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Anxiety in the era of global calamity - (4/7/2020)

By Dr. Ron Gasbarro 

The pharmacist heard the coughing and the hacking as soon as Greg came into the pharmacy. “You’re not getting sick, are you?” asked the pharmacist. “No, I started smoking again. Quit 6 years ago. Now back to 2 packs a day. Damn that COVID-19!” Greg said. He explained that his nerves were “toast” and he could not sleep. His blood pressure shot up to an unsafe level. A cough would trigger a panic attack – did the virus catch Greg? Then he would light up another cigarette. He was not eating well – just comfort foods that he dug out of the freezer. Moreover, Greg was furloughed from his job and the mortgage payment is due. “Hey, doc, when does the liquor store down the street close?” he asked with trembling hands as he lit up a cigarette. “Can’t smoke in here,” warned the pharmacist. 

Yes, thought the pharmacist, Greg is a wreck. Because anxiety is a real thing. The American Psychological Association says that anxiety is an emotion characterized by feelings of tension, nervous and disturbing thoughts, and even physical changes like increased sweating, dizziness, digestive problems, and a rapid heart rate. Anxiety disorders are the most common of mental afflictions and impact approximately 30% of adults at some point in their lives, says the American Psychiatric Association. That’s 30% of adults when the world is relatively normal. With the coronavirus pandemic, more people are stressed than ever. People are feeling overwhelmed, fearful, sad, angry, and helpless. Some may have difficulty concentrating or sleeping. Fears of contact with others, using public transportation, or going into stores and shops have skyrocketed. Should you wear surgical gloves? A mask? Can you even find those items? 

The World Health Organization (WHO) cautions that people with emotional or mental problems may deteriorate more rapidly than those who can deal better with stressors. Greg, for example, has returned to smoking, which can result in heat and lung problems. He appears to be self-medicating himself with alcohol that can cause liver damage, or cause him to make bad decisions. Case in point: Greg has been drinking all day to feel better and alleviate his boredom. If he decides to drive to the liquor store, then he may get into a car accident at a time when hospitals and first responders are already overburdened. 

Practitioners can treat anxiety with anti-anxiety medications such as alprazolam. These drugs are typically reserved for people with long-term, severe forms of anxiety, such as phobias, social anxiety, and substance abuse. Whether or not Greg qualifies for this type of treatment remains to be seen. If Greg continues to smoke and drink after this pandemic settles down, then he should seek professional help. In the meantime, Greg should turn off the news. The endless narratives are depressing: the rising death rate; the mortuaries that are overflowing; the constant and confusing misinformation. 

The pharmacist knows that no federal response to the pandemic has yet to be put into place. For a democracy to succeed three factors must be in place: a strong leader, a press that is free to communicate the truth and a sense of helping each other, despite age, creed, or color. Yet, our fuehrer is feckless. Freedom of the press is imperiled. The only asset with which we are left is the yearning to band together and help each other. The world has become more intense since we were kids. Headlines and news alerts bombard us 24/7. Remember that good news does not sell newspapers or drive up TV ratings. However, as humans, we can only take so much bad news. You cannot fix the world, but you can fix yourself. Put down the smoke, the drink, and the Twinkie. Take a shower, go outside, do a good deed, and believe that good times will return.

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com


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