Are you struggling to wear your face mask?
Managing anxiety-related mask aversion
Face masks are a new part of everyday life that we are all beginning to adjust to. Masks being made mandatory was a positive move to protect everyone from the spread of the COVID-19 infection, for many people this was a welcome move and they experience no issues wearing a mask/ face covering, however there are some who have experienced a great deal of distress.
Many people are experiencing anxiety around wearing a face-mask, but may not be aware that the physiological response they are experiencing is anxiety. Anxiety is not always obvious; we might not be aware of our thoughts of concern, we may express it through anger and irritability, or it may become apparent through physical manifestations such as breathing difficulties and sweating. People may feel “suffocated”, feel that it is difficult to breathe, experience a racing heart, and perhaps even feel tingling in their limbs. The brain can misinterpret these sensations as the possibility of suffocating, thus sustaining the fight-flight response. When we experience this panic response, a chain of events begins to unfold and effect our body in many ways: our breathe becomes more rapid and shallow to bring more oxygen to our blood (to prepare the body for fight or flight), this can result in feeling dizzy and having shortness of breath which can cause hyperventilation (when you breathe in too much oxygen). The area a mask covers is sensitive to heat and the brain can sometimes misinterpret the increase in temperature as a sign that there is a threat present. All of these physical sensations can make us feel unsettled and tense, which further signals to our brain that there is a threat. We then associate this panic response with the mask, after all the feeling began after putting on the mask! The good news is there are techniques that can help!
Accepting masks are part of our daily life now can also be anxiety provoking as it reminds us of the real threat of illness, and that life has changed- humans crave familiarity so this big change can be quite unsettling.
People who have experienced trauma, or suffer from an anxiety disorder or claustrophobia can feel particularly affected by this. Wearing a mask may take a little getting used to and symptoms should diminish over time.
Here are some techniques you may find useful:
1. Practice wearing your mask in a space that feels safe to reduce the anxiety and help you get used to wearing your mask. Try putting your mask on for 5 minutes while watching TV, build up to longer periods at rest, then practice building up your tolerance walking in a place you feel safe.
2. Your mind has identified a threat and activated the panic response, it can be helpful to reassure yourself with positive facts such as “Masks have been proven to be safe, it has been proven that masks show no significant changes in oxygen or carbon dioxide levels (Roberge, 2012), wearing a mask protects me and others and will not cause me any harm, this will pass, this feeling is temporary”
3. Notice your body and relax any tense areas, pay particular attention to the jaw, shoulders and stomach.
4. Practice diaphragmatic breathing- breathing through your nose and expanding your belly instead of your chest, breathe in for 3 seconds, and out for 4 seconds. This helps regulate your breathing again and calm your fight or flight response.
5. Notice your feelings and thoughts, acknowledge them for what they are, accept that they are there. Notice what your thoughts are telling you and challenge these: “I cant wear this mask, I will suffocate!”- switch this with “I am not used to this but I can wear my mask and I am ok”
6. Bring your focus into the present, anxiety is often experienced as we are worrying about the future and can manifest in “what if” questions. To bring yourself back into the present, you can begin by noticing what is around you, consider: 5 things you can see (white walls, grey lamp, brown seats…), 4 things you can hear, 3 things you can feel (the weight of your phone in your hand, the way the floor feels on your feet), 2 things you can smell, one thing you can taste. Using your 5 senses helps ground you in the present.
7. Try a few different masks! Lighter material may be less anxiety-provoking, there are many styles available now online including Etsy, and Two Thirds. Many places such as screwfix and homebase sell masks with filters, which may help breathe easier. Vogmasks and Cambridge Masks are often worn by individual with athsma and cystic fibrosis (lung diseases) and can be tolerated for long periods of time.
Written by:
Hollie Harland MBACP, PGdip, PGcert, BSc, DipHE
References:
Roberge, R. J., Kim, J., & Benson, S. M (2012). Absence of consequential changes in physiological, thermal and subjective responses from wearing a surgical mask. Respir Physiol Neurobiol, 181(1), 29-35
Evidence links:
https://youtu.be/0ZEYFgmXrLc (“Do Masks affect your oxygen levels?” by Dr Ed Hope)
Links for masks:
https://twothirds.com/collections/protection-masks
https://www.screwfix.com/c/safety-workwear/dust-masks-respirators/cat850348