COVID-19: Coping with emotional distress

30 May 2020

COVID-19: Coping with emotional distress

Phobia is a type of anxiety disorder characterised by the persistent feat and dread of certain things or situations – but have you heard about nosophobia? Also known as the fear of disease.

According to Sunway Medical Centre’s Consultant Psychiatrist, Dr Phang Cheng Kar, nosophobia is a general term that refers to the excessive fear of contracting a specific disease like HIV, tuberculosis, cancer or heart attack.

As COVID-19 continues to spread globally and the Movement Control Order (MCO) has been extended again and again, many have developed a fear and anxiety for the virus, and if we are not alert enough, we may even start to develop nosophobia.

“In any event, excessive fear can impair our physical immunity, lead to mental health problems such as panic attacks and depression, and trigger mass hysteria,” Dr Phang said.

But does COVID-19 and the MCO increase the risk of nosophobia? Dr Phang said there is no absolute yes or no answer, but that both are possible.

“The MCO and social isolation worsens mental health in general. More people are visiting my clinic for COVID-19 related worries, insomnia, frustration, anxiety and depression. When mental health is poor, it increases the risk of nosophobia.

“People who stay home for long periods of time with nothing to do but being worried all the time are at a higher risk. However, if people knew how to take good care of their physical and mental health during MCO such as staying calm, being hopeful and getting more correct information, the phobia is less because the risk of infection is lower if everyone adheres to the MCO,” Dr Phang said.

It is inevitable that people will have fear and anxiety, especially those with poor mental health or those who already suffer from mental health problems. The following are those who are at high risk of nosophobia during the COVID-19 pandemic:

  • Those with pre-existing mental health disorders, such as clinical depression, panic and generalised anxiety disorders.

  • Those with an anxious personality, in particular, those who often worry too much about their health.

  • Those with excessive exposure to news related to COVID-19, especially fake and negative reports.

  • Those with a traumatic experience combating a severe disease in the past.

  • Those with repeated exposure to individuals who died of or suffered from COVID-19.

Dr Phang stressed that COVID-19 is not just a physical illness, it also comes with various psychosocial complications like excessive stress, anxiety, depression, burnout, loneliness, frustration, domestic violence, substance abuse, and even suicide.

“During this critical time, remember to take good care of your health, both physically and mentally,” he said, appealing to the public to not forget to pay attention to their health, during the MCO or when the pandemic is slowing down, and to seek medical advice as soon as possible if they notice any abnormal behaviour among friends and family.

Dr Phang offers the following practical advice to help people cope with the emotional distress associated with COVID-19 during the outbreak and in the post-pandemic era:

Focus on what you can do

It’s easy to feel helpless amidst the daily bombardment of messages related to the COVID-19 outbreak. Instead of panicking, which is unhelpful, let’s be proactive and channel your energy to do what you can to minimise the risk of infection. For example, wash your hands regularly, wear a medical mask if you have respiratory symptoms, avoid crowded places, cover your mouth and nose when coughing and sneezing, avoid touching your face, and rest well.

Remember – You’re not alone

Feeling isolated and believing that we’re the only ones suffering from the impact of the outbreak (e.g. travelling restrictions, economic downturn) make us feel terrible. Since we're living in a global village, we’re all negatively affected. Together, we can overcome and grow from the challenges and build a better world. Communicating our negative feelings is good for our emotional health. In the process of expressing and sharing our concerns, we realise we’re not alone in our struggles. This awareness is useful to buffer stress.

Practice mindfulness & self-compassion

The practice of mindfulness and self-compassion increases immunity and reduces inflammation. When you notice yourself worrying about the virus, try the following the ‘kindful hand’ mindfulness-based exercise:

  • Pause and take a few slow, deep, and mindful breaths.
  • Tune into your experience and pay attention to the part of the body (e.g. chest) that feels the most distress.
  • Place your hand on that part of the body and soothe it (e.g. massage, stroke, or pat the chest, sing a song, or say something positive).
  • Remind yourself that many people around the world share similar unpleasant feelings; you’re not alone.
  • Radiate kind thoughts to everyone with the same experience, “I wish myself, you, and everyone well. May all the people infected by the virus anxiety be safe, healthy, and happy”.

Be aware of the corona cyber infection

Far more infectious that the virus is the fear associated with the illness due to the spread of stories through the internet and social media. Here are some ways to curb cyber infection and prevent mass panic:

  • Check the facts with reliable sources such as the World Health Organization (WHO), the Ministry of Health Malaysia (MOH), and the Centers for Disease Control and Prevention (CDC).

  • Check if other reputable news agencies report the same stories.

  • Use, a useful internet fact-checking resource to identify fake news.

Pray and radiate loving-kindness
As a psychiatrist, Dr Phang thinks that continuously emitting kind thoughts to everyone who is emotionally affected by the outbreak is very important. For instance, people can pray (of any orthodox religion) that they and others are safe, healthy, happy and free from the viruses. According to Dr Barbara L. Fredrickson and other experts on the study of positive psychology, this kind of loving-kindness practice can help to enhance positive emotions (e.g. love, joy, gratitude, hope), physical health and perceived social connections, all which are crucial during a crisis.

Be grateful and pay attention to the positive
Dr Phang noted that in psychology, there’s a funny thing called ‘negativity bias.’ Experiments show that our brains are wired to pay more attention to adverse events, like the COVID-19, than positive ones. Luckily, our brain is also neuroplastic and can change continuously throughout life.

Therefore, we should cultivate gratitude – the habit of paying attention to and recalling the good things in life to re-programme our brains positively. This can help to lower blood pressure, anxiety, depression, improve immune function and facilitate more efficient sleep.

While waiting for the world to find a definite cure for the virus, why not make a gratitude list to remind yourself that there are still many good things in your life:

  • I can work to support my patients
  • I can take good care of my family members
  • I can sleep, eat, and have time for reading (my hobby)
  • I can write this article to support people with COVID-19 anxiety
  • I can do mindful breathing and appreciate the present moment
  • I can learn valuable lessons from the virus such as humility, appreciation and kindness

“Everything in life is impermanent. Just like the Ebola, SARS, and MERS coronavirus, the COVID-19 outbreak will eventually stabilise and come to an end. Sooner or later, we will subsequently find a cure for the disease. Remembering the natural law of impermanence helps us to stay hopeful and ease anxiety,” Dr Phang said.

Source: China Press