Q:

My partner and I have been together for three years and decided to move in together early in the pandemic. My question is: how can I support a partner with chronic health conditions in a seemingly unending global health crisis? I don’t want to dismiss her (very real! very scary!) concerns about COVID, her pre-existing conditions and the tapped-out healthcare system, but I don’t know what to do when these concerns spiral into anxiety and hypochondria — rehashing daily activities to pinpoint the likelihood of COVID exposure, deep dives into Doctor Internet at the appearance of vague symptoms, checking her vitals multiple times a day when worried, doubting the accuracy of her vitals readings, getting COVID tests, doubting the results of negative COVID tests, stress-induced insomnia, tears. For reference, we both work from home and are about as careful as it’s possible to be, so our contamination risk is limited to outdoor passers-by on walks, contactless grocery pickup and perhaps a weekly, masked outdoor visit to family. She has always been attentive to her health, but nothing at all like this.

I understand that it is incredibly frightening to have pre-existing conditions that can mimic COVID symptoms and that it’s incredibly frustrating to be a woman with chronic illness who routinely has doctors dismiss her symptoms. So I don’t know what to do when a health-related anxiety spiral starts. I can’t promise it will all be ok, and I don’t want to dismiss or downplay her concerns. I also don’t want to make her feel like she can’t rely on me to listen, especially when we’re already more isolated than usual from our support networks. On a few occasions, she has gotten upset that I’m not as upset as she is, implying that I must not care as much or must be repressing my true fears in order to function well. I think it might help her to speak with a therapist, but I worry that suggesting this will make her feel like I’m one more person downplaying her health concerns.

A:

Sometimes we can out-logic our anxiety. The chances that you’ll fall into a sewer or a plane will crash through your ceiling are slim (and yes, both of those scenarios come from my personal Worst Case Scenario reel). But when your anxiety stems from a valid concern about a real and terrifying threat, it’s hard to draw the line between reasonable, manageable fear and full-blown panic. That panic is real for many of us right now, and for those of us who are immunocompromised and/ or chronically ill, the terror is even more tangible.

I’m not a doctor or a therapist, but I wanted to answer this question because I relate to part of your girlfriend’s experience. I contracted COVID-19 in March of last year. Fortunately, I wasn’t hospitalized, but I was very, very sick and very, very scared for about two months. Since recovering, I’ve dealt with some lasting effects from the virus. When I received negative antibody results over the summer, I fixated on the possibility of contracting COVID again, fearing the disease would wreak more havoc on my already fragile system. I worried that every little itch in my throat was COVID-19 Round 2, and I leaned hard on my partner for support. She was willing to soothe me in the same way that you’re willing to support your girlfriend, but at a certain point, I recognized that I was demanding too much from my partner and that my COVID anxiety was demanding too much from me. With the help of my therapist, my girlfriend, my friends and some lifestyle adjustments, I have mostly transitioned from “full-blown panic” to “manageable fear.” I’m maintaining conservative precautions, but I’m no longer waking up in the middle of the night to check my breathing and heart rate.

Your girlfriend’s concerns are absolutely valid, but it sounds like her COVID anxiety is getting in the way of her life and yours. It’s possible to acknowledge that reality without invalidating her experience. You just have to approach the subject with care, and it sounds like you’re already coming at this from a place of love and empathy. Don’t question whether or not her concerns are real, because they are real. Instead, ask her if those worries are helping her. Then encourage her to incorporate some health anxiety-reducing tools into her routine. Below are some practices you can share with her that helped me navigate my COVID anxiety.

1. Make a list of all the physical symptoms that are “normal” for you.

Does your chronic illness make you cough? What does that cough sound like? Do you frequently experience digestive symptoms? How frequently do those symptoms occur and how do they manifest? When you start feeling unwell, check your list before you panic. You might just be experiencing what’s typical for you.

2. Set boundaries with yourself.

When you’re chronically ill, checking your temperature, heart rate and oxygen levels might be a critical part of your everyday care routine, especially in the context of a pandemic. If checking your vitals is starting to interfere with daily tasks, it’s time to rein it in. Commit to checking your vitals once or twice a day at specific times. Set an alarm and stick to those times unless you’re experiencing a symptom that doesn’t fall on your “normal symptoms” list.

3. Keep a log of your anxious thoughts.

Every time you start worrying that you may have contracted COVID-19, jot it down with the time and date. You might start noticing a pattern. Maybe you typically start worrying when you’re trying to fall asleep, or maybe your anxiety rears its head the second you’re home alone. Once you’re aware of the times when you’re most likely to panic, you can prepare for them in advance.

4. Engage in distracting activities.

Start embracing activities that engage your mind more than Netflix. Play an instrument. Write letters to your friends and family. Play a game with your pals on Zoom. Reorganize your closet. Cook something elaborate. When you’re engaged in a task that requires focus, your mind is less likely to wander to the pit of doom. Speaking of doom…

5. Quit doom scrolling.

Scary headlines and alarmist Facebook friends can really stoke the flames of COVID anxiety. Take a break from news and social media for a while. If you don’t want to fully cut yourself off from virtual connection, start focusing on news outlets that leave you feeling a little more hopeful and unfollow people who share COVID-realted content.

6. If you choose to engage with COVID-19 news, focus on the good stuff.

My girlfriend checks the vaccination data for our zip code every day. Watching the rising numbers of vaccinated residents gives her hope that the pandemic won’t last forever. Can you follow the numbers in your own area? Do you have friends or family members who have already been vaccinated? In the midst of so much fear, we now have real evidence that there’s a light at the end of the tunnel.

7. Stop asking yourself, “Is this true?” Instead ask, “Is this helpful?”

If you’re experiencing COVID-related anxiety, you probably know all the terrifying facts about the virus. Is it true that COVID-19 tests are not 100% accurate? Yes. Is it true that you can contract COVID-19 during a simple trip to the grocery store? Sure. Having accurate information is important, but fixating on the “what if’s” won’t help you if you do contract the virus. Here’s a trick I learned in therapy that’s been helping me for years: any time you imagine a “worst case scenario,” make yourself reimagine the scene with a big “X” over it and say something like “NOPE” or “THAT’S NOT REAL” or “WE DON’T DO THAT ANYMORE” out loud. This helps you get in the practice of interrupting a spiral. The more spirals you interrupt, the less time you spend stuck in the muck.

8. Remember that basically everyone needs a therapist right now.

Living through a pandemic is trauma. Dealing with chronic health issues is trauma. Navigating an impossible medical system is trauma. Seeking help from a therapist doesn’t mean you’re weak, and it doesn’t make your health worries any less valid. A therapist isn’t the CDC — they’re not going to tell you what you should or should not worry about. They will give you tools to help you navigate those worries, and we could all use some of those right now.

9. Maintain a wide, mutual support network.

Just because you’re physically isolated, that doesn’t mean you have to be socially isolated, too. It’s easy to only lean on the person or people in your pod, but remember that there a whole lot of people who are accessible by phone, text or FaceTime who are missing social contact and would love to talk to you. Plus, getting our needs met by multiple loved ones means that you’re not overtaxing one person. You might even find that supporting someone else helps you get out of your own head, too.

Good luck to you both! Take care of yourselves and each other.

You can chime in with your advice in the comments and submit your own questions any time.

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