How to Deal with Re-entry Anxiety and Post-pandemic Stress.

Rational vs. irrational anxiety.

Rational anxiety is rooted in truth. For example, at the time of this writing, the U.S. is widely lifting domestic travel restrictions. Simultaneously, new virus variants are emerging and we’re hearing news of catastrophic viral spread in Brazil and India. It’s natural to worry whether our country is on the right track.

Other rational pandemic-related fears may include:

• Going in public after having COVID-19: If you or a loved one were affected by the virus, it’s rational that you might be more concerned about spreading the virus or catching it again.
• Traveling by mass transit: Close proximity with others in an enclosed space can be a recipe for illness—a fact-based concern, regardless of the pandemic.

Irrational anxiety is characterized by unsubstantiated worry or fear when there is clear evidence to the contrary. In daily life, this may include hesitance to enter a tall building or feeling terrified by an innocuous sight or sound.

Irrational pandemic-related anxiety may include conspiracy theories, such as:

• Obsessive worry that Americans are being microchipped through the vaccine: More than 80% of U.S. adults use smartphones, which already enable geolocation. The idea of going to such great lengths for tracking is as unreasonable as it is unlikely.
• Fear of developing COVID-19 from the vaccine: This is scientifically impossible, since there is no actual virus, alive or dead, in any of the approved vaccines.

Both rational and irrational anxiety can absorb one’s thoughts, making it tough to focus, perform daily tasks, or even leave home. However, both can be treated with a thoughtful approach to how we perceive and react to pandemic-related stressors.

Related reading: How to spot depression and anxiety in teens.

8 anxiety management strategies.

Some patients with newly diagnosed or existing-but-worsened anxiety may benefit from medication. However, symptoms often can improve significantly with supportive, guided behavioral changes to help you regain control of anxious feelings.

1. Control the controllables.

A proven technique for managing anxiety is to focus on what you can control and minimizing what you can’t. Throughout the pandemic, many patients had trouble sleeping due to racing thoughts, such as an overwhelming fear that we were all going to die. I’ll admit, this worry crossed my mind at the beginning of the pandemic.

Yes, all of us will die someday. That is not something we can control. But what we can control is how we handle the present. I typically recommend that patients work through an internal dialogue about what they can and can’t control. This can help you find positives on which to focus your thoughts.

For me, my “controllable” was getting up, getting ready for work, and presenting my best self for my patients. What might “controllables” look like in your situation?

2. Practice deep breathing.

Take deep breaths through your nose and exhale out of your mouth. Repeat this 10 times. Focusing on manual breathing subconsciously refocuses your mind away from whatever was bothering you, if even for a moment. Deep breathing is a form of mindfulness, which is key to more sophisticated awareness practices, such as meditation.

3. Set healthy boundaries.

Several friends invited me to dinner a few weeks back. We’d all been vaccinated, but I requested that we all sit outside where it’s well-ventilated. I still preferred to wear my mask, and I decided in advance that I would leave early to avoid excessive hugging, handshakes, and crowds. What I told all my friends was that I had to be home at a certain time, and no one gave me a hard time about leaving before they did.

It’s up to you what you are comfortable with. Conversely, we owe it to each other to be kind if someone isn’t as ready as you to unmask or hang out at an event or in a restaurant.

Related reading: 6 signs you should be concerned about your mental health.

4. Exercise outdoors.

Moving and getting a change of scenery can help reset the mind and body. I enjoy walking around the koi ponds and flowers at MedStar Washington Hospital Center when I have a few moments between appointments.

If you live in Southern Maryland, you may have easy access to enjoy outdoor activities such as fishing, crabbing, canoeing, and boating. In Baltimore, you might catch a baseball game. Find an activity you enjoy and take your mind off worrying for a while.

5. Give back.

It can be tough to make yourself participate when you have anxiety. However, volunteering can temporarily replace racing thoughts by helping you focus on something positive. Animal lover? Volunteer at a pet shelter. Enjoy reading? Offer to read to kids at your local library. Worried about the homeless? Help out at a food bank. There’s always work to be done, and plenty of opportunities to help in your passion area.

6. Laugh a little!

At the start of the pandemic, I began carrying a stuffed lemur in the pocket of my hospital coat. Patients and colleagues would walk by, give me an odd look, then burst out laughing. Every time, I would beam ear-to-ear behind my mask. Laughing feels good, and it feels even better to make others laugh!

7. Prepare for naysayers.

There will always be a few people who feel it is their right to ridicule others for wearing or not wearing a mask as restrictions are lifted. At work, ideally you could turn to your boss or human resources professional to proactively manage or mitigate these situations. However, that’s not always possible.

If you feel comfortable speaking your mind, remain polite but firmly state, “I respect your decision. Please respect mine.” Sometimes it helps to plan out what you will say or do in certain situations. Role playing with your therapist or a friend can help build your confidence.

8. Take your time.

Whether you are anxious about returning to work or taking your first post-pandemic vacation, incremental steps are key. In our practice, we often recommend “extinction” or “exposure therapy,” which incorporates visualization to manage stressors.

For example, if a patient is afraid of crossing bridges, they’ll start with visualizing themselves crossing the bridge. Once they’ve mastered that, we arrange for them to cross a bridge with a loved one. Over time, they can work up to crossing solo. Some patients never cross alone, and that may be sufficient for them. The point is to set realistic, personally achievable goals you can stick to and go from there.

As we all adjust to our post-pandemic society, remember: Everyone’s timeline will be a little different based on their mental health and their experiences over the past tumultuous year. If anxiety is interfering with your life, don’t hesitate to seek help. We’ve been here for you, and we will be here—no matter what curveballs the next year throws our way.