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With vaccination efforts ramping up across the United States, people are looking forward to a sense of normalcy. However, for many, the thought of things returning to normal brings a paralyzing sense of anxiety. Shannon O’Neill, PhD, licensed psychologist and Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai, discusses the post-pandemic anxiety you may be experiencing and how to overcome those complicated feelings.

Why are people feeling anxious as we see signs of the pandemic easing?

It makes a lot of sense that people are feeling anxious and unsettled right now. Just when we were finally adjusting to a new normal with some predictability and flow, the world is preparing to change all over again. Future uncertainty and a sense of not knowing what to expect can fuel anticipatory anxiety. There is even a diagnosis for this feeling: adjustment disorder.

What does that mean?

Adjustment disorder is described as an emotional or behavioral reaction to stress or change in a person’s life. As vaccinations tick up and warmer weather approaches, there will likely be a significant readjustment of phasing normalcy back into our lives, similar to the adjustments made to social distancing or quarantining at home. This can, naturally, cause feelings of anxiety, as well as depression.

In most circumstances, beginning to reintegrate a ‘normal’ routine can enhance ones confidence. So, having the extra protection of the vaccine amongst ourselves and within our community may offer added physical and emotional security for those who are feeling anxious about things going back to normal.

How can I overcome the new feelings of anxiety I’ve developed during quarantine?

A classic treatment approach for an anxiety diagnosis is exposure. Rather than avoiding what is feared, it is important to lean into those activities.

Technology has been a wonderful and very helpful incentive for us to stay home when it was important to do so. Whether enabling us to receive a grocery or pharmacy delivery or attend a virtual happy hour, technology has allowed us to obtain resources and socialize from a distance. However, for some, this adaptation can turn into over accommodation and avoidance.

Thankfully, through repeated exposures to feared stimuli, while also following CDC guidelines, you should eventually become more comfortable. However, this may mean that you will need to ease in with smaller social commitments that have time limits before expanding out to larger outings. For instance, if attending an extended outing with your larger—hopefully fully vaccinated—social group sounds too much, try connecting with a friend you haven’t seen in a year with an hour-long picnic in the park. Once you feel comfortable with these smaller interactions, you can begin to safely expand your social network.

Another good rule of thumb is to know your boundaries and limits ahead of time as this will allow for some predictability and certainty. Ask yourself, what are you willing to tolerate? Is it the group size, rules around mask wearing, or the amount of time you are present? Acknowledging your boundaries and sticking to a plan can offer a good sense of confidence when you leave your home.

How can I tell if my anxiety about leaving the house is agoraphobia? What are the symptoms?

Agoraphobia is a clinical diagnosis under the umbrella of anxiety. This entails marked fear or anxiety across a number of situations whether that is going outside alone, using public transportation, standing in line, or being in large crowds or within closed spaces.

When there is fear of leaving the home, significant avoidance or behavioral modifications can develop. This can be turning down invitations, starting to self-medicate before leaving the home, or engaging in ‘safety behaviors’ such as only leaving the home with a trusted loved one.

How do I know if I should seek care for these feelings?

If current behaviors and emotions cause significant distress, impact daily functioning, or affect interpersonal relationships, it would be a good time to seek help from a trusted provider. Additionally, if self-medication—via drugs, alcohol, or even food—is necessary to white-knuckle your way through a task, seeking help would be important.

Telehealth services have expanded throughout the Mount Sinai Health System during the pandemic and this can be a wonderful way to begin psychotherapy for those with anxiety or agoraphobia. Working towards even just meeting in person with your provider is a great treatment goal at the start of these sessions.

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