Social Anxiety After COVID

We’ve reached the point where the US is relaxing its COVID-19 precautions. That cases have fallen to the point that this is possible is incredibly good news, the answer to prayer, and a source of great joy. However, I am also seeing a spike in anxiety in my outpatient psychiatric practice. As I recently heard someone say, “it’s like I’ve forgotten how to be human.”

Although the person was joking, there is some truth to the comment. Many of us have been isolated for the last 15+ months. Social interactions have been online, or with masked strangers on the occasional essential trip out of the house. If we interacted with others in person, it was only with a select few and usually with people we knew very well. Or we were essential workers living with the stress of the unknown—would we catch the virus? If so, how severe would our case be? Were we exposing our loved ones and family due to our work? Many of us have lost loved ones, and the threat of death was present everywhere. Some people faced their own mortality and the mortality of those they love for the first time.  It has been a very difficult and stressful time.

Many people live with diagnosable anxiety disorders. These include:

• Social Anxiety: Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others
• Generalized Anxiety Disorder: excessive anxiety and worry, an “apprehensive expectation” about a number of events or activities
• Panic Disorder: An abrupt surge of intense fear or discomfort that reaches a peak in minutes during which physical and cognitive symptoms occur
• Agoraphobia: Intense fear or anxiety triggered by the real or anticipated exposure to a wide range of situations

For some people who lived with an anxiety disorder prior to the pandemic-imposed isolation, returning to “normal” life can be extremely stressful. Many people who live with these disorders described a feeling of relief that they did not have to be out in the world during the pandemic, and that they could interact with others free of some of the stressors that induced symptoms.

But even if a person does not live with a diagnosable anxiety disorder, returning to “normal” life can still be hard. Some people remain fearful of interactions due to safety concerns. Is it okay to interact with others without a mask? Is that person really vaccinated? What about my children (or grandchildren) who aren’t eligible for the vaccine?  Will it be safe to return to work in person? For others, it is that we are out of the habit of interacting with others. We are used to being around our homes, and we have forgotten how to interact with others in person.

So how do we cope? One way is to take comfort in the fact that we are not alone if we experience fear and discomfort in social situations. If you are feeling a little uneasy about being back out in the real world, chances are that those around you are too. It is a time for us to be especially gentle and understanding with one another.

Another way to manage is to remember some of the coping mechanisms that we developed during the pandemic to handle stress. Many people found solace in new, calming activities: cooking, gardening, playing chess, virtual yoga and workouts, writing real letters on paper to others, walking/hiking and more. We can take these activities with us as new ways to cope with our anxiety and worry as life begins to return to normal.

And we can pray, and take comfort in God’s word as found in Isaiah 41:10:

do not fear, for I am with you,
    do not be afraid, for I am your God;
I will strengthen you, I will help you,
    I will uphold you with my victorious right hand. (NRSV)

However, some people may need professional help. If your anxiety or worry is causing you significant distress or impairment in social, occupational, or other important areas of functioning, it is time to reach out. You can start by talking to your primary care doctor who can assist or refer you to a mental health professional for therapy or medication if indicated.

This has been a very difficult year filled with loss, fear, and isolation. As we begin to emerge from the darkness of this time, we can remember that anxiety is normal given what we have all been through. In fact, it is very “human.”

The Rev. Suzanne Watson, M.D.  came to medicine as a second career after 10+ years of ordained ministry in the Episcopal Church where she served in congregations in California, New Zealand, and Connecticut, as well as on the staff of the Presiding Bishop in New York. She was also a candidate for Bishop of Alaska.

She attended medical school in her 20s, but left to devote time to raising her family. However, her dream of practicing medicine never died, and at the age of 50 she embarked on this vocational change. Part of her motivation was the loss of her physician husband to suicide. She is strongly committed to mental health advocacy, the reduction of stigma, and suicide prevention

She is currently in her last year of residency in  Psychiatry at the University of Nevada, Reno. She is returning to San Diego this Summer and will be working at the VA hospital in La Jolla.