Friday, July 17, 2020

Why You Might Be Feeling Socially Anxious After Quarantine


Photo: 123rf.com

As we start emerging from our caves and re-entering the world little by little, there are some people who will feel unbridled enthusiasm as they pack their calendar with as much as they can, and others who—despite being somewhat socially starved—might feel anxious at only the thought of it, hesitant to start interacting just yet.

But why? There’s actually a lot to unpack. Long story short: Your fearful brain is trying to keep you safe, and nothing really feels completely safe right now. Here’s more on why you might be feeling this way, how to know when it’s a serious issue, and what you can do to help.

Why You Might Be Feeling Socially Anxious Post-Lockdown

“Put simply, social anxiety is the fear of situations and interactions involving other people,” says Kathleen Dahlen deVos, holistic psychotherapist. “It’s often rooted in the intense worry of how we anticipate others will view us or the fear of judgement. But it can also become generalised into a phobia; fear of people and social situations.”

That last bit, in particular, tracks. Especially given the current situation.

Think about it: “The one slim hope that existed [at the beginning of the pandemic] was to shelter in place,” says Talley. “It was the rational thing to do. Moreover, it was one of the few things people could control—no matter how burdensome, it nevertheless provided a sense of safety.”

If your brain is safeguarding you via social anxiety, it’s because “your mind is trying to protect you and keep you alive,” says clinical psychologist Kevin Gilliland, director of Innovation360, an outpatient group of counsellors and therapists, in Dallas. The thing is, that “protection” can easily crossover into being hyper vigilant. “Too much worry can lead your brain to think that everything is dangerous, even when it’s actually a safe place or a safe person,” he says.

It’s illogically logical, which sounds paradoxical (and pretty much is). That’s anxiety for ya! “The thing about fears and phobias is that they aren’t always logical or rational,” says Dahlen deVos. “That’s why we’re not able to just talk ourselves out of them. Instead, we have to understand them from a primal perspective: The brain is perceiving the thing we are phobic of as a possible threat to our survival, either because the thing itself is dangerous, or because we’re associating it with someone that is dangerous.”

Though there may not be a current threat to your health or life, it can still feel that way, given the immense amount of uncertainty.

“I know there will be people who find it difficult to go back out into the world,” says Habib Sadeghi, founder of Being Clarity, an integrative medical center based in Los Angeles. “The media coverage of the pandemic has been far more intense than anything I’ve experienced in my lifetime, and it’s hard to get those words and images out of the mind. We wonder, ‘Is it really safe? How do we know?’” This comes back to a common theme for anxiety: uncertainty. (Good news? Dr. Sadeghi has a silver-lining take on that: “No one knows for certain [what will happen next] and yet, it’s the uncertainty of life that makes it so worth living.”)

As we try to emerge into the world, we’ll need to let go of the safety we’ve come to rely on (staying home). Talley likened it to swimming with a pool float. “It’s like telling someone who has counted on a life-ring to keep them from drowning to now let go because the water is not so deep after all,” he says. “But unlike the person in the water—whose feet would be able to confirm that the water was now shallow enough to be safe—the public has no first-hand knowledge that social interaction poses little danger.”

It might take some time to feel comfortable with it, and that’s ok. The strategies below can help as well. “During this time of sheltering in place, our brains had to quickly adapt to perceiving others as a possible ‘threat’ to our immunity,” says Dahlen deVos. “Because we’re so oriented towards behaviours and beliefs that support our chances of survival, it’s going to take longer to dismantle this new wiring than it took to create it.”

Do those above scenarios sound familiar to you? Have you been missing your best friends and your Pilates studio, yet on the cusp of having those things back, you’re hesitant to join in? In addition to (or instead of) being aware of those feelings, you may be experiencing physical symptoms, too.

Symptoms of anxiety, “in addition to extreme anxiety or panic, might include fear and nervousness about going into public and interacting with others, or physical symptoms that are related to an activated nervous system, such as an elevated heart rate or dry mouth,” says Dahlen deVos. You may also feel tired, worn out, lethargic, and like you don’t want to do much of anything, but at the same time you might have trouble falling or staying asleep, says Gilliland.

Your habits may be changing, too. “Humans hate the feeling that worry produces,” he says. “It makes sense why we drink more alcohol than normal, binge watch the whole series, or eat when we’re not even remotely hungry. We’re just trying to get away from the way we feel.”

These signs may very well appear for those who have never experienced any type of anxiety in the past. “Some of us will start to have some symptoms of social anxiety in spite of never really feeling like this before,” he explains. “That can start to develop into a bigger problem—diagnosable social anxiety—a fairly common type of anxiety. When you look at studies from other quarantines, it is a very real concern.”

(Also read: How Covid-19 is Triggering Health Trauma-Related PTSD)

An important distinction to make is the difference between social anxiety as typically classified by a therapist or generalised anxiety about being in social situations, says Talley. “It’s an easy distinction to make once you know how social anxiety is defined.”

So what is social anxiety, exactly? “The hallmark of social anxiety is a fear of being humiliated or embarrassed in social situations and therefore avoiding such gatherings,” says Talley. But feeling anxiety as we return to social settings, from his perspective “is more akin to a generalised anxiety about being in a social setting.”

Because this type of anxiousness does not include specific fears of being embarrassed, but rather “non-specific concerns related to ‘readjusting’ to the flow of social interactions that now feel somewhat foreign,” that means this is not, in fact, social anxiety (at least according to the Diagnostic and Statistical Manual of Mental Disorders or DSM-5), he says.

This type of anxiety comes from letting go of what we felt provided safety (social distancing) and “adjusting to interactions that may seem somewhat foreign and risky,” adds Talley. “Not risky just in the sense of people worrying about their health, but risky in the sense that people have different comfort levels with how you interact with them. Discovering how best to navigate these interpersonal exchanges will also cause some to become anxious.”

(Also read: How Covid Affects Our Mental Health: What’s Normal, What’s Not)

Feeling anxiety can cause major disruptions in your life, and the sensation itself is quite distressing—but how do you know when it’s a disorder vs. temporary feelings in response to this extreme situation?

“As a rule of thumb, if your anxiety causes significant disruption of your daily life on a consistent basis (e.g., reduced social activities, avoiding travel, increased use of alcohol to self medicate, problems with sleep, etc.) it is a pretty good bet you have some form of a diagnosable anxiety disorder,” says Talley.

If this feels familiar, it might be time to see a professional; don’t try to diagnose yourself. “Diagnosis of anxiety versus feeling anxious requires looking at a number of criteria listed on the DSM-5, and ruling out other disorders,” says Talley. This is best done by a mental health professional, which can include a licensed clinical social worker, licensed marriage and family counsellor, psychiatrist, or psychologist.

Reminder: You don’t need a diagnosis to validate your experience. “The impact of anxiety on your life is what matters most, not whether one’s symptoms meet the criteria for a diagnosis. If someone by chance does not meet the criteria for a diagnosis but finds their anxiety to be terribly disrupting, then it is a problem that needs to confronted.”

(Also read: 5 Healthy Ways To Cope With Stress And Anxiety)

The experts agree that this is logical, albeit frustrating, and those who have feelings of anxiety or social anxiety upon re-entering the world are certainly not alone—but what can you actually do about it?

“It’s important to remember that people are not the threat; the virus is the threat,” says Dahlen deVos. Check in with what’s concrete and real, and what you can and cannot control. “Reminding yourself what is (and is not) in our control can help you manage your anxiety—in this case, there are steps you can take to protect yourself when engaging socially, and ways to manage or mitigate risk.”

And it’s so worth it to overcome this anxiety, especially in this case: “Isolation is terrible for emotional wellbeing, and the stress it creates affects physical wellbeing,” says Dr. Sadeghi. “At the first available chance, get together with friends in the real world, not the virtual one,” he says. “Energy is more contagious than a virus, and soon you’ll be synching up with your friends’ confidence and courage. You’ll probably be having so much fun after so many weeks apart that the only thing you’re worried about catching is an Uber home.”

(Also read: Super Stressed at Work? Relax and Combat Anxiety with These Meditation Apps)

Start Small

You don’t have to jump into the deep end with this. Ease yourself back into things outside the house. “Start small with social activities,” says Cassie Majestic, an emergency medicine doctor and blogger. “Stick to people that you trust and who make you feel good. Try not to judge others or yourself, it will help you feel less worried and stressed. Do something positive each day.”

Starting small includes setting boundaries. “Understand what feels safe for you and what would make you anxious, and set clear boundaries in social and work situations,” says Sara-Mai Conway, Pause + Purpose yoga and meditation instructor.

“There’s nothing wrong with saying, ‘I would love to, but I don’t feel comfortable doing that right now,’” says Conway. You don’t have to be a ‘yes’ person right now, let alone a people pleaser. Prioritise your mental (and physical) wellbeing.

Things are going to feel strange, but that’s OK—lean into it. “Allow things to be new and different,” says Conway. “It’s not going to look exactly as it did before and that’s ok.” Releasing our attachment to past routines may help us embrace new ones. “Mindfulness can help free us from our attachment to doing things the way they’ve always been done,” she says. “Approach the future with curiosity, and you’ll feel some of your anxiety melting away.”

(Also read: How to Meditate Your Way to Glowing Skin)

Take Concrete Anti-COVID Action

Reassuring yourself by taking all the proper precautions may help you get some mental relief, says Dr. Majestic. “Many of us worry about getting sick, and that is truly expected in this situation,” she explains. “I advise all of my patients, family members, and friends to continue practicing excellent hygiene—this will drastically reduce your chances of catching the virus. Wear a mask in public areas, maintain social distancing recommendations, and wash your hands, frequently!”

You can also start to socialise without immersing yourself in crowds (which can very well still pose a health threat). “I highly recommend avoiding large public gathering locations such as bars, night clubs, water parks, etc.,” says Dr. Majestic. “This can really help provide some peace of mind that you’re doing your best to avoid becoming ill or passing the virus onto others.”

(Also read: Covid-19 Pandemic: Prepare to Live With It For One More Year At Least)

Limit COVID-Centred Media & Discussion

It’s obviously important to get pertinent health information during a pandemic, but Dr. Majestic urges you to put a cap on it, particularly if you’re dealing with a high level of anxiety. “Avoid consuming too much media or news that highlights the pandemic,” she says. “Narrow in on sources that you trust and that help you learn, but don’t make you anxious.”

“Get your media in measured doses,” agrees Dr. Sadeghi. “Yes, it’s important to be informed, but it’s unhealthy to be inundated with a relentless stream of such highly negative news. The stress triggers the fight-or-flight response in the body, raises cortisol, and suppresses immune function. Even post-pandemic, that’s definitely not what you want.”

Talley urges you to avoid talking about coronavirus as much as you can, particularly with coworkers and friends. “Most often, this leads you to think more about it, magnify fears, and perpetuate anxiety,” he says.

(Also read: 8 Tips to Avoid Oversharing On Social Media)

Challenge Your Thoughts

“To support yourself in reconnecting with your old, social ways, start slow and small in order to begin rewiring your brain to understand that it’s safe to be with others again,” says Dahlen deVos. She encourages looking at a specific therapy model to use some of its tips and tricks: Cognitive Behavioural Therapy (CBT).

“CBT has been found to be highly effective in treating a social anxiety diagnosis, and you can borrow some tools from CBT to use on your own,” she says. One strategy is to challenge your limiting beliefs. For example:

  • When you think about engaging socially, identify the first thought/fear that comes up. Ex: “I’ll definitely get sick.”
  • Once you identify this thought, you can work to challenge the validity of that thought. Ex: “Is that really true? How do you know?”
  • Then, entertain other beliefs. Ex: “What if it’s not true? How might I act or what would I do if that wasn’t true?”

“Be critical of your thoughts. Literally, critique them,” says Gilliland. “Review them for accuracy; They are almost always extreme.” Once you’ve assessed what the thoughts are, “discard the ridiculous ones and settle on some reasonable ones,” he suggests. Dr. Mjestic agrees. She advises you to start questioning what you’re afraid of and why to start dismantling any fears that may be irrational. “The first step in reemergence post-COVID is to really ask yourself what in particular is making you anxious,” she says. “Homing in on your answer to this question can really help you combat those anxious feelings.”

And keep a healthy perspective. “Remind yourself that you will look back on your life and how you responded to the challenges,” says Talley. “Set a goal to respond in ways that you will look back on with satisfaction: you were gritty, faced your anxieties, compassionate with others, generous in providing help or support, etc.”

(Also read: 25 Things That Will Make You Happy and Forget Your Troubles)

Start a New Routine

Talley believes you may see some success with overcoming your anxiety if you start to build a new routine. “Decide upon a rational course of action and move forward. For example, if you’re allowed to return to work and you don’t live with someone who’s high-risk, start back to work,” he says.

Develop a schedule and stick to it,” he says. “Schedules are routines and these provide a sense of control and calm.” And keep track of how your schedule is working for you. “At the end of each day make a quick note of what went well, what role you played in that success (large or small), and how you can use that insight to make tomorrow a good day as well. Consider what went poorly, and consider what lesson you learned as a result that can be used in the future. This turns setbacks into stepping stones for future success.”

(Also read: How to Cut Your Morning Beauty Routine in Half)

Get Some Help

Getting professional help is always useful when it comes to anxiety, especially if it’s severe. “Of course, if your symptoms of social anxiety feel unmanageable or are greatly impacting your life, you may choose to seek out a CBT therapist or a psychiatrist,” says Dahlen deVos.

You can also lean on the support of loved ones. “Talk to your friends or partner about your worries,” says Rachel Wright. “Everyone is in really different places in terms of comfort level, even within the CDC guidelines. It’s really important that you verbalise your concerns. This will also create a safe space for them to express their worries too.”

(Also read: Use These Apps to Book Medical Appointments, Do Teleconsultations and More)

Continue to Take It Seriously

While we want to manage anxiety so we can live as normally as possible (and support our emotional health), it would be foolish to think the threat is completely gone and done with. “We can’t make the mistake of using too much rational thought and thinking this is all overblown, but we also can’t allow the survival center [in our brains] to tell us that this is the second act of the Bubonic Plague of the 1600s,” says Gilliland.

He suggests looking at the information you’re presented with (about the virus) like a researcher. Knowing that data and anxiety both tell stories, but anxiety has “an agenda”—one that always ends in catastrophe.

“The unknowns attached to this process will make some people anxious,” says Talley. “This is accentuated by the lack of information that remains about the virus, and the continued concern that there will be a second wave of illnesses and deaths in the fall.”

It’s important to exercise caution with a healthy amount of scepticism and concern. “Everyone understands that life will not simply resume where it left off; The return to what life was like before the coronavirus will be a process that takes time and will occur in phases,” says Talley.

“It’s incredibly important right now to know what are facts and what are feelings,” says Wright. Her solution to this is self-education. “Educate yourself on how you can have a socially distanced date, or friend date and do that. If you educate yourself along the way and take baby steps, a lot of anxiety will dissipate.”

(Also read: This Stay-Home Covid Period Can Actually Improve Your Mental Health)

Get Creative

Overcoming anxiety may take some out-of-the-box thinking. “For most people, we now know perhaps more than ever how important relationships and being social is to our psychological and physical health,” says Gilliland. “Stay anchored to that and now be willing to try things that accomplish that.”

Gilliland shared the stories of two clients to illustrate how this might play out for you. “I work with someone that invited five of his wife’s friends over for her birthday and they sat in the front yard (he put chairs around the perimeter of the yard) for two hours talking—genius. I worked with some grandparents that drove to their granddaughter’s house on her birthday and sat in the car talking with her while she played in the yard and opened presents—genius. Is it ideal? No. Is it better than video calls? Absolutely!”

(Also read: 5 Ways to Be More Creative And How It Benefits Your Brain)

Focus On Positive New Things

All of us have been introduced to our own unique ‘new normals,’ and Conway says. “We each get to decide what ‘normal’ looks like for us.”

One way to better embrace this and find anxiety-quashing joy: “Take a gratitude inventory of all the wonderful new habits you developed while staying at home, and make a mindful commitment to keep your favourites part of your new routine,” she says. Finding this gusto via gratitude and reflection may give you the anxiety relief you need to embrace the outside world again.

(Also read: How to Stop Stress-Induced Overthinking, According to Mental Health Experts)

But Remember: It’s Going to Be Okay

Some words of encouragement: “The anxiety we’ve all felt from the pandemic is actually a gift,” says Dr. Sadeghi. “It should keep us from being complacent and taking life for granted. If this experience has taught us anything, it should be that. So take a risk, and really live again because as a Spanish proverb wisely said, ‘A life lived in fear is a life half-lived.’”

“Lastly, keep in mind that happiness nearly always lives on the other side of a doorway guarded by our fears,” says Talley. “Push the fear aside and walk through the door. You’ll find greater happiness and be stronger for having done so.”

(Also read: 3 Things You Need to Do Immediately After a Workout)

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