ST. LOUIS — For some, being vaccinated against COVID-19 has provided a dizzying sense of freedom after a year of isolation — opening the door to everything from baseball games to haircuts.
But not everyone is ready for the transition.
As life gradually inches back to normal, many are struggling with anxiety about resuming certain activities, even after they’re fully vaccinated. Nearly half of Americans surveyed in February said they felt uneasy about returning to in-person interactions after the pandemic ends, according to a study from the American Psychological Association.
That kind of discomfort is to be expected, said psychologist Alison Menatti — especially given uncertainty about the role of new virus variants and continued outbreaks among unvaccinated people.
Menatti said many people are out of practice with normal social interaction. “A lot of people have talked about feeling as though their mask has almost become this safety blanket that keeps them from feeling exposed,” she said. “Sometimes anxiety comes along for the ride and makes us question, ‘Am I socially adept? Have I lost my skills?’”
St. Louis Public Radio’s Shahla Farzan spoke with Menatti, director of the Center for OCD and Anxiety-Related Disorders in St. Louis, about what’s driving pandemic-related anxiety, ways to manage it and how to ease back into in-person activities.
Listen to this story here.
Why are people feeling anxious after they’ve been vaccinated?
Often when people experience anxiety, it’s really about the unknown — and the pandemic has just been about uncertainty in its purest form. What I’m hearing most is: ‘I’m vaccinated. I know that it’s safe to resume these activities again, but I don’t know what it is — I just don’t feel comfortable doing it.’ And oftentimes, that’s what happens with anxiety; it doesn’t always follow the rules of logic.
Part of it is we’re all out of practice with doing these normal activities that we used to do day to day, so of course there’s going to be a natural adjustment. But I think an important piece of it is the fact that for over a year, we’ve all been getting this information about how dangerous this virus is, how important it is for us to keep ourselves safe and other people safe. There’s been some reasonable fear and obviously some anxiety about that. That’s just not going to change overnight, because one day you get a vaccine.
Of course, there are other concerns that people are having. It’s still an uncertain situation. People are questioning, ‘Well, if I’m vaccinated, but I have family members that aren’t, how should I operate under those conditions?’ People also have concerns about variants and the potential they could still become ill. It’s a number of different concerns, but it’s all tied together by the uncertainty of the situation.
What is COVID anxiety syndrome and how is it different from other forms of anxiety?
There are a lot of different terms for it, but I don’t think there’s a clear definition of what COVID anxiety syndrome entails. Generally speaking, it’s characterized by excessive worry, feeling as though you’re in a state of hyper-vigilance or constant threat monitoring. Avoidant behavior is also really a hallmark that we also see with COVID-specific anxiety. That entails avoiding any situation that’s going to elicit any anxiety. Earlier in the pandemic, a lot of people were engaging in checking behaviors, like scanning their own body for symptoms of COVID or maybe mentally replaying different situations that they engaged in and trying to give themselves that assurance that it was a safe situation.
For any mental health condition, if people have one or more risk factors, they’re going to be more predisposed to difficulties. Generally speaking, that includes having poor social support, having prior chronic conditions, financial difficulties, food or housing instability. Certainly people that had anxiety before the pandemic or were predisposed to it might be more likely to have difficulties in this situation.
Are doctors seeing more cases of COVID-related PTSD?
It’s completely reasonable to expect that there is going to be an increase in COVID-related PTSD. This has been a traumatic time for many people: those who were very ill and fearful that they would die, people that have lost a loved one, front-line responders who are witnessing people dying from COVID. We know that after traumatic events, most people experience symptoms of PTSD, especially in the immediate aftermath. Thankfully, there is typically a natural recovery process that occurs without anybody necessarily having to do anything. For example, usually three months after a traumatic event, we see about a 50% reduction in the symptoms of PTSD compared to immediately after the trauma.
There’s no set definition of how long it should take somebody to recover from something like a global pandemic. But on the whole, most people do recover. Some people, unfortunately, do get stuck in that natural recovery process. Fortunately, we have a lot of really effective treatments that are available to help people in those situations.
Where do we draw the line and say that anxiety is starting to become harmful?
Where that line is will look different for every individual. For example, somebody might say, ‘I’m not able to go to the grocery store right now, and I need to be able to do that.’ Or, ‘Before I go to the grocery store, I need to do a lot of prep work and spend 10 minutes decontaminating my grocery cart. So it’s just really arduous, and I have to do it in such a way that just isn’t sustainable and just makes life really hard.’
It’s a problem if it’s a problem for you. Nobody else can make that determination about what’s acceptable for you in your life, but it’s about you being able to do the things that you want in the way that you want. If something is getting in the way of that, then there’s something you can do about it.
What are some coping strategies for people who are anxious about resuming activities they did before the pandemic?
I think it’s really helpful to figure out what your goals for yourself are. Like, what are the most important things that you’re trying to accomplish — or that you feel anxious about but want to be able to do — and then figure out how you can take steps toward that.
Basically, that boils down to this notion of taking it slow: Dipping your toe in the water, waiting until you acclimate to it and then getting in the water a little bit more. Trying to find something that you can do that might be a little anxiety-provoking, but not to the point where it’s overwhelming, and so you can get a sense of mastery with that before you potentially move to the next step. What that looks like is going to be different for everybody based on the concerns they have and what’s been difficult for them to do.
Maybe it’s keeping your camera on for more meetings that you have; maybe that’s even the first step before being back in person with people. Maybe once you get to that point, it’s going to a store when you know it’s not going to be really crowded, still keeping your distance and staying for a short period of time.
Follow Shahla on Twitter: @shahlafarzan