How to limit your anxiety over events out of your control

Lesley Alderman, LCSW, is a Brooklyn-based psychotherapist.

One of my patients showed up tired to her virtual psychotherapy session last week. She has always been ambitious and concerned about injustice. During that session, she sighed as she discussed a meeting where her colleagues complained of unfair treatment. She said, “I don’t know why they bother to get upset when it feels like nothing matters.”

I was worried about her withdrawal. But then a colleague sounded similarly worn down. She had spent the pandemic helping her third and fourth graders with distance learning while trying to keep her small business afloat. She confided in me, “I haven’t followed the war in Ukraine at all, I just don’t have the bandwidth.”

People are tired to an unusual degree.

In the spring of 2020, when the pandemic started, the question my patients asked was, “When do you think things will get back to normal?” Now nobody is talking to me about a return to normal. There is an unspoken realization that the chaos we are experiencing could be with us for a long time.

Patients who were concerned about national and world events and visibly frightened during the pandemic now appear exhausted. The murder of George Floyd was horrific and mass shootings are becoming more common. Now it feels like we’re all in an unrelenting game of moles, but in this case, the rodents are an existential threat.

I notice that many of my patients suffer from optimism and are overwhelmed about important matters beyond their control.

I call it “hope fatigue”.

People are tired of hoping that the pandemic will end, that the war in Ukraine will be over, that mass shootings can be controlled and that our government can handle these urgent crises. Two in 10 Americans in a 2022 Pew Research Center poll said they trust the Washington government to do the right thing “almost always” or “most of the time.”

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The symptoms of this fatigue are feelings of anxiety, shutting down, or giving up.

“People have a lot of difficulties – Covid has done a lot to us. And now they’re unsure about the state of the world,” said Paul Slovic, a psychology professor at the University of Oregon who has studied the psychology of risk and decision-making for over 60 years.

Therapists try to help. We try to instill in our patients a sense of hope: that they can feel better, that they have agency, that their catastrophic thoughts are exaggerating reality. But when a patient is bemoaning climate change and wondering if they should have children, it’s a challenge.

It’s sometimes tempting to feel sorry for them – but it’s not productive. I try to validate their concerns and then explore what this means for them personally.

Our nervous system is not designed for this

Many of the problems threaten our basic sense of security. Will fires decimate my community, will my children be safe at school, could nuclear war ensue?

“I see a lot of people ‘moving through the motions of life’ but not knowing what to make of life, how to protect themselves, how to be in control of anything or change something like they do they’re supposed to have fun, they get into a kind of distancing,” said psychologist Judy Levitz, founding director of the Psychoanalytic Psychotherapy Study Center in New York City.

People need to feel they have some level of control. When you deprive a person of their sense of security, depression and anxiety can set in. Our nervous system is simply not designed to deal with so many crises at the same time.

It’s no wonder 33 percent of Americans reported symptoms of depression and anxiety this summer, up from just 11 percent who reported those symptoms in 2019, according to the Centers for Disease Control and Prevention’s Household Pulse Survey.

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Dwelling on problems that seem unsolvable can lead to anxious paralysis, but there is hope.

“Just because you can’t solve a problem doesn’t mean you should ignore it,” said Slovic, whose Arithmetic of Compassion website highlights obstacles to humanitarian decision-making. “We are not helpless”

This is some of the advice I give my patients.

Take a break from the news. Doom scrolling can be addictive and reinforce the tragic nature of events. In one study, researchers found that those who were immersed in the news of the Boston Marathon bombing for several hours a day in the week after the event experienced higher levels of acute stress than those who were at the scene. “We speculate that the graphic nature of the reporting and the repetition of these images triggered the intense distress,” said Roxane Cohen Silver, the study’s lead author and distinguished professor of psychology, public health and medicine at the University of California at Irvine.

I advise patients who feel depressed by the headlines to only read the news once a day, turn off notifications on their phone, and check social media sparingly if possible.

Take care. I tell my patients, “You have to be in good fighting shape to deal with the current turmoil.” That means building your resilience by taking care of your nervous system (sleep well, eat well, move wisely). and engage in life-affirming activities.

Focus on the present. Get used to anchoring yourself in the here and now. Worrying about the future is not helpful.

Try a breathing exercise. Taking a few deep breaths — for example, inhaling to five and exhaling to five — will help calm your sympathetic nervous system (the fight or flight response) and reduce your anxiety.

When I offer deep breathing exercises, some of my patients can be skeptical, as if I’m offering some kind of woo-woo, new-age mumbo-jumbo. But I remind them that the exercises are scientifically based. They usually report that the breathing at least gives them something to do when they feel their heart rate escalating.

Think of your victories. Remind yourself of what’s working well in your own life — whether it’s your work, friendships, or the uplifting array of houseplants you’ve nurtured during the pandemic.

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Be your own therapist. Are you asking yourself why am I feeling particularly hopeless and why? Being able to put into words what is weighing you down can help you feel less overwhelmed by emotions and be more able to process the information rationally.

take action. Worrying doesn’t help mental health, but taking action does. Look around your community. Perhaps your local playground would benefit from a basketball court, or your church or synagogue could sponsor a refugee family. When people get involved in local issues, they gain new optimism.

Team up with a friend. Choose a cause. There are hundreds of nonprofit organizations dedicated to solving some of the toughest challenges on the planet. Donate money to an inspiring organization or volunteer.

Slovic gives this advice: “Think about what you can do instead of what you can’t do.”

Are you a psychiatrist who would like to contribute to this column? E-mail [email protected].

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