Stay in the Present (and Toss your Crystal Ball)
MEDICAL AND MENTAL HEALTH UPDATE
“Dr. McBride, is this winter going to be a disaster with the flu and COVID together?”
“Do you think the coronavirus vaccine will be safe?”
“When will the pandemic be over?”
These are some of the (excellent and valid) questions I’m hearing from my patients on a daily basis. I am more than happy to address them. After all, it is my job and my pleasure. I am here to help!
However, it’s important to recognize that these are not medical questions; they are anxiety-driven questions.
What do I mean, and why does this matter?
First, as much as I’d like to be clairvoyant, I’m not. (Please don’t tell my kids.) The trajectory of the pandemic—and whether the winter will be the proverbial COVID shit show that the media suggests—is entirely dependent on human behavior.
In other words, it’s not a mystery whatsoever as to why the virus surged this summer. It’s not because the virus is more virulent. It’s not from touching pizza boxes or inhaling toxic toilet plumes. It’s not because doctors, scientists, and epidemiologists don’t know how coronavirus is transmitted.
The pandemic is bearing down on us because we started to move about, congregate indoors, socialize up close, and (naturally) grow weary of the vigilance required to shut this beast down.
But to answer the question: Because the pandemic hinges entirely on human behavior, I cannot accurately predict what the fall and winter will hold.
If we all double down on masks, social distance, avoid crowded indoor spaces, and wash hands, we’d slam the door on COVID!! We’d also have a quiet flu season! (Recall that the flu spreads almost exactly how COVID does: person-to-person through respiratory droplets.) But if we submit to this unforgiving virus, we can expect a rise in COVID and flu infections.
So when we ask these impossible-to-answer questions about the future, it’s essential to identify their REAL origin.
It’s called anticipatory anxiety—or “future state” anxiety.
Intellectually we know that even on a good day, the future is uncertain. We know that even Dr. Fauci can’t predict when the pandemic will end. We know that we can’t evaluate the risks of a vaccine that doesn’t yet exist.
We also know that anxiety hates uncertainty. Rather, anxiety craves predictability, consistency, and sameness. It wants answers. It wants to know the future. It wants to control the uncontrollable.
So it’s natural to seek a crystal ball, Ouiji board, or palm reader. It’s our brain’s way of attempting to quell anxiety.
So what do I tell my patients seeking unknowable truths? Do I dismiss them for being worried? Do I shame them for asking questions that no one can answer? Not at all.
Instead, we address the mental gymnastics caused by uncertainty and fear. We discuss the amount of brain space occupied by excess worry. We assess the emotional, physical, and medical consequences of anticipatory anxiety. Because while some amount of worry is normal, it can easily overtake us and cause harm.
Even if situational, excess worry needs to be identified and managed. Waiting for a vaccine, widespread testing, or herd immunity to turn off the anxiety spigot means depriving yourself of the very control you crave right now.
In fact, for anyone trying to exert some control during this unpredictable time, I highly recommend moving anticipatory anxiety OUT of the driver’s seat.
Just because the media cues us to worry about the upcoming “twin-demic” of the flu and COVID doesn’t mean you have to react to it.
Just because we don’t know what the vaccine will look like doesn’t mean it’s productive to think about it now.
Just because we don’t know when the pandemic will be over doesn’t mean we have to live in fear.
We have a heck of a lot more control over TODAY than we think. And the cool thing is that once we identify the funky free-floating fear-of-the-future feeling, we can actually DO something about it. Right now.
There is no one-size-fits-all recommendation, but try starting with this checklist:
☑️Exercise daily.
☑️Get outside.
☑️Learn to breathe. (Not just to qualify as being alive, but REALLY breathe.)
☑️Write down your worries and fact-check them.
☑️TURN OFF THE NEWS.
☑️Ask for help. There is no prize for doing this alone.
I am right here with you, breathing, moving, spending time outside, and talking to whomever will listen. (Thank you, my dear readers!! You help me stay present.)
I’ll see you later this week. Until then, be well.