Anxiety and Depression in a COVID-19 World
by J. P. Moreland
In 2003, 15% of the U.S. population between the ages of 18–54 (40 million people) suffered from an anxiety disorder1. Since then, the numbers have increased. Anxiety disorders are the most common mental illness in America (with depression second), and they affect women and teenagers especially hard (besides post-traumatic stress disorder, women are twice as likely as men to have an anxiety disorder). More generally, anxiety disorders affect around one out of every 13 people2. And given the strange situation we find ourselves in this COVID-19 world, most of us have experienced an increase in anxiety/depression (hereafter, anxiety).
There is a very important coping device in these statistics: You are not alone, a sick-o, a hopeless cause or a failure as a Christian. The next time these thoughts come into your awareness, remember that they are lies! Through practice, change your self-talk to reflect the truth: You are a normal member of American society with millions like you, you live in a very stressful culture that is so individualistic that community and friendships are rare.
Statistics show that there is reasonable hope to significantly minimize or get rid of anxiety entirely if you do the right things. If you do the right things, it is quite likely you will get much, much better. Recall this to mind if you are in need and feel alone and picked-on by God: I Corinthians 10:13: “No trial or hardship has overtaken you but such as is common to man;” and I Peter 5:9: “ … knowing that the same experiences of suffering are being accomplished by your brethren who are in the world.”
What causes anxiety? I offer this list so you can engage in an exercise. You may want to slowly read through the list with pen and paper in hand, note the factor or factors that seem most relevant to your situation (rank them in order of importance if you can), and jot down some initial thoughts about what you can do to engage properly those factors3:
- Genetic Predispositions
- Parenting (over-protective, over-controllers, inconsistent responders)
- Early Childhood Experiences that Fostered Shame or Insecurity
- Current Lifestyle (especially stress, stress, stress; but, also, unanticipated threats, escalating demands, confidence killers, negative self-talk, terrorizing trauma, significant change)
Due to space limitations, I want to suggest that during these difficult times, you practice what Christian neuroscientist and UCLA professor Jeffrey Schwartz and Rebecca Gladding, M.D. call The 4-Step Solution, a habit-forming exercise for replacing negative with positive self-talk4:
Step 1: Relabeling
These thoughts are simply uncomfortable, deceptive, destructive brain messages that are mere habits of mine with no connection to reality. Call these messages what they really are — merely bad, false habits. In practicing step 1, always invite God to help you attend to your self-talk (see Psalm 139:23–24); this both provides a biblical basis for step 1 and it offers us guidance in practicing it wisely: “Search me, O God, and know my heart; Try me and know my anxious thoughts; And see if there be any way of pain in me, and lead me in the everlasting way [in the path of health with joy and peace].”
Step 2: Reframing
Label the self-talk message correctly under one of the major types of distorted thinking patterns5:
All or nothing thinking (If you’re not perfect or get anything wrong, you’re a total failure.)
Overgeneralizing (“I always do that.”)
Mental filter (You pick out a single negative detail and dwell on it.)
Discounting the positive (If you did a good job, you tell yourself that anyone could have done it.)
Jumping to conclusions or mind reading (Interpreting others’ actions, tone of voice or body language in a negative way — and fortune telling — you assume and predict that others don’t like you and that things will turn out badly.)
Magnification or catastrophizing (You engage in “what-if” thinking and exaggerate your weaknesses or the harmful aspects of events that may happen, and minimize your strengths or the odds that the event will never happen and, even if it did, the results won’t be that bad.)
Emotional reasoning (You actually believe that reality is the way you feel.)
Avoid inappropriate “should” statements (Example: “I should avoid being around people because they will see what a loser I am.”)
Self-labeling (“I made a mistake so I am a loser.”)
Self-blame (You blame yourself for events outside your control).
In a study performed in 2007 by UCLA psychologist Matthew Lieberman, it was discovered that the simple act of helping a suffering patient know the name of the negative emotion and labeling it appropriately helped the patient calm down and lower his/her emotion’s intensity6. Steps 1 and 2 combined are designed to do this with anxiety-producing self-talk.
Step 3: Refocusing
Refocus your attention on something that distracts you and gets you into a flow — move on. Flow occurs when you are so focused on something that you lose track of time and what is going on around you. The key is not to ruminate about the message, arguing with yourself why it isn’t true, or drawing out horrible implications of it. Such rumination, even telling yourself why the message isn’t true, actually deepens the brain groves that trigger the message and makes it harder to get rid of.
The goal is to move away from the message that is disempowered by steps 1 and 2. Have ready something that can distract you and it need not be particularly spiritual. Start reading a book, check out your favorite website, interact with someone on the phone or by email, listen to music, watch a television show for a while. Do something for 15–20 minutes that takes your mind completely off the negative self-talk. After weeks of practice, you will need to take only a minute or two to get into a distracting flow. Step 3 offers one a way of turning to something after steps 1 and 2 have helped us turn away from something.
Step 4: Revaluing
After a while and when it is safe to go back and reflect on your employment of steps 1–3, then reflect on what you did, be strengthened by what you did well, learn from your mistakes, and recommit yourself to doing this repeatedly throughout each day to make all this a habit.
Learning to deal with anxiety and depression involves much more than practicing the 4-Step solution, and I have written elsewhere about a broader approach that includes further resources to help you7. But the 4-Step solution is a biblically, psychologically and practically sound aid for coping with anxiety and depression.
1 Edmund Bourne and Lorna Garano, Coping with Anxiety (Oakland, CA: New Harbinger Publications 2003), p. vii.
2 See Edmund Bourne, The Anxiety & Phobia Workbook: 5th Edition (Oakland, CA: Harbinger Publications, 2010), pp. 1-4; “Eight Facts about Anxiety and Anxiety Disorders,” https://www.elementsbehavioralhealth.com/mental-health/8-facts-anxiety-anxiety-disorders.
3 Bourn and Garano, Coping with Anxiety, pp. 6-10; Charles Elliot and Laura Smith, Overcoming Anxiety for Dummies (Hoboken, N. J.: Wiley Publishing, 2003), pp. 47-50. For the most comprehensive exposition of causes of anxiety, see Edmund Bourne, The Anxiety & Phobia Workbook: 5th Edition, chapter 2.
4 Jeffrey M. Schwartz and Rebecca Gladding, You are not Your Brain: The 4-Step Solution (New York, New York: Avery, 2011).
5 See Harriet B. Braiker, “The Power of Self-Talk,” Psychology Today (Dec 1989): 23–27.
6 See Geert Verschaeve, Badass Ways to End Anxiety and Stop Panic Attacks! (Spring City, PA: GVPublishing, 2017), 119.
7 See J. P. Moreland, Finding Quiet: My Story of Overcoming Anxiety and the Practices that Brought Peace (Grand Rapids, Michigan: Zondervan, 2019).