In my last post, I talked about strategies for managing anxiety during these harrowing times. I have added some new tips for boosting psychological immunity and staying on track with sound mental health practices while sheltering in place in a post I wrote for the National Alliance on Mental Illness (NAMI).
The new Coronavirus outbreak has infiltrated our public consciousness, and it is exhausting. When the media are constantly bombarding us with updates about fatality counts and quarantines, even the most unflappable are finding it hard to stay calm. Everyone seems to be running to the nearest supermarket to stockpile disinfectant wipes, bottled water, and canned goods. So how are people with health anxiety and OCD—who are already prone to excessive worry about uncertainty, contamination, and illness— supposed to cope?
In treating anxiety, I use the evidence-based approach called Exposure/Response Prevention to help people tackle their fears and limit the compulsive behaviors, such as excessive washing, designed to make them feel less anxious about risk. But some of the practices my colleagues and I would typically recommend for someone with contamination worries, such as limiting hand-washing and avoiding the use of hand-sanitizer, fly in the face of current public health recommendations. Even so, if you keep in mind the rationale for exposure-based approaches to anxiety, which is to learn to tolerate discomfort and uncertainty, you can still come up with a personal plan allowing you to follow reasonable disease- prevention guidelines without letting your anxiety skyrocket and control your behavior.
This is a challenging time for all of us. But we don’t need to make it worse than it already is by fueling our anxiety. If we practice responding to the uncertainty with reason and thoughtfulness rather than reacting out of panic, everyone will benefit.
Update: When I wrote this post only ten days ago, the coronavirus situation was very different from how it is now. The current national emergency mandates strict social-distancing practices, which make my advice to carry on normal activities no longer medically sound. or feasible.
I will be writing another post in the coming days with tips for staying sane while stuck in the house.
You can’t walk past the magazines in the supermarket, go out to dinner with friends or check your Instagram feed or Facebook these days without being bombarded by diets aimed to cure whatever ails you. All these plans—whether they’re gluten-free, Paleo, organic, vegetarian, or vegan—involve eliminating foods purported to cause a host of health problems.
One such popular program goes so far as to promise it will “change your life in 30 days,” offering testimonials (which, I might point out, do not count as scientific evidence) from participants who claim it has cured them of a long list of so-called “lifestyle-related diseases.” These include but are not limited to: high blood pressure and high cholesterol, diabetes (both Type 1 and Type 2), asthma, allergies, infertility, depression, bipolar disorder, arthritis, ADHD, and inflammatory bowel disease. The psychiatric literature, last I heard, doesn’t consider depression, bipolar disorder, or ADHD lifestyle-related diseases. That’s a topic for another post. But for now, I’ll get back to the subject at hand.
Even the widespread trend towards “clean eating”—whose proponents like to think of it not as a diet, but as a lifestyle choice or even a movement—comes with rules. Eat lots of fruits and vegetables. Eat only “whole” meats, preferably organic, whose sources you know. Eat only whole grains. Avoid all processed and refined foods (e.g., sugar, baked goods, white flour, white rice, empty-caloric junk foods). Avoid saturated and trans-fats. Drink at least 8 cups of water a day.
“What’s wrong with trying to follow a healthy eating plan?” you might ask. And my answer would be, “Nothing. Usually.”
But if you tend to become fixated on avoiding specific foods because you’re excessively concerned about controlling your weight or think they might cause cancer or other diseases, be careful. Even a so-called “non-diet” like the clean-eating approach can lead to emotional struggles for perfectionistic people prone to eating disorders or health anxiety.
Any time perfectionists impose all-or-nothing restrictions on themselves, they run the risk of getting upset and ditching the diet altogether if they think they’ve broken the rules. It doesn’t even have to constitute a major transgression, such as picking up a Big Mac, fries, and large Coke from the MacDonald’s drive-through on the way home from work. If you’re evaluating your food choices from the perspective of a black-and-white mentality (and comparing them with the colorful Instagram images of the kale smoothies, grain bowls, and lush farmers market produce others appear to be eating), you could easily beat yourself up for popping a handful of M&Ms at the movies or having white rice with your homemade, clean Pad Thai. Then you might decide you’ve blown it for the day (or week), and let loose with a full-blown binge. You’ll feel guilty, vow to atone and never stray again, and set yourself up for the next self-punishing cycle of deprivation and excess.
Let me make my position clear before the critics jump on me for questioning sound nutritional practices. I’m not suggesting you go overboard with the junk food and the trans-fats. I’m not urging you to forego whole grains in favor of Wonder Bread. I’m not recommending you trade your bottled water for a Big Gulp. I’m not even telling you the clean-eating lifestyle is bad. (Though I might be telling you not to drink the diet Kool-Aid du jour without seriously evaluating its claims from an evidence-based perspective).
But when food—no matter how nutritionally pure, unadulterated, and good for your body it may be—becomes a source of internal conflict, guilt and anxiety, you might want to think about what it’s doing to your mind.
As with most things in life, moderation and flexibility are the keys to emotional wellbeing. Your mindset about eating is just as important for your health as the foods you eat. Sadly, Instagram can’t capture that.
This blog is intended solely for the purpose of entertainment and education. All remarks are meant as general information and should not be taken as personal diagnostic or therapeutic advice. If you choose to comment on a post, please do not include any information that could identify you as a patient or potential patient. Also, please refrain from making any testimonials about me or my practice, as my professional code of ethics does not permit me to publish such statements. Comments that I deem inappropriate for this forum will not be published.