Nervous about resuming activities? How to manage 'COVID transition anxiety'

Let's say you love the Minnesota State Fair and you really want to celebrate its post-pandemic return later this summer. But just the thought of being inside the packed Food Building, waiting in a long line for cheese curds, makes you feel anxious.

There's a name for what you're feeling: COVID transition anxiety.

With COVID-19 restrictions lifted and long-awaited events on the horizon, some people are finding that they're hesitant to do the things they had looked forward to doing post-vaccine. Instead of feeling joy and anticipation, they're racked with unexpected feelings of anxiety or even panic.

We asked Reese Druckenmiller, a therapist with Mayo Clinic Health System, and Dr. C. Sophia Albott, a psychiatrist with University of Minnesota Health, about why this period of transition can be so difficult and what we can do to make it go more smoothly. Answers have been edited for space and clarity.

Q: Why might some people be feeling anxious now?

RD: Our brains like patterns. We like for things to come in predictable ways. So at first, when the pandemic hit and we were all doing these new things that we weren't used to doing, that caused us a lot of anxiety.

Now that we're getting back to some normalcy, for our brains and our anxiety, it doesn't really feel normal yet. And it will. Eventually our brain will start to go, "Oh, wait a minute, this is back to the old way. And I'm getting used to it."

CA: When we know what our boundaries are and the right thing to do, when there are limits set for us, we feel better. Having things like routines and going to bed on time and all of those things, they help people to keep unexpected emotions in check. It works for kids, and it works for adults, too.

Now that there is this situation where it seems like those clear-cut boundaries are gone, that contributes to anxiety about the right thing to do.

The pandemic is not over. There are still people who are getting infected. I had a colleague die. When those competing realities happen, it's harder for our brains to settle into [a feeling that] "my world is predictable and I know what is going to happen to me today." It's hard. That's why we feel this way.

What I hope is that people don't feel like this uneasiness is, in any way, inappropriate or wrong. I think the idea that we're going to go back and everything's just going to feel the way it did in February 2020 is not realistic.

Q: How long will this take?

RD: It's going to be different for every person. I can't give you a time, but what I can tell you about is how to make it go smoother and faster.

The first thing would be to recognize that that's what you're experiencing. Anxiety has this really sneaky trick, where it tries to take away our insight, and not make us realize what's going on. Check in with your thoughts. Check in with how your body feels, check in with how you are behaving.

Some people act out and get kind of angry or frustrated or irritable. So look for these signs in yourself and say, "Oh, hey, that's probably anxiety." So name it. And then think about: What's my plan to engage in exposure?

Exposure means doing that thing that's making me anxious, even though it's making me anxious. The more that we do that thing that makes us anxious, the easier it's going to get.

Q: Is there a way to prepare to go to an event — a play or concert — that you feel anxious about attending?

CA: Often, one of the things that can perpetuate anxiety is avoiding things wholesale. Not talking to anyone about it, pretending it isn't there, just staying at home. So I think it's a good idea to acknowledge it and also then try to talk about it. Also explore ways to be around a crowd or be in a smaller group of people. See if that feels good, and once that feels good, then you can try [attending larger events], maybe they will feel a little bit less anxiety-provoking.

RD: Be on the offense, and say to yourself: "I've got this ticket to this concert. I kind of know what my anxiety is going to do. I know that when the day gets closer, I might start to ruminate about my worries. I might try to come up with excuses to avoid it. I might start to feel physically sick. But I'm going to know that those things are likely coming, and I'm going to remind myself that I know how to deal with them, and I can do hard things." We don't have to feel 100% safe in order to engage in an activity.

Q: What can you do in the moment to manage this kind of anxiety?

RD: Sometimes just engaging in a mindfulness practice can help to bring us back into the moment. For example, with adults, I might say, "Hey, I just want you to take a little bit of time and use your five senses. One thing that you can see, one thing that you can hear, one thing that you can touch and so on, using those five senses to just ground yourself back into the here and now."

With kids, we might use that same strategy or we might use something a little bit more silly. Playing a game like the ABC game, where I'll say to a kid, "OK, you think of an animal that starts with an 'A' …"

We have to be careful because we don't want kids and adults to think that that is going to take their anxiety away or fix it. It's just to get those emotions and those feelings to not be quite so big, so that you can have a more rational response.

Q: Should people continue to wear masks if that helps them feel comfortable?

RD: That's a hard one. In the world of anxiety, we talk about things that are crutches. We talk about things that serve a purpose to make us feel safe, but will often perpetuate our anxiety. Now, there may be people for whom it's appropriate to continue to wear a mask because of health conditions or such.

I would want a person to ask themselves: Is there a legitimate reason for me to continue to wear a mask, or is this serving as a crutch to perpetuate my anxiety?

CA: I think people just need to decide what feels right for them. I don't think there's anything wrong with continuing to wear a mask. The other piece, too, is that kids aren't vaccinated.

Q: What are some signs that you might want to have some professional help getting through this?

RD: This is true for anxiety or any mental illness: If it is interfering in your functioning — your employment, career, ability to parent, ability to have relationships, sleep, general overall well-being — if that's happening, we definitely want to get some outside help.

Erica Pearson • 612-673-4726