Responding to anxiety with an underlying health condition

The current Covid-19 pandemic is generating a lot more stress and challenges - in the threat to health (which can feel exacerbated for someone with an underlying health condition), concern about vulnerable family and friends, financial anxiety, and general disruption to our lifestyles.

As someone with long term CFS/ME I notice how anxiety has increased, and with it my fatigue symptoms. Just managing the increased complexities of simple activities, such as going to the shops or going for a walk, has become more demanding. The anxiety about my own health and others’ is also draining my energy quite rapidly. As CFS/ME has been found to be linked to the contraction of a virus (in my case chicken pox) and degrees of stress or trauma, I have concerns about how the virus may affect these symptoms should I contract it and be serious enough to be admitted to hospital.

So, what can we do to manage all this anxiety?

Staying flexible & present

I believe that it is necessary to keep an approach of flexibility and receptivity to how the body is in any given moment in these new circumstances. This in turn can help us make a better choice in terms of what activities are manageable. So I find it helpful to measure what I can achieve towards my overall intention in a kind way that doesn’t compare how I am doing to others, or to how I might have been able to do things in the past. 

Coming back, again and again, to the present moment is crucial to help with the mind’s tendency to propagate anxiety by fuelling the ‘what if’ fears. Returning to the body is central to this. As is returning to the breath - especially a longer out breath to release tension. There are lots of apps available online to support body awareness, such as guided body scans and so on, which can be vital to enable the nervous system to switch into a restorative ‘rest and digest’ mode, which is crucial for balance and wellbeing.

Be realistic

Often just simply clocking that my mental state or mood is quite low, or that I feel tearful or angry about the debilitating nature of my condition and associated fears about the Covid-19 virus, and realising that this is perfectly understandable, can help to ease it a bit.  The more I keep trying to run away from the truth of my current experience, the more trouble I find I shore up for myself.  I make it worse by adding a layer of judgment to what is already a painful experience.  So being realistic and taking into account the impact of being in pain or feeling fatigued has on my overall mood is a good choice.

Attitudes to our self: Compassion is crucial

Noticing this connection between mood and pain/fatigue must be met with a compassionate response as well or, in my experience, it’s all too easy to use it as a reason to feel even more miserable.  I sometimes say internally to myself in a soft tone of voice: ‘of course, this is hard. It’s ok and perfectly understandable to feel like this.’  People often say to ask yourself if you would treat a friend or a child in a disparaging or judgmental way if they were presenting feeling as I do.

Stop comparisons 

In fact, if one is going to do a comparison, I can recommend taking a quiet moment when you won’t be interrupted to think back over a certain timeframe and jot down what changes or improvements there have been in that time. Invariably, whilst the highs and lows, good and bad days are prevalent, overall, I notice a general steady upward trajectory. This always gives me a reality check especially if I have gone down a depressive hole of frustration or despondency about my condition.

Noticing the positive

One of the best strategies I am aware of that’s worked for me has been quiet reflection and noting down at bedtime what’s been beautiful/pleasurable or comforting about my day.  This can vary from small things like a young blackbird taking an exuberant bath in a water bowl in my garden this lunchtime, to more significant things like taking a positive step of self-care when my symptoms flared up, or enjoying the sun momentarily shining amidst the rain.

Pleasurable activities

Just bringing a simple bit of unadulterated pleasure, and to do this routinely, can also assist. With anxiety it is possible that a sense of pleasure, self-expression or opportunities for laughter can diminish.  So, it’s always helpful to keep weighing up what are the priorities on any given day, and sometimes pleasure is key.  Giggling my way through a series on Netflix can be a real tonic to my mood. I have also been relishing the joys of dancing in my living room on a remote class or even attending my acting class via Zoom.

Do something for someone else

This can really work if you are feeling caught up in a low mood or perpetual negative thinking. It doesn’t have to be a grand gesture; just something small works just as well. I have been speaking to old friends from 40 years ago or more and exchanging supportive texts with a friend who is a nurse in the front line.

The art of self-care

It has taken me almost 50 years, and 16 of those living with a chronic condition, to finally realise the importance of the art of self-care. I call it an art, because it feels like it’s a creative process that needs the right attitude and it can take practise too.  Having always tended to be someone who’s very driven and motivated by the dopamine hit of ‘getting things done’, I have had to re-teach myself how to use this in a way that is conducive to self-care.  What I mean by this is that it’s ok to desire a sense of satisfaction and being honest with myself that hurtling through a to do list with a forceful attitude doesn’t actually make me very efficient, and in fact is more likely to exacerbate a symptom flare up.  I can still achieve things but in a very different way. I have had to practise and keep regenerating my positive motivation to live in accordance with this approach.  Realising my basic human need for rest and restorative activities has finally alerted me to prioritising ‘unplugged’ times when I put everything down and just flow with whatever feels most soothing to engage in or to simply not be productive at all and stare out of the window at the sky for as long as my heart desires.

Sharing and connecting

It can be tough living with a chronic condition living alone (as I do) or with others when the other person has their own challenges and responses in relation to it.  All of this is being further tested by the collective stressors of the pandemic. It’s been my experience to try to have a small mandala of different types of connection (now remotely) such as evening classes, neighbours, colleagues and friends to keep me from becoming too isolated, especially if I feel low.  Sharing with others who are in a similar place can sometimes be helpful, sometimes not.  For me, having a therapist has been invaluable.  A problem shared is a problem halved as the saying goes and often the act of ventilating my experience (to a supportive other) can help me to regain positivity.

Positivity can be a glimmer

Finally, I think it’s important to state that having a realistic version of what ‘positivity’ as a value might mean to you is crucial.  For me, it can be quite subtle and often is more of a vague glimmer or warmth rather than full on blazing, bouncy positivity.