Regaining balance during ‘reality vertigo’: six insights gleaned from the front-line to manage pandemic-related anxiety

One month ago, most of us had never heard of ‘Zoom’. One month ago, most of us would never imagine that scarcity of toilet paper, masks or ventilators would become a global concern. In academic medicine in the USA 1 month ago, our reality and focus were on caring for patients, equipping trainees with the skills to become good doctors, working to identify ways to navigate and improve electronic health records (EHR) and systems in order to enhance physician-well-being. However, as we are all now exquisitely aware, previous plans and efforts—our entire reality—has suddenly nosedived at a dizzying pace as we collectively turn our focus to the new reality of COVID-19. Life as we knew it has disappeared in a heartbeat. We now find ourselves on an emotional rollercoaster in the theme park of uncertainty. No one likes to feel out of control, especially smart people. And physicians are very smart people. Perceiving oneself as out of control creates overwhelming feelings of anxiety and dread. Unfortunately, at this moment in time, uncertainty permeates every aspect of our lives: from what course this pandemic will take, to the future economic repercussions, to concerns about family and colleagues. We have written previously about the concept of ‘reality vertigo’1 but from a patient’s perspective. This term refers to the idea that receiving a potentially life-altering diagnosis leads to intense perceptual shifts and emotional turmoil. During this turbulent period, it appears that the individual’s entire world view, as well as his or her plans and hopes for the future, are suddenly thrown into question. Depression, anxiety and somatisation of emotional distress may be strongly related to this overall belief that one has completely lost control …