Dr Louis Awerbuck

Dr Louis Awerbuck

Clinical Psychologist Stellenbosch

Understanding General Anxiety in the time of COVID-19

The experience of anxiety has many names. Being stressed, tense, worried, anxious and “on the edge” (amongst others) are all descriptors of a specific process occurring in your body as a reaction to perceived threat. The term that is generally used to describe this process, namely “anxiety”, can be confusing to some as it suggests an emotional experience. Although the experience of anxiety/stress/worry certainly leads to certain emotions, it is not emotional in its origin. Being stressed, even only slightly, always starts as a physiological reaction. It starts in the body.

The origin of the stress-reaction is directly related to the well-known concept of fight-or-flight. The fight-or-flight reaction developed through an evolutionary process designed to protect mammals in order to survive. As primitive cave dwellers literally had very small brains and limited thinking power, they could not interpret their environment in order to protect themselves from harm. For example, they could not learn that certain dinosaurs were not carnivorous and therefore did not need to be avoided. Cave dwellers were dependent on their physiological flight-or-fight mechanisms to instantly prepare their bodies to fight danger, or in the case of the dinosaurs, to hopefully run away. The fight-or-flight reaction is governed by a certain part in our brains (amygdala), an area which is also responsible for interpreting fear and danger. When danger is perceived, this area instantly causes muscles to contract, pupils to widen, adrenaline to be secreted and heart rate to increase in order to get maximum oxygen to the muscles via blood flow.

It is clear how physiological fight-or-flight programming is to our advantage. It has enabled us as humans to survive past the cave-dwelling era. However, we have also developed the mental ability to think and to interpret, which enables us to constantly anticipate life’s dangers. In modern life, the dinosaurs have been replaced with threats like financial problems, relationship conflict, and struggling with finding meaning in life. Because we can interpret and understand, our bodies react to the perceived danger (stressors or threats) and subsequently the plight of modern man has quickly become the constant entrapment in a fight-or-flight mode. Statistics reflect that the experience of physical anticipation, i.e. a constant, vague feeling that something bad is going to happen (general anxiety) is rapidly becoming the illness of our time. The mental and physical impact is devastating, and almost always goes hand in hand with depression. In this regard, general anxiety can be seen as an engine that is constantly on high revolutions – it starts wearing down the body (via excessive secretion of blood sugar, cortisol and adrenaline) and has become the biggest cause of disability in the world.

Add the occurrence of COVID-19 to the list of life’s pressure and challenges, and the result has been an increase of millions of people’s fight-or-flight response. From an evolutionary standpoint we have a better chance to survive if we are in control of our environment. If we feel in control of life around us, we feel we understand how life works, and we have a sense of certainty that we can more or less predict what will happen in general. The sudden occurrence of a pandemic like COVID-19 is a harsh reminder that we actually are not in control of our environment and that unexpected things can happen at any moment. The fact that we are not really in control is a fact that does not sit easy with humans, as it provokes excessive anxiety about what might happen (fight-or-flight).

Especially during this period of COVID-19, we are therefore once again forced to embrace the well-known cliché: “focus primarily on only controlling what you can control”. Although it is easier said than done, it is imperative for the sake of our physical and mental health to aid and teach our bodies to not adhere to unnecessary fight-or-flight reactions. A visit to your GP, resulting in the prescription of simple medication, could lead to relief of intense anxiety symptoms. Focusing on breathing exercises, as well as relaxation therapy or meditation, have been proven antidotes to the physiological grip of anxiety.

Fighting general anxiety is fighting unnecessary fight-or-flight reactions and is therefore possible to achieve. Many people live fairly stress-free lives by managing their diet, lifestyle, physical health, and especially by practicing intensive meditation or yoga. Even a slight effort produces results. No vehicle lasts without maintenance, and the principle applies to the human body as well. The price to pay for low physical maintenance is being more vulnerable to the side-effects of increased fight-or-flight reaction in modern life.

Author: Dr Louis Awerbuck

Clinical psychologist