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Ask an Expert: What Is Fueling Pandemic Anxiety?

ask an expert Dr. Z

Jaime Zuckerman, PsyD, is a Philadelphia-based licensed clinical psychologist in private practice who treats mood disorders, anxiety, adjustment to medical illness, and relationship difficulties. 

When COVID-19 first emerged, some experts presumed that it would pose the same threat as the seasonal flu. The narrative was direct: lockdowns would be short-lived, recovery periods swift, and death and disability restricted to older adults and people with compromised immune systems.

As droplets spread the virus, data was spread to researchers. The respiratory virus had clear vascular implications. For some patients, the projected two-week recovery period stretched into months.

As the scientific findings evolved, public health protocols had to adapt. Then, the negligence of some to follow those protocols permitted the rise of multiple viral variants that trapped us in a vicious feedback loop. 

Jaime Zuckerman, PsyD, a licensed clinical psychologist, says that the constantly changing environment of the pandemic could be at the root of rising anxiety and depression levels. The deluge of news—both good and bad—is a carousel of uncertainty that never stops.

We don’t know when things will get better, or when we’ll finally escape pandemic purgatory—and that sense of unease has generated a public health crisis in its own right.

Verywell Health: Health information is constantly changing. What are the psychological ramifications of that unpredictability?

Dr. Zuckerman: Human beings are creatures of habit. We seek consistency. Our brains like to be able to predict what comes next. And when we can’t, it can lead to increased stress and anxiety. If uncertainty is met with a moderate amount of anxiety, it usually leads to some sort of resolution to resolve the uncertainty with the goal being to bring back a sense of equilibrium.

However, when that state of equilibrium is continuously (and randomly) disrupted, it becomes almost impossible to maintain a sense of predictability. Feelings of hope and control are haphazardly replaced with uncertainty and fear. This constant unpredictability leaves you in a “fight or flight” mode of existence.

This can result in heightened anxiety, feelings of hopelessness, or depression. People feel paralyzed. They can’t plan, can’t coordinate, and can’t engage in their normal enjoyable activities. This disruption of everyday life, with no set endpoint, enhances a feeling of powerlessness.

Variables That Contribute to Chronic Uncertainty

  • The constant shift of the pandemic “time frame." When and how will we transition into the post-pandemic world?  
  • The evolution of our understanding of the virus’s impact on our bodies. For example, ongoing findings of the potential for cardiovascular and neurological damage related to the virus.
  • The variants’ potential impact on vaccine efficacy. How well will vaccines protect us from new mutations? When will we reach herd immunity?
  • The arbitrary nature of who contracts COVID as well as how it will affect them.
  • Who is safe? The young and healthy were supposed to be protected, but many of them sustain permanent damage and disabilities from mild infections
  • Ever-changing restrictions. While they are meant to promote safety, they can also cause confusion—especially when restrictions vary not only from state to state but from county to county.
  • New information on children and COVID. Kids were once thought to be innately immune to the virus, but it is now clear that they can be infected and spread the disease. Research suggests that they may spread the B.1.1.7 variant more easily than other strains.
  • Contagiousness before symptom development. It can be tricky for people to comprehend how presymptomatic transmission works.
  • The length of infection. How long is someone positive for, and how long can they shed the virus for and be contagious to others?
  • The unreliability of some COVID tests, which have the potential for false negatives.
  • How long will symptoms last? 14 days? 14 months? 14 years? What ARE the long-term symptoms?
  • Vaccination information—and misinformation. Distribution and protocols have differed from state to state and the grouping order of those eligible has not always been regulated. There are also lingering questions about how long the vaccine will protect us and how well it can protect others from us if we are infected.

Verywell Health: How can this phenomenon lead to burnout, fatigue, or hitting a “pandemic wall?”

Dr. Zuckerman: Like anything else in life, after multiple failed attempts at a given task, many people will ultimately give up or find an alternative method to achieve their goal. However, when multiple efforts and variations on attempts continue to fail, we risk the development of extreme effort fatigue and burnout.

This is no different when trying to navigate one’s way through this new pandemic world. Because of the ever-changing guidelines, symptoms, restrictions, and general information about COVID, people have been forced into a state of chronic uneasiness and worry. This constant worrying mindset is what often leads to feelings of pure emotional and physical exhaustion and burnout, or in this case, hitting a pandemic wall.

Moreover, many people are under the assumption that worry is a result of anxiety. However, worrying actually serves as a method of avoidance: it takes you out of the present moment where you are feeling the anxiety itself and moves you inside your head. In other words, if you are worried about something, you are not actually in the present moment or solving your situation.

Worry provides us with an illusion of control. We think that if we worry about something enough (i.e., catching COVID) we can problem solve all possible scenarios to keep us safe. Yet, all that has done has kept us in our heads for 30 minutes, on our couch, alone. We haven’t actually done anything to help resolve our anxiety.

In this sense, ongoing worry about all the uncertainty that COVID brings with it can result in significant increases in worry. This level of worry not only exacerbates anxiety, but it exhausts us emotionally, cognitively, and physically. The danger of this mental exhaustion of pandemic burnout is that can lead people to make irresponsible or unhealthy decisions.

The bottom line is we make more mistakes the more “fatigued” we are. We tend to become careless in our actions and lose touch with the potential consequences of these actions. People just don’t have the same level of energy left to consistently remain vigilant and maintain high levels of caution.

Verywell Health: Can this type of unstable schedule potentially lead to a mental illness? Has it done so in other scenarios?

Dr. Zuckerman: It is the inability to control when, how, what, or why the reinforcement is offered that makes this type of reinforcement schedule not only toxic but also addictive. The uncertainty and unpredictability foster feelings of heightened anxiety and hopelessness. To avoid these negative mood states, people often develop faulty control strategies in an attempt to gain some sort of predictability.

Gambling, for example, often falls within this type of reinforcement schedule. The reason why gambling can become so addictive is that the reinforcement is so extremely variable. In other words, it sucks you in with the hope for just one more win.

We see this in toxic relationships as well. In abusive relationships, for example, there exists a constant inability to predict the abuser’s behavior. It ranges from violence to gift-giving, to silent treatments to doting. It is this inconsistent behavior that makes these relationship dynamics the most difficult to break.

Verywell Health: How can we reinforce or rebuild our trust in health organizations and the media?

Dr. Zuckerman: I think that we should use this tragic event as a massive learning experience. I think going forward, people will be more inclined to ask doctors and insurance providers more questions than they would have previously. I think people will potentially become bigger advocates for themselves in general within the medical community. We may find that more people will start “doing their homework” on everything from providers, diagnoses, medications, and even insurance coverage.

And while I think that this is an excellent thing for consumers and patients to regain trust, it could be a slippery slope if non-credible sources are used. It remains imperative that we continue to rely heavily on the research as well as reputable media outlets.

A healthy way for consumers to remain educated yet not overwhelmed is to pick two news outlets—one national and one local—and listen only twice a day. This helps people to feel less overwhelmed by the constant barrage of ever-changing news.

Verywell Health: How can we stay emotionally grounded despite the instability and chronic overstimulation?

Dr. Zuckerman: Outside of a pandemic, when a person’s self-worth is contingent on someone else’s perception of them, they often report lower self-esteem, higher rates of anxiety and depression, and an unstable sense of self.

When applied to the pandemic, a healthy amount of fear is necessary to maintain safety measures. However, if our sense of safety is solely contingent upon ever-changing and inconsistent media reports, we will likely continue to feel as though we have no control over our safety and that the precautions, we take are insignificant.

To maintain feelings of safety in the face of such unsettling information, here are three useful strategies:  

  1. Look for things that you can control within their environment. Do things like educating yourself with reputable fact sources, limiting and structuring your exposure to media, and monitoring social media usage. People can control whether they get the vaccine, who they socialize with, and how they socialize. Even things that appear unrelated to COVID—like what you eat, when you exercise, and what you wear—can help you feel more in control.
  2. Maintain as much of a daily routine as possible. When our brains can predict what comes next in any given situation, we naturally feel less anxious. A daily schedule frees up our cognitive resources which we can then put towards more enjoyable things.
  3. Provide yourself with various options to choose from in any given situation, no matter how small they may seem. For example, choosing what to wear each morning or what to make for dinner. While these scenarios may be unrelated to COVID, it’s the act of having and making choices that offer people a sense of control over their environment and helps to ground them within the chaos.
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  1. Day M. Covid-19: More young children are being infected in Israel and Italy, emerging data suggest. BMJ. 2021 Feb 9;372:n383. doi:10.1136/bmj.n383