Community Psychiatry’s Allie Shapiro, MD and Pavan Madan, MD were featured in an article discussing how to handle anxiety as society begins to reopen.

Do You Have ‘Re-Entry Anxiety?’ Here’s How to Cope With Your Fears As Society Reopens

It’s pretty much impossible to forget that we’re in the middle of what nearly everyone is calling “challenging and unprecedented times.” We’re constantly reminded of the global pandemic via commercials, news segments, social media posts, conversations, and more. With shifting health recommendations, increasing caseload counts, and unanswerable questions around how long this will last, the only constant throughout the pandemic has been the uncertainty around it. We’re learning as we go and it’s exhausting.

Unsurprisingly, all of this can lead to anxiety, even in individuals who may not have described themselves as anxious before. As it is, around 19 percent of Americans already suffer from an anxiety disorder, and there is data to suggest that anxiety and depression are on the rise directly due to the COVID-19 pandemic. Now that states are re-opening and re-closing at different rates, anxiety around the pandemic has expanded to include re-entry anxiety. At least with most cities’ lockdowns, we knew exactly what was open (essential businesses and that’s pretty much it). Now, we have to navigate around partial reopenings with variations across neighborhoods and county lines even within the same state.

Ahead are some common types of re-entry anxiety you may be experiencing (you’re not alone!)–and some psychiatrist-recommended tips to help you manage them. Remember, even though most of us are isolating in some form or another, we’re still all in this together.

1. Re-entry anxiety over how to balance your desire to start socializing again with knowing the inherent dangers of crowded spaces

“As different parts of the country open up at their own speed, it’s important to realize that acting, feeling, and being normal is going to look different now. Even in places that have opened, they still look and feel different,” says Dr. Allie Shapiro, M.D. with Community Psychiatry. Life now vs. life six months ago has dramatically changed, and the idea of “normalcy” is shifting day by day, week by week, as we learn more about the virus and how to respond to it. However, she says, “Accepting the change is made easier by knowing you have full control to keep yourself safe. Wearing protective gear and staying vigilant, as we are now all accustomed to doing, drastically reduces the risk of infection.“

Dr. Shapiro says that one way to manage social anxiety is to start by socializing in small groups with close friends or family. “It’s far easier—and safer—to begin the resocialization process with people you know and trust well. Remind yourself about the importance of having a social support system and letting friends know when you need help.” Open communication is key. Let people know what you’re comfortable with, what concerns you may have, and how you want to socialize if you choose to do so.

2. Anxiety about going out, even if things are opening up again

It’s completely normal to be nervous to start going to places outside your home, even if they are open, especially as things open up at different speeds with different restrictions. “You have every right to take things at your own pace. You’re not obligated to do anything that makes you feel uncomfortable or puts you at risk,” says Dr. Shapiro. The important thing is to make decisions that are right for you; it’s counterproductive to go out just to go out if that ultimately makes you more anxious than just staying at home. “There are a lot of different factors that will affect when you feel it’s the best time to start venturing out. Think about your age, health history, quarantine situations, and even your own anxiety when taking that next step outside.”

3. Anxiety about being around people outside who might be infected

“The biggest fear I’ve heard from patients is about unmasked people coming up behind them on walks or runs without warning, and feeling unsafe while trying to improve their emotional and physical health. The fear of being infected, for most, is coming from a genuine place,” says Dr. Shapiro. She notes the best way to deal with this re-entry anxiety is to recognize that the only person you can control is yourself. Everyone has different levels of risk tolerance and is making their own decisions accordingly. Focus instead on what you are comfortable with and take the precautions to make yourself feel safe.

4. Anxiety over seeing everyone wearing masks

The CDC recommends wearing face coverings in public, especially when you can’t maintain social distance from others. But while masked-up faces are important for public safety and health, they can have an impact on you personally. Says, Dr. Shapiro, “Seeing faces is a very important aspect of our socialization. Not seeing faces removes that familiarity and connection. “We are used to looking at people’s faces for visual cues such as a friendly smile, and with masks, it is near impossible to catch these non-verbal expressions.

Dr. Shapiro recommends remembering why the masks are in there in the first place. ”[People] are keeping themselves, and you, safe. The masks also serve as a visual reminder that while things are ‘open,’ the underlying problem is not gone. It’s called a pandemic for a reason, in that it affects the entire world. Everyone is in this together.”

5. Anxiety about the pandemic even if it seems like others aren’t scared

Understand that your own feelings and anxieties are valid, regardless of how other people are dealing with the situation. “Remember, no one has ever been through anything like this in the modern world. So no one really knows how to do it ‘right,’ says Dr. Shapiro. “Even the experts don’t have all the answers, so it’s normal to have your own uncertainties and doubts.”

Some additional tips for managing your re-entry anxiety during this time include:

  • Relaxed breathing: Anxiety can trigger ‘flight or fight response’ like shallow breathing, racing heart, muscle tension, or increased sweating. Relaxed breathing can send signals to the brain to undo some of these stress responses,” says Pavan Madan, M.D. at Community Psychiatry. He says a popular breathing technique is “square breathing,” where you breathe in slowly for five seconds, hold for five seconds, breathe out for five seconds, and then hold for five seconds. He recommends starting the exercises for five minutes, twice a day, and gradually increasing them to up to 15 minutes twice a day. Mindfulness or meditation techniques could also be helpful.
  • Write it down: Dr. Madan suggests writing down your worries to determine how reasonable they are. “Seeing thoughts on paper can often bring about a quick reality check.”
  • Limit your news intake: It’s easy to get overwhelmed by the sheer amount of heavy headlines every day, particularly since many of us are sitting at home in front of multiple screens for hours on end. Step away, take a break, and limit your time watching or reading the news.
  • Consider getting professional help: If you are having a hard time managing on your own, consider finding a professional to talk with. Says Dr. Madan, “Many psychologists and psychiatrists are seeing patients remotely during these times, and teletherapy is a useful option.“

Dr. Madan also has general advice to maintain mental resilience, which is important regardless if we are dealing with a global pandemic: “We should try to have a routine in our lives, wake up and sleep at the same time of the day, cook and eat regular and healthy meals mostly at home, exercise regularly, incorporate some form of mindfulness in our routine, stay in touch with our friends and family members, learn to save for at least six months of expenses, and try to find small moments of love and joy each day.”

This post is meant for informational purposes only, you should always follow the most up-to-date CDC guidance on COVID-19 protection, and reach out to a medical professional with specific issues.

If you’re having suicidal thoughts, call 1-800-273-TALK (8255) to talk to a skilled, trained counselor at a crisis center in your area at any time (National Suicide Prevention Lifeline). If you are located outside the United States, call your local emergency line immediately. 

 

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