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We’re all washing our hands constantly and doing our best to avoid touching our faces. These are, of course, the instructions we’re getting from every direction to help prevent the spread of the coronavirus.

But for people with underlying mental health issues, such as anxiety or obsessive-compulsive disorder, it’s easy for those directions to cross the line from healthy precautions to unhealthy worry.

Therapists and psychiatrists in Minnesota, where health officials 

confirmed the state’s first case of COVID-19

 on Friday, say they’re already starting to see it.

Maple Grove psychotherapist Jenny Reimann said she’s not seeing full-on panic yet. But when her regular clients come in, it’s coronavirus they want to talk about.

“They're most worried about leaving their house, having enough supplies, having their kids go to school or be with friends because they're worried of contracting the virus,” she said.

Reimann’s job as therapist is to listen and to help her clients find ways to handle that anxiety, she said.

One client told Reimann she didn’t want to leave the house, and that she wanted to go to Costco and buy everything in the store as a precaution.

Reimann recalled telling her, “Let's see what would make you feel the most comfortable if you can't do those things, which isn't realistic and financially responsible. What could you do?’”

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The answer for that person was to make gift baskets of supplies for her friends. Some stores have had to limit purchases of things like Lysol and other cleaning products as shoppers have left shelves barren. 

Reimann’s practice already offers telehealth — therapy via video — for people who can’t come into the office because of work or child care trouble. She’s been offering that option for people who are worried about coming in because of the coronavirus, but nobody’s taken her up on it yet.

Psychologist Sean Truman’s practice, The Truman Group, uses telehealth to provide mental health to expatriates living all over the world. He said he’s been getting calls from people whose lives are already being disrupted with evacuations and quarantines.

One call he got recently came from the counselor at an international school in Europe that’s going to have to shut down because of the virus.

He said the counselor reported that students were having more mental health problems and more symptoms. Meanwhile, the counselor worried that the students wouldn’t have access to mental health care because they were quarantined.

Truman said it’s important to keep the danger in perspective, though. People seemed much more worried for him as he was getting ready to leave for Ethiopia last week — where, at least as of this writing, there were no cases reported — than the fact that he’d recently been in Seattle, where there have been a number of deaths, he said.

It’s also important to note that for a lot of people, coronavirus isn’t the only stressor right now. Many Americans are already emotionally taxed from political divisiveness, the economy, the environment, and personal crises.

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Rebecca Makkai, the author of “The Great Believers,” came to this realization recently after 

asking her Twitter followers to post their worries

. While she did receive some responses about the coronavirus, others confided in her about lost jobs, broken marriages and other problems.

Still, she thinks coronavirus is definitely a trigger: “When you’re already anxious and that reptilian part of your brain is already activated by other stuff, then something like [the coronavirus] comes along and you’re primed to freak out,” she said in an interview. 

Part of what makes this outbreak so tricky from a mental health perspective is that the anxiety and fear aren’t totally irrational. We understand so much in medicine and we know so much about diseases, 

and yet we can’t do anything about the coronavirus

Nidal Moukaddam, an attending psychiatrist at the Baylor College of Medicine in Houston, said the essence of anxiety is fear: You’re afraid something really bad is going to happen, and then an outbreak like this confirms your worst fears.

“And there you go, something bad has happened that has paralyzed everybody on Earth,” she said.

Still, in many cases, even anxiety about the coronavirus isn’t enough to overcome the stigma of seeking help. Moukaddam said she’s seeing lots of questions about coronavirus anxiety on Facebook and in professional forums.

“But I think that when you make an appointment [to see a therapist or psychiatrist about coronavirus related anxiety], it’s almost like admitting there’s something wrong with you,” she said.

Even health professionals aren’t exempt from anxiety over the coronavirus outbreak, she said. When an acquaintance posted a group text asking whether to cancel her family’s spring break trip, everybody eagerly awaited a response from the one infectious disease doctor in the group, she recalled. 

The answer? Mostly avoid unnecessary travel and possible exposure.

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Mental health practitioners say the challenge is to help people figure out which anxieties are realistic and how best to deal with them.

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