‘Virulent microbes everywhere’: how can anxious people fend off reopening panic? | Mental health
I recently took my first flight since the pandemic began. As I arrived at the airport, I prepared for a scene of utter carnage: people everywhere, all of them insisting on breathing; virulent microbes reveling in a field of unsuspecting targets.
As someone with a history of anxiety, I took a deep breath – figuring it would be my last opportunity to do so before landing – and entered the fray.
The masks were the only sign the pandemic had ever happened, as crowds swelled at check-in and security. I kept my distance and moved quickly, doing my best to mute the part of my brain screaming at me to dive out the nearest window. If no one else is worried, you must be OK, I told myself, without believing it. And if this is the end, you’ve had a decent run.
I was headed across the US to see my parents and I was terrified by the risk Covid posed to them, although we were all fully vaccinated. I’d picked a window seat, having read online that it was slightly safer, and I vowed not to remove my mask. Onboard, that meant minimal food and water and maximum anxiety, a perfect recipe for the ensuing migraine.
After a five-hour flight, the descent seemed interminable as the nausea grew. Finally, we landed and I grabbed my bag and dashed outside, where my parents were pulling up. I greeted them for the first time in 15 months by throwing up at the curb.
Many lucky people can mentally equate reopening with a return to normal, but reopening, of course, doesn’t mean Covid has disappeared. Anxious people like me – who have had the privilege of working from home – are keenly aware of that fact and now find ourselves in a bind.
Social pressure is building to venture out. Workplaces are beginning to summon staff, friends are texting to hang out, families are planning gatherings. But re-emerging can feel fraught with danger, especially for people with significant anxiety. For more than a year, we’ve been conditioned to see our fellow humans as disease vectors. Even before the Delta variant took hold, the question loomed: how can we return to the world without panicking?
The visit home brought these anxieties to a head, since my parents are in a demographic at higher risk from the disease. I returned to my early pandemic habits of wiping down surfaces and washing my hands until they were raw; the Happy Birthday song will probably be triggering for the next decade.
I wanted to see childhood friends – but first had to delicately inform them that I was neurotic and needed us all to keep wearing masks and stay outside, despite everyone being vaccinated. After such gatherings, I felt contaminated, as if my body were crawling with unseen invaders that required dousing in the shower. Trips to pick up food were worse. When I stood in a shop, I imagined Covid particles swirling around my head and a clock ticking ominously: stay in here for more than 10 minutes, I warned myself, and your family has breathed its last.
I knew all this was irrational. I didn’t really believe any of my friends were sick or even at particular risk; they’re not the types who proclaim they’re “being safe” while holding choir practice on exercise bikes in windowless basements. I knew that surfaces were no longer considered a major source of danger. The area’s case numbers didn’t support my fears, and my parents themselves were far less worried than I was.
The trouble is that, for people with brains like mine, the pandemic seems somehow distinct from the case numbers. It feels like a fantasy novel: as though some nebulous evil has descended upon the land, and it will go where it chooses, laughing maniacally. When the threat seems so abstract, it becomes difficult to imagine that we are safe just because the local statistics have improved.
Precautions against Covid, whether wearing masks or staying home, have become rituals to ward off the darkness, offering a measure of comfort simply in their performance – with a fear that failing to observe the rules magically summons an infection, regardless of whether there are actually pathogens nearby.
All this gets at a central problem for anxious people: uncertainty. Yes, intellectually we are all aware that vaccines have changed the landscape. But before I emerge from hibernation, I want an expert to proclaim that the danger is zero, that the forces of good have entirely vanquished that spreading evil – which, of course, will never be the case. So it becomes a matter of either staying home for ever, or determining what level of risk we are each willing to tolerate.
In that sense, reopening will be a sort of global psychological exercise.
I was diagnosed with OCD as a child, and I’ve tackled it through cognitive-behavioral therapy, using a process known as exposure and response prevention (ERP). In this procedure, a patient works with a therapist to create a “ladder” of anxiety-provoking behaviors, starting with easier ones – perhaps going an hour without hand-washing – and growing more difficult – perhaps going a day without washing, or deliberately getting one’s hands dirty. The goal is to gradually increase the patient’s tolerance for these activities and the associated uncertainty, without the futile effort of trying to prove that there is no risk – perhaps there is, the patient might think, but I can live with it.
Reopening will, in a way, be ERP on a giant scale. Anxious or not, we will all feel a bit out of our element during our first interactions with the outside world. Our first exposures might be visits with one or two vaccinated friends, then perhaps an uncrowded outdoor restaurant. As time goes by and cases rise and fall, we will climb our individual ladders – as slowly or quickly as feels safe.
The world right now reminds me of how I perceived the ocean as a child: beckoning and beautiful but ruthless, with an undertow that could haul me away any moment. I’m in no rush to share air with strangers.
My own ladder, if I had my way, would probably start with a gas mask and a Lysol bottle in each hand. As it is, I have begun by occasionally removing my mask during outdoor walks. Tasting unfiltered air for the first time in a year has been a revelation, perhaps even worth the brief sense of impending doom when the sound of a cough echoes from a nearby home. I don’t see Coachella, or even TGI Friday’s, in my immediate future. But it’s been getting easier to meet friends at well-spaced outdoor gathering places, and soon I expect to be able to leave my yardstick at home.