How to manage your anxiety around the Coronavirus.
The anxiety most people felt about COVID-19 wasn’t irrational. The situation was genuinely threatening. But for driven women whose nervous systems were already running hot, the pandemic added an uncontrollable uncertainty on top of systems that were already working overtime. This post offers concrete, neuroscience-grounded tools for managing health anxiety. Written during the early days of the pandemic, and still deeply relevant for anyone navigating uncertainty, threat, and the particular way fear lands in a body with a trauma history.
Last updated: June 2026 by Annie Wright, LMFT
- She Refreshed the Dashboard Every Hour
- What Is Health Anxiety?
- The Neurobiology of Uncertainty and Threat
- How Coronavirus Anxiety Shows Up in Driven Women
- When Anxiety Meets a Trauma History
- Both/And: You Can Be Scared and Still Be Okay
- The Systemic Lens: Why This Anxiety Isn’t Just Personal
- Tools for Managing Coronavirus Anxiety
- Frequently Asked Questions
Health anxiety is persistent, disproportionate worry about illness that continues even when medical evidence is reassuring, driven by a nervous system oriented toward threat detection. During the early COVID-19 pandemic, this anxiety was rational, but for driven women with trauma histories the nervous system was already primed to scan for danger, compounding fear well beyond the baseline. Pandemic uncertainty activates the same threat circuitry as earlier relational unpredictability. In my work with driven women during crisis periods, the anxiety isn’t irrational; it’s a learned survival response meeting an actual threat.
In short: Health anxiety during the COVID-19 pandemic was especially intense for women with trauma histories because a nervous system already wired for threat detection experienced new medical uncertainty as compounded danger.
I saw this intersection of trauma history and pandemic fear emerge clearly across more than 15,000 clinical hours, particularly with clients whose early environments had never felt predictably safe. Stephen Porges, PhD, psychophysiologist and neuroscientist, explains how the autonomic nervous system continuously evaluates environmental cues for safety or danger through neuroception, a process that operates below conscious awareness (Porges 2011).
She Refreshed the Dashboard Every Hour
It was February 2020. Mei, 43, is a physician and mother of three. She described her first week of reading coronavirus case counts the same way she described her second, and her third: compulsively, repetitively, unable to stop even when she knew the data wasn’t going to change in the next twenty minutes. She’d refresh the case map, close her laptop, walk to the kitchen, come back, refresh again. She was sleeping four hours a night. Her jaw ached from clenching. At work, she was seeing patients with respiratory symptoms and holding herself very still inside while her mind ran the calculations over and over: exposure risk, incubation period, protective equipment supply, what happens if I get sick, what happens to my kids.
By every clinical definition, Mei was experiencing acute anxiety. But she was also doing something extremely intelligent: she was paying attention to a real and unfolding threat. The difficulty. And this is the difficulty at the center of this post. Is that a body with a trauma history doesn’t always know how to calibrate between those two things. Between appropriate vigilance and a nervous system that’s already been chronically overloaded and doesn’t have much reserve left for another genuinely frightening situation. (PMID: 35645742)
I wrote this post in the earliest weeks of the COVID-19 pandemic. I’m leaving it largely as it was, with additions, because the clinical framework here doesn’t expire. Uncertainty, uncontrollable threat, collective fear, the peculiar exhaustion of sustained vigilance. These aren’t COVID-specific experiences. They’re the territory of being a driven woman with a nervous system that was shaped by early adversity, in a world that keeps generating new reasons for that system to run hot. (PMID: 22729977)
If you found this post because the pandemic is still echoing in your body years later, or because you’re navigating a different kind of uncontrollable fear. This is for you.
What Is Health Anxiety?
Health anxiety is one of the most misunderstood presentations in the clinical literature. And it’s understandable why. From the outside, it can look like hypochondria, catastrophizing, or irrationality. From the inside, it often feels like the only sane response to a genuinely uncertain world.
Health anxiety. Sometimes referred to in the clinical literature as illness anxiety disorder. Is characterized by persistent, excessive worry about having or developing a serious illness, in a way that is disproportionate to actual medical symptoms or risk. As described by Gordon Asmundson, PhD, professor of psychology at the University of Regina and one of the leading researchers in the field, health anxiety exists on a spectrum from adaptive (appropriate monitoring of real health concerns) to maladaptive (preoccupation that significantly impairs daily functioning). During a genuine public health crisis, the distinction becomes critically important: some level of health monitoring is appropriate and necessary. The anxiety becomes clinically significant when it is persistent, consumes substantial time and energy, and remains unresponsive to reassurance.
In plain terms: There’s a difference between “I’m staying informed and taking reasonable precautions” and “I can’t stop refreshing the data even when I know it’s making me worse.” The first is smart. The second is your nervous system stuck in a loop it doesn’t know how to exit.
What makes health anxiety particularly common among driven women is the intersection of two things: a general tendency toward hypervigilance (often rooted in early experiences where staying alert was genuinely adaptive) and a cultural expectation that they be the managers and protectors of everyone around them. When a new threat emerges, many driven women don’t just worry about themselves. They’re simultaneously tracking the risk to every person in their orbit, making contingency plans, preparing for scenarios that haven’t happened yet, and doing all of this while maintaining their professional performance and presenting as calm to colleagues and family.
That’s not anxiety as a character flaw. That’s anxiety as the predictable output of an impossible load.
The Neurobiology of Uncertainty and Threat
To understand why a pandemic. Or any sustained, uncontrollable threat. Is so neurologically costly, it helps to understand what the brain is actually doing when it encounters uncertainty.
Hypervigilance is a state of heightened sensory sensitivity and sustained threat-scanning in which the nervous system remains in a persistent state of alert. As described by Bessel van der Kolk, MD, psychiatrist and trauma researcher at Boston University School of Medicine and author of The Body Keeps the Score, hypervigilance in trauma survivors reflects the nervous system’s learned adaptation to environments where danger was unpredictable. A state in which the brain’s alarm centers (particularly the amygdala) remain chronically activated even in the absence of current threat.
In plain terms: If you grew up in an environment where you had to stay alert to survive. Where a parent’s mood could change without warning, where you never quite knew what was safe. Your nervous system learned to stay on. That wiring doesn’t switch off when the original threat is gone. And when a new real threat appears, it can send that already-activated system into overdrive.
Research by Rik Heller and colleagues at the University of Amsterdam has demonstrated that uncertainty activates threat-response systems in the brain more intensely than known negative outcomes. (PMID: 9635069) In other words: not knowing if something bad will happen is neurologically more costly than knowing something bad will happen. This is why the early weeks of a public health crisis. When no one has good information, when projections change daily, when the threat profile is genuinely unclear. Tend to produce the most acute anxiety.
For individuals with pre-existing hypervigilance or complex trauma histories, this effect is amplified. Their nervous systems are already running at a higher baseline activation. They have less physiological buffer between “alert” and “overwhelmed.” And they often have deeply engrained cognitive patterns. Forged in early environments where staying two steps ahead was genuinely necessary for safety. That make it very difficult to tolerate not knowing.
Understanding this neurological reality is the first step toward managing it. Your compulsive dashboard-refreshing isn’t irrational. It’s your nervous system trying to resolve uncertainty by gathering more information. The problem is that it doesn’t work: more data, in a genuine pandemic, doesn’t produce more certainty. It produces more data. And the loop continues.
How Coronavirus Anxiety Shows Up in Driven Women
In my clinical work during the early pandemic months, I observed a remarkably consistent presentation among driven women. Not the presentation you might expect. Not falling apart, not in obvious crisis. But a particular kind of high-functioning distress that looked, from the outside, like someone managing beautifully.
Jenny is a 36-year-old operations director at a healthcare company. In the first weeks of the pandemic, she built elaborate tracking spreadsheets for her family’s exposure risk. She wrote detailed contingency plans for every scenario she could imagine. She was productive, organized, and visibly composed at work. She also hadn’t slept more than five consecutive hours in three weeks. Her hands shook when she made coffee. She cried twice in her car in the parking lot at work and then went back to her desk and ran a meeting.
This is what pandemic anxiety looked like for many driven women: performance maintained at the cost of everything else. The competence didn’t go away. It turned inward and became hypercompetence as a defense against terror. Because the one thing many driven women have learned, often from very early on, is that staying useful is how you stay safe. Keep working, keep planning, keep managing. And maybe the chaos won’t get you.
What Jenny eventually named, sitting in therapy, was that the pandemic had done something specific and destabilizing: it had removed her primary coping mechanism. She couldn’t control this. She couldn’t plan her way out of it. The spreadsheets and contingency plans weren’t actually reducing the uncertainty. These patterns were just giving her hands something to do while her nervous system spun. And underneath the spinning was something old and familiar: the feeling of being a child in a household where she was never quite sure what was coming, and where staying on top of everything was the only strategy she had.
When Anxiety Meets a Trauma History
One of the most important things I want to say about coronavirus anxiety. And about health anxiety in general. Is that for women with trauma histories, the anxiety is rarely only about the present threat. It’s also about what the present threat activates.
The pandemic, like any sustained, uncontrollable danger, has a specific quality that makes it particularly potent for trauma survivors: it removes the illusion of control. And for many driven women, that illusion. The belief that if you’re competent enough, prepared enough, vigilant enough, you can stay safe. Is one of the primary ways they’ve managed the residual terror of early adversity.
“Trauma is not what happens to us, but what we hold inside in the absence of an empathetic witness.”
PETER A. LEVINE, PhD, Founder of Somatic Experiencing, author of Waking the Tiger: Healing Trauma
What Peter Levine’s framing illuminates is something clinically essential: the trauma being activated by the pandemic isn’t the pandemic itself (at least, not yet, for most people). (PMID: 25699005) It’s the emotional residue of earlier experiences. Of helplessness, of unpredictable danger, of needing to stay perpetually alert. That the pandemic’s particular texture has stirred up.
This matters for how you approach your own anxiety. If you notice that your fear is disproportionate to your actual, current risk. If you’re catastrophizing despite the data, or unable to stop even when you want to. It may be worth asking what older fear the current situation is pulling forward. Not because the current fear isn’t real, but because working with both layers, rather than just the surface one, tends to produce more lasting relief.
Understanding your nervous system’s baseline state is often the most clarifying first step. Because when you can name what’s happening neurologically. When you can say “my system is in threat-response mode right now” rather than “I’m broken” or “I’m going crazy”. The shame that often accompanies anxiety starts to loosen, and you can begin to actually work with what’s happening rather than just trying to outrun it.
Both/And: You Can Be Scared and Still Be Okay
This is the Both/And that I find myself saying, in some form, to almost every client I worked with during the pandemic. And to almost every client I work with now who is navigating sustained uncertainty:
You can be genuinely scared and still be fundamentally okay. These are not mutually exclusive.
The driven women I work with tend to have a binary relationship with fear. Either they’re in control. Performing competence, managing the situation, staying on top of everything. Or they’re not. And “not in control” feels, to a nervous system shaped by early adversity, like imminent disaster. There’s no middle ground. There’s no “I’m scared and I’m handling it.” There’s only performing calm or falling apart.
What trauma-informed therapeutic work slowly builds is exactly that middle ground. The capacity to feel fear. Genuinely, honestly, in the body. Without the fear becoming the whole story. To hold “this is frightening” and “I have survived frightening things before” in the same moment. To be scared about the pandemic and also present enough to eat dinner with your family, sleep (somewhat), and show up for work the next day.
Zoe is a 39-year-old marketing director who came to therapy in the spring of 2020 describing herself as “completely falling apart.” What she meant, when we unpacked it, was that she was crying sometimes. She was scared. She was admitting, to herself and to a few trusted people, that she didn’t know how this was going to go. By her own internal standards. Which were extremely high, and had been set in a childhood where emotion was seen as weakness. This felt like collapse.
“Actually,” I told her, “what you’re describing is being a person during a pandemic.” Fear without performance isn’t collapse. It’s honesty. And honesty is often the thing that allows the system to finally, partially, exhale.
Both/And also means this: you don’t have to choose between taking the threat seriously and protecting your mental health. You can follow public health guidance, stay informed, take precautions. and decide that you’re not going to refresh the case map more than twice a day. You can care about what’s happening without letting it consume all of your remaining bandwidth. These two things coexist. One doesn’t cancel the other out.
The Systemic Lens: Why This Anxiety Isn’t Just Personal
Something I feel strongly about saying in this post. And something I didn’t say clearly enough in the original 2020 version. Is that the anxiety driven women experienced during the pandemic wasn’t primarily a function of individual vulnerability. It was a function of structural reality.
During the pandemic, driven women were, in enormous numbers, managing: remote work (often in jobs that couldn’t easily be done remotely), the full-time labor of childcare (as schools and daycares closed), eldercare responsibilities that intensified, household management that became more complex and more time-consuming, the emotional labor of supporting partners and children through their own anxiety, and the performance of professional competence in video meetings while all of the above was happening in the same room.
The pandemic didn’t create that load. It revealed it, and then piled more on top. The anxiety that many driven women experienced wasn’t, at its root, a dysregulated nervous system. This experience was a nervous system responding accurately to an impossible situation. Naming that systemic reality. Rather than pathologizing individual women for struggling under genuinely crushing conditions. Is a clinical and ethical necessity.
I also want to name something about how women were talked about during the pandemic that still bothers me. There was significant commentary, from well-meaning quarters, about women needing to “lower their standards” for themselves, “let go of perfectionism,” “accept ‘good enough.’” As if the standards women hold themselves to are simply internal preferences that can be adjusted by mindset shift. Rather than often being the product of real external pressure, real professional stakes, real consequences for dropping the ball that are not evenly distributed across genders.
Systemic problems don’t resolve through individual mindset work. You can do a tremendous amount of valuable internal work. including with a coach. And still be living in a structure that isn’t designed for you to thrive in. Both things are true. And addressing one doesn’t mean ignoring the other.
What I want to name here. Because it rarely gets named. Is that health anxiety in the context of a global pandemic is not a pathological response. This response is, in many respects, the logical response of a nervous system that has correctly identified that the threat is real, that the information is incomplete, and that the usual mechanisms of control and prediction are inadequate to the situation. The problem is not that you’re anxious. The problem is that the anxiety is running continuously without the kind of regulation and discharge that allows it to be metabolic rather than corrosive. That allows it to be information you act on rather than a state you’re trapped inside.
For women with relational trauma backgrounds, the specific quality of COVID-19 anxiety often has an additional layer: the threat to others, the hypervigilance about protecting the people you love, the specific activation of the nervous system when you cannot guarantee the safety of those you’re responsible for. In my practice, I’ve found that for many driven women, their own safety was far less activating than the safety of their children, their parents, their communities. This isn’t selflessness exactly. It’s the pattern of a nervous system that learned, in childhood, to calibrate primarily to others’ vulnerability rather than its own. Healing, in this context, involves being allowed to include yourself in the circle of care. To let your own nervous system be as worthy of protection as the people you’re protecting so intently.
Sunita is a thirty-nine-year-old emergency medicine physician who, in the early months of the pandemic, was simultaneously one of the people most equipped to understand what was happening medically AND one of the most activated. She could explain viral transmission mechanics, personal protective equipment protocols, and mortality statistics with clinical precision. She could not stop checking the case counts at 2 AM. “I know exactly how this works,” she told me. “That’s the problem. I know exactly how this works.” The expertise, in this case, was not protective. This dynamic was a source of additional information to process in a nervous system that was already running at maximum throughput. What helped Sunita was not more information. She had plenty. But the practice of deliberate sensory grounding: physical contact, movement, the experience of the body in the present moment rather than the racing mind in the probabilistic future. The body always knows only now. The mind can go anywhere. And sometimes, the most effective regulation is returning from wherever the mind has gone to the only place the body has ever been: here.
Tools for Managing Coronavirus Anxiety
Here’s what I’ve found actually helps. Not as a replacement for addressing underlying trauma or the systemic conditions that create impossible loads, but as immediate, practical support for a nervous system in a genuine threat state.
1. Ground yourself first. Before you try to think your way out. Anxiety is a body state before it’s a thought pattern. When your nervous system is in threat-response, the prefrontal cortex (the part that does rational analysis) goes partially offline. Trying to logic your way to calm before you’ve addressed what’s happening in your body is like trying to drive with the handbrake on. Ground first: both feet flat on the floor, five slow breaths, cold water on your wrists, a short walk outside. Anything that brings sensation back into the body helps. Then think.
2. Set information boundaries. This is not about burying your head in the sand. It’s about choosing when and how often you receive threat-level information. Decide, explicitly, how many times per day you’ll check news and case counts. Write it down. Then hold to it. The anxiety brain will tell you that any information is better than uncertainty. It isn’t. More data at hour eleven of checking doesn’t reduce uncertainty; it just keeps your nervous system aroused.
3. Distinguish between productive and unproductive worry. Productive worry leads to action. You worry about your at-risk family members, so you make a plan to check in regularly and arrange grocery delivery. Unproductive worry loops. You worry about an outcome you can’t control and you replay it, with variations, until you’re exhausted. When you notice yourself looping, the intervention isn’t to stop worrying. It’s to ask: Is there anything actionable here? If yes, take the action. If no, you’re in unproductive worry. Give yourself permission to set it down temporarily.
4. Tend to your body with deliberate warmth and care. Fear is cold. Literally. Blood moves away from the extremities during a threat response, concentrating in the core. Counteract this: hot showers, warm food, an extra blanket, a heating pad on your chest. Warmth activates the parasympathetic nervous system, signaling to the body that you’re physically safe. It sounds simple because it is. And it works.
5. Let yourself be co-regulated. The nervous system regulates through relationship. Which is why isolation is one of the most acutely difficult features of pandemic restrictions. Seek out, as much as you can, the people whose calm and presence help you settle. A phone call with someone whose voice helps you breathe more slowly. A video call where you don’t have to perform. If you’re in therapy, lean on it right now. This pattern is exactly what the therapeutic relationship is for.
6. Name what’s old and what’s new. If your current anxiety feels disproportionate to your actual risk level, it may be worth asking what it’s triggering from the past. This isn’t about dismissing the real threat. It’s about understanding why your response is the size it is. Early adversity, relational trauma, childhood experiences of helplessness or unpredictability. These can all make a current threat feel more total and more catastrophic than it objectively is. Getting support to address that layer, through trauma-informed therapy or Annie’s Fixing the Foundations™ course, can make a lasting difference.
Finally: you’ve survived frightening things before. Your capacity for resilience is not theoretical. It’s demonstrated, over and over, in the history of your own life. Whatever is happening right now, you bring that history with you.
If you want support in doing this work more deeply, reach out for a consultation. You can also take Annie’s free quiz to understand the specific nervous system patterns shaping your responses. And if you’d like to stay connected to clinical writing about the inner lives of driven women, Annie’s essays. Annie’s Sunday newsletter. Is a good place to start.
You don’t have to be fine. You just have to keep going, one regulated breath at a time.
Warmly, Annie
Q: My anxiety about the pandemic (or other health threats) feels way out of proportion to the actual risk. Should I be worried about that?
A: Not worried. But curious. Disproportionate anxiety in response to a real threat is often a signal that the current situation is activating something older. If your nervous system is responding to COVID-19 with the same intensity it would use for a truly survival-level threat, it may have learned to do that in a different context. One where that level of vigilance was genuinely necessary. That’s worth exploring with a trauma-informed therapist, not because you’re broken, but because you deserve to understand your own patterns.
Q: I keep refreshing health statistics and news, even when I know it’s making me worse. Why can’t I just stop?
A: Because the behavior makes neurological sense, even when it doesn’t help. Your nervous system is trying to resolve uncertainty by gathering more information. This is a threat-response pattern, not a character flaw. The problem is that more data doesn’t reduce genuine uncertainty. The loop continues because the underlying nervous system state hasn’t changed. Setting explicit information limits (twice a day, at designated times) and addressing the nervous system directly. Through grounding, movement, co-regulation. Tends to break the loop more effectively than willpower alone.
Q: I’m managing everything at work just fine, but at home I’m falling apart. What’s happening?
A: This is one of the most common presentations I see in driven women. And it’s a sign of how much energy you’re using to perform competence during the workday. The nervous system isn’t infinitely elastic. When you stop performing, the system exhales. And what it releases can look like falling apart. It isn’t breakdown. It’s the cost of holding it together finally becoming visible. It’s worth asking whether the performance at work is actually serving you, or whether it’s another way you’ve learned to manage fear by staying useful.
Q: How do I tell the difference between healthy caution and anxiety that needs clinical attention?
A: Healthy caution leads to proportionate action and then releases. Anxiety loops. If you find yourself unable to stop monitoring, planning, or worrying even when you’ve already taken appropriate action. If the anxiety is consuming significant time and energy and isn’t responsive to reassurance or evidence. That’s a signal worth taking seriously. Other indicators that clinical support would help: sleep disruption lasting more than two weeks, physical symptoms (jaw pain, chest tightness, GI disruption), difficulty concentrating, and a sense that the fear has become the primary organizing principle of your daily life.
Q: I have a trauma history. Does that mean I’ll always have a harder time during crisis situations?
A: It means you have a nervous system that was calibrated to an earlier threat environment, and that certain types of situations. Particularly those involving unpredictability, loss of control, and sustained uncertainty. Will activate that older calibration. But “harder time” doesn’t mean “unable to cope” or “permanently damaged.” Trauma-informed therapy, somatic work, and understanding your own nervous system patterns can substantially change your baseline capacity. Many clients with significant trauma histories develop remarkable resilience. Not because the trauma went away, but because they built new tools and new resources around it.
Q: My children are watching me be anxious. How do I protect them from absorbing my fear?
A: First: you don’t have to be perfectly calm to be a good enough parent during a crisis. Children can handle age-appropriate honesty about difficult situations much better than they can handle a parent who’s clearly distressed but performing cheerfulness. What children need most is a regulated-enough adult presence. Not a perfectly regulated one. Attend to your own nervous system first (grounding tools, support, rest when possible) and then you’ll have something more authentic to offer them than a performance of calm they can see through anyway.
References
Peer-Reviewed Research (Vancouver)
- van der Kolk BA, Wang JB, Yehuda R, Bedrosian L, Coker AR, Harrison C, et al. Effects of MDMA-assisted therapy for PTSD on self-experience. PLoS One. 2024;19(1):e0295926. doi:10.1371/journal.pone.0295926. PMID: 38198456.
- Payne P, Levine PA, Crane-Godreau MA. Somatic experiencing: using interoception and proprioception as core elements of trauma therapy. Front Psychol. 2015;6:93. doi:10.3389/fpsyg.2015.00093. PMID: 25699005.
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Annie Wright, LMFT
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Annie Wright is a licensed psychotherapist (LMFT #95719) and trauma-informed executive coach with over 15,000 clinical hours. She works with driven women. Including Silicon Valley leaders, physicians, and entrepreneurs. In repairing the psychological foundations beneath their impressive lives. Annie is the founder and former CEO of Evergreen Counseling, a multimillion-dollar trauma-informed therapy center she built, scaled, and successfully exited. A regular contributor to Psychology Today, her expert commentary has appeared in USA Today, Forbes, Business Insider, NBC News, and The Information. She is currently writing her first book with W.W. Norton.
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