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It’s no surprise that the COVID-19 pandemic caused worldwide emotional upheaval. A report from the World Health Organization found that anxiety and depression increased globally by a staggering 25% during its first year. But a new study found that people  diagnosed with anxiety who received two widely available forms of therapy experienced less stress than others during the pandemic, even during the toughest days of lockdown. 

Researchers at McLean Hospital/Harvard Medical School followed 764 outpatients with moderate anxiety. These patients had received one of two treatments: cognitive-behavioral therapy (CBT) or dialectical behavioral therapy (DBT). CBT is a form of talk therapy that emphasizes the power one’s thoughts can have on their feelings. DBT helps patients identify thought patterns that may cause distress. 

The researchers expected to find that the stressors caused by peak points during lockdown — specifically from March 2020 to July 2020 — would cause worsening of these patients’ anxiety. 

Rather, they found that patients who started CBT or DBT prior to the start of the pandemic had decreased symptoms of anxiety. The researchers found that CBT and DBT gave these patients served as a protective effect. This means patients demonstrated fewer symptoms related to anxiety than many people who never had anxiety at all but who were feeling the stress of lockdown. 

What’s more, CBT or DBT started at any time can help many people build the same resilience so that major world events or personal upheaval will not cause them to experience worsening of their mental health, the researchers said. 

“I was surprised by how robust the intervention was,” said lead study author David H. Rosmarin, PhD, a clinical psychologist at McLean Hospital in Belmont, MA, and associate professor of psychology at Harvard Medical School in Cambridge. “Yet with CBT and DBT, we really teach people not to be afraid of anxiety. Anxiety will not kill you, even though it feels like death to some patients. We’ve been conditioned to fear anxiety, but what we really need to do is to increase our tolerance of uncertainty.”

As the patients in the study progressed through treatment, they began to demonstrate this resilience. 

“Patients felt more prepared tolerating COVID-related anxiety as they became comfortable being less prepared,” said Henry J. Eff, PsyD, supervising psychologist at the Center for Anxiety in Brooklyn, NY, where patients in the study were seen. “Those who experienced higher levels of anxiety prior to the pandemic, but who were taught CBT and DBT skills, felt better equipped to manage, and more importantly, tolerate, COVID’s uncertainty.”

In a nutshell, CBT can help build your “toolbox” for when feelings of anxiety hit. 

CBT helps change the ways a patient thinks that are not helpful.  By recognizing that your thoughts affect your actions, you gain a sense of control and can make choices that help you respond better to the stresses in your life that make you anxious. 

CBT also helps you build emotional strength because it helps you face and overcome challenges. 

“CBT is like going to the gym for your emotions,” Rosemarin said. 

How does DBT help manage anxiety?

DBT, on the other hand, focuses on acceptance to bring a sense of control to those experiencing powerful feelings. 

“DBT can help us manage the intense emotions we experience with anxiety,” said Eff. For example, during the pandemic, “We worked with patients on accepting the realities of COVID: isolation, worry for our loved ones, and complete disarray of normal activity. Accepting this unfortunate situation enables better coping and reduces suffering.”

Can Anxiety Sometimes Be Positive? 

The energy that anxiety produces can be used as a powerful motivator — a great tool to push you toward accomplishing whatever you want. 

“It can feel counterintuitive to push through anxiety and feel your feelings. We think of anxiety as something we need to get rid of, but anxiety can be a catalyst to things like change,” Rosemarin said. “Anxiety can be utilized; it can be used as a tool.”  

The key is to manage the amount of anxiety you feel. 

“You typically don’t turn the dial of a stove all the way up or your food will burn,” explained Eff. “However, turn it off completely, and your food won’t cook. There are times where the burner — or your anxiety [in this case] — is higher, and that’s OK. Once we can begin to recognize and label our various levels of anxiety, we can better manage it and learn how to use it to our advantage.”