You’d be hard-pressed to find someone who doesn’t feel a little wary about stepping out in public these days. (Even the most mask-averse folks probably flinch a little when someone in the grocery checkout line gets a little too up close and personal.)
Almost a full year into the COVID-19 pandemic, the majority of us have gotten used to staying inside as much as possible and avoiding places where people gather. Now that new variants with increased transmissibility have surfaced, we’re even more inclined to stay home.
But when is your anxiety around venturing out ― be it to the supermarket, back to the office or to any other public space ― a sign of something more serious?
An uptick in chronic anxiety and agoraphobia ― an anxiety disorder characterized by excessive fears of leaving the house or being in open spaces ― are among the mental health issues therapists are concerned about in the wake of the coronavirus pandemic.
Many people already have reached a point where their aversion to going out is veering into unhealthy territory, said Amelia Aldao, a psychologist and anxiety specialist in New York City. And that likely will intensity now that some workplaces are phasing out of work-from-home arrangements.
“Clients of mine who now have to go back to the office are noticing that even simple interactions, such as talking to someone on the elevator or by the kitchen, takes extreme effort,” she said.
Social muscles haven’t been exercised in almost a year, so interactions that once seemed easy, casual and commonplace now take some working up to, she said.
At this point in the pandemic, everyone has formulated their own opinions on safety and risks, but for many, staying home is not only the safer option, it takes a whole lot less mental energy.
“Some clients would say they would rather be working from home every day ― but then, when that happens, they begin to sink into loneliness and depression,” Aldao said.
“If you notice that you never seem to want to socialize or engage with others, it might be a sign that you are engaging in compulsive behavior that can make your anxiety worse.”
– Sheva Rajaee, a therapist and the director of The Center for Anxiety and OCD.
Some anxiety is normal. But if you’re increasingly concerned about how you perceive the outside world, pay attention to how your body reacts when you’re safely out in public, said Sheva Rajaee, a therapist and the director of The Center for Anxiety and OCD.
“One sign that you might be experiencing something more than regular anxiety is the presence of physical symptoms,” she said. “Things like increased heart rate, excessive sweating and lightheadedness which can be an indicator of a potential panic attack.”
Look for these other warning signs
“Panic attack” searches online reached an all-time high during the pandemic, which is understandable given how little we knew about coronavirus and how to tackle it when all of this started. It’s cause for concern if panic attacks continue, or when panic attacks at a specific triggering event generalize to other more innocuous settings, said Gregory Kushnick, a psychologist in New York City.
“For example, waiting in a crowded doctor’s office may trigger a panic attack, but you now find yourself feeling intensely anxious chatting with someone on the sidewalk while both of you wear masks,” he said. “That’s concerning.”
Rajaee said to also take note if you find yourself looking for excuses to avoid any social interactions ― even if they are considered safe by the Centers for Disease Control and Prevention guidelines.
“In moderation, avoiding socializing might not be an issue, but if you notice that you never seem to want to socialize or engage with others, it might be a sign that you are engaging in compulsive behavior that could make your anxiety worse in the long-term,” she said.
Outside of panic attacks, Aldao said people may experience an increase in social anxiety symptoms. (You’re hardly alone if you’ve struggled to make small talk or sweat and feel your heart rapidly racing when a coworker or neighbor simply wants to stop and chat.)
At the farthest end of the spectrum, a person could experience agoraphobia or post-traumatic stress disorder-like reactions, such as hypervigilance and increased physical reactivity, the therapist said.
Most people who experience agoraphobia develop it after having one or more panic attacks in a specific setting. That leads them to worry about having another attack and avoid that place altogether, according to the Mayo Clinic. Those with severe agoraphobia may never leave their house.
PTSD, meanwhile, can be triggered by almost any distressing event: war and combat experience, sexual assault, mass shootings, terrorist attacks, natural disasters, a car accident that shakes you, a global pandemic and lockdown.
As Aldao told HuffPost previously, the coronavirus pandemic is a particularly traumatic experience for a number of reasons, among them our acute fear of catching the virus and the economic impact of lockdowns and business closures.
“There’s an inherent grief that comes with social distancing and how our social lives have changed drastically and will continue to change over time,” she said. “Plus, again, there’s that additional element that makes this crisis particularly traumatic: We don’t know when it’s going to end.”
If your anxiety or panic attacks continue, or if you’re dealing with what seems like PTSD or agoraphobia, it’s absolutely worth looking into specialized therapeutic help before the conditions worsen.
“If it feels paralyzing and debilitating, and you’re avoiding even the most mild forms of human contact outside of your home, then seek mental health counseling,” Kushnick said.
How to address your fears before it gets to that point
If you’re jittery about going out in public or engaging with someone outside your household, it makes sense that you’d avoid such settings and people. But with avoidance, we get short term relief while paying a steep price in the long run.
Exposure ― or slowly and repeatedly facing experiences or places you fear until you feel less anxious ― is the best way to nip such fear in the bud. But we’re living in pandemic times; you’re not going to high tail it to the supermarket every other day or embed in a crowd to face your fears. Experts say that instead, you can take baby steps to ease yourself back into social life in a safe, socially distanced way.
“I’d recommend finding a nearby outdoor space that has the fewest amount of people present and get used to being there, just based on exposure,” Kushnick said. “Next, try a public space that has slightly more people and work on either distracting yourself or actively calming yourself with breathing, self-talk, music or podcasts.”
To get a handle on burgeoning social anxiety, start to refocus on friendships and other social ties that may have fallen to the wayside as the pandemic has gone on.
“If you haven’t been, try to connect with others via Zoom and phone calls, even when you don’t feel like it or find virtual connection less satisfying than in-person social interaction,” Rajaee said.
Socialization and our need for connection is “part of who we are as humans, and eventually, when it is safe to do so, we will find our way back to one another,” she said.
In the meantime, anticipate that re-entering society after lockdown will come with some hiccups and discomforts.
“Your brain has been on alert for close to a year now, and has been viewing other people, crowds and public spaces as dangers,” Rajaee said. “But with practice and a willingness to work through that fear and discomfort, most people will be able to re-enter society without too much turbulence.”