When COVID-19 began spreading in the U.S., Dan Kerber was drawn to the data. The 48-year-old from Plano, Texas read about case counts and projections every day, keeping his team at the telecommunications company Ericsson up to date on the latest news. So in May, when states including Texas began to reopen before the data showed it was time to do so, Kerber began to get nervous.
“If more people are out, does that mean my family and I are going to get it despite our precautions?” he thought. “Until there’s a vaccine or a treatment, I still worry about being in public.”
Kerber, who says he’s never struggled with anxiety before, now feels “underlying concern or unease” when he spends time in public, in large part because he has an autoimmune condition that makes him more susceptible to coronavirus. At the same time, he says, he’s anxious about the prospect of working and living remotely for months more, or longer. “I’m concerned about going into public, but now I’m also concerned about how long I can [last] without going out,” he says.
When COVID-19 lockdowns were first instituted, it felt, for many people, unfathomable to stay home nearly 24/7. But for people like Kerber, it now feels equally strange—and nerve-wracking—to do anything else after months cocooned inside. Psychologists have dubbed the phenomenon “re-entry anxiety.”
Lily Brown, director of the Center for the Treatment and Study of Anxiety at the University of Pennsylvania’s Perelman School of Medicine, says there are two distinct types of re-entry anxiety. Some people are anxious because they have a “lurking fear” of catching or spreading COVID-19, she says, while others have fallen out of practice socializing and are finding it difficult to resume.
Both types of anxiety are likely driven by uncertainty and a fear of unknown harm, Brown says. Ambiguous and ever-changing public-health advice likely doesn’t help, either.
Brown says some anxiety is probably healthy as society reopens, since the virus is still spreading and still poses health risks. A little bit of nervousness can motivate you to follow public-health guidance like social distancing and wearing a mask. But when anxiety starts to interfere with your day-to-day life, it may be a problem, Brown says.
If you’re struggling to find the right balance, try these expert-backed tips for combating re-entry anxiety.
Take baby steps
“Exposure therapy“—or safely confronting sources of fear—is the gold-standard treatment for many fear and anxiety disorders. The same tactic may help with re-entry anxiety, says Dr. Ryan Sultan, an assistant professor of clinical psychiatry at Columbia University’s Irving Medical Center in New York City.
“Don’t go from staying locked in your apartment to taking the subway,” Sultan says. Instead, set progressive small goals that will get you closer to behavior you find scary. For example, you could start with a walk in the park alone, then try chatting with a friend from your window and finally go for a walk together.
If you do feel yourself getting pulled into an anxiety spiral, focus on your breathing. “The simplest way to pull yourself back from that anxiety is to really concentrate on taking controlled, slow, deep breaths,” Sultan says.
“Social isolation absolutely has short-term mental-health impacts,” Sultan says. “But it potentially also has long-term impacts, and they’re directly proportional to the duration. The longer people avoid things that are making them anxious, the harder they will be to overcome.”
That does not mean you should rush out and socialize just like you did before coronavirus. (Large social gatherings are still not condoned by health experts, and most recommend meeting up outdoors.) But think about what you can do safely right now—perhaps sitting with a friend in your backyard while wearing masks and staying six feet apart—and take steps to do it sooner rather than later.
But think long-term
Sultan says he’s seen multiple patients who are remaining more isolated than necessary because of re-entry anxiety. He asks them a simple question: “Is this the life that you want to live indefinitely?”
Almost invariably, he says, people realize they “miss being outside, seeing their friends, living their life.” Having that moment of realization can motivate people to start taking small steps back toward normal, Sultan says.
Be wary of crutches
Brown says it’s easy for recommended public-health practices, like washing your hands regularly, to spiral into “safety behaviors” that, consciously or subconsciously, you rely on to keep anxiety at bay.
Be honest about how these safety behaviors are affecting you. If wiping down your groceries “takes you five minutes and it really helps you,” it’s probably not a big deal, even if it’s not strictly recommended, Brown says. But if you’re spending hours a day cleaning your home, that could be a bigger issue. “It’s never really up to me to decide, ‘Is this behavior a problem?’” Brown says. Ask yourself, “Is it getting in the way of the life you want to be living?”
Recruit a partner
Like most behavior changes, quelling re-entry anxiety is easier with a buddy who can both support you and hold you accountable, Brown says.
Similarly, if someone if your life is struggling with re-entry anxiety, try to be their partner through it, Sultan says. “Ask them, ‘What would make you feel more comfortable doing this? Is there something I can do that would help you with that? What’s something you would feel comfortable with us doing?’”
Then, of course, actually accommodate their answers, rather than forcing the issue, Sultan says. If your loved one is too nervous to go to a busy park, try suggesting an early-morning visit to beat the crowds, rather than convincing them everything will be fine at midday, Sultan recommends. And remember that people may have COVID-19 risk factors that look different from yours. Respect that people are going to want to move at different paces, often by necessity.
One bright spot to the COVID-19 pandemic: it’s never been easier to connect with a mental health professional, thanks to an uptick in telemedicine services. If you’re struggling with anxiety, don’t hesitate to seek professional help, Brown says.
“I see people suffering with anxiety for years before they do anything about it,” she says. “We know that cognitive behavioral therapy is really effective in managing anxiety. My vote is always just reach out.”
If you don’t know where to get started, Brown says she and her colleagues can offer referrals. Contact them here. You can also call the Substance Abuse and Mental Health Services Administration’s hotline 24/7 at 1-800-662-4357.
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Contributor: Jamie Ducharme