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Mental health“I’m working and then sometimes my heart starts to beat faster and I have a difficult time breathing.” “And what are you thinking about when that’s happening?” I ask. “Just for a second” he says “I’m thinking I got the virus.” I was holding a virtual session with a patient the other day as he described increased anxiety for the past couple of weeks. He said they were lasting longer than usual and that his usual coping strategies—breaking the cognitive cycle of anxiety; disengaging from harmful thoughts—were not helping. He and I had discussed what he would do if he did contract the coronavirus and, before we turned to additional strategies for coping with anxiety, I said “well, you’re feeling more anxious—you and the rest of the world.” He smiled. “yes of course,” he said.

The rhythm of our daily lives has been upended. Our family and work routines—the train, car or subway to work; saying hello to staff in our building; getting settled in our office; stopping by to say hi to colleagues down the hall—those and so many other minute and routine daily behaviors and interactions, all gone for now. What we are left with is ourselves in the place we inhabit alone, with family, or with roommates. These routines and the places that represented the order of our work week and gave structure and meaning to our professional lives have vanished—and been replaced by Zoom. For who knows how long. Of course we are anxious. How could we not be?

Anxiety—unlike a Major Depressive Episode—does not necessarily indicate an illness. Though anxiety is an unpleasant experience, anxiety like other emotions such as anger, sadness, and guilt, can be the normal response to a given situation. This is because anxiety, like other emotions, has a function. The function of anxiety is to prepare us to meet an anticipated but still undefined threat or challenge.

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