Anxiety Is Contagious. Here’s How to Contain It.

Anxiety Is Contagious. Here’s How to Contain It.

by Judson Brewer - March 18, 2020

As my class began on Thursday (March 10th), I looked around at my undergraduate and graduate students. Their faces were somber. I asked how they were doing, but I already knew. Harvard and Princeton had, days earlier, announced that they were closing in response and as a precaution to the COVID-19 pandemic. My wife, a professor at Holy Cross, told me the night before that her students were informed they would have a week to pack up and leave their dorms.

My students were waiting to get an email from Christina Paxon, the president of Brown University. It was rumored that Brown may be closing for the rest of the semester and the announcement was scheduled to go out early that morning. But here we were, at 9am, sitting in a technology-free seminar without access to our phones or computers.

Even though their devices were off, my students’ phones were burning holes in their pockets. My tech-free policy was blocking them from receiving vital information. Did the email go out yet? What was it going to say? Their slumped shoulders told me that they were in no mood for debate. They needed to know what was going to happen to them today. This email was going to affect their lives in significant ways - particularly my seniors’, some of who were holding back tears. Their “senior spring” was destined to go down in the record books as the most memorable, and not in a good way.

Perhaps the most difficult part of this pandemic is the uncertainty we are all facing. Uncertainty about how contagious and deadly Coronavirus is. Uncertainty about the travel that we have planned. Uncertainty about the economy. Uncertainty about our jobs.

Yet, uncertainty can be compared to a virus itself, one that is only adding fuel to the anxious fires burning in many of us. This is because uncertainty triggers the fear centers in our brains. Knowing how this process works, however, can help us take proper countermeasures and develop better mental hygiene.

First, it’s important to understand that fear is a basic human mechanism. It helps us survive. When something scares us, we are triggered, and through fear, we learn to practice behaviors that will help us avoid that danger in the future. When we successfully avoid that danger, we then feel rewarded. We inherited this three-step mental process from our ancient ancestors: see saber-toothed tiger (trigger), run away (behavior), live to tell our kids to avoid that part of the savanna (reward).

While fear helps us survive, when mixed with uncertainty, it can lead to something quite bad for our mental health: anxiety. And when anxiety is spread by social contagion - defined as the spread of affect from one person to another — it can lead to something even more problematic: panic. Just like walking into a party and suddenly feeling like you’re in a “social mood” when you hadn’t been moments before, fear and anxiety are two emotions that spread easily from one person to another.

Worse, thanks to social media, you don’t need to be in physical contact with people to catch an “emotional infection.” While many people on social media have good intentions and intend to share useful information about Coronavirus with the masses, as they report supply shortages and speculate on how bad things might get, they may be inadvertently doing the opposite. Constantly scrolling through the latest news on your phone or desktop is like walking by people who are sneezing fear. The more you read, the more you are likely to take on their worry, and spread it. The problem is that these emotions keep us from being able to think straight, and when overdone, they no longer protect us from dangers. Rather, they become the danger.

There are ways to combat this. Perhaps one that may be really effective, according to my research and that of others, is mindfulness.

The class I was teaching at Brown on Thursday morning serves as a case in point. In that particular seminar, my students are taught about the various scientific methods that are used to study the process and outcomes of mindfulness training. That day, we were scheduled to explore the relative benefits and detriments of functional magnetic resonance imaging (fMRI) as a tool for measuring the neural correlates of mindfulness. Put plainly, we were examining whether peering into someone’s brain as they meditate is an effective way to gather accurate information and move the scientific field of mindfulness, which is still very novel, forward. The students had been assigned to read some early studies that my lab published on the effects of mindfulness back in 2011. I was particularly interested in hearing how they digested the research. But I needed to help them calm their anxieties before we could move forward.

We spent the first fifteen minutes of class meditating, the same way we had begun each class this semester. (It is hard to measure how mindfulness works if you don’t first have a sense of what it is.) I led them in a type of meditation called “loving kindness.” This practice is aimed at awakening and fostering our inherent capacity for kindness and connection. It is a type of mindfulness that my lab has studied for years. We’ve found that loving kindness decreases activity in the very same brain regions that get fired up when people are anxious.

More recently, we’ve found that even simple, app-based mindfulness training, which teaches people how to use a number of in-the-moment exercises, significantly reduces anxiety in healthcare workers. We found a 57% reduction in clinically-validated measures of anxiety in stressed physicians. This kind of training also reduces anxiety in people with Generalized Anxiety Disorder. We found a 63% reduction in anxiety in our NIH-funded randomized controlled trial.

With this context, loving kindness meditation seemed like  the perfect Purell for my students’ minds that morning.

I asked my students to close their eyes and take a deep breath. I told them to bring to mind dear friends or family pets, and ground themselves in feelings of love that arise when they picture those images. I told them to repeat silently to themselves simple heartfelt phrases of kindness (e.g. “May you be happy.”) as anchors to keep them in the present moment. The practice is as simple as this: bring to mind a family member, a pet, a loved one, and silently offer them a phrase of well-wishing that feels authentic to you. Use the image and repeat the phrases at your own pace to help you stay anchored in the present moment. If your mind wanders, simply bring back to mind the image and begin repeating the phrase again.

After we finished the meditation, they were visibly more relaxed, but still not ready to engage with the day’s discussion. With the hope that they were more armed with some calm and present-centered awareness, I broke my technology-free classroom rule, and let my students check their phones for the anticipated email from President Paxon. I could tell by their eyes that it had arrived. They were glued to their screens.

I asked one student to read the email aloud to the class. Brown was moving to online learning for the rest of the semester. Classes were cancelled for the following week, and students were expected to vacate their dorms as soon as possible. They were also expected not to return to campus after spring break the following week. Though President Paxon tried to convey a hopeful note, writing that Brown was working to ensure that seniors and alumni could return to campus for graduation and reunions, I could see many of my students were defeated.

We spent the next fifteen minutes discussing how to utilize the very mindfulness training practices that we were dissecting in the course (breath awareness, loving kindness, etc.) to help them prevent the spread of social contagion, and maintain healthy mental hygiene. I encouraged them to begin as soon as they walked out of class. Beyond loving kindness, here is what we discussed. If you find yourself experiencing similar anxieties, I recommend you try them too:

1) Run a code. In medical school, when I learned how to “run a code” - our code for resuscitating someone who’s heart had just stopped - I was taught to first stop and take my own pulse. This reminded me to pause and take a deep breath (or three) before proceeding. Taking a mindful pause works by keeping the thinking parts of our brains “online” so we can help rather than hinder. Taking a moment to pause in stressful situations, whether that means you take three deep breaths or simply pay attention to the feeling in not-anxious parts of your body (like your feet or your hands), helps ground you in calmer emotions. Especially for people who haven’t practiced mindfulness before, focusing on the parts of your body where you typically feel anxiety, such as your chest or stomach, only heightens your awareness of the negative feeling, and often makes it worse. That’s why grounding yourself in more neutral areas can help you stay connected to yourself in the present moment without triggering more anxiety. Another way to do this is to anchor your awareness in an external object (e.g. look out a window at trees or nature, or listen to the sounds around you). These are simple, ten second practices that anyone can do. Practice them when you feel your heart beginning to race as a sign of a social sniffle, so that you don’t sneeze and spread social contagion.

2) Get in touch with your “calm.” On top of simple mindfulness practices, you can also take a moment to pause and notice what it feels like when you are calm among the storm of people unknowingly spreading social contagion. When you do, you will notice that calm feels a lot better than anxiety. Use this to hack your brains’ reward centers. When given a choice, our brains will learn to perform the action that is most rewarding. Calm is the obvious, more rewarding choice when compared to anxiety. The more you practice it, the more it will become your norm rather than your exception. You can also look around to see if your calm catches. It might not be as contagious as fear, but done over and over, it can go a surprisingly long way to not only disinfect your brain, but spread that natural immunity that comes when you step back and see that we are all in this together.

3) Take it one day at a time. Our brains are hardwired to plan for the future. We don’t have enough information right now about how this pandemic is going to play out to plan 6 months down the road. If/when you notice that your brain is starting to spin out into future thinking and worry, take a mindful pause and remind yourself to take it one day at a time. Do what needs to get done today, and then take care of tomorrow, when it comes: tomorrow. When it comes to information, the closer to now you stay, the more clearly you will be able to think. For example, you can check in with yourself right now to see if you are hungry or thirsty. Based on that information, you can decide whether you need to eat or drink something. You cannot only remind yourself to take it one day at a time, but if needed, to help you stay calm, use an even smaller timescale. Ask: What do I need to do this hour? Take on the day hour by hour, minute by minute, and even moment by moment if thats what it takes to stay grounded in the present moment.

Knowing that uncertainty can spread social contagion through the viral vector of anxiety and coupling this with some simple mindfulness practices can help us all stay mentally connected and spread calm instead of germs. In moments of doubt, use the above practices to calm your mind, to stay present, and move forward.

Judson Brewer, MD, PhD, is an associate professor at Brown University’s Schools of Public Health & Medicine, Founder of MindSciences and the author of The Craving Mind: From Cigarettes to Smartphones to Love - Why We Get Hooked and How We Can Break Bad Habits. To learn more about his research, visit www.drjud.com. You can also watch his short daily videos on mental health and how best to manage during these uncertain times on YouTube.