How to know if your pandemic anxiety is normal or a problem, and what to do about it

• One-third of Americans are experiencing coronavirus pandemic-related anxiety. For many, it's their first time coping with mental health issues.
• According to psychiatrist Dr. David Rosmarin, it's important to determine whether you're panicked over an actual threat, or if your brain going into anxiety-induced overdrive.

Thom James Carter can count on one hand the number of times he's left his home in Scotland in the past four months.

Ever since the coronavirus pandemic began, Carter, 26, noticed his anxiety worsened to the point that hearing people outside of his window put him on edge. And his more severe obsessive-compulsive disorder (OCD) symptoms, which he hadn't experienced in over 10 years, started to return.

"Every time I touch something that's come from outside but hasn't been in the house for over five days — a grocery product like an orange juice carton, a letter, an Amazon delivery — I'll wash my hands each and every time after handling it," Carter told Insider. "Even after removing the letter or delivery from its packaging, there's a part of my brain that thinks, somehow, the virus might still exist on whatever was inside."

In April, Carter washed his hands so often his skin was peeling, broken, and bleeding.

Carter's previous experiences with anxiety and OCD made him hyper-aware of his return to those unhealthy behaviors. But for those who are dealing with heightened anxiety for the first time, it could be difficult to discern whether coronavirus-related panic is normal or something that's cause for concern.

Learning the difference between fear and anxiety can help, according to Dr. David H. Rosmarin, an assistant professor of psychiatry at Harvard and founder of the Center for Anxiety.

Ask yourself: Is there a tangible threat that I'm afraid of?

When determining whether you're justified in your precautions or not, it's important to figure out if there's an actual threat.

"The difference between anxiety and fear is fear is based in reality and an anxiety is not," Rosmarin told Insider.

Since the pandemic involves an invisible infectious disease that spreads at an alarming rate, it can be difficult to figure out that difference, Rosmarin said. You can, however, use facts about the coronavirus to analyze whether your individual protective behaviors are warranted or not.

"For example, if we knew that when you walked outside you get sick, then that would not be anxiety [to stay inside]. That would for sure be fear," but actions need to be analyzed on an individual level that takes into account a person's location and situation, Rosmarin said.

Take, for example, an immunocompromised person living in Florida, where COVID-19 cases are extremely high, versus a healthy 20-year-old living in Pennsylvania where new cases are relatively low.

If the immunocompromised person refused to leave their home and took extra care to deep-clean, it would be a justified fear-based action because their health is more vulnerable.

But if the 20-year-old Pennsylvanian did the same thing, their actions could be rooted in anxiety because science suggests it may be safe to go for walks and grocery shopping while wearing a mask.

"It has to be a clear excessive [amount of] anxiety to the actual risk," for it to be potentially problematic, Rosmarin said.

'Do the thing' to get past your anxiety

In the case of the coronavirus pandemic, Rosmarin said it's important to follow federal and state public-health advice.

But if your anxiety prevents you from going on a socially distanced walk, he suggested challenging yourself to do that.

"I would definitely, so-to-speak, violate those rules," that your anxiety is creating and stick to what the CDC and WHO advise, he said.

Rosmarin does this with his own patients who deal with crippling anxiety.

"It's called exposure therapy, the approach where we encourage people to face their anxieties. So if somebody is afraid of going outside because they might have an aneurysm or an IBS flare-up or a panic attack, then go outside, just face it," Rosmarin said. "When people know how to handle their anxiety, by what we call 'approach,' as opposed to 'avoidance,' I think they're better able to handle the current pandemic."

That's why, according to Rosmarin, people who have worked through their anxiety long before the pandemic are likely having an easier time than their previously less-anxious counterparts.

If your anxiety makes it difficult to get through day-to-day tasks, seek help

If you find yourself unable to work through your pandemic-related anxiety on your own, seek help from a professional.

There are specialized hotlines dedicated to helping teenagers, people with a history of substance abuse, and those dealing with generalized anxiety during the pandemic.

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