Understanding Anxiety in Pandemics and How to Cope

Get a slice of life in Health Matters

on #channelnewsasia CNA938Live radio show with DJ Daniel Martin.

Our Director, Dr. Shawn Ee, was invited to comment on the current issues related to healthcare workers and the COVID-19 crisis in a LIVE Interview. The interview was on air 26/2/2020 at 4.10pm.

If you’ve missed it live, you can access the recorded interview here. Alternatively, you can click and listen to the interview on YouTube.

Learn More

More on The Expert: Dr. Shawn Ee

More on The Host: Daniel Martin

More on Coronavirus Anxiety: Speaking of Psychology: Coronavirus Anxiety

What you can do to cope

Keep things in perspective. Government officials are preparing for possible worst-case scenarios in order to protect the public. The public, however, does not need to expect the worst. Studies show that annual seasonal influenza is more severe than the coronavirus. Most people who have contracted the COVID19 disease in Singapore have recovered. In the limited number of fatal cases, the people affected were already battling a life threatening illness prior to contracting the coronavirus.

Get the facts. Gather information that will help you accurately determine your risk so that you can take reasonable precautions. Find a credible source you can trust such as news from moh.gov.sg, a local public health agency, or local elected official such as an MP. The situation could evolve rapidly, so gather information at regular intervals in order to help you distinguish fact from rumours. Be wary of unsubstantiated rumours, which can be upsetting and may deter you from taking appropriate action.

Maintain a hopeful outlook. Public health agencies around the globe are working to identify outbreaks of the illness and to ensure the availability of the best medical care to those who are sick. Work has been underway for several months to develop a vaccine. For centuries, people have survived difficult life circumstances and gone on to live fulfilling and productive lives. There is no reason why this situation cannot be similar. Limit worry and agitation by lessening the time you and your family spend watching or listening to sensationalised media coverage.

Stay healthy. A healthy lifestyle — including proper diet, exercise and rest — is your best defence against any disease threat. Adopting hygienic habits such as washing your hands regularly will also minimise your exposure to all types of germs and disease sources. A healthy body can have a positive impact on your thoughts and emotions, enabling you to make better decisions and deal with the coronavirus’ uncertainties.

Build resilience. Resilience is the process of adapting well in the face of adversity, threats or significant sources of stress. Draw on skills you have used in the past that have helped you to manage life’s adversities and use those skills to help you manage concerns about a flu pandemic.

Have a plan. Think about how you might respond if the flu were discovered in your area. You may want to stock up on nonperishable foods in case officials recommend staying home, consider options for working from home, and caring for sick family members, and establish an emergency family communication plan. Explore how you might spend your time if schools or businesses are closed. Planning some of these scenarios in advance can lessen your anxiety.

Communicate with your children. Discuss the flu with honest and age-appropriate information. If your children have concerns, addressing these together may ease their anxiety and distress. Parents can also help allay distress by focusing children on routines and schedules that remain unchanged despite any changes due to flu preparations. Remember that children will observe adults behaviours and emotions for cues on how to manage their own emotions during this time.

Keep connected. Maintaining social networks can foster a sense of normality, and provide valuable outlets for sharing feelings and relieving stress. If officials have recommended limiting your social contact to contain an outbreak, you can stay connected via social media sites, email and telephone.

Seek additional help. If you have intense feelings of anxiety or hopelessness or are having trouble performing your job or other daily activities, a licensed mental health professional such as a psychologist can help you develop an appropriate strategy for moving forward. Visit our FAQ for more information, as you may consider psychotherapy.

Share this interview with your friends & families, or show some support to someone you know who works tirelessly as a healthcare worker.

#yourneedsarekeptinmind #beapartofthecommunity

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The interview transcript is included below.

- Start transcript -

Daniel: Hi everybody, I’m Daniel Martin and I’d like to talk to you about why Health Matters. Our healthcare worker, key players in any response to epidemic or pandemic situations. They are the frontline of exposure to infection - I have been speaking to them for years, and I know it comes from a place of professional responsibility, duty, obligation and a love for the work that they do as well. But during crises like COVID19, which we are facing right now, our workers may become acutely concerned about a variety of issues. I’m about to find out what they may be and what emotional support healthcare workers need in such situations. Joining on today’s Health Matters, Dr. Shawn Ee, Clinical Psychologist and Director of The Psychology Practice.

Welcome aboard, Dr. Ee, thanks for joining me.

Shawn: Thanks for having me.

Daniel: Help our listeners understand: Our healthcare workers, what kinds of issues or anxieties would they likely be facing right now, in your opinion?

Shawn: So Daniel, to understand our healthcare workers’ anxieties, we actually need to understand what we all have to deal with in such trying times. So when we feel anxious, we tend to blow things up, and view things quite catastrophically - so this is usually our baseline, if that makes sense?

But when there’s widespread experiences of anxiety in the community, this anxiety can be raised to a disproportionate level. So this anxiety that’s associated with the pandemic or epidemic, in my view, is sort of like a paranoid anxiety based on psychological defence processes. So for e.g., along the lines of something or somebody does it to me, and intends to annihilate me. So in other words, this disease can be passed onto me, and I will really have to deal with real life/death concerns.

So when we were to apply this thinking to healthcare workers on the other hand, these may actually be quite amplified. So I’m talking about both individuals in the frontline, as well as backend administration. The degree of which they fear others, for e.g., fears of discrimination, as well as fear of actually contracting the disease are all real issues for these individuals, such as myself as well.

So a paranoid anxiety that causes individuals to fear others being able to put the disease into us, can also create a sense of vulnerability in us. And of course, be concerned about the safety of their loved ones too.

Daniel: Dr Ee, one would assume just like people in the military, who have training for this, or people in civil defence, who have training for this, would their training help mitigate some of these feelings?

Shawn: Certainly. I mean, the thing is when duty calls, comes first, usually what happens is that we might place ourselves at the back end of the room before actually having to concern ourselves with our own needs.

Daniel: Right.

Shawn: So, healthcare workers generally try to put ourselves forward and that’s why we’re in the job in the first place. If we were to look at it in an interesting way, when we all start to become quite concerned about ourselves, and we start getting into a process of self-preservation - you might see this in the form of the buying of masks, sanitisers, or even toilet rolls.

Daniel: I want to get your advice about the kinds of help that should be extended - what do you think they should be receiving from their employers to ensure that they in the best emotional state to do their jobs, because you’re right, sometimes it’s not just about doctors, and nurses, and allied healthcare professionals, it could be the receptionist in the clinics, or in the hospitals. It could be the workers who are working in the backend. What can be extended?

Shawn: Certainly, we want to try to understand what we’re dealing with before actually recommending something right, so usually what happens is that we might most likely involve some psychological effects like stress, anxiety and depression, and even post traumatic experiences, given we’ve experienced SARS before. And not knowing where COVID19 is going, actually triggers a lot of vulnerability.

So in fact, help can come from assisting our healthcare workers to contain their own anxieties. It can come from, in the form of good infrastructure like a well-coordinated healthcare system, and actually our leaders providing accurate and timely news. Psychologically speaking, we know that a trusted source of information actually insulates from rumours, providing a clear picture, and seeing how the situation evolves helps us feel better.

So in addition, there can be other things like employee assistance programmes, emotional support, encouragement, material support, so that these healthcare workers can do their jobs properly. And of course, very importantly, to promote the need to be treated respectfully. Above all, taking the lead to show how self-care is done.

Daniel: Actually, to talk about that, the self-care aspect, the self-help perspective, what can workers do at times like these? Your replies.

Shawn: Okay, so, an understanding of our automatic processes to our triggers of our anxiety, as a normal human would react to crises is quite paramount. So we want to try to understand this as it kicks us into high gear to protect ourselves.

I would say try to see how we risk analyse, and try to get at the reasons why we would think we are at risk. So not just social media, news media, around us, for e.g., today I just read some news that people are going out to buy private property at a new condo that’s coming up,… just over the weekend, I been to the parks and playground at East Coast Park - lots of families are out there, so are we really at risk?

So we need to balance this off by also, some things we can do quite effectively, already which has been advised/said many times, by washing hands, don’t touch your face, avoid being a source of risk to other people. I think importantly to practice social responsibility. With what I said earlier about trying to self-preserve, right now, to do the opposite - which is to be concerned by not infecting people if we were sick.

So if you’re at work, if you’re a healthcare worker, take it from me - if you’re sick, please take leave. If we have the tendency to feel like we need to maintain a strong front, to be present at work, then time to reconsider this persona of ours.

Be kind to others who have those vulnerabilities or insecurities as well.

So we’re all really the same - I would say, as a last thing, next time you see someone in scrubs or uniform on public transport, do say a kind word of thanks for their job and what they are doing.

Daniel: That is a great idea, Dr. Ee. Thank you for words of advice.

- End transcript -