Using Exercise and CBT Techniques to Combat Coronavirus Lockdown Anxiety

"I could be bounded in a nutshell, and think myself a king of infinite space, were it not that I have bad dreams." Shakespeare, Hamlet.

Elisha Nochomovitz has run a marathon on his balcony. In March 2020, Elisha Nochomovitz, a French marathon runner, under quarantine in his apartment due to the Covid 19 pandemic, decided to run a marathon. On his seven metre long balcony. This involved running up and down the balcony over 6000 times in seven hours. A 26.2 mile marathon on a seven metre balcony.

This incredible feat is not only an impressive sporting achievement, it also shows a useful way to cope with the anxieties, pressures, stresses and strains of confinement to houses, flats and rooms over the coming weeks and months.

The coronavirus lockdown is affecting everyone in different ways but I believe there will be common features for many people: this is a time of heightened anxiety - we are all worried about the spread of the virus: how many people will die? Will my family and friends be safe? Will I be safe? When will it end? What will happen to my job? Business? The economy? What about my exams? Will I find enough food? Will I be able to pay my rent? My mortgage? Will I lose my home?

But at this time of heightened anxiety, we are put in a position which makes it harder to cope with it: many people rely on various forms of distraction to manage their anxiety - keeping busy, socialising, talking with friends, exercising, working, having other issues to focus on. As we are now prevented from going out, cannot in most cases , go to work, can only talk with friends on social media and cannot go to the gym or our regular outdoor exercise classes, these coping mechanisms are more difficult to make use of.  We stay at home and are left with lots of time to think. And with space and time to think, worrying thoughts can grow, multiply, increase and spread, with nothing to check them.

These two elements - a genuine threat to worry about and more time to think - are, for many people, a potentially dangerous mix.

So how can the example of Elisha Nochomovitz help us in the current situation? I am not saying that everyone needs to start running marathons on their balconies some people may not have a balcony for a start but there is still something we can all take from Elisha, which can help us get through the coming weeks, and possibly months of lockdown.

The difference between worry and anxiety

To see how Elisha can help, we first need to understand a bit more about the difference between "worry" and "anxiety": these two words are often used interchangeably but strictly speaking, there is an important difference: "Worry" refers to worrying thoughts, while "anxiety" refers to the physical expression of those worrying thoughts, felt in the body. Or, the impact of the worrying thoughts on the body.

So, you might be thinking about whether your company will survive the virus and what will happen to your job: that is worry. At the same time, you might notice that your heart-rate is higher than usual, your breathing is fast and shallow, you have butterflies in your stomach, you might be sweating and your neck and shoulders are stiff: this is anxiety and its an uncomfortable, unpleasant, sometimes scary experience. You might also notice that the more you think worrying thoughts, the worse the physical symptoms become.

Because the physical feeling of anxiety is affected so much by thoughts, we need to work with both mind and body to relieve the feelings.

The physical symptoms of anxiety

Anxiety, the physical manifestation of worry, is caused when the brain's alarm system, the amygdala, senses threat or risk and sends out stress hormones  including adrenaline and cortisol to prime the heart, lungs and muscles for "fight or flight": literally getting the body ready to fight the danger or run away from it. The physical exertion of fighting or running discharges the stress hormones and once we are safe, we return to a state of balance.

This is a healthy, protective factor; when faced by an actual physical danger you can fight or run away from, but how do you run away from a virus that is everywhere and you are not allowed outside? You sit at home with your worries and the stress hormones pumping round your body, causing the discomfort and agitation of anxiety.

This is why the physical experience of anxiety can be relieved through long, slow, diaphragmatic breathing and physical exercise - running, cycling, resistance exercises: burning off the hormones.

Different schools of psychotherapy have developed wonderful ways of helping people with their worrying thoughts: psychodynamic psychotherapy can help you explore your past to understand where your worries arise from and identify possible issues in how your worries were addressed when you were a child, which could be part of the problem if, for some reason, you felt you weren't able to express your worries as a child and have them understood and soothed by a parent or carer, then this could partly explain the difficulties you have with worries as an adult : Psychotherapy is a space where you can learn how to identify and sooth your worries for yourself.

CBT cognitive behavioural therapy can help you understand the thinking patterns which are causing the anxiety and provide you with healthier ways to address them: the CBT theory is that feelings cannot be addressed directly you can't just tell someone to "stop worrying" and expect them to feel better but that as thinking cognitions and behaviour affect our feelings, by changing the way we think and behave, we can change the way we feel.

If you have a worrying thought, rather than just sitting with it, allowing it to grow and take us over, a CBT therapist might recommend we use the following exercise:

• Ask yourself what is the evidence that the thought is correct?
• Ask yourself what is the evidence that the thought is not correct?
• If you find evidence it is not correct, how can you then think differently about the situation?
• What can you now do differently to reduce your anxiety?