C.J. is a recently divorced 38-year-old mother “going through a lot of stuff.” I hadn’t seen her since the start of the pandemic. Entering the exam room, I saw her, and she was wearing a hat, two face masks, and oversized plastic gloves—at least she wore designer sunglasses. I was a little taken aback and asked if she was OK. She blurted out that she had received both vaccine doses, but she has a 7-year-old that she needs to protect.
Sadly, I’ve seen way too many patients like C.J. this past year. Fear has taken over their lives. It didn’t matter how well I explained that her fears—while understandable with all the media hype—were irrational. They were only irrational to me. To her, they were rational. I get that.
Fear has become a disease of our time. Fear is commonly defined as the belief that someone or something is dangerous and likely to cause pain or act as a threat, such as a shark swimming next to you.
My fears include blood in the belly or a fetal heart rate dropping. That’s probably because I spend half of my time in my clinic and the other half as a hospitalist, managing emergencies that show up in the emergency department or labor and delivery.
Fear is a healthy emotion to own when applied within reason. But there are also irrational fears that don’t compel us toward better decisions—only toward more fear.
False fear lives only in our thoughts and imagination. We all exhibit false fear at some time in our lives, but we usually handle it and it quickly subsides. Like my fear of tight spaces. I don’t like it, but I can control it. That said, don’t ever put me in the middle seat on an airplane!
I asked C.J. what she was afraid of. Her response was “dying from COVID and leaving my daughter alone.” She now homeschools her daughter and only ventures out when absolutely necessary. She quoted statistics she had read and stories she had heard from TV and social media. Those statistics even scared me! Never mind that they were false, but she believed them.
How does a smart, seemingly rational person start down this rabbit hole of fear? Fear-mongering media companies certainly play a role. And the consequences of this fear are severe. This type of pathological fear becomes anxiety, worry, and stress. Since the pandemic, we’ve seen skyrocketing rates of anxiety and stress-related disorders, as well as other serious mental health issues.
Every action we take in medicine or health care policies has unintended consequences, and that includes lockdowns and social distancing requirements. The increase in teen suicide rates since the lockdowns is one example. So is the increase in people—including children—being medicated with anti-anxiety and anti-depression medications.
How does one combat these irrational fears? The root of the problem is that these fears are based on belief—and all too often, our beliefs become fixed. We stop taking in new facts, revisiting our assumptions and only accepting information that validates what we already believe.
If you meet someone like this, finding common ground is a good first step. Acknowledge that the person’s fears are real to them. Not the illusory facts, but the fear itself. Don’t invalidate how they feel.
I told C.J. that I know COVID-19 is bad and none of us want to get it. I told her how I had operated on active COVID-19 patients, but controlled my fear. That may not have been the best thing to tell her, since she looked set to hold her breath until I left the room. I’m not going to tell you that I convinced her that all was fine and she should start to live her life again. I did get her to agree to talk with a therapist who could help her and, by doing so, help her daughter as well.
This pandemic of fear is, in part, rooted in being overloaded with limited types of data. Our brains have to sift through and determine what we think is or isn’t valid. Unfortunately, some numbers are broadcast over and over again, such as the number of new COVID-19 infections, while other numbers are rarely heard, such as the number of people infected who never even felt ill. Even as we are overwhelmed with some data, we are deprived of crucial context for other data. Sometime we just need to take a break from data dumps that offer nothing but fear.
Amid all of this uncertainty, finding support is critical. This can be spiritual (religious networks), physical (exercise and the outdoors), and mental (meditation and soothing activities like hobbies).
There are studies that find higher intensity exercises can be very beneficial for treating anxiety and fear. Yoga has been shown to reduce symptoms of generalized anxiety.
C.J. actually sent me a note a few weeks ago. She was doing much better. She started going on long walks with her daughter. They even went to the beach. She did see the therapist to whom I referred her, which was of great help.
When I went into medicine, I never thought I would be counselling my patients as though I were a therapist. However, it’s amazing how much we can all learn by just listening to what another person is saying and being able and willing to help. Many people just need someone in their life to help put their irrational fears in check and encourage a broader perspective. It’s something we may all want to consider, given the dangers of too much fear. Yoda said it best. “Fear is the path to the dark side. Fear leads to anger. Anger leads to hate. Hate leads to suffering.”
