Life is slowly returning to normal — whatever that means now that the pandemic has turned normalcy upside-down — but you’ve noticed you’re not feeling very comforted by that fact.
Instead, you’ve been feeling afraid to leave the house. When you get groceries or go for a walk, the sight of other mask-wearing humans (even from 6 feet away) fills you with anxiety. Or maybe you’ve stopped going outside altogether and just order in all the time.
Anxiety disorders have been affecting people since long before the pandemic. I should know: I started experiencing panic attacks and agoraphobia, which involves the intense fear of being out in public, when I was 11, and I later went on to develop other types of anxiety.
When I began self-isolating during the pandemic, I feared my agoraphobia would flare up. Thankfully, it hasn’t (knock on wood) but now that the state is slowly starting to reopen, I wonder if I’ll start panicking when I’m allowed to go to restaurants and movie theaters again.
Maybe you’re worried about this, too. Or maybe you’re having enough trouble leaving the house now.
Here’s what I learned — from personal experience and from talking with a psychologist — about how to recognize when you have problematic anxiety and what you can do about it.
More anxiety is the norm now
First, let’s get one thing clear: You could say anxiety is the new normal of the pandemic.
“As much as everybody wants to get back to everything that they’ve been doing, I think once more doors are open there will be reticence to go through them,” says Kendra Read, a clinical psychologist and anxiety specialist who teaches in the UW School of Medicine’s Department of Psychiatry and Behavioral Sciences.
Read and her colleagues are actively planning for an anticipated surge in patients as the state keeps reopening. They’ve also changed programing and individual treatment plans to address how anxiety is presenting within the context of a pandemic.
It’s only natural that we’d be more anxious. Many of the things we used to do as part of our everyday lives have changed. Things that were usually not significant health risks — like going to the grocery store, meeting a friend for lunch or going to work in the office — now are.
And we don’t know when things will return to normal — and, in some cases, if they even can.
Anxiety feeds on uncertainty. For me, it means I’m afraid of all the things I don’t and can’t possibly know: When will the worst of the pandemic be over? What will the long-term consequences be for me and my community? Will anyone I love get sick? Will I get sick?
Under pre-pandemic circumstances, having persistent fears about my long-term safety wouldn’t make much sense. Sure, life is unpredictable, but normally I have more control over mine. If I constantly worried about my health, it wouldn’t match up to my reality.
Now, however, these kinds of worries are more warranted — to some degree.
“The key to understanding problematic anxiety is understanding disproportionate fear and worry. That’s where the fuzzy line is going to be coming out of this pandemic. What is disproportionate now?” Read says.
What agoraphobia is — and isn’t
Agoraphobia is one of those mental health terms that gets thrown around more casually than it should, like OCD, ADHD and panic attacks.
To help you understand what agoraphobia really is, let me tell you a story. (Keep in mind, this is just my experience — other people with agoraphobia may have very different experiences.)
When my agoraphobia was at its worst as an adult, I regularly had panic attacks going anywhere in public, even something as simple as getting dinner with a friend down the street. When I started panicking, I would make an excuse to leave, but even back at home I wouldn’t feel any relief.
I couldn’t sleep because I knew I’d have to go to work the next day. Sitting at my desk was eight hours of unending anxiety where I could barely eat, my body shook constantly, I felt faint and feverish, and I desperately wanted — more than I’ve wanted anything else — to run back home.
For most people with agoraphobia, it’s tied to having panic attacks, but sometimes the agoraphobia develops on its own or with another mental health condition. Some other common signs — things I’ve also experienced — are the fear of losing control in public or of going places where it might be hard to escape, fear of going anywhere alone, and feeling like your body or the environment around you aren’t real.
If none of this sounds familiar, then your chances of having agoraphobia are probably slim, Read says. (It’s also a rare condition: Only a little more than 1% of adults will experience it.)
Ultimately, whether or not you have diagnosable agoraphobia often comes down to a matter of functioning.
Are you still able to go outside when you need to, like for groceries or to get your car fixed? Can you get work done? Are you eating regular meals? Are you able to get out of bed, do household chores, maintain personal hygiene?
How much is too much anxiety?
Even if you’re functioning relatively normally, you may still feel pretty distressed. So how can you tell if what you’re experiencing is a problem?
Read recommends comparing your actions (how anxiety is governing your behaviors) against what you’re allowed to do per public health guidelines. Is there a big difference? Are you overdoing it?
For example, say you want to get some fresh air. If you walk to a local park that’s packed with people just sitting around, it makes sense that this might provoke an anxiety response — and a decision to pick a different park.
But if instead you go for a walk and see only a few people from a distance and still feel anxious about it, your fear is now disproportionate to the potential risk (which is very small).
“That could be an indication that we’re starting to veer off the path from typical, nonproblematic anxiety,” Read says.
Ultimately, anxiety is a normal feeling that exists on a spectrum — some people have more, some less. Mental health professionals only consider it a disorder when it starts interfering with someone’s life.
“What’s hard about defining normal is we don’t really have normal for a pandemic. It’s an ongoing conversation about weighing risks and benefits and checking that against what you’re doing,” Read says.
Tips for leaving your house with less fear
Here are some things you can do that will lessen your anxiety plus help you become more resilient long term.
Compare your plans to official recommendations
Feeling afraid to do an out-of-the-house errand or activity? First ask yourself if what you want to do goes against official recommendations from public health and government officials.
If it does, that could be why you feel anxious about it — and it’s probably a good idea to skip it. If it doesn’t go against recommendations and the activity is low risk, remind yourself that you’re not doing anything dangerous and that you’re feeling more fear than is probably needed.
Don’t believe everything you think
When you’re feeling anxious, your mind might be racing with anxiety-ridden thoughts. Will you come in contact with someone who’s sick when you go to the store? What if you have the virus now but don’t have symptoms, and you go outside and expose people? Is there coronavirus on that bag of chips?
A good rule of thumb is that just because you think it doesn’t mean you should believe it.
“Thoughts are just thoughts, they’re not always true and not always helpful,” Read says.
Sometimes, anxious thoughts can be helpful because they stop you from doing something that’s actually risky. But whenever your mind starts spinning, it’s a good idea to check in with yourself and see if your thoughts are actually helpful or if they’re preventing you from doing something that’s fairly safe.
Acknowledge — and accept — uncertainty
OK, I know this sounds impossible. But the more you let yourself recognize how uncertain things are right now — and that that’s OK — the more you’ll get used to uncertainty. And the more you’re used to it, the less anxiety can latch onto it.
Remind yourself that everyone is facing the unknown right now. Remind yourself you’re doing the best you can. Remind yourself that just because you don’t know the future doesn’t mean it will be bad.
Control what you can
You can’t control whether or not you’ll lose your job or get sick. But you can do productive things like review your spending habits, make healthy food, take time for yourself and wash your hands regularly.
That’s why I work hard to take care of myself in the ways I can, so when I need extra strength I’ll have a little in reserve to pull from.
Controlling the things you can won’t make your anxiety go away or prevent it, but it could help you feel more prepared to face it when it does make an appearance.
Feel the fear and do it anyway
As a teenager, my agoraphobia was so strong I rarely left my house — and when I did, I felt like I would die. I’ll never forget something my doctor at the time told me: Feel the fear and do it anyway.
Anxiety didn’t have to stop me from doing what I wanted to do. It may make things harder, but I was strong enough to handle it. So I started doing all the things that scared me — and slowly, I grew confident that I could handle them.
It may seem obvious, but when you’re in deep, the idea of not being afraid seems impossible. But it isn’t — and it’s important to remind yourself of that, as much as you need to.
In therapy, doing what you’re afraid to do is called exposure therapy, which involves the therapist setting up a situation so the patient has to face their fear directly instead of avoid it.
Doing exposures to face your fears is the most important part of cognitive behavioral therapy, the most scientifically-backed type of therapy to treat anxiety disorders.
Usually, exposure therapy is done gradually. If you’re terrified of needles, for example, the first step isn’t to donate blood — instead, it might be to talk about needles or hold a needle. Each step helps build confidence.
You can do that if you’re afraid to leave home, too. Maybe don’t start with the long walk at the park. Instead, walk around the block.
Even though it can feel unbearable in the moment, you will get through it. I should know, after all; I’ve been there.
“Anxiety is changeable if you seek change. It’s not something you’re saddled with for the rest of your life if you get help,” Read says. “The sooner you get support and make steps toward change, the easier it will be and the faster that will happen.”