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The Toilet Paper Shelf is Empty: How to Calm the Fight-or-Flight Response

Updated: Apr 3, 2020

Whitney H. Mitchell, MD

Toilet paper has all but disappeared from shelves of local stores over the past 2 weeks. While the illness associated with Covid-19 may cause gastrointestinal symptoms, it may seem puzzling that preparing for isolation has resulted in a nation-wide shortage of paper on a roll. Our body's response to stress may help us understand why we respond to fear by hoarding household supplies, obsessively consuming the news and social media, or excessively worrying about our health.

Fear is an adaptive response that helps us to avoid danger. When we perceive a threat, our bodies respond with a fight-or-flight response that is set off by a very small structure in our brain called the amygdala. The amygdala becomes activated by fear, causing a downstream cascade of stress hormones involving the brain, adrenal glands, and the sympathetic nervous system. Our bodies become flooded with adrenaline (epinephrine and norepinephrine) and cortisol, and our sympathetic nervous system reacts by preparing our bodies for danger. We become ready for battle as our blood vessels direct blood and oxygen to our major muscle groups, heart, and lungs. We breath faster. Our heart pounds. Our muscles become tense. So long as a threat is looming, our bodies continue to keep us alert and ready. Once the danger has passed, our parasympathetic nervous system is allowed to take over and start the process of calming our bodies back to our baseline state.

The fight-or-flight response works beautifully when there is clear and present danger, however new, uncertain, or pending threats provoke anxiety rather than an adaptive response. Despite images, news stories, and social media posts that create fear in our amygdala, there is no actual nemesis wearing a Covid-19 jersey. We cannot fight. We cannot flee. Our activated fight-or-flight response prompts our brain to start processing the world around us in maladaptive ways.

Despite knowing what is logical, our brains on adrenaline and cortisol become a bit more irrational. We might become consumed by the news or worry incessantly about our health. We might become fearful of foreigners or look for conflict on social media. As evidenced by the national shortage of toilet paper, many of us will panic-buy and stockpile supplies.

There is no doubt that fear of Covid-19 is causing community-wide distress. We as a community are activated and ready for a battle but without a common enemy to face. Without consciously engaging the logical part of our brain, we are in danger of our less rational fight-or-flight brain taking over.

Here are things that you can do to work through your fight-or-flight response:

1. Do what you can do: stay home, wash your hands, and adhere to social distancing guidelines.

2. Remind yourself that you are not presently in danger and that, if danger comes, you will be equipped to deal with it then.

3. Stay informed but limit your consumption of news and social media.

4. If you are not in a high risk group, buy the supplies you need for the next week or two. While it's tempting to buy more, your neighbors need supplies too.

5. Exercise! There is no better way to bring our bodies down from a fight-or-flight response.

6. Help someone else. Call your neighbor or reach out to your church or other organization, and ask how you can help.

7. Self-care: prioritize sleep, eat well, meditate, pray, talk or videochat with supportive people, journal on gratitude, get outside, love on your pet, or read a book.

Dr. Whitney Mitchell is a physician in New Braunfels, Texas. She is a diplomat of the American Board of Psychiatry and Neurology, has been in private practice for 11 years, and has an interest in public health.

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