The flood of articles offering “Quick tips for controlling your Covid anxiety” makes me nervous. After 30 years treating patients in one of the first specialty clinics devoted to anxiety disorders, I should have super advice, right? Not really, but here are 6 observations.
Quick tips can help but they can be worse than useless. Exercise, eat right, get sleep, talk with friends, and challenge negative thoughts. Like diet suggestions, they can help, but they can be hard to follow, ineffective, or prone to make some people feel like failures.
Some articles advise readers they MUST control their anxiety to avoid heart disease and cancer. There is hardly any evidence that anxiety directly causes medical illness but worry about that can initiate a vicious cycle that turns ordinary anxiety into a serious problem.
Most anxiety is normal but useless. It is worthwhile whenever its cost is less than the cost of not responding times the probability that the danger is present. So, when risks are uncertain normal false alarms abound. Knowing this “Smoke Detector Principle” can help.
Anxiety is not always a mental health problem. It is often just anxiety. Like pain, it feels awful and should be relieved whenever that can be done safely. But most anxiety is a product of danger, not mental illness. People have enough problems without being told they are sick.
Anxiety is excessive and even crippling for some people. Some because of their genes, some because of experiencing awful events, some for complicated reasons. These anxiety disorders need professional treatment; thank goodness it is usually effective. @Got_Anxiety
The pandemic is causing terrible mental suffering but talk about a mental health epidemic distracts from individual experiences of fear of sickness, loneliness, exhaustion, job loss, poverty…and the positive experiences of those finally freed from long commutes and awful jobs.
Painful emotions, especially anxiety & depression, are by far the most common reasons people seek help. An evolutionary perspective recognizes emotions as special states shaped by natural selection along with control systems that express them in situations where they are useful.
Most of us who have prescribed antidepressants for thousands of patients have heard hundreds of them report transformed lives. “It is as if I walked out of a dark room into sunlight” “All of a sudden I can experience pleasure again”
But perhaps the effectiveness is an illusion. The improvement of patients taking #placebo is barely better than that for those taking antidepressants.
Here are 10 reasons why antidepressants
->Could seem effective when they are not, or
->Could seem ineffective when they are
Starting June 1, I will tweet a chapter each day from my new book goodreasons.info about how the light of evolutionary biology can dissolve the mists that swirl around mental disorders. Well, some mists for some disorders. @DuttonBooks@hbes2019@LondonEvolution@ISEMPH
From the Preface: I wanted to write this book as soon as I realized that evolution could explain why bodies are vulnerable to disease. But the rest of medicine had to come first. Why We Get Sick stirred lots of interest. The new book is about why mental illness exists at all.
For each chapter I address the question, "So what?" Saying what is true changes only views unless it also changes what people do. Mental health clinicians who understand evolution do their work differently and better. For all others, self-understanding is valuable in itself.