COVID-19 Anxiety
Topics covered on this page:
What is anxiety?
Anxiety is a feeling of worry, uncertainty or stress. It is completely normal to feel anxious or stressed during this pandemic as you may feel worried about protecting yourself from the COVID 19 virus (and those around you).
- How does it affect me? Even mild anxiety can affect the quality of your everyday life. It can affect how you feel about situations and people. It can also affect your ability to carry out your daily activities at home and work. How anxiety is felt can be very different from person to person.
- Does it get better? Feelings of anxiety can improve or get worse at different times. Depending on the cause, anxiety may come and go (e.g., when you’re waiting for test results). Or it may feel like it’s there all the time (e.g., because of uncertainty about the future). Self-management strategies can help improve anxiety in many cases (see What can I do to help manage my anxiety?).
What causes anxiety during the COVID-19 pandemic?
You may feel especially anxious with the uncertainty related to the COVID-19 pandemic. Some—but not all—of the things that may cause anxiety as you are coping with COVID-19 stress and cancer include:
- Fear about your own health and the health of family and friends
- Needing to depend on family and friends
- Feeling stressed about having to organize medical appointments
- Feeling socially isolated because of living alone or inability to have visitors
- Worrying about the future
- Feelings of sadness either for people who have caught the virus or for your loss of routine or safety
What are the signs of anxiety?
Anxiety can have many different effects on your body and mind. Typical signs of anxiety include:
- Irritability, impatience
- Restlessness, difficulty relaxing
- Worrying more than usual
- Loss of interest in social activities or seeing people
- Difficulty with tasks or activities that you usually find easy
- Difficulty concentrating or making decisions
- Headaches
- Loss of appetite
- Trouble sleeping
- Stomach discomfort
- Fatigue
- Dizziness, vertigo
- Diarrhea
- Nausea
- Choking sensation
When should I get help for my anxiety?
It is normal to feel anxious during an infectious disease pandemic. However, if your anxiety is so bad that you feel overwhelmed or that you can’t cope, you should talk to to your oncologist, your nurse, or your pivot nurse at your next appointment (For tips on talking with your healthcare team see Talking to your healthcare professional about your symptoms or concerns). If any of the following situations are true for you, it probably means your anxiety is too much for you to handle on your own:
- You feel “frozen” and that anxiety is preventing you from doing the things you have to do or want to do.
- You experience any of the signs of anxiety very strongly and/or all the time.
- You can never sleep through the night.
- You can’t make necessary decisions.
- Your worries and fears are hurting your relationships.
- You can’t cope with your basic daily activities.
- You can’t seem to enjoy life at all or look forward to the future.
- You frequently experience sudden shortness of breath, fast heartbeat or chest pains.
Talk to someone in your healthcare team immediately if:
- You have had an experience with depression or an anxiety disorder in the past.
- You have a history of physical or emotional trauma.
- You are having thoughts about harming or killing yourself. If you can’t reach someone in your healthcare team, call Suicide Action Montreal at 1-866-277-3553.
What can I do to help manage my anxiety?
There are many things that you can do to manage your anxiety and to keep it from getting worse. To help you cope with your anxiety, you may want to use ways that have worked for you in the past to help lower your stress. If these do not work as well as before, think about trying something else. You may have to test a few different things to see what works best for you. Below are some suggestions you can try.
- Keep a diary of when you feel anxiety. Write down:
- When did it start?
- What seems to make it worse?
- What makes it better?
- Track if there’s anything you do, like meditation or exercise, that lessens your anxiety.
- For more information see Symptom Diary.
- Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic can be upsetting.
Looking at what is happening in the world can make you feel helpless. This can drain your energy and take your attention from what you can control.
- Think what you can do instead of what you can’t
- Following a daily routine can help
- Knowing more about COVID-19 and your cancer, your cancer treatment options, and the side effects of treatment can help you feel more in control and less anxious.
- Understand how you can protect yourself and those you live with from COVID-19 by practicing the recommended precautions—this can help you to feel less anxious (see the COVID-19 factsheet).
- In between appointments, keep a list of questions to ask your oncologist (or radiation oncologist) at your next visit. You may worry less if you feel more prepared.
- When you feel anxious or stressed, it can be difficult to ask your doctor questions or speak up for yourself. But being assertive in this way can help remove some uncertainty that may be causing your anxiety. It can make you feel a bit more in control.
- Sleeping well can give you more energy and help reduce anxiety.
- If you are having trouble sleeping, try doing an activity that you know relaxes you before going to bed, such as listening to music, reading or meditating.
- It is recommended that you turn off computers and tablets at least one hour before you plan to go to bed—the bright screens of these devices can trick your brain into thinking it is daytime and make it hard to sleep.
- A healthy, balanced diet can help boost energy and improve your mood.
- Foods that help physical and mental well being include: fruits and vegetables, foods rich in omega 3 fatty acids (e.g., salmon, mackerel, sardines, flaxseeds, soybeans) and B vitamins (e.g., eggs, dairy products, whole grains, broccoli, spinach).
- Limit foods that are high in fat, sugar or salt, such as processed foods, desserts, sugary drinks and fast food. Also limit caffeine and alcohol—both can make anxiety worse.
- Check with your healthcare team to find out if there any foods or beverages that you should not eat or drink because of your cancer or treatment.
- For more information see Looking after yourself.
- Regular exercise can help improve your sleep, as well as help you relax and reduce anxiety. It may also help you manage pain and fatigue better, and improve your appetite.
- It is generally fine to exercise during treatment, but check with your healthcare team before starting any exercise.
- Choose an activity or exercise that you enjoy doing and can practice safely keeping physical distance from others. Try activities you can do at home like gardening or vacuuming. A goal amount of activity to gradually work towards is about 3 sessions of 10 minutes daily of moderate activity.
- Pay attention to what your body tells you—only increase the amount and difficulty of your activity when you feel comfortable.
- For more information see Get Moving.
Relaxation strategies are a useful way to help relax your mind and body, and reduce anxiety. The good thing about these techniques is that they can be done within the comfort of your own home.
- Breathing exercises. This technique focuses on slow, deep breathing. Even a few minutes of deep breathing can help you relax. Try an online breathing or meditation class.
- Progressive muscle relaxation. This involves tensing and relaxing a muscle, or group of muscles, one at a time.
- Guided imagery or visualization. Some people find that this technique relaxes them by helping them imagine or visualize being in a place that makes them feel calm in real life. Guided means someone talks you through the process in person or using a recording.
- Meditation. Meditation is a practice of quieting the mind, usually by focusing attention on the breath. You can meditate sitting, lying down and even walking.
- Massage therapy. Use a certified massage therapist who has experience working with cancer patients.
- Relaxation activities. Yoga (some types) and tai chi involve slow, meditative movements that help relax the mind and body.
- For more information see Relaxation Strategies.
Take a break from thinking and talking about COVID-19 —try to do something you enjoy every day. It could be as simple as listening to music, reading a book, watching a funny movie or spending time with people who make you laugh.
- Make time for your hobbies or other creative outlets that have always brought you joy in the past. You might want to try something new that you’ve always wanted to do—creative writing, online art or music lessons.
- Don’t try to deal with your problems all on your own. It can be difficult to ask for help, particularly from family and friends—but it is important to let the people in your life know when you need help so that you don’t get overwhelmed. Lean on family and friends for help, connect by phone or online!
- Talk about your feelings and fears with a family member or friend who is a good listener—or you might like to share your worries with people in a support group who have had experiences like you.
- You might prefer to talk on your own to a professional counsellor, such as a psychologist. A psychologist can help you think about your worries differently and give you ideas to help you manage your anxiety.
- For more information see Getting Support.
⚠ Important information about cannabis
Some patients do use cannabis to reduce pain, help with relaxation or as a sleeping aid. However, the research is still unclear about the use of cannabis to manage cancer-related symptoms, including anxiety. It is important to talk to your doctor before trying cannabis. For more information on what cancer patients should know about cannabis, go to: www.bccancer.ca/health-info/coping-with-cancer/medical-cannabis.
Resources
For more information on cancer-related anxiety, COVID–related anxiety, self-management strategies and support organizations, check out the resources below.
University Health Network – What Cancer Patients Need to Know About COVID-19
BC Cancer – COVID-19 and Cancer Treatments
Canadian Cancer Society – Coping with cancer and COVID-19
Government of Quebec – Protecting your well-being in the COVID-19 pandemic
Acknowledgement of sources
The content of this document has been adapted from the following sources:
- BC Cancer. Anxiety. 2018.
- Canadian Cancer Society. Coping With Anxiety and Stress. 2019.
- Canadian Cancer Society. Coping When You Have Cancer. 2017.
- Cancer Care Ontario. How to Manage Your Anxiety. 2016.
- Coping-Together. Dealing With Stress and Worry.
- COSTaRS. Anxiety. 2016.
- Quebec Cancer Foundation. Anxiety and Depression. 2020.
- University Healthcare Network. Managing Anxiety After Cancer Treatment. 2017.
- University Healthcare Network. What Cancer Patients Need to Know About COVID-19. 2020.
- BC Cancer. COVID-19 and Cancer Treatments. 2020.
- CDC Mental Health and Coping During COVID-19. 2020.
- Canadian Cancer Society. Coping with cancer and COVID-19. 2020.
- Canadian Cancer Society. Being active. 2020.
Healthcare professional endorsement
The content of this document has been reviewed and approved by a team of healthcare professionals and clinical experts.
Disclaimer
Please note that this fact sheet is not intended as a substitute for consultation with a healthcare professional. Rather, it was designed to complement interventions by your treating team. If you have questions about your health, or any medical issue, you should contact a healthcare professional right away. You should not delay seeking medical advice, or disregard professional medical advice, because of information in this fact sheet. Before beginning any health treatment, always consult your doctor. All care has been taken to ensure that the information contained in this document is accurate at the time of publication. e-IMPAQc is not responsible for any injury or damage to persons or property arising out of, or related to, any use of the fact sheet, or because of any errors or omissions.
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