By now, the coronavirus and COVID-19 are probably on your mind and the minds of everyone you know. People’s responses to the perceived threat are wide-ranging from dismissive to measured concern to outright panic. If you are in the latter category and struggling to cope both with what you know and all that you do not know about the coronavirus and the resulting illness, COVID-19, please read on.
 
What is panic?
 
Panic is an abrupt surge of intense fear with at least four of the following symptoms:

• Palpitations, pounding heart, or accelerated heart rate.
• Sweating.
• Trembling or shaking.
• Sensations of shortness of breath or smothering.
• Feelings of choking.
• Chest pain or discomfort.
• Nausea or abdominal distress.
• Feeling dizzy, unsteady, light-headed, or faint.
• Chills or heat sensations.
• Numbness or tingling sensations.
• Derealization (feelings of unreality) or depersonalization (being detached from oneself).
• Fear of losing control or “going crazy.”
• Fear of dying.

 
Does panic help?
 
Panic can be helpful in a very limited number of circumstances. Psychologically, humans have two systems that we use in decision-making—an intellectual system and an emotional system. Generally, we make the best decisions when we utilize data from both systems. This is not the case when your physical survival is on the line.
 
Many of you have probably heard the saber-toothed tiger origin story behind the evolution of the panic response. To summarize it, when your ancestors stood in the wilderness and laid eyes on a saber-toothed tiger who also had eyes on them, time spent standing there and weighing out the best options for a response could make the difference between those who did and those who did not survive an attack. In the case of staring down a tiger, survival depends on a more efficient system of decision-making.
 
Panic is that system. Panic mobilizes your body and bypasses the part of your brain responsible for methodical, deliberate reasoning. Instead of giving you the full menu of response options that you usually have, the panic system boils down your options to fight, flee, freeze, or faint. In modern times, rarely is there a saber-toothed tiger, but for folks with internal emergency alert systems that go off more easily, panic and its limited menu of possible responses are all too familiar.
 
Panic is not problem-solving
 
One of the lies that we tell ourselves about what we’re doing while we’re in a state of panic is that we are taking steps to solve the problem. Our ability to panic is designed to be a shortcut—one that intentionally short circuits the intellectual system and is activated by a momentary state of fear. When you panic, you lose access to 50% of your capacity to make good decisions.
 
The thing to remember is that despite panic’s utility in helping you react to a physical attack, emotional and psychological wellbeing requires the ability to respond—a behavior that involves mobilizing the intellectual system that panic is actively working to deactivate.
 
From a state of panic to a place of calm
 
Once you’re in a state of panic, the name of the game is to get back to a calmer place. Until you do that, any efforts at problem-solving will be hijacked by the panic response. Any decision you make from a panicked place will be about alleviating fear but possibly at the expense of making a good choice. The first step to getting back to calm is to acknowledge and accept this truth. Unless the danger before you is something that you can literally fight, hide from, or run away from, then the panic response is not going to help you.
 
As a side note, there are going to be times when you must make a decision despite being panicked. In those circumstances, your only option is to get through the moment as best you can and then give yourself a healthy dose of self-compassion in the aftermath.
 
When you’re panicked and trying to problem-solve, start by reminding yourself:

• Now is not the time for problem-solving.
• Once I am calm, I will look for solutions.
• My only job, right now, is to address the panic.

 
If you are already working with a therapist to overcome panic, then put into place any plan of action that you’ve discussed, otherwise, you might try:

• Getting some cardio: If it is medically safe to do so, get your heart rate up. Aerobic exercise can have anti-anxiety effects. Experts vary in their recommendations for the required duration to receive these benefits, so aim for at least 15-20 minutes.
• Distracting yourself with something non-triggering: Avoiding the source of your anxiety is not a good long-term strategy for overcoming an anxiety disorder, but distractions can help you survive the moment. Try re-reading a book that made you feel good. Listen to upbeat music that you can dance and sing along to. If you’re alone, play a game that requires some concentration (like Sudoku) or get out a board game and play with your roommate.
• Limiting your exposure to triggering things: You may find yourself listening obsessively to the news, reading through worried posts on Facebook, or talking only about the coronavirus. Try setting a time limit for such exposures. Consider no more than 30 minutes each day reviewing updates from a small number of trusted sources.
• Scanning through your senses: In the midst of a panic attack, get grounded by identifying: 5 BLUE things that you can see; 4 things that you can feel (tactile/physical sensations—not emotions); 3 sounds that you can hear; 2 things that you can smell; and 1 thing that you can taste.
• 4-7-8 breathing: Inhale through your nose for a brisk count of 4. Hold your breath for another count of 7. Exhale through your mouth for a count of 8. Repeat until your body starts to relax. If you feel dizzy, try this while lying down.
• Taking a warm bath or shower: Use your favorite pampering products and focus on the soothing sensations. Engage your senses in order to move you from your mind and back into your body.
• Counting backwards from 10,000: If your thoughts are racing or you can’t stop yourself from returning again and again to the same thought, put your mind to work on something else. As you count backward, if your mind wanders, gently bring it back. If you forget the last number you were on, just pick a number in the vicinity of where you left off and start again. If this is too simple, count backward by 7’s.
• Calling a friend or family member who is good at staying calm: Reaching out can help soothe one’s anxieties, but the key here is to talk with someone who is not prone to anxiety. Talking to a similarly anxious friend or family member can result in what we call “co-rumination” and wind up increasing, rather than decreasing, your anxiety.

 
Returning to the problem
 
Once you have truly regained a sense of calm, you may feel less urgency to go back to problem-solving. Be careful that you don’t fall into the trap of avoiding topics that deserve your attention because you are afraid that you may panic by thinking of them again.
 
Try to gently revisit one area of concern and ask yourself if there something that you can do about it, right now. If not, make an agreement with yourself to set that problem aside. Do this with each problem that you identified and take action where you can.
 
When more help is needed
 
If you need more help, consider contacting a mental health professional who offers HIPAA-compliant telehealth services for support. The Emergency Response Plan that I use with my clients is posted on this website under Resources. Feel free to use the resources there, as well.
 
Reference

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.