For most people, the world has changed since the end of 2019. 

We all stayed at home (except for essential trips to the supermarket, and for healthcare). Those with vulnerable health conditions, and the elderly, may have remained in their homes and not ventured out at all. All of this was to keep ourselves safe, but also to safeguard the community in general.

A “new” normal was created of working and socialising via Zoom and Skype, or phoning friends rather than meeting in person. This initially made some people feel anxious and uncertain.

Now, the good news is that many governments are starting to ease restrictions to get the economy, employment and society back to something approaching the “old” normal. It should also help the high levels of anxiety, stress and other mental health problems seen during the lockdown.

But the coronavirus is still with us, and many people may still have fear and anxiety around leaving home, and meeting people again. This has created new words – e.g. “corono-phobia” and “corona-paranoia”– related to the fear and stress of returning to normality. It can be thought of as post-lockdown anxiety – anxiety about further change while COVID-19 is still with us.

If you’re anxious, you’re not alone. Researchers at the Black Dog Institute (1) surveyed more than 5,000 Australian adults during the peak of the COVID-19 pandemic. They found one in four were very or extremely worried about contracting COVID-19; about half were worried about their loved ones contracting it.

Researchers from Australian National University (ANU) (2) surveyed Australian adults at the end of March, about a week after restaurants and cafes first closed, and with gatherings restricted to two people, and found levels of depression and anxiety were much higher than usual in the community.

They found that the social and financial disruption caused by the restrictions had a much more marked effect than fear of exposure to the coronavirus itself. 

It’s important to realise that these feelings are reasonable. The world has been through rapid change in the past few months. Very few people alive today have experienced anything like this pandemic, and the actions taken to manage it. However, the good news is that we can adapt to change, and there are several ideas and activities that we can do that will help this adaption.

The ANU survey (2) found that restrictions also benefited some of the people surveyed. Around two-thirds of people listed at least one positive impact coronavirus has had on them, such as spending more time with family. 

A recent survey by mental health charity Anxiety UK (3) on more than 700 people in the UK found that the prospect of lockdowns lifting caused more than two-thirds of people to experience an increase in anxiety levels. 

After being inside for a long time, it is naturally going to feel strange and challenging for people to start to return to their pre-pandemic routine. It’s essential therefore that additional support is made available for this group of people.

Nicky Lidbetter, CEO of Anxiety UK

For most people, anxiety about the easing of restrictions will only be temporary.

But how do you know if your fears of coronavirus are out of control? And what can you do about it?

Signs that anxiety is out of control

Your anxiety may be out of control if you notice:

  • your fears are out of proportion to the actual danger (for instance, you’re young with no underlying health issues but wear a mask and gloves to the park for your daily exercise where it’s easy to social distance)
  • the fear and anxiety is intense and persistent (lasting weeks to months)
  • it’s hard to stop worrying about coronavirus
  • you’re actively avoiding situations (for instance, places, people, activities) even when they’re safe
  • you’re spending a lot of your time monitoring your body for signs and symptoms, or searching the internet about the virus
  • you’ve become overly obsessive about cleaning, washing, and decontaminating.
  • you’re avoiding seeking medical care due to fear of contracting coronavirus
  • you’re debilitated with fear

Post-Lockdown Anxiety

This can include:-

  • worry about increased risk of catching the virus through returning to usual activities – using public transport, meeting people face-to-face, going shopping, returning to work, etc.
  • worry about how to do activities you haven’t done for several months – e.g. cooking and entertaining guests, getting up early to reach work in time, sales meetings with prospective clients
  • activities that used to be stressful, but that you haven’t done for a while – e.g. working in the office under the watchful eye of the boss, driving to work in the rush hour, having less control of your work day due to frequent interruptions in the office
  • sensory overload – e.g. traffic, noise, people chatting on the train and in the office

These activities may be worse for someone who was feeling anxious about them before the coronavirus situation. Ironically, living in ‘lockdown’ may have been positive for such people (e.g. those with social anxiety or fear of germs), as they could avoid activities that caused anxiety. They may also have to become ‘desensitised’ to outside / social activities all over again.

The ANU survey (5) found around half of Australians were at least moderately concerned about becoming infected with COVID-19 as restrictions eased.

If you are anxious about leaving your home, you may be wondering if you have developed agoraphobia. Agoraphobia (6) is a fear of or worry about having a panic attack in a place that you can’t escape from, like public transport, crowds or queues. It can include a fear of being in open spaces, enclosed spaces, or anywhere where help would not be available if you had a panic attack.

However, if the above paragraph does not apply to you, and you fear leaving home or feel uncomfortable in public spaces because of the risk of infection with COVID-19, it is more likely that you have anxiety around life after lockdown.

Tips for people who are feeling anxious

  1. Use the skills and techniques that have worked previously for you. If you have experienced anxiety previously, you will know which techniques work for you. Use them! You can also try any new techniques that you feel could help you, but start with the tried and tested techniques.
  2. Practice mindfulness.
  3. Take regular exercise.
  4. Make sure you are getting sufficient sleep. No-one feels good if they are tired!
  5. Reassure yourself that it will get better. For most people, the anxiety will get better as the threat of COVID-19 passes. If anxiety doesn’t go away, it can be treated
  6. Control the media you read and listen to, and how much time you spend on it. Some media outlets are more sensational than others. Choose to pay attention to (read / watch / listen to) media which has balanced coverage. Don’t spend too long on this – checking once a day is probably enough. If there is an important COVID-19 development meanwhile, you will hear about it from a friend or relative!
  7. Think logically about the risk. Over 90% of people infected with coronavirus in Australia have already recovered. The number of cases is also still extremely low in Australia. Even in countries with higher rates of COVID-19, the numbers are generally coming down.
  8. Do not concentrate on your body. When we pay too much attention to our bodies, it can make us notice things we wouldn’t normally notice – aches and pains etc., which then makes us more anxious.
  9. Take things slowly, at your own pace. You do not have to jump into activities “with both feet”. Don’t feel that you need to restart doing all that you used to do. Take it one activity at the time. Maybe start going for a takeaway coffee and walk with your friends twice a week for a few weeks, then re-start going to the gym, then start inviting friends back to your home after a few more weeks, etc.
  10. Focus on what you can control. This can be by choosing some activities from this list, and using them to improve your health.
  11. Follow government advice. This relates to social distancing, hand washing, etc. For Australians, this advice can be found here and is usually included in daily news bulletins on various TV and radio stations.
  12. Get help. Seek advice from your GP, psychologist or a hypnotherapist who specialises in anxiety. There are also community services like LifelineSANE Australia, or Beyond Blue. There are plenty of programs to help with anxiety.

References

  1. Newby, J., O’Moore, K., Tang, S., Christensen, H., Faasse K. (2020). Acute mental health responses during the COVID-19 pandemic in Australia. British Medical Journal preprint. Available here.
  2. The Australian National COVID-19 Mental Health, Behaviour and Risk Communication Survey. Available here.
  3. Coronaphobia and life after lockdown – Anxiety UK [Internet]. Anxiety UK. 2020 [cited 18 May 2020]. Available here
  4. Anxiety UK survey indicates a further rise in anxiety levels can be expected with easing of lockdown restrictions – Anxiety UK [Internet]. Anxiety UK. 2020 [cited 18 May 2020]. Available here.
  5. Dawel, A., Newman, E., and McCallum, S. (2020). Coronavirus lockdown made many of us anxious. But for some people, returning to ‘normal’ might be scarier. Available here.
  6. HealthDirect. Agoraphobia. Available here.
  7. Newby, J. and Werner-Seidler, A. (2020). 7 ways to manage your #coronaphobia. Available here.
  8. Butterly, A. (2020). Coronavirus anxiety: How to cope with life after lockdown. Available here.
  9. YourMD. (2020). Post-lockdown life: How to look after your physical and mental health. Available here.

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