Vaccinated but not yet integrated
COVID-19 fears keep some from reentering society
As the weather warms up and millions of people continue to get vaccinated each day, Americans are beginning to feel optimistic that the worst of the coronavirus pandemic may be finally behind them.
The Centers for Disease Control and Prevention has been issuing new guidelines that say fully vaccinated individuals can safely travel, meet with friends and family, and take off masks while outdoors, indicating a dramatically different world for many Americans who adhered to public health safety guidelines.
But after more than a year of living in fear of COVID-19, some fully vaccinated individuals are hesitant to leave their homes and let their guard down.
“Many of us have gotten very comfortable with the safety that our isolated environments have provided and taking these initial steps out of our safe, home-controlled environments can cause fear and anxiety,” said Dr. Marni Chanoff, integrative psychiatrist at McLean Hospital and Harvard Medical School. “Anxiety is not a bad thing ... but when it takes over and becomes more powerful, then our ability to navigate these next steps can be problematic.”
Anxiety may stem from habitual fear learned during the pandemic, individual past trauma and inconsistent messaging from health agencies, health experts say. However, there are ways to manage it and slowly return to society.
Where does the fear, anxiety come from?
The human brain is hardwired to respond to fear and threat, said Kirsten Koenen, professor of psychiatric epidemiology at Harvard T.H. Chan School of Public Health. Fear is adaptive and used to teach humans to avoid things that threaten their being.
“The challenge is because it’s so easy to learn, it’s hard to unlearn,” she said. “Because our brains have evolved to encode fear so well, it’s hard to turn off.”
For the past year, Americans have learned to avoid meeting with friends and family, eating at bars and restaurants, and traveling for fear of getting infected with the coronavirus. Unlearning that fear will take active and purposeful work, Koenen said, especially for people who are naturally risk-averse.
Some people are innately more anxious than others and avoid risk-taking behavior based on past experiences and trauma, she said. These people are more likely to take more time reentering postpandemic society.
“One of the things we talk about in trauma is called shattered assumptions. Some people go through the world with assumptions about the world and that influences how you respond,” Koenen said. “If you think the world is generally a safe place ... a lot of people’s answers are different and shaped from different experience and trauma.”
Fear and anxiety are further shaped by one’s experience during the pandemic, she added. If someone lost a loved one to COVID-19, they may be more wary to let their guard down regardless of vaccination status.
In general, studies have shown anxiety among Americans has shot up since the start of the pandemic. WebMD has seen a 251% increase in searches for anxiety medication from April 8 to 23, according to Dr. John Whyte, chief medical director of WebMD.
“For a lot of people, it’s going to take some time to readjust to a new norm that isn’t quite pre-pandemic but getting closer,” he said.
Inconsistent messaging from public health officials and the medical community hasn’t helped Americans’ anxiety, mental health experts say. It fosters uncertainty about the COVID-19 vaccines, community transmission and whether it’s truly safe to step outside, which can fuel people’s anxiety.
“The problem with the conflicting information – which is totally normal in science because knowledge is evolving – is that it creates uncertainty, which feeds fear and anxiety,” Koenen said.
How to manage fear, anxiety post-pandemic
Growing vaccination rates and an increase in outdoor activity due to warm weather will make for “a very quiet summer,” said William Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health.
“The vaccines that we’re using are extraordinarily good at preventing the worst outcomes of the disease,” he said. “That’s happening at the same time as cases are already quite low in the community.”
Despite the good news, some fully vaccinated individuals may need time to adjust to the new freedoms recommended by the CDC, mental health experts say. One of the best ways to overcome this anxiety and fear is through exposure therapy.
Exposure therapy is a psychological treatment where individuals are “exposed” to the things they would normally fear and avoid, according to the American Psychological Association.
“The way to work through anxiety is to take very small steps forward and expose yourself to manageable amounts of anxiety,” said Chanoff of McLean Hospital. “As you become more and more comfortable with small amounts of anxiety, that builds confidence and it allows you to take the next step.”
Start with exposures that are personally important, Koenen says. If it’s important to socialize with friends, then start by picking a controlled environment outdoors that presents little risk of infection. From there, a person can build to a visit at an outdoor public space to see that friend or invite them inside the house.
“People are going to have to be their own therapist, their own coaches figuring it out,” she said.
Overcoming pandemic anxiety may also require a shift in perspective, Chanoff said. Instead of looking at this year as a time of uncertainty, she urges those struggling with anxiety to look at it as a chance for new beginnings.
“This is a wonderful opportunity for people to not just go back to the life they’re living that probably had wonderful aspects but wasn’t perfect,” she said. “A lot of people have found that this year has really allowed them to slow down, to let go of things, to create new patterns and ways of being.”
“There’s a real opportunity for people to think about what they really want.”