Anxiety and fear

Produced by Dr Nathan Smith, University of Manchester

Expert reviewed by Professor Marc Jones, Manchester Metropolitan University

Download the printable 1-page PDF version of this brief here.

Why is anxiety and fear relevant?

In tackling the covid-19 outbreak workers will be faced with a lot of uncertainty and may, at times, encounter scary situations. This can lead to a sense of threat and result in feelings of anxiety and fear. A major source of anxiety and fear is likely to be related to the possibility of contracting the virus from sick patients. 

Core constructs/concepts

Anxiety and fear stem from anticipating things that are about to happen, or which could happen in the future.

Although often discussed in parallel, anxiety and fear can be differentiated both biologically and behaviourally.

Anxiety is a negatively-valenced emotion that is characterized by sustained hyperarousal in response to uncertainty, is thus future-focused, and aids in defensive approach or risk assessment. Research has distinguished between trait and state anxiety.

Fear can be considered a negatively-valenced emotion that is brief, focused on the present, occurs in situations of specific threat, and aids in avoidance or escape.

These definitions help us understand when anxiety and fear may be felt by covid-19 workers. Anxiety, influenced by individual characteristics and context, may be more likely to be experienced throughout the outbreak, whereas fear may be more likely in discrete scary situations.

Both anxiety and fear are emotions experienced by almost all individuals and can serve to be adaptive in shaping decisions and behaviours related to survival, performance and wellbeing. In this sense, anxiety and fear can be functional.

Problems may occur when anxiety and fear are felt excessively. Chronic feelings of anxiety and fear may contribute to the development of anxiety disorders and have been implicated in PTSD.

Due to the high levels of uncertainty surrounding the covid-19 outbreak, individuals may be at risk of inaccurate context appraisals/evaluations and attribute threat to situations unlikely to result in harm, thereby inflating feelings of anxiety and fear. 

Practical recommendations

  • Encouraging workers to recognise that anxiety and fear are normal reactions that have a biological basis designed to serve a specific function can be helpful. This might help them see the situation more positively - as a challenge rather than a threat.

  • Asking workers to assess the demands they think they might face and getting them to identify what resources they have to deal with those demands can be empowering and aid coping efforts.

  • Anxiety and fear can help ensure focus, but it is important that people are made aware of the risk of tunnel vision and potentially missing important safety-related cues as a result of being too ‘zoned in’. 

  • One way to reduce feelings of anxiety and help manage fear is by promoting confidence and feelings of effectiveness. When people know how to stay safe (perhaps by using standardised checklists), they are more likely to be able to control these feelings and use them in a more positive way.

  • Perceived control is important. Workers could be encouraged to develop their own routines which emphasises what they can control and what they are trying to achieve in any given situation. Routines can provide a fall back when anxious or scared. 

  • In situations of fear, stepping back and taking a moment to evaluate options before jumping into action can facilitate more rational decision-making.  

  • Because feelings of anxiety and fear are associated with autonomic activation, breathing and meditative exercises may help individuals bring activation levels down and feel more in control of their emotions. Similarly breathing exercise can help strengthen the parasympathetic nervous system to make the intensity of emotional response less acute. As such, doing breathing exercises for 5-10 minutes a day away from work can be helpful strategy.  

  • Using a buddy system, where workers are encouraged to check and keep an eye on each other’s safety-related behaviours (e.g., donning and doffing protective equipment) could be helpful. Knowing someone is looking out for you, especially under conditions of extreme stress, where tiredness and fatigue might have set in, can promote feelings of safety.  

  • Workers will have developed and refined many effective coping strategies as a result of working in demanding situations. While this is a new and uncertain scenario, it does not necessarily require a whole new range of coping strategies. Focusing on what has been helpful in past similar situations will limit how much additional effort is needed to develop new approaches.

Relevant literature

Forster, G. L., Novick, A. M., Scholl, J. L., & Watt, M. J. (2012). The role of the amygdala in anxiety disorders. The amygdala-a discrete multitasking manager, 61-102.

Ho, S. M. Y., Kwong-Lo, R. S. Y., Mak, C. W. Y., & Wong, J. S. (2005). Fear of Severe Acute Respiratory Syndrome (SARS) Among Health Care Workers. Journal of Consulting and Clinical Psychology, 73(2), 344-349.

Jamieson, J. P. (2017). Challenge and threat appraisals. In A. J. Elliot, C. S. Dweck, & D. S. Yeager (Eds.), Handbook of competence and motivation: Theory and application (p. 175–191). The Guilford Press.

Zhang, S., Woodman, T., & Roberts, R. (2018). Anxiety and Fear in Sport and Performance. In Oxford Research Encyclopedia of Psychology.