By Jonathan Langridge, MA, MBACP, Psychotherapist, SM1 Therapy (UK)
Another ‘Mental Health Week’ has passed but for those living with any mental health issues their concerns are not constrained to one week per year, rather they deal with their demons week in, week out.
Obviously with the COVID-19 pandemic there has been a focus to work from home where possible, as advocated by the UK government and the scientific community. This in itself can give rise to its very own anxieties let alone those fears surrounding health.
For many they may well experience a sense of loss, loss of their physical workplace, loss of the immediacy of their colleagues, and loss of the commute during which they might be able to ‘decompress’. These losses can easily lead to anxiety, and anxiety appears to be quickly becoming the largest issue during lockdown. Because of that the main focus of this piece will be around anxiety.
What is anxiety?
Anxiety differs from rumination (which is usually associated with depression, more on this at the end) as it is ‘future focussed’ thinking.
It is a fear or worry of what ‘might’ happen, very often the fear gets expanded by our thoughts, and we end up looking at the worst-case scenario and this then stops us from even attempting a task. Why would you want to do something if it is going to go horribly wrong?
So why do we have anxiety? Is it any use to us?
Very simply within our brains there is a tiny primitive part called the amygdala, and it is the amygdala that is responsible for our ‘fight, flight, or freeze’ response. It is reactionary and is activated quicker than our frontal cortex which is responsible for thinking. The amygdala has been honed over thousands of years of evolution to do a job and it does it well, sometimes too well. When activated by our fears or worries it starts our heart beating faster to pump blood and oxygen to our muscles. This gets us ready to either fight, run, or freeze. The adrenal glands start going to work, and adrenalin is now coursing through our bodies and our breathing becomes quicker. Because of all of this physiological action our bodies heat up and we start to sweat, trying to cool down.
So why do we need to know about these physical signs?
When the amygdala is activated it stops blood flowing to ‘non-essential’ parts of the body, such as our stomach (you don’t need to digest food right now) so we may feel nauseous, and also our frontal cortex, so thinking is impaired.
If it’s more difficult to make sense of why you’re anxious it is extremely helpful to realise you are getting anxious by recognising the physical signs.
Great, so I’m sweaty and out of breath, what can I do?
Because you are in the middle of an anxiety moment it will be difficult to reason what is going on (don’t forget the frontal cortex is deficient of blood), so what can you do?
The easiest thing to control is the physical sensations, and the easiest way to do that is to breathe deeply. There are a huge number of breathing techniques you can try and a quick search on the internet will lead you to videos or scripts.
Personally, one of the easiest I have used (especially for veterans dealing with anxiety as part of their PTSD) is what I call the 4-1, 4-1 method.
Very simply, breathe in for the count of 4, hold for the count of 1 then breathe out for the count of 4, hold for the count of 1 and repeat. Practice this for 5 minutes per day when you’re not feeling anxious, and you can pay attention to how your body feels. Then when feeling particularly anxious you can easily use this technique and know what your body should feel like as the physical symptoms subside. Then you are better able to think as blood flows back to the frontal cortex.
In very simple terms, if you feel the physical sensations of anxiety growing;
‘STOP, BREATHE, THINK’
What about anxiety and working from home?
Anxiety can take many forms and have many reasons.
So, if working from home causes you anxiety it will take some objective thinking to understand what causes you to worry and then you can look at what to do about it.
- A loss of a physical office
- A loss of daily routine
- A loss of the commute and catching up with emails in the morning, decompressing in the evening
- A loss of connection with colleagues / managers and the immediacy of their feedback
- Unable to ‘see the wood for the trees’
- Instability of technology (virtual meetings / internet connection / hardware)
- Looking after children / family and still working from home
These are just a few examples and there will be more or less for individuals, and they will all have individual solutions, in whole or in part.
- A loss of a physical office
Create a specific space for your work area, no matter where that may be, if you can. This is a place that you can then associate solely with work and psychologically your mind will, with a little time, differentiate this from your home life and home routine.
This will help with point 2 below.
- A loss of daily routine
Obviously if you are new to working from home (as many may be due to the impact of COVID-19) your daily routine will be affected. However, it is a very good idea to create a new daily routine.
- Get up at the same time each working day, schedule in breaks (perhaps one in the morning and one in the afternoon).
- Step away from your PC / phone and have a cup of tea / coffee for 5-10 minutes.
- Maybe stop at 10:30 and play Pop Master on BBC Radio 2.
- Have a lunch break away from your PC.
- Finish at the same time each day when possible.
- Create a ‘to do list’ for the next day (and keep this handy for later).
- A loss of the commute and catching up with emails in the morning, decompressing in the evening.
If you used to have a morning and evening commute, factor this into your new daily routine. I’m not saying get up at 6am and sit in your dining room for 90 minutes. But don’t wake up and rush straight to your work area. Give yourself time to get ready psychologically to start your working day.
- A loss of connection with colleagues / managers and the immediacy of their feedback.
If there is someone you specifically miss talking to or getting advice from then you could, with their permission, arrange a daily / weekly catch up or impromptu call when you need their help or just need to shoot the breeze.
In a wider work context, group chats, team meetings and briefings could still form part of your working week. If this doesn’t, then speak to your team and see if there is a need for it.
- Unable to ‘see the wood for the trees.’
This is a very common issue with anxiety, and often leads to greater anxiety. It could be a work project, setting up working from home or both or, indeed, more.
There are two ways of tackling this issue, one way is often referred to ‘eating the frog’.
Eating the frog means taking on the most unpalatable part first, the thinking being that once you have that out of the way the rest will be easy.
Another way, and one I would advocate to decrease anxiety, is to stop looking at this as one big ball of work, but rather break it down to bite size manageable chunks.
One way I have found useful is to ‘reverse engineer’ the problem. So, take a look at what your end goal is, now think of what the immediate step before that would look like. Once you have got that step, write it down. Psychologists have long known that writing something down has the effect of getting it out of your head as your mind knows you have a written reminder and so it stops over worrying that you’ll forget. Once you have that step written down, think of the next step before that and so on until you get to where you are now.
It is important that when you attempt any of these steps, if you feel it’s too much, then your right, it is. That particular step is too big so break it down again into more manageable steps. Keep doing this until you can actually start. Give yourself the best chance of success.
If you attempt to do too much too soon and don’t succeed, it may have the effect of stopping you from attempting other things.
- Instability of technology (virtual meetings / internet connection / hardware).
Like most of the coping mechanisms I have mentioned so far, what I’m about to advocate is far easier said than done. All of the techniques will take repeated practice.
For issues such as unstable technology, I encourage you to ‘control the controllables’. What does that mean?
If something is physically within your control, then you can worry about it but only as you look at how to resolve it.
If something is outside of your control, let it go. For instance, if your internet connection is unstable or down, what can you physically do about it? You can report it to your provider and carry out various tests but the likelihood is, you can’t affect the outcome. So, try to let it go. Yes, it may be frustrating, you may have an important virtual meeting to attend, you may have an email that needs to be sent. However, you can not change the time it takes to remedy the situation. You can call the provider for updates, but you can not fix it yourself.
- Looking after children / family and still working from home.
Again, this is something that may be helped with a set routine. Perhaps you start work earlier or later and work outside normal working hours. Perhaps you have a partner or family member who can ‘share the load’.
Again, looking at how you can break the problem into bitesize pieces may well help you come to a solution. It may not be perfect, but it could well be a workable compromise.
At the start of this piece I mentioned rumination and said that it differs from anxiety. Whilst anxiety is future focussed, rumination is very often the reliving of past events and usually associated with self-critical thoughts.
We think about what happened and say, ‘if only I… what if I… I should have…’ We replay these scenarios and change parts and come to different outcomes in our head.
But what has actually changed? Can you change the past? The simple answer is no, no-one can change the past.
When ruminating and replaying scenes in our head we think that we are problem solving when in reality we are not. Problem solving involves ‘how to’ thinking rather than the if only thinking.
If you find yourself ruminating, ask yourself these three questions;
- Have I made any progress to solving a problem?
- Do I understand something about this problem (or my feelings about it) that I haven’t understood before?
- Do I feel less self-critical or less depressed than before I started thinking about this?
If the answer to anyone of them is no, accept that you have been ruminating and stop, I’d recommend physically moving.
One technique to lessen both anxiety and rumination is mindfulness.
Jon Kabat – Zinn described mindfulness as;
“awareness that arises through paying attention, on purpose, in the present moment, non-judgementally,”
I liken this actively engaging in what you’re doing at that time. So, if you are making a cup of tea, really engage in what you are doing. Engage your senses, what can you see, smell, hear, touch, taste. If you concentrate fully on one thing it is very difficult for intrusive thoughts to take over. This can help with working from home because you can concentrate on what you are doing and hopefully start to prevent your mind from wandering off into anxious or ruminative thoughts.
There is a wealth of mindfulness techniques on the web, take a look at what works for you.
Earlier I said to keep your to do list handy, that is because we are coming to the end of this piece, and I want to quickly talk about sleep.
A lot of people with anxiety or depression struggle with sleeping. There are a couple of things you can do as you go to bed that hopefully will help.
- Put the day to rest, think about what you have done and / or achieved, be objective.
- Think of three positives from the day,
- Perhaps you heard birdsong as you woke
- You reduced your inbox
- You broke the work you had into manageable chunks
- Write anything you need to do tomorrow on your to do list, get it out of your head before you go to sleep. Your unconscious will then not be thinking about it and hopefully won’t wake you.
As I said, all of this takes time and repeated practice, but these techniques and coping mechanisms can help to alleviate anxiety and rumination.
For a more in-depth understanding of what might cause you to be anxious, etc. then I would always recommend counselling or therapy.
If you feel that you want more help with your mental well-being you can always try your local doctor as they can help with medication, but they will also have details of local low cost counselling services and in the UK your local NHS service which is free.