In Part I, “Why Am I So Anxious About The Coronavirus and COVID-19 Pandemic?” I showed how Productive Worry is useful, but Non-Productive Worry can easily lead to anxiety during the COVID-19 Pandemic.
Part II: “I Know I’m Just Anxious, But This Must Be What COVID-19 Feels Like”
Anxiety is experienced both emotionally, and physically. A lot of people right now are experiencing serious anxiety for the first time, or experiencing anxiety more intensely than they have previously. The COVID-19 Pandemic has changed all the rules. A very brief, simplified look at the neuroscience of anxiety can help us understand what’s going on. Anxiety is “produced” by the amygdala, a small organ in the brain (two of them, actually) whose purpose is simple: the role of the amygdala is to attach emotion to experiences and events, which gives us memories with emotion.
What Does the Amygdala Do?
When discussing anxiety, it’s simpler; think of the amygdala as having one job: assess danger, initiate “Fight-Flight-Freeze” response. In its most basic form, anxiety is produced in the brain in one, or both of, two ways.
Two Ways Anxiety Gets Triggered:
- “Bottom up” triggering, where our perceptions (visual, auditory, etc.) go straight to the amygdala.
- “Top Down” triggering, where perceptual input goes through the cortex (thinking part of brain), and then signals are sent to the amygdala.
An example of “bottom up” triggering would be if you were walking along a path, and suddenly saw a rattlesnake: an instantaneous response would be triggered with no thought whatsoever, activating the flight-fight-freeze circuitry.
An example of ‘top down” triggering would be anxiety that is influenced by our thoughts. For example, someone who is afraid of cats, based on an earlier negative experience. This type of triggering responds more readily to psychotherapy.
How Does the Amygdala Cause Anxiety and Panic?
Something to keep in mind when working on managing your anxiety is that the cortex has few connections directly to the amygdala, but the amygdala has many to the cortex. Sounds confusing, but what this means is that the amygdala has an easier time signaling the cortex than the cortex does to signal the amygdala. It’s easier for the fight-flight-freeze to get triggered emotionally before we can appraise the danger of the situation cognitively. It’s harder for your cortex to influence the amygdala to stop the triggering of the fight-flight-freeze response.
What Happens When the Amygdala is Triggered?
As was mentioned earlier, the amygdala has one basic purpose: prepare us for danger. Fight or flight. How does it do that? The amygdala seems to come prepackaged for most people with some basic fears: spiders, the dark, etc. The amygdala also adapts quickly, a child who gets bitten by dogs a couple times will quickly develop a fear. Regardless, the amygdala is wired to be your body’s alarm system. Instead of sounding an auditory alarm, it signals you through body sensations. Also, the amygdala makes mistakes, not always attaching the correct emotions to the event.
Let’s look at how the fight-flight-freeze response being triggered sends confusing physical sensations.
Brain Racing: Danger requires quick, flexible thinking. When triggered, this can cause you to overly focus on the anxiety provoking situation and ignore other sensory input.
Shallow, Quick Breathing: Breathing quickly brings more oxygen into the body, which is useful if you need to run or fight. If you don’t this can lead to feeling lightheaded, or dizzy.
Tunnel Vision: When facing danger, it’s important to be able to focus on the danger, and to block out other stimuli.
Digestion Shuts Down: When facing a dangerous situation, your body shuts down non-essential functions, so more resources (energy) can be sent to the muscles to respond.
The amygdala signals the body to release adrenaline, to get the body revved up for action. This can be experienced as:
- Nausea, or “butterflies” in the stomach.
- Dry mouth.
- Racing heartbeat: your heart does beat faster, in order to pump more oxygen rich blood to your muscles.
- Hands, feet get cold: blood is diverted, through blood vessels contracting, to the muscles.
- Sweaty palms: the body sweats to help cool off, which increases physical stamina.
- Need to urinate: muscles relax, you’ve heard of “getting so scared you pee yourself”
- Muscles get tense: Your body getting ready for instantaneous action if required.
Anxiety In the Age of COVID-19 and Quarantine
When I ask clients to describe to me how they physically experience their anxiety, they generally start with “butterflies in the stomach.” If you’ve ever observed someone having an anxiety attack, they frequently appear to be hyperventilating and show signs of muscle tightening, racing heartbeat, and inability to focus thoughts.
The Amygdala Makes Mistakes Sometimes
To someone who does not experience intense anxiety regularly, many of these symptoms appear to overlap with both the real, (1-2% chance of death) and perceived (toilet paper shortage!) symptoms of COVID-19. If you are anxious about whether you have “symptoms”of a potentially life threatening disease that has still unknown early symptoms, you may be panicked by the presence of rapid, shallow breathing.
The Vicious Cycle of Health Anxiety
Let’s put this all together, and look at an example of what might be happening to us if we’re having a panic attack about Coronavirus or COVID-19 illness.
In this example, the anxious person gets the thought in their head that they’re not being told the truth, and that the COVID-19 Pandemic is much worse than they’re being told. When they are unable to resolve that thought in their mind, it is perceived as a threat. The amygdala does it’s job, lighting them up with adrenaline. Those physical cues, coupled with the runaway thought of imminent death, causes an immediate panic attack, that validates that the individual is surely going to die. This is so frightening that it increases the sense of panic. In short, our automatic fight-flight-freeze response gets misinterpreted as the very thing we fear.
Mental Health Resources for Coronavirus and COVID-19
- https://www.nimh.nih.gov/about/director/messages/2020/coping-with-coronavirus-managing-stress-fear-and-anxiety.shtml
- https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/share-facts.html
- https://www.cdc.gov/coronavirus/2019-ncov/prepare/prevention.html
