Anxiety in the age of COVID

Over the last 6 months we have seen a surge in cases of anxiety and health anxiety in our clinical caseload.

Far from being a local NZ situation, this has been well documented overseas as well as an emerging trend from the COVID19 pandemic. One recent paper (Asmundson et al, 2020) studied an adult population with current anxiety (n=700) and mood (n=368) disorders in Canada and the USA. They found that the anxiety group exhibited higher COVID19 related stress and anxiety (fear about infection and contamination, socioeconomic consequences, xenophobia, and traumatic stress), than healthy subjects.

The same was true for mood disorders (traumatic and socioeconomic scales were elevated). This suggests that the pandemic has been exacerbating preexisting anxiety.


Photo by Yogendra Singh on Unsplash

A shifting trend in work and study habits into a more computer-based learning/work model, as well as poor ergonomic spaces (working in bedrooms) may be implicated in rising anxiety.

Traditionally our home is our place of rest and relaxation and sleep but now we are seeing many patients with more dysfunctional sleep patterns, anxiety and cyberchondria (repeated excessive internet health related search behavior) through increased internet and web based work and schooling.

While lockdowns may have allowed some individuals to feel safe in a narrowed home environment, re-exposure to school, in person meetings and return to work after lockdowns seems to have triggered social anxiety in many of our patients. This seems to be borne out by a German study (n=1615) (Jungmann & Witthöft, 2020) which included questionnaires on anxiety associated with COVID19, health anxiety, cyberchondria, and emotion regulation. The participants reported significantly increased virus anxiety compared to pre-COVID19, and this was especially significant among individuals with heightened health anxiety. Cyberchondria showed positive correlations with current anxiety also. The findings suggest that health anxiety and cyberchondria serve as risk factors for heightening general anxiety levels.

Bottom Line: Anxiety in the time of COVID19 COVID19 is increasing stress and anxiety in adolescents and adults. Lockdowns, and lifestyle factors such as working and schooling at home, overuse of health searching (cyberchondria), and preexisting anxiety and mood disorders need to be managed with education and treatments.

Medication and psychology services remain the mainstay of treatment, but relaxation and breathing treatments along-side education around appropriate computer use and sleep hygiene are useful therapies that may reduce the burden of anxiety in our patients.

Asmundson G, Taylor S. How health anxiety influences responses to viral outbreaks like COVID-19: What all decision-makers, health authorities, and health care professionals need to know. Journal Anxiety Disorders. 2020; 71:102211. doi:10.1016/j.janxdis.2020.102211

Knopf, A. (2020), During and after COVID‐19, anxiety and depression will increase: Study. The Brown University Child and Adolescent Behavior Letter, 36: 6-7. doi:10.1002/cbl.30488

Jungmann, M & Witthöft, M. (2020). Health anxiety, cyberchondria, and coping in the current COVID-19 pandemic: Which factors are related to coronavirus anxiety? Journal of Anxiety Disorders, 73, https://doi.org/10.1016/j.janxdis.2020.102239.