protection for ourselves and our families.