Using Exercise and CBT Techniques to Combat Coronavirus Lockdown Anxiety

Mar 30, 2020

Elisha Nochomovitz ran a marathon on his balcony while in coronavirus lockdown
Therapist and PT Andrew Keefe explores the benefits of challenging unhelpful thinking patterns and making the time to move to help soothe coronavirus anxiety
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“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?

Which brings us back to Elisha Nochomovitz: I have never met Elisha, but I am making an educated guess that he loves running and when he realised he would have to go into quarantine, may have had the worrying thoughts that he would not be able run for some weeks or months, would not be able to run the marathon he had been training for, that he would lose his fitness and possibly even that this would impact on his overall mood. Elisha may have thought these thoughts while sitting on his sofa.

To speculate further, he may then have gone through a version of the exercise above and found that while it was true the Barcelona Marathon had been cancelled and he could not go outside to run, it was not true that this meant he could not run at all.

He may have then asked himself how he could think differently about the situation and concluded that another way of thinking about his balcony was that it could also be a running track. I like to think he then stood up, put on his running shoes, went out onto the balcony and tried running up and down a few times to see what it felt like to have to stop and turn round every seven metres. While running up and down his balcony, he may then have had the idea that actually he could still run the marathon there and I like to think this may have cheered him up.

Elisha changed his thinking, changed his behaviour and changed his feelings.

What can we learn from this example?

As mentioned earlier, I am not saying that everyone has to start running marathons on their balconies (or in their kitchens, if you don’t have a balcony), but I am saying that changing the way we think about our situations can be liberating: Instead of concentrating on and worrying about what you cannot do in your current situation of being confined to your home, asking what you can do, changes the conversation you have with yourself from one of restriction and loss to one of opportunity and possibility: are you stuck in a small space, with your freedom of movement restricted, bored, lonely and deprived of social contact, frustrated and scared about the future?

Or could your space be a library? A gym? A dancefloor? A running track? A café? A Restaurant? A University? An office? A workshop? A studio? An art gallery? A church? A mosque? A synagogue? A temple? A beach? A forest? A mountain? A river, sea or ocean? Or a ship?

(Hamlet understood the potential of this approach, but sadly felt too weighed down by his own depressive thinking to be able to take advantage for himself and hence remained weighed down by his particular circumstances).

You can ask yourself the same question of the time you will have to spend in lockdown: is it lost time, time wasted, time gone and never to be found again? Or could it be time gained? Unexpected time you would not usually find, bonus time, additional time added onto your life? (Elisha, remember, made use not only of his balcony but also of seven hours of time to run his marathon, seven hours he might not have found, had the circumstances been different).

And if you can think of the physical space of your home in different ways and expand it in your mind, and think of the time you are gaining through lockdown, you can then ask yourself, what can I do with this extra time and space?

So if you are feeling worried and anxious, overwhelmed with uncertainty at this difficult time and don’t know where to start with finding a way to cope, take some time to follow this exercise and explore how you can think differently about the space and time of your situation and see what ideas you can come up with, noticing how you feel differently physically and emotionally as you move your thoughts from what you have lost to what you might gain.

And remember to exercise and keep moving: if you are able to run a marathon on your balcony, go ahead, but a 10k in your kitchen would still be highly impressive. There are also numerous ways to stay fit and physically reduce your anxiety which require no equipment and very little space: yoga, pilates, body-weight exercises, dancing. Covid 19 is also a respiratory disease, so maintaining cardio fitness can help strengthen us against it. If this sounds too energetic, at least try to keep up your 10,000 steps with the daily walk we are still permitted, housework and getting up to move around your space as often as you can.

I am aware that over 1000 people have died already in the UK alone and over 30,000 people world-wide. Sadly, many, many more people will die before this is over and I do not wish to ignore the real human tragedy of the situation. I, like everyone, have to accept that I may lose family members or friends. What I am trying to do is explore ways to make staying at home not just bearable but creative, rich and rewarding so that more of us will stay at home for longer, because the longer we stay at home, the sooner we will stop the spread of the virus and the more lives will be saved.

And you never know where this process of thinking differently about what lies ahead of you might lead: Michelangelo was once asked to explain where he found the inspiration for a particularly beautiful statue. He replied:

“I saw the Angel in the marble, and carved until I set him free.”

Andrew Keefe is a verified welldoing.org therapist and a personal trainer. He is based in London and offers online sessions.