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A Brain Hack to Break the Coronavirus Anxiety Cycle A Brain Hack to Break the Coronavirus Anxiety Cycle
(7 days later)
Anxiety is a strange beast.Anxiety is a strange beast.
As a psychiatrist, I have learned that anxiety and its close cousin, panic, are both born from fear. As a behavioral neuroscientist, I know that fear’s main evolutionary function is helping us survive. In fact, fear is the oldest survival mechanism we have. Fear helps us learn to avoid dangerous situations in the future through a process called negative reinforcement.As a psychiatrist, I have learned that anxiety and its close cousin, panic, are both born from fear. As a behavioral neuroscientist, I know that fear’s main evolutionary function is helping us survive. In fact, fear is the oldest survival mechanism we have. Fear helps us learn to avoid dangerous situations in the future through a process called negative reinforcement.
For example, if we step out into a busy street, turn our head and see a car coming right at us, we instinctively jump back onto the safety of the sidewalk. Evolution made this really simple for us. So simple that we need only three elements in situations like this to learn: an environmental cue, a behavior and a result. In this case, walking up to a busy street cues us to look both ways before crossing. The result of not getting killed helps us remember to repeat the action again in the future.For example, if we step out into a busy street, turn our head and see a car coming right at us, we instinctively jump back onto the safety of the sidewalk. Evolution made this really simple for us. So simple that we need only three elements in situations like this to learn: an environmental cue, a behavior and a result. In this case, walking up to a busy street cues us to look both ways before crossing. The result of not getting killed helps us remember to repeat the action again in the future.
Sometime in the last million years, humans evolved a new layer on top of our more primitive survival brain, called the prefrontal cortex. Involved in creativity and planning, the prefrontal cortex helps us think and plan for the future. It predicts what will happen in the future based on past experience. If information is lacking, our prefrontal cortex lays out different scenarios about what might happen, and guesses which will be most likely. It does this by running simulations based on previous events that are most similar.Sometime in the last million years, humans evolved a new layer on top of our more primitive survival brain, called the prefrontal cortex. Involved in creativity and planning, the prefrontal cortex helps us think and plan for the future. It predicts what will happen in the future based on past experience. If information is lacking, our prefrontal cortex lays out different scenarios about what might happen, and guesses which will be most likely. It does this by running simulations based on previous events that are most similar.
Enter anxiety.Enter anxiety.
Defined as “a feeling of worry, nervousness or unease, typically about an imminent event or something with an uncertain outcome,” anxiety comes up when our prefrontal cortexes don’t have enough information to accurately predict the future. We see this right now with coronavirus.Defined as “a feeling of worry, nervousness or unease, typically about an imminent event or something with an uncertain outcome,” anxiety comes up when our prefrontal cortexes don’t have enough information to accurately predict the future. We see this right now with coronavirus.
Scientists are racing to study the characteristics of the coronavirus so that we can know precisely how contagious and deadly it is — and act accordingly. Uncertainty abounds.Scientists are racing to study the characteristics of the coronavirus so that we can know precisely how contagious and deadly it is — and act accordingly. Uncertainty abounds.
Without accurate information, it is easy for our brains to spin stories of fear and dread.Without accurate information, it is easy for our brains to spin stories of fear and dread.
In addition to being fueled by uncertainty, anxiety is also contagious. In psychology, the spread of emotion from one person to another is aptly termed social contagion. Our own anxiety can be cued or triggered simply by talking to someone else who is anxious. Their fearful words are like a sneeze landing directly on our brain, emotionally infecting our prefrontal cortex, and sending it out of control as it worries about everything from whether our family members will get sick to how our jobs will be affected.In addition to being fueled by uncertainty, anxiety is also contagious. In psychology, the spread of emotion from one person to another is aptly termed social contagion. Our own anxiety can be cued or triggered simply by talking to someone else who is anxious. Their fearful words are like a sneeze landing directly on our brain, emotionally infecting our prefrontal cortex, and sending it out of control as it worries about everything from whether our family members will get sick to how our jobs will be affected.
Wall Street is a great example of social contagion: We watch the stock market spike and crash, the stock indexes being a thermometer for how feverish our collective anxiety is at the moment. Wall Street even has something known as the Fear Index, or VIX, which outstripped the 2008 financial crisis this week.Wall Street is a great example of social contagion: We watch the stock market spike and crash, the stock indexes being a thermometer for how feverish our collective anxiety is at the moment. Wall Street even has something known as the Fear Index, or VIX, which outstripped the 2008 financial crisis this week.
When we can’t control our anxiety, that emotional fever spikes into panic. Panic is defined as “sudden uncontrollable fear or anxiety, often causing wildly unthinking behavior.” Overwhelmed by uncertainty and fear of the future, the rational parts of our brains go offline. Logically, we know that we don’t need a six-month supply of toilet paper, but when we see someone’s cart piled high, their anxiety infects us, and we go into survival mode.When we can’t control our anxiety, that emotional fever spikes into panic. Panic is defined as “sudden uncontrollable fear or anxiety, often causing wildly unthinking behavior.” Overwhelmed by uncertainty and fear of the future, the rational parts of our brains go offline. Logically, we know that we don’t need a six-month supply of toilet paper, but when we see someone’s cart piled high, their anxiety infects us, and we go into survival mode.
So how do we not panic? Too many times, I’ve seen my anxious clinic patients try to suppress or think themselves out of anxiety. Unfortunately, both willpower and reasoning rely on the prefrontal cortex, which isn’t available at these critical moments. Instead, I start by teaching them how their brains work, so that they can see how uncertainty weakens the brain’s ability to deal with stress, priming it for anxiety when fear hits.So how do we not panic? Too many times, I’ve seen my anxious clinic patients try to suppress or think themselves out of anxiety. Unfortunately, both willpower and reasoning rely on the prefrontal cortex, which isn’t available at these critical moments. Instead, I start by teaching them how their brains work, so that they can see how uncertainty weakens the brain’s ability to deal with stress, priming it for anxiety when fear hits.
But this is only the first step.But this is only the first step.
To hack our brains and break the anxiety cycle, we need to become aware of two things: that we are getting anxious or panicking and what the result is. This helps us see if our behavior is actually helping us survive, or in fact moving us in the opposite direction — panic can lead to impulsive behaviors that are dangerous; anxiety is both acutely mentally and physically weakening and a slow burn that has more long-term health consequences.To hack our brains and break the anxiety cycle, we need to become aware of two things: that we are getting anxious or panicking and what the result is. This helps us see if our behavior is actually helping us survive, or in fact moving us in the opposite direction — panic can lead to impulsive behaviors that are dangerous; anxiety is both acutely mentally and physically weakening and a slow burn that has more long-term health consequences.
Once we are aware of how unrewarding anxiety is, we can then deliberately bring in the “bigger better offer.” Since our brains will choose more rewarding behaviors simply because they feel better, we can practice replacing old habitual behaviors — such as worry — with those that are naturally more rewarding.Once we are aware of how unrewarding anxiety is, we can then deliberately bring in the “bigger better offer.” Since our brains will choose more rewarding behaviors simply because they feel better, we can practice replacing old habitual behaviors — such as worry — with those that are naturally more rewarding.
For example, if we notice that we have a habit of touching our face, we can be on the lookout for when we act that behavior out. For example:For example, if we notice that we have a habit of touching our face, we can be on the lookout for when we act that behavior out. For example:
If we are starting to worry: “Oh no, I touched my face, maybe I’ll get sick!”,If we are starting to worry: “Oh no, I touched my face, maybe I’ll get sick!”,
Instead of panicking, take a deep breath and ask: “When was the last time I cleaned my hands?”Instead of panicking, take a deep breath and ask: “When was the last time I cleaned my hands?”
Think. “Oh, right! I just washed my hands.”Think. “Oh, right! I just washed my hands.”
Just by taking a moment to pause and ask the question, we give our prefrontal cortex a chance to come back online and do what it does best: think.Just by taking a moment to pause and ask the question, we give our prefrontal cortex a chance to come back online and do what it does best: think.
Here, we can leverage certainty: If we’ve just washed our hands, and haven’t been out in public, the likelihood that we’re going to get sick is pretty low.Here, we can leverage certainty: If we’ve just washed our hands, and haven’t been out in public, the likelihood that we’re going to get sick is pretty low.
Updated June 24, 2020 Updated June 30, 2020
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
The more we can see the positive feeling and effects of good hygiene and compare them to the negative feeling of uncertainty or getting caught in anxiety, the more our brains naturally move toward the former, because it feels better.The more we can see the positive feeling and effects of good hygiene and compare them to the negative feeling of uncertainty or getting caught in anxiety, the more our brains naturally move toward the former, because it feels better.
How do I know this works? My lab has studied these mechanisms for decades. We’ve recently found that simple awareness training (delivered through an app) can reduce anxiety by 57 percent (in a study with anxious physicians) to 63 percent (in a study with people with generalized anxiety disorder) in two to three months.How do I know this works? My lab has studied these mechanisms for decades. We’ve recently found that simple awareness training (delivered through an app) can reduce anxiety by 57 percent (in a study with anxious physicians) to 63 percent (in a study with people with generalized anxiety disorder) in two to three months.
Understanding these simple learning mechanisms will help all of us “keep calm and carry on” (which is how London dealt with the uncertainty of constant air raids in World War II) instead of getting caught in anxiety or panic in the coming days, and whenever we face uncertainty.Understanding these simple learning mechanisms will help all of us “keep calm and carry on” (which is how London dealt with the uncertainty of constant air raids in World War II) instead of getting caught in anxiety or panic in the coming days, and whenever we face uncertainty.
When our prefrontal cortex comes back online, we can compare anxiety to what it feels like to be calm. To our brains, it’s a no-brainer. It simply takes a little practice so that the bigger, better offers become new habits.When our prefrontal cortex comes back online, we can compare anxiety to what it feels like to be calm. To our brains, it’s a no-brainer. It simply takes a little practice so that the bigger, better offers become new habits.
Judson A. Brewer is an associate professor at Brown University and the author of “The Craving Mind.”Judson A. Brewer is an associate professor at Brown University and the author of “The Craving Mind.”