• Gordon Doctors

Worry in the Time of Covid ...

Updated: Sep 24



What is worry?

Worry can be defined as feeling troubled, concerned, or apprehensive about actual or potential problems. All of us have experienced worry at some point – and it is helpful to think through our current issues or think ahead to anticipate future problems, as it allows us to plan solutions and achieve our goals, if we do it in a constructive manner. There is no “right” amount of worry, but it becomes unhelpful or excessive when it causes us significant distress or impacts on our ability to function in everyday life.


What can worry feel like?

Sometimes, worry can feel like a chain reaction of thoughts, escalating from something relatively minor to increasingly catastrophic and unlikely scenarios. At other times, worry can feel like being stuck in a whirlpool of thoughts, circling repeatedly without being unable to break out. It can feel like an uncontrollable and overwhelming emotion.

We may feel physical symptoms too – muscle tension, restlessness, difficulty concentrating, insomnia, and fatigue. Sometimes we may experience palpitations, shaking or sweating, “butterflies” in the stomach, nausea, or even chest tightness and shortness of breath. Some of these symptoms may have other serious causes, so it is important to seek medical attention to exclude these.


What triggers worry?

Worry can be triggered by anything at all! Even when things are going well, we might worry about the possibility of things falling apart. However, certain situations are more likely to trigger worry, including the ambiguous, the new, and the unpredictable.

The COVID situation is all of these things! It makes sense, then, that many of us have been experiencing a lot of worry. We might be worrying about our health, our work and the impact of COVID on our businesses. We may be worried about how to juggle working from home with home learning, and how our loved ones are doing, far away. Our relationships may be feeling the strain of all these worries, and we may be feeling exhausted with the constant uncertainty and decision fatigue. We have all had to make many decisions based on first principles in the past year and a half, because the whole situation has been new to us and we have limited past experience to fall back upon.


What can I do about worry?

If your worry is causing you distress or impacting your ability to function in everyday life, please seek help!


Booking an appointment with your GP can be a good first step, as you can talk about your different options, including the best way for you to access psychological services.

There are many helpful online resources listed on the Head To Health website:


https://www.headtohealth.gov.au/


Useful phone numbers include:

- Mental Health Line: 1800 011 511

- Lifeline: 13 11 14

- Kids Helpline: 1800 55 1800

- Suicide Call Back Services: 1300 659 467

- Beyond Blue: 1300 22 46 36

In an emergency or crisis situation, please dial 000.


The next few paragraphs are not intended to replace advice from your health professional – these are just general strategies that you might find helpful.


* Maintaining balance

Well-being comes from having balance between activities that give a sense of achievement, relational connection, and enjoyment. An imbalance of these things can affect our well-being – it makes sense that if we spend most of our week working with no time for social connection or rest and relaxation, it will impact our mood. Conversely, if we spend most of our time relaxing and not doing other things that are important to us or give us a sense of achievement, this may seem fun initially, but can also impact our well-being long term. Therefore, finding a balance is important.


Promoting well-being won’t stop all our worries, but it may help us cope a little better with them. Psychological flexibility refers to the ability to adapt to changing situations, rather than being rigid in thinking and perspective. Having this flexibility helps with mental well-being, and low flexibility has been found to impact negatively upon mental health and make us more prone to worry. We can practise flexible thinking by reflecting on past situations where unexpected changes happened and thinking about how we did manage to cope and what we learned from it.


* Understanding our worries

It can be helpful to reflect on the situations in which we tend worry – who are we with? What are we doing? Where and when does it happen? We might start to see patterns emerge. For example, if reading the news on social media for hours on end causes us to worry, it might be wise to set limits on how much we do this.


It can also help to understand the physical sensations we might experience when worried, like muscle tension or pounding in the chest. When faced with a threat, our body prepares to fight or flee. This is a physiological response that serves to protect us from danger – but sometimes, the threat is perceived rather than real. When we realise this, we can learn to counteract the “fight or flight” response by consciously calming our breathing and relaxing our muscles. The more we practise relaxation exercises when we’re not feeling worried, the more easily we will be able to use them when we need to.


It is also helpful to understand that the subject matter of our worry. Some worries are about current issues that require immediate attention, but other worries are about things that could possibly happen in future but don’t currently exist. The probability of things occurring, the impact if they do occur, and the amount of influence we have over them are variable. When we dwell disproportionately on low probability events outside our influence, even if they might have high impact (i.e. the unlikely worst-case scenario), this can become counterproductive. We all have a finite amount of attention and energy, and when we spend it worrying about unlikely hypothetical situations we can’t control, it distracts us from the things we can act upon.


* Mindfulness

Mindfulness, or learning to be aware of the present, can be helpful with worry. Some techniques include focusing on your breathing to start with, then noticing what you hear or see around you, the sensations you feel physically, and how you are feeling mentally and emotionally. The key thing to mindfulness is to take note of things from an observer’s perspective with a sense of openness and without judgement. Our feelings themselves are not the problem, it is what we do with them that can cause problems.


So instead of “buying” into a thought or getting “hooked” by a particular feeling, you might notice “I’m feeling worried but that’s ok – that’s just how I’m feeling right now. I wonder what is making me feel this way?” When you can identify how you’re feeling from an outside perspective, with a sense of curiosity, this creates psychological distance.


Once you identify your feelings of worry, you can experiment with two strategies. Firstly, try deferring or postponing your worry. I understand that worry can feel insistent and make you feel like you must engage with it right now; but if you can postpone worries that do not require immediate attention, you may find that you may start to have a little more control over them. Try setting aside time each day to let yourself worry (e.g. 30 minutes at the end of the day) and if worries about non-immediate situations come to mind, try to defer engaging with them until “worry time”. You know you will have time to deal with them – just not right now.


There is another strategy called “cognitive defusion” where you can imagine your thoughts like leaves floating down a stream or plates of sushi moving along a conveyor belt. When your mind starts moving into the slippery slope of unproductive worries, try naming them and letting them go. You don’t have to engage the worry by disproving it or reassuring yourself, you can just let it be.


Real worries: daily decisions

Some of our worries may be based around the many decisions we have to make each day, and sometimes these can feel overwhelming. Often it boils down to two main issues: (1) deciding what to do and (2) what to do with the feelings that arise. With deciding what to do, instead of focusing on the illusion of the “one right answer” we must find, it might be better to focus on a way to decide:

Do I need to make this decision now? If yes, perhaps a framework for decision-making might help:

  • Frame the question – what are you considering doing and what is the alternative?

  • Mitigate risk – what is the safest way to do what you are considering?

  • Evaluate risk and benefits

  • Decide and move forward


​We need to make decisions knowing there is no way to be 100% sure that they’re right. We don’t know for sure how things will turn out – we’re not fully in control of that – and that is the uncertainty we need to accept to move forward.


Once we’ve made a decision, we then have to cope with the feelings that might arise – worry, guilt, fear, uncertainty; have we made the right choice? What if it doesn’t turn out as planned? There is a psychological approach called Acceptance and Commitment Therapy that might help with this. The Acceptance part acknowledges that we face real problems and difficult decisions, and that we will have uncomfortable feelings about them. It aims to help us accept these feelings, rather than struggling against them or avoiding them. There is some overlap between this and mindfulness. The Commitment part is about understanding what we value personally and then committing to actions that are consistent with our values. We can then learn to accept the consequences – be they feelings in ourselves or the reactions of others – because we know that we have acted in accordance with what we value.


Hypothetical worries

If our worries are largely about hypothetical situations, it can be useful to identify unhelpful thought patterns that our minds might slip into by habit. For example:

  • believing something must be 100% perfect otherwise it’s ruined

  • magnifying negative things to seem bigger than they really are

  • interpreting one example of something as happening all the time

  • thinking that something negative will happen in the future or that someone is thinking negatively about you, without supporting evidence

  • thinking that your feelings or emotions reflect the true reality, when often they don’t

  • blaming yourself for things that you are not responsible for

These are just some examples, and once we are aware of unhelpful thought patterns, we can then challenge them and learn to change them to more helpful ways of thinking. This is a technique of Cognitive Behavioural Therapy.


In summary…

The COVID situation has been difficult, and we have all had many real issues to worry about. Unfortunately, it is impossible to fully eliminate worry, but if you are finding that your worries are causing you distress or difficulty functioning in everyday life, please do seek help. Booking an appointment with your GP can be a good first step to discussing your options.

​For easy reference, here are the resources mentioned above: Head to Health: https://www.headtohealth.gov.au/ Mental Health Line: 1800 011 511 Lifeline: 13 11 14 Kids Helpline: 1800 55 1800 Suicide Call Back Services: 1300 659 467 Beyond Blue: 1300 22 46 36 In an emergency situation, please dial 000.

Dr Mei Tan

BSc(Med) MBBS(Hons) DCH FRACGP

Dr Mei Tan practices at the Gordon Doctors in the Upper North Shore suburb of Gordon. Growing up right in Gordon, Dr Tan has returned to serve her community and is highly enjoying the varied aspects of General Practice, the continuity of care and empowering patients with health knowledge. Having the prestigious UNSW, RACGP as well as Child, Sexual and Reproductive Health training under her belt, Dr Tan has worked tirelessly in both urban and rural settings. An area of particular interest to Dr Tan is Mental Health which she also does community education programs on this important topic. Life is busy but as much as she can, she enjoys spending time with her very active young family and is a keen musician of the piano and the flute. Dr Mei Tan can be reached at 94999999 or consult her at an appointment made here.

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