Anxiety after shielding: Understanding and overcoming anxiety as restrictions are lifted
This article is aimed at people who have been shielding and are struggling to adjust as restrictions are lifted in the UK
Infection levels in the UK have been decreasing and restrictions are being lifted, 67% of all adults in the UK have received their first vaccine and 35% have received both vaccines with tens of thousands of people receiving their vaccines every day. Daily cases are at their lowest since last August, it’s what many of us having been looking forward to! We have missed going shopping, going to the cinema, going to gigs, spending quality time with friends and family, hugging, even going to supermarkets! Yet we feel a discomfort, a resistance, an unsettled sense within us as this shift in life occurs. In this article I will talk a little about why this is, and what you can do about it.
There is a psychological phenomenon called Paired Association that occurs where the brain associates an object, idea, or experience with an emotion. This happens because the brain wants to protect us from future discomfort and danger, and this process ensures we learn from past experiences and avoid that danger in the future. It also happens with positive experiences and occurs to promote more enjoyment in our lives. In the case of the pandemic, going out to public indoor spaces, meeting friends and family, having close contact such as hugging and touching, and mingling with the public, were all dangerous to our health and a threat to our mortality, over the past 14 months we have made that paired association through repeated pairing of the emotion and the situation. This can be unsettling as it seems not too long ago, a trip to the grocery store was a simple activity to a neutral space, not one that created a strong emotional response in either direction. Now such a trip can cause physical symptoms of anxiety, and when we have physical symptoms of anxiety, we can enter a cycle where the symptoms signal more danger. To manage this, we need to intercept this brain-body response.
Before I go on to explain what you can do to start making changes and getting relief from this discomfort, its important I touch on neural pathways. Studies in neuropsychoanalysis have shown that our brains form neural pathways based on our experiences. This is a physical representation, observed through fMRI and PET scans, reflecting our experiences. Over time and with repetition, the cells create this bridge to each other based on specific experiences, so it becomes quick and easy for them to communicate. If you have ever learned a new skill like driving, or playing an instrument, you are forming a neural pathway. At first you find it difficult but the more you repeat the behaviour (practice) the more easy it becomes; a bridge has been built; a neural pathway has formed. Now it’s almost automatic, you get in your car or pick up the instrument and you just ‘do’. We can see that, similar to paired association, this becomes an unconscious process, but this time it’s a behaviour associated with a situation. In relation to reintegrating into society after shielding, you may feel resistance and discomfort when you think about getting back to normal, because over time your behaviour has been to avoid these situations- that neural pathway has been built and the bridge is strong and sturdy.
The good news is you can begin to make changes to build new neural pathways over the old ones! You can also make new paired associations. The result of this will be that you’ll once again have a positive emotion when you do things that were normal for you pre-pandemic, and you’ll notice less resistance and discomfort when you do. To get there, there are a few different methods you can try.
CBT is the most effective method in bringing about behavioural change. To use this method, start by making a list of things you want to do, and break them down, and break them down again, then start with the least scary activity and tackle this first. Start small and build up a little each time. This works because each time you do something and it goes well, your brain realises that nothing terrible will happen. The brain doesn’t differentiate between anxiety you’d have as you are walking through the jungle and could be attacked by a tiger, and the anxiety of leaving the house- to the brain, fear is fear. Start with the situation that causes the least anxiety, and repeat until the anxiety has gone before taking the next step. It is not advisable to jump straight into the situation that causes the most anxiety because the anxiety response may be big which can lead even more resistance in future
When you feel anxiety, don’t avoid it- avoidance is a condition in which anxiety thrives. Relax your brow, your jaw, your shoulders, do this body scan; relaxing your whole body. This calms the fight/flight response as your body is now sending the signal to your brain that there is no threat. Talk to yourself with compassion and understanding, “this feeling is anxiety, there is no immediate threat, in this moment I am safe, it is only temporary, I’m feeling anxiety because I’m not used to this and I’ve been scared of catching the virus, but that is so unlikely now because…” ( I am fully vaccinated now, we took lateral flow tests, we wore masks, no one has symptoms, the infection rate is very low, etc). Use these facts to reassure your brain that the threat level is extremely low, and no longer a threat to your mortality (if this applies), while at the same time being a friend to yourself. The anxiety is a scared part of you that deserves reassurance and comfort.
Be assertive with family and friends and communicate openly in advance. Don’t go in with a defensive tone and try not to have any expectations about what might happen. Let them know what you are comfortable with at this time, put your boundaries in place and stick to them. For example, asserting that the first time you meet indoors you’d like to keep a distance, or that you would like your friends/ family to take lateral flow tests before meeting you. (Lateral flow tests are now available to order for free online in the UK in boxes of 7). When you stipulate these conditions, do not negotiate; that is your boundary. We can’t control what other people do but we can control how we manage situations.
During the pandemic we have developed unconscious and chemical responses which served to protect us, and they did, but we now no longer need them. Through understanding these and learning how to move away from them, gradually our minds will return to associating these activities with positive emotions and we will feel an eagerness to engage with others again. We can all struggle with change, but with this change comes a lot of positives too, it can help to have something pencilled in to look forward to, something that brings joy. Remember the importance of positive self-talk and self-compassion, gradual behavioural change will impact the way you think, and changes to the way you think will gradually change behaviour. I hope this understanding empowers you and arms you with some tools to begin working towards your goals with reintegrating after shielding.
Disclaimer: If you cannot be vaccinated or don’t form an immune response to the vaccine, and if restrictions are re-introduced, please take the appropriate steps to stay safe and create balance for your physical and mental health. This article has been written as restrictions and being lifted due to low infection numbers and most of the clinically vulnerable individuals being vaccinated. Please follow appropriate guidelines set out to protect your health. Remember that the main reasons we feel fear is to protect our lives, so fear in a pandemic is normal and rational. However, when that fear is disproportionate and negatively effecting daily life it is important to get support.
Written by:
Hollie Harland MBACP, PGdip, PGcert, BSc, DipHE
Sources:
1. www.travellingtabby.com for vaccine statistics
2. Psychotherapyresearch.org for information on neural pathways
3. Order lateral flow tests in Scotland https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/coronavirus-covid-19/test-and-protect/coronavirus-covid-19-get-a-test-if-you-do-not-have-symptoms
4. Order lateral flow tests in England https://www.gov.uk/order-coronavirus-rapid-lateral-flow-tests
5. Order lateral flow tests in Wales https://gov.wales/get-rapid-lateral-flow-covid-19-tests-if-you-do-not-have-symptoms
6. Order later flow tests in Northern Ireland https://www.nidirect.gov.uk/articles/coronavirus-covid-19-testing-and-contact-tracing