Anxious as we transition out of the pandemic? That’s common and can be treated, experts say

By Sandee LaMotte, CNN

America is in celebratory mode. States are dropping Covid-19 restrictions, plane travel is breaking records, and many Americans are gearing up to celebrate summer as if the last year plus of pandemic madness never happened.

“Many people are experiencing a relief. They’ve been vaccinated and are able to gather again with others,” said psychologist Kristen Carpenter, who is director of Women’s Behavioral Health at the Ohio State University Wexner Medical Center.

Yet the pandemic isn’t truly over. The highly contagious Delta variant of Covid-19 is sweeping through unvaccinated communities, and there is worry that even the vaccinated among us are at risk.

“It’s not like somebody put a period on the sentence, and we’re done with this pandemic. We really don’t know what’s ahead,” said stress management expert Dr. Cynthia Ackrill, an editor for the magazine Contentment, produced by the American Institute of Stress.

That’s not all. Violent crime is up, historic heat waves are devastating areas of the country not prepared to cope, and mental health practitioners can’t keep up with the demand for services.

“I think for many people this ‘return to normal’ feels awfully abrupt and jarring,” Carpenter said, adding that the pandemic has been an incredibly difficult period, “with lots of opportunity for confusion, for disagreement, and for discord.”

She continued, “It’s a real mixed bag. While many will experience much of this reopening as positive, there is a subset of people that will really struggle with how to move out of this very challenging time.”

Blame the brain

If you are tense or anxious about reentering today’s so-called “normal,” experts say that’s understandable. Blame it on your brain — especially your frontal lobe, where you do your higher-level thinking.

“We’ve just expended enormous energy navigating this whole pandemic — constantly with loved ones, hypervigilant going to the store — and that takes extra brainpower,” Ackrill said.

“When your frontal lobe is tired from doing emotional regulation on steroids for a year and a half, you’re not as good at it,” she added. “You could even be at your breaking point.”

If, however, you find yourself giddy with relief and ready to act as if there was no pandemic to worry about, that too makes neurological sense, said Dr. Bruce Wexler, a senior research scientist in psychiatry at Yale School of Medicine.

“Humans are the only animals that shape the environment that shapes our brains and we function and feel better when there’s a fit between the two,” said Wexler, who has studied brain plasticity for more than 35 years.

“Every day we strive to renew ourselves by reconnecting with the familiar faces and places that shaped us and are inside of us. That’s one of the reasons people were so agitated about wanting to go back to their favorite bars and hangouts,” Wexler added.

When he realized that motivation, Wexler said, “I had more sympathy for the people who were complaining ‘Open up, open up!’ I could understand their urgency.”

It’s time for compassion

Safely getting back to normal, in whatever shape that currently looks like, will require being fully vaccinated and adhering to the latest social distancing requirements of local communities and businesses, according to the US Centers for Disease Control and Prevention.

Coping with anxiety, tension or worry about risky pandemic behaviors — both our own and those of other people — will take a combination of self-care and compassion, experts say.

“We all have to give ourselves a little grace,” Carpenter said. “It’s really important that we try not to judge ourselves for our emotional response to this change. This is objectively really stressful and to have some combination of relief, happiness, fear, or maybe even some anger and frustration is normal.”

It’s just as important to show compassion to those around us who are navigating their own reactions to change, Ackrill said. She tells a story of being on a walk (while wearing a mask) when a woman came close to her and began yelling “I’m not wearing a mask and I’m never wearing a mask!”

“I ignored her. I had longer legs and walked faster. She charged after me again, yelling at me and then coughed in my direction, on purpose,” Ackrill continued.

“And it just floored me because I thought, this is probably a woman whose friends and relatives would be appalled by her behavior, and it was her fear coming out — fear of feeling out of control and wanting so badly to control things.”

By seeing the woman’s behavior through compassionate eyes, Ackrill was able to calm her own reaction and reduce her stress.

“Self-compassion and giving compassion don’t make us more vulnerable, they make us stronger,” she said. “So when you’re feeling heightened emotions such as anxiety, or even anger about someone’s risky behavior, calm yourself, and have some compassion for yourself and that other person.”

Taking stock of your emotions

Like all things, this pandemic too shall pass, but how well we weather it will be based on our actions, experts say.

“Recognizing and taking stock of our emotions, addressing those and then giving ourselves a little grace are essential to moving forward productively in ways that protect and enhance our well-being,” Carpenter said.

Do a wellness check-in: Ask yourself “Am I protecting my sleep? Am I eating right? Am I getting some kind of physical activity into each and every week?”

“It’s back to basic self-care,” Carpenter said. “Many of us have developed great habits with our time at home, but many of us evolved into bad habits. It’s time for a check-in.”

Do the same for your emotions: “We have to be more mindful, give ourselves time and space to assess how we’re doing psychologically and emotionally,” Carpenter said. “It’s important to set aside time to disconnect, unplug from all the various things we are now plugged into and ask: ‘How am I feeling?'”

She advises her patients to begin tracking their activities, mood and energy over the course of each day, including weekends, for at least two weeks.

“Is there a rhythm to the way I feel, to my stress, to my energy level, to my mood? Lots of us don’t notice we are struggling until we’re kind of halfway or maybe three-quarters of the way there,” she said. “Once you start to notice what that rhythm is you can start to implement change for the better.”

Recharge your energy: The next step is to plug in activities that you find rewarding and give you “a greater sense of well-being,” Carpenter advised. “Activities that give a sense of mastery or accomplishment are natural mood boosters, reduce stress and help ultimately enhance well-being.”

For some that might be social contact, for others it might be time spent alone, doing hobbies, reading or listening to music. And don’t forget laughing at silly jokes or upbeat movies, Carpenter said.

“Humor is really important, you know, so engaging with media that does lift the spirits can help,” she said. “And of course physical activity is a natural sort of mood enhancer, such as walking in nature.”

When to reach for help

Not everyone will be able to cope with a return to normalcy without assistance. For all too many people, the past year and a half has been filled with unbearable loss, grief and anguish. How can you tell if you need professional help with your feelings and concerns?

Anxiety: Having difficulty concentrating, poor sleep, restlessness and irritability are signs that anxiety may be taking over your life in an unhealthy way, according to the American Psychological Association. Persistent or excessive worry about your health or finances, often feeling overwhelmed by emotions and a general sense that something bad is going to happen are more signals.

“You’re exhausted, more irritable and you’ve lost the ability to recover between bouts of worry, or your anxiety is intruding on your everyday function,” Ackrill said.

Panic attacks: At times, anxiety can spiral out of control, leaving you in a full-fledged panic attack. You may feel as if you’re having a heart attack: Your heart rate may speed up or pound in your chest. You may tremble, sweat, feel like you’re choking, or have shortness of breath and feelings of dread.

Such attacks can happen suddenly, without warning, and leave some people “fearful about when the next episode will occur, which can cause them to change or restrict their normal activities,” the APA said.

Depression: This condition often begins with a lack of energy and interest or pleasure in daily activities. You may develop an inability to concentrate and feel worthless or guilty about an action or the lack thereof. Paradoxically, you can experience significant weight loss or gain a lot of weight. You can also either sleep all the time or develop insomnia and sleep little. You may even begin to think of death or suicide.

Signs of suicidal thoughts: Often triggered by a recent loss through death, divorce or separation, many of the signs that a person is at risk for suicide duplicate those of depression and anxiety: a loss of interest in friends or hobbies; changes in sleep patterns, eating habits and personality; low self-esteem, sadness, withdrawal, irritability, and feelings of guilt or worthlessness,

People who are at risk for suicide may begin behaving erratically and talk about dying or harming themselves. They may show “no hope for the future, believing things will never get better or nothing will change,” according to the APA.

Where to find help

First look to the people in your own life who can be supportive and can help you, experts say.

There are also federal, state and local resources. The Substance Abuse and Mental Health Services Administration, or SAMHSA, has a national helpline — 800-662-HELP (4357) — which provides free, confidential treatment referral and information in English and Spanish 24/7 every day of the year.

The American Psychological Association also has a webpage of resources for suicide, substance abuse and domestic violence. Of course, if the situation is potentially life-threatening, get immediate emergency assistance by calling 911.

If you have health insurance, many clinics and therapists are offering phone or video telehealth visits. Many employers are offering free access to therapists as part of their employee benefit plans, and many communities have mental health centers with sliding scale fees.

“It’s OK to not feel OK and to not know what to do about it, but do know there are resources out there,” Ackrill said.

Many people don’t choose to go to therapy, experts said, because they believe that makes them “weak” or feel it would be too invasive.

“The general public does not understand what therapy means,” said Eve Byrd, director of the mental health program at The Carter Center, in a May 2020 online forum.

“They might say, ‘Oh my gosh, I am not going to be laying on a couch telling my deepest, darkest thoughts. That’s frightening,'” she said.

But that’s not what therapy is, Byrd added. “Therapy is really an educational activity,” she said, adding that a therapist’s role is to help you think about different ways to react to situations and more positive ways of interacting with individuals.

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