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How to Handle Anxiety During COVID-19 

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT
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Wherever you live, you are likely experiencing the impact of coronavirus. Schools and non-essential businesses are probably closed. Restaurants, theme parks, libraries, movie theaters: same. As of this writing, COVID-19 has already affected the health and lives of millions of people around the world. It’s already claimed the lives of more than a thousand people in the USA alone.

In addition to our physical health, there’s another aspect of life coronavirus affects: our mental health. Every passing day brings more bad news, restrictions, and travel bans for the U.S. and the rest of the world.

It’s no surprise that anxiety is skyrocketing. We’re worried about our health, we’re worried about our jobs, we’re worried about the economy – we’re worried about everything.

So how do we deal with all this worry and anxiety?

How do we help our teens – and ourselves – cope with all our tumultuous emotions in this time of uncertainty?

Alyson Orcena, LMFT, Executive Clinical Director of Evolve Treatment Centers, has some valuable tips.

Some Anxiety is Good

First, she clarifies, a measure of anxiety right now is normal and necessary.

“In order to be safe in the current situation, you need to be somewhat anxious,” Orcena says. “No anxiety would be a problem right now. People who aren’t the least bit anxious may be endangering themselves, their families, or their communities.”

Because it’s anxiety that motivates you to wash your hands when you walk in the door. It’s anxiety that keeps us from hugging our friends. And anxiety also motivates us to adhere to government and public health guidelines. A measure of anxiety is necessary in order to protect ourselves and our families during this pandemic. A lack of anxiety might mean you’re not keeping yourself – or your community – safe.

When Anxiety Does Not Help

On the other hand, too much anxiety can become debilitating.

“If your teen is in a constant state of panic, that’s worrisome,” Orcena says. “When you become too anxious or emotional, you stop trying to become strategic. Instead, you become hopeless.”

Let’s take social distancing as an example. As of this writing, government mandates have asked Americans to shelter in place unless they’re going out for essential needs like food or medicine.

But if your teen struggles with overwhelming anxiety, they may be too scared to leave the house at all – even for the noted exceptions. That’s when anxiety becomes a problem.

“If we’re too afraid to go out at all, or live within the allowances granted, we can also start doing harm to ourselves,” Orcena says. “Complete isolation and seclusion for weeks on end may lead to severe mental health issues like major depression. Unless your teen has coronavirus or is under quarantine, staying inside all day every day for months isn’t healthy or safe.”

Too much anxiety can also harm others. For example, a teen whose anxiety reaches debilitating levels might start engaging in obsessive-compulsive behaviors such as hoarding. “At this point, the anxiety might have shifted from the protective/productive range to the dangerous range, because if your teen has bought out the entire stock of hand sanitizer they’re not leaving any for the rest of the community.”

So how do we stop ourselves, and our teenagers, from getting too anxious?

The First Step

Orcena says the most important skill she can suggest right now is acceptance. She says many people are in a state of distress and debilitating anxiety because they simply don’t want the current state of things to be the new truth.

“The very first step in coping with this reality is accepting the fact that it is the new reality. Many people, including your teenagers, may not want it to be true. But until we accept that this is the new normal, we’re going to be in pain. The more we resist, the more anxious, angry, and hopeless we become.”

It sounds simple, but it could be difficult for some. Orcena says reaching this point of acceptance (or Radical Acceptance, as it’s called in Dialectical Behavior Therapy) may, for some teens, require going through the various stages of grief.

She clarifies, though, that acceptance doesn’t mean the same thing as happiness. You and your teen don’t have to be happy about the fact that schools are closed, parties are canceled, and you can barely leave the house. But you do need to accept that this is the current state of reality.

“Acceptance doesn’t mean approval,” Orcena clarifies.  “It just means accepting that this is the way things are today—even if we don’t like it.”

At the same time, make sure to validate disappointments: your own and your teenagers’. Very likely, your teen will be extremely upset that school has been closed for the rest of the year, or that they won’t have prom or graduation. Empathize: don’t brush their feelings aside.

After You Accept, Adapt

Once you accept the new normal, then you can adjust and adapt your life to reality. Orcena recommends a number of strategies to help teens (and parents) cope in the following weeks and months.

  1. Mindfulness. Teens with anxiety can benefit from practicing mindfulness skills, but so can the general public. Orcena points to free online resources and tools for helping teens learn how to practice deep breathing and meditation. “It’s not uncommon for everyone right now to have moments of panic, but teens with preexisting anxiety or mental health issues are especially at risk. Meditation can help soothe panic the body and calm the mind.” One of Orcena’s favorite meditations in Dialectical Behavior Therapy is called the Loving Kindness Meditation. “It’s a way of wishing yourself and others well, especially at times when you are feeling helpless.” Which is why it’s a perfect meditation to practice for the next few months.
  2. Check the Facts. Some might feel it’s the end of the world. But it’s not: there are just new rules for how to live, for now. When your teen engages in catastrophic thinking, remind them to Check the Facts. Reputable public health agencies like the Centers for Disease Control (CDC) and World Health Organization (WHO) have established safety protocols that everyone can follow to stay healthy and contain the virus. Encourage your teen to read these reports. Staying informed with the help of reputable, trusted sources – and learning how to take safety precautions to minimize the risks of danger – can help keep anxiety at bay.
  3. Create a safety plan. After your teen is informed of all the risks and ways to mitigate them, help them figure out their own safety processes. Will they use gloves when they leave the house and go grocery shopping? Do they prefer Lysol wipes to open doors outside, or will they just rub their hands with sanitizer immediately afterward? The process of creating a safety plan may cause anxiety while they’re doing it, but after they’re done, it will be calming. Once they have their plan in place, they don’t need to spend precious mental energy worrying about how to stay safe: they already know what to do.
  4. Come up with a routine. During times of uncertainty, creating a daily schedule can be very centering for your teen – and for you. “By creating that structure, you’re able to control your limited environment. Will you wake up and do some running on a treadmill before you start work? What time will you have lunch? Do they want to pencil in some time to Facetime family every day?” Create a daily schedule that works for everyone, and stick to it: that can the stability that eases your anxiety when the situation outside your door seems to change every day.
  5. Plan for the longterm, just in case. Orcena recommends parents create a long-term plan for riding out the pandemic. “Every household needs to take a moment to pause and figure out a long-term plan for how to survive this time. Who will cook? who will do grocery shopping? If you have young children, how will you divide your shifts caring for them? These are decisions you can control when everything else feels out of control.” If you don’t end up needing the long-term plan, that’s great. But if you do, you’ll have one ready when you need it.
  6. Limit media consumption. Though teens might become very attached to their devices now that they have no in-person contact with their friends, encourage them to minimize their media consumption if the news triggers their anxiety. “A constant feed of info can keep terrorizing an anxious teen,” Orcena says. On the other hand, some teens find that social activism can decrease anxiety. For example, if your teen finds it calming to disseminate information to friends and family about safety precautions (e.g. handwashing technique videos) or share online appeals for more personal protective equipment for healthcare workers, let them continue. Contributing to the community can be cathartic, and it’s a great way to channel pent-up energy.
  7. Remember to laugh and have fun. Having fun when you’re in a state of panic might sound difficult, but once a teen accepts the new reality it becomes easier. Orcena suggests teens try their best to live life as normally as possible despite the concerning circumstances. Everyone should find something that brings them joy, that, obviously, they can do at home. Whether it’s spending more time on a favorite hobby or learning a new trade, there are countless ways you can keep busy and have fun during the pandemic

When Anxiety Causes Paralysis

You might be reading this list and thinking none of our suggestions will work – because you’re too panicked.

Or maybe your teen is in a state of paralysis due to their overwhelming fear and anxiety about coronavirus.

Whereas reasonable anxiety leads to productivity, catastrophic anxiety becomes debilitating. It can shut you down.

“If you find yourself becoming paralyzed by your anxiety, and it’s not helping you to take action but instead keeping you stuck and overwhelmed, that’s when you need to get help,” says Orcena.

Enlisting the support of mental health professionals can help your teen tell the difference between catastrophic thoughts and reasonable thoughts.

Examples of catastrophic thoughts include:

  • There’s no way to do this safely
  • I’m hopeless
  • The world is coming to end
  • I can’t survive

Examples of reasonable thoughts:

  • I don’t like this new way of doing things
  • It’s hard to live like this.
  • I’m disappointed.
  • There are risks, and I can take safety precautions to minimize those risks.

With the help of mental health professionals, your teen can learn to identify their own catastrophic thoughts and transform them into reasonable ones. For example, through Dialectical Behavior Therapy, teens can learn how to reframe a thought like “I’m never going to survive this pandemic,” to “This Is a painful time, and I can take measures to minimize the risks.”  Mental health professionals can also teach your teen ways to channel their anxiety or depression into appropriate, reasonable action instead of distressing thoughts and emotions.

Just in Case: Tips for Teens

During extreme moments of panic, your teen can also learn distress-tolerance strategies to calm down.

Here are several that work very well:

  • A cold shower
  • Going for a walk (if local rules allow)
  • Deep breathing
  • Holding fuzzy blankets
  • Smelling soothing essential oils, like lavender

Therapists use these techniques with anxious teens all the time. They seem simple, but they’re effective. They can all help your teen during moments when their anxiety becomes paralyzing – and here’s a secret: they can help you, too.

Our Behavioral Health Content Team

We are an expert team of behavioral health professionals who are united in our commitment to adolescent recovery and well-being.

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