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Living With Covid-Related Anxiety

Updated: Dec 3, 2021

At the beginning of the pandemic, I was working in residential programs and quickly needed to resign due to being immunocomprommised. I then switched back to doing outpatient work managing a community mental health clinic and seeing clients for individual therapy. It has been a fascinating time to return to working with individuals because the need for mental health treatment is so high right now and the anxiety people are feeling is so specific, so much of the time.

As we all know, the impact of the pandemic has been an extremely personal experience. There are people who made minimal changes to their lives and, for that reason, their mental health has been minimally affected. They've gone on doing whatever they did before the pandemic for the most part. For millions of other people, though, the impact on their mental health has been huge due to social isolation, fears about their health and the health of their loved ones, and, for some, living with effects of covid long haul symptoms.

One of the most interesting themes I find when speaking to clients every day is that everyone thinks their experience of anxiety is a unique, solitary experience. Anxiety makes you think that everyone else is somehow more together than you so your anxious thoughts must be happening because you're fundamentally flawed. The reality is far different. It's extremely common and the experience is nearly universal. Almost without exception, my clients describe their anxiety in an identical way to the next client. It's worst case scenario thinking. It's the negative hypotheticals. It's not being able to turn off the racing thoughts, avoiding situations that increase the anxiety, and sometimes just not being able to function at all.

I don't say that to minimize anyone's experience. It's actually the opposite. We need to normalize the experience of anxiety, especially when we're talking about the anxiety about a global pandemic which is a collective trauma for everyone. Everyday I hear things like this:

"I want to go to the gym but I can't. I know it's safer now and I've been vaccinated but I'm just too afraid to be in a room with all of those people."

"I'm afraid of the long haul symptoms. I'm not even worried about dying. I'm worried about living with covid symptoms long term."

"I don't know what's safe anymore. How do I know what's safe?

As therapists, what do we say to people who are experiencing anxiety about the pandemic? How do we balance what is a very real public health risk with trying to help people feel less afraid? It's been one of the greatest challenges of the pandemic for us. What I generally say to people is that fearing covid is normal. It's the reason that anxiety exists. Evolution tells us that anxiety, the fight or flight response, was created to help keep us alive. We need to feel nervous in the face of danger otherwise we would do stupid, risky shit and all die off. So, in some ways, we should be grateful for the little voice in our head that shouts "Danger!" It is protective. It is healthy in some measure.

Where it gets tricky is when that voice won't shut up. It's a problem when you can't do things that you need to do because you're held back by anxiety. When you can't go to the grocery store for food because you're paralyzed by fear of getting covid. When you've isolated so much that you are now beginning to feel depression symptoms.

This is where regular anxiety and covid anxiety overlap. We have to begin challenging the thoughts and fears we're having to determine if our responses to those thoughts and fears are appropriate to the situation. If you're vaccinated, the covid rates are low in your area, and there's a mask mandate, is it still a reasonable fear to be afraid of grocery shopping? Maybe not. Our own personal risk tolerance factors in heavily. One person may find that to be a low risk situation while another may believe that this is still dangerous. Therapists can't tell you what is safe and what isn't but we can prompt you to look critically and logically at the facts and make a choice about your behaviors.

Another commonality that I have noted when talking to clients about covid anxiety is the extra level of complexity that happens when you and your partner or your family don't have the same risk tolerance for covid. If you feel that the danger still exists but your partner doesn't, you may find yourself constantly wondering if it's safe to be around them. Having open and honest conversations about your risk tolerance and theirs and how you may be able to bridge that gap is essential.

Similarly, we are going through a generational clash at the moment with the younger generations of millenials and Gen Z pushing back on the attitudes and values of the older generations. Many people are finding themselves deeply divided with their families on political and social issues and no longer being able to sit back and bite their tongue at family functions. The pandemic, as needlessly politicized as a scientific issue could be, has fueled that fire. I have worked with many clients over the past year and a half who are now estranged from their families for this reason. Many young people are feeling the anxiety of not knowing how to navigate these complicated family dynamics or trying to find ways to set boundaries with toxic family members on top of everything else that's going on.

For people who have compromised immune systems, many of us feel as though not much has changed. While the rest of the world is moving on as though the pandemic is largely over, we still have to worry about it nearly as much as we did before. This piece of the conversation reflects the ableism that has been the elephant in the room for the entire pandemic. When covid deaths are discussed, often people who minimize the pandemic will say things like "Well, those deaths are probably people who had health problems" which feels to people with compromised immune systems as though those are deemed acceptable deaths.

Moreover, many people have begun to feel as though the world they thought they lived in doesn't exist. You could argue that this reflects a distinct position of privilege. People of color, LGBT+ individuals, and other marginalized groups have known since time eternal that the world doesn't always care about them. Realizing that empathy and compassion for others isn't a priority for everyone is a hard pill to swallow if you've never had to confront that head on. I often hear from people that they can't believe that people are not willing to sacrifice a bit of comfort in order to protect their fellow humans from a potentially fatal disease. This reckoning has done nothing to ease the anxiety that people are feeling. To that I say, surround yourself with like-minded people. Talk to people you know about how you're feeling so you can remember that there are a lot of people out there who do care and are doing everything they can to be socially and morally responsible.

If you're experiencing anxiety related to covid, know that you're not alone. It's an extremely common reaction to the pandemic. The things that you did before the pandemic may now seem scary. You may feel uncertain about when you can resume activities you used to love doing. Consider some of the following to help you through it:

  1. What is my covid risk tolerance? You may need to ask yourself this question every week. Under what circumstances do you feel very safe? Under what circumstances do you begin to feel anxious? Now objectively look at the facts about that situation. Does your response feel reasonable? Are there protective factors (mask, vaccines, social distancing) that minimizes the risk in those circumstances?

  2. Have you talked about your risk tolerance with the people that you want to be around? Have you talked about ways to bridge the gap between their tolerance and yours? Having that conversation can ease a lot of tension.

  3. If you're experiencing political or pandemic related conflict within your family, what sort of boundaries might you want to put in to place to minimize your stress? Remember that you do not owe anyone your time or emotional energy, even family.

  4. Find ways to reach out. In the beginning of the pandemic, we were much better at this. We were zooming and FaceTiming with everyone. Get back to that. Schedule some sort of contact with a friend or coworker or family member once a week. Send a text to someone once a week that you haven't checked in with in a while.

  5. Purge your social media. If you're worried about covid, the last thing you need is to follow only news outlets or to follow your conspiracy theory loving Uncle who thinks it's a hoax.

  6. When in doubt, go outside and get fresh air. The air is free and covid safe when you're distanced. Go for a walk. I know it's a cliche but it does actually help.

This is, as I said before, a collective trauma that we're all going through. It's hard to have hindsight about something that's still happening. It's okay if you're still figuring out how you feel about it. We're going to be unpacking this situation for a long time. Be kind to yourself. Be kind to others. And, above all, remember that all things are temporary.

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