As days in lockdown turn into weeks and cases of the novel coronavirus continue to grow, many people may feel overwhelmed with anxiety — both about what might happen in the future, and what could happen if they get sick.
But intense anxiety can, in some cases, cause similar symptoms to COVID-19 itself.
Here's what experts recommend for telling the difference between anxiety and the coronavirus, and how to cope with the stress of living through a global pandemic.
Being isolated at home, inundated with news of a global health crisis, and fearing for the health and safety of ourselves and loved ones, can be a constant source of stress, according to Theresa Nguyen, LCSW and chief program officer for Mental Health America.
This can cause your body to over-respond with defense mechanisms, she explained, similar to other types of trauma.
"In trauma, toxic stress and anxiety, your body always feels like it's under assault, it's always telling itself something is a threat, your body is constantly pushing those chemicals for the tiger that's going to attack that never comes," Nguyen said.
Shortness of breath, muscle pain, headaches, nausea, and extreme fatigue could be signs of the coronavirus. But prolonged periods of heightened stress can also cause shortness of breath, rapid heart rate, digestive issues, fatigue, and even muscle pain, according to Dr. Venus Nicolino, a doctor of clinical psychological known as Dr. V.
"It's normal to feel brief anxiety every now and again because anxiety and the physical symptoms that accompany it alert your body to threats and possible danger," Nicolino told Insider via email. "Short stress responses are vital to our survival but kept in this gear for too long, it's a crash and burn situation."
This can include a major spike in your heart rate and breathing as your body tries to make more oxygen available.. But that can make it feel like you're actually gasping for breath, causing more panic.
At the same time, your muscles will tense up, which over time can cause headaches and muscle pains. Finally, the rush of cortisol and adrenaline, hormones that prep your body for an emergency, can lead to digestive issues, trouble sleeping, and other issues. All of the above can end up leaving you exhausted, Nicolino said.
"If you had never experienced anxiety before in your life, these new experiences you have are all very scary right now," Nguyen said. "And with everything that's new right now, people are suspicious of the coronavirus, which brings up an automatic response of fear."
The biggest difference between coronavirus symptoms and anxiety symptoms is that symptoms of COVID-19 won't go away once you've calmed down.
Check in with yourself to assess what you're feeling — are you able to slow your thoughts and breathing down? Were your symptoms triggered by some exposure to stress, possibility after hearing concerning news from a friend, family member, or the media?
Nguyen recommends two techniques for regaining control during moments of panic. First, try box breathing or square breathing — envision a box, inhale and exhale for a slow count of time (4 seconds is a common recommendation), imagining your breath moving along the sides of the box. Picturing the box can help focus your mind on something other than panic.
She sometimes has clients imagine putting their problems or fears inside the box and locking it up or getting rid of it.
Next, ground yourself in the present moment by focusing on what you can see, hear, smell, taste, or feel. Mental Health American offers a step-by-step guide that includes strategies for bringing your mind back to a calming space.
If these practices alleviate your symptoms, it's likely you're experiencing symptoms of anxiety, not coronavirus.
"You are grieving your new normal. Nothing you had available is necessarily available now," Nguyen said. "We're dealing with trying to triage our mini crises and being aware at any moment the decisions we make might not be available anymore."
"Fear and anxiety can work for us, just as long as they're in the gas tank, not the driver's seat," Nicolino said. "My point is that a little anxiety can go a long way. It keeps you quarantined, social distancing, washing your hands 40 times a day and checking the CDC website for updates."
Daily habits like exercising, taking a break from news and social media, spending time outdoors, and staying in touch with loved ones virtually can help keep anxiety from taking over, she said.
But if those feelings begin to interfere with your daily life, it may be time to seek professional help.
Many mental health experts, from therapists to couples counselors to psychiatrists, have moved their practices online.
Nguyen encourages people to seek help sooner rather than later, since it can be a time-consuming process to find the right therapist.
"We all often wait until its a little too late, we need it right now, and we try to get it and realize there are a lot of barriers," she said.
Nguyen said that some of her clients who previously struggled with severe anxiety are handling the coronavirus outbreak with surprising calm. That's because they're familiar with the symptoms of anxiety, and are able to recognize them as part of a psychological response, not an impending illness, she said. People with previous anxiety issues are also more familiar with coping mechanisms, and may have the tools to help calm themselves.
There are some common physical signs of coronavirus infection that aren't linked to anxiety. A fever and dry cough are among the most common symptoms experienced by people with COVID-19. If you have these symptoms, stay home, get plenty of rest, and monitor any changes.
Other symptoms, like a runny nose or sneezing, are more likely to be a common cold or allergies.
Even if you don't feel sick, continue to practice social distancing, hand washing, and other guidance from health officials, since evidence suggests even people without symptoms could spread the disease.
10 ways to cope with coronavirus anxiety, according to psychologists