Stepping out
As we re-enter society and get “back to normal”, many are anxious about stepping out of their protective pandemic circle. Meg Walker talks to the experts about why so many of us are feeling the fear.
It’s been a long 15 months since Covid-19 entered our lives. At first, lockdown presented both fear and comfort – we worried about catching the virus, and possibly losing our jobs or business, but many of us revelled in the novelty of battening down the hatches and staying in, our pantries overstocked, streaming watch lists bulked up, and online shopping carts full of loungewear in every colour.
Then, after a rollercoaster year of various restriction announcements, the novelty wore off. But while most of us were ready for some sort of normality to return, that also came with some trepidation. Many worried whether it was actually safe to return to their workplace. Others felt that taking that giant leap back into their old normal was just a step too far.
For some, an underlying anxiety disorder may have presented itself over lockdown. Social anxiety – where a person experiences a persistent fear of being evaluated and judged by others and may avoid social situations as a result – is experienced by approximately one in eight adults (socialanxietyireland.com). Agoraphobia – the fear of places and situations that cause the person to feel panicked or trapped – is another anxiety disorder which many experts feel is on the rise since the start of the pandemic in a milder, more temporary form, brought on by long-term confinement. Meanwhile, generalised anxiety disorder (GAD), where a person feels anxious much the time for a variety of reasons, with a range in severity of symptoms, affects around one in 20 adults, though experts have also seen a rise in GAD during the pandemic. These are, of course, just three mental health issues people face.
While those with an underlying anxiety disorder are more likely to be feeling anxious as restrictions ease, anyone can be overwhelmed by the prospect of returning to old routines. “In 2020, the most prevalent issues amongst our clients were anxiety (26 per cent), depression (15 per cent), and relationship issues and stress (8 per cent), and it was the conditions brought on by Covid-19 that was the main contributing factor,” says Gráinne O’Rourke, head of communications at MyMind (mymind.org), which with support from the HSE and Sláintecare has been delivering free online counselling sessions for those directly affected by Covid-19 over the last year, with funding extended for this service until the end of September. “A lot of people have reservations about going back to ‘normal’ for a number of reasons,” she says, one being the fear of the virus, while Gráinne says MyMind therapists have seen an increase in cases of temporary agoraphobia in the last year. “People have become used to maintaining social distance, not shaking hands, so there is this anxiety about going back into that space. We will adapt, but where I think it will continue to be a problem is for people who are naturally introverted, who almost thrived in lockdown because they’ve been allowed to remain in their own company. I believe there’s going to be residual anxiety and stress coming out of Covid for a long time.”
One person who’s benefitted from MyMind’s free service is Lauren*, a teacher who in March, after returning to the classroom, went to see her doctor about how she was feeling: “I didn’t feel myself in work. I was having what the doctor told me was depersonalisation, where I was feeling out of my body, spaced out. I’d get panic attacks at the supermarket. I’d feel dizzy, shaky, have a rapid heart rate. I tried mindfulness, exercise… everything you’re meant to try, and it wasn’t going away. I started cognitive behavioural therapy (CBT) online with MyMind – in my first session, my therapist said, ‘I can see it in you – this isn’t fight or flight, this is a proper anxiety disorder.’ I left teaching and got a job as a Montessori manager. You think, ‘I’ll get the job, and then I won’t be stressed’, but that’s not how anxiety works. I feel really anxious about going back to social settings. I’m not going to push myself. I’m doing CBT once a week – it’s a life skill I hope will give me a good base.”
“Anxiety is an overwhelmed central nervous system that can be measured in the body – we can see it through increased heart rate and breathing. It’s something that affects the whole chemistry and physiology of the body. So, in order to ease or remove anxiety, we need to look at it from a holistic point of view,” says Gerry Hussey, health and performance coach, founder of Soul Space, and author of Awaken Your Power Within (Hachette Ireland, approx €17.50). Gerry suggests people look at their diet – reducing foods that increase adrenaline and cortisol, such as caffeine – and their breathing. “Our lungs are designed to take six litres of oxygen and eight to 10 breaths per minute, but most people are only using a half a litre, breathing
over 20 breaths a minute. Breathing fast and shallow triggers the sympathetic nervous system and that is fight or flight. Once we learn to stop and breathe, we can take the nervous system out of sympathetic nervous system and into parasympathetic nervous system.” Finally, exercise and connecting with nature is important, and switching off the news from time to time helps.
As Dr Harry Barry, a GP and author of Embracing Change (Orion Spring, approx €17.50), explains, “It’s the situation that’s abnormal, not us. When you go back in to work, expect to be slightly anxious, and don’t be afraid to say, ‘I felt very strange coming in here this morning.’ If everybody starts doing that, then we’ll begin to normalise it. At the moment, people are thinking there’s something wrong with them, that they should be delighted to be going back into workplaces and social situations. Feeling anxious and stressed is a normal response to an abnormal situation.”
Dr Barry says change is inevitable, and we need to develop the tools to cope with those transition periods. Just like when a new mum returns to work after maternity leave, going back to work or school or social settings when you’ve been out of that comfort zone for so long is naturally going to cause worry. “The reason we’re anxious is because it’s out of our control,” explains Dr Barry. “It’s very uncertain, we’re not sure how it’s going to work out, and we catastrophise – we visualise all the things that might go wrong. When we realise this is unhelpful, we can start challenging our thinking, and reducing our anxiety levels.”
Dr Ciara McEnteggart, co-director of Perspectives Ireland (perspectivesireland.ie) suggests taking this time before the big return to reflect, and take a few steps to help you ease back in. “Use this transition period in a way that works for you instead of against you. Reflect on the things that really matter to you. What did you learn about yourself during lockdown? What worked for you? One of the things we do with clients is graded exposure: If you have a big change coming up, write a list of all the small details that change will involve; for instance, if it’s returning to work, it might be getting up earlier, doing a morning commute. Once you have your list, slowly start introducing them one at a time before you go back. If any overwhelm or anxiety shows up, then we can deal with that one step at a time.” She also suggests setting boundaries, and practising saying no. “Saying no doesn’t make you selfish, it protects your wellbeing and that me-time you might have built up over lockdown.”
Change can be positive, too, providing you with some perspective and helping you realise that perhaps you weren’t 100 per cent happy with the way you were living before. “Every single one of us has to sit down and ask the question, ‘What is my life about? Am I happy?’” says Hussey. “I ask people to think about their last day – what are the possible regrets if you continue to live the way you live, and nothing changes? Your two biggest gifts in life are time and health. No matter what you do, your success can’t be at the detriment of your health, time or happiness.”