Thread by @DrHasson2

I promised a discussion of some of the anxiety (and denial of anxiety) I’ve be seeing in practice. This definitely isn’t everything. Here’s a thread:

1- Fear of getting sick. It’s not just Covid. For some, the fear has generalized to any illness. I’ve seen people go to extremes to avoid illness and have developed agoraphobic type symptoms as a result. If the don’t leave their house or interact with anyone, they can’t get sick

2- Guilt with getting sick: I’ve had clients express guilt over getting sick (not just Covid) because it meant they did something wrong.

3- Fear of breaking the rules: I’ve had clients in my office ask if they could step out to another open office so that they can take their mask off and take a sip of water. I assure them it is ok to take a drink in my office because I am vaxxed, the air purifier is on, etc

Even then, some say they don’t want to because they would feel guilty if they got me sick. Another thing I hear a lot is that because I’ve been working in person, they are worried about what I have been exposed to and don’t want to catch whatever I may have.

4- Compulsive Rituals to Avoid Covid: I’ve heard a lot of fairly unique rituals to avoid Covid that do not necessarily make scientific sense (like wearing a mask outside to run but not when visiting friends in their homes). Others are washing groceries with a bleach solution.

5- Hyperawareness of Body Sensations: this is a big one. Some are now fixated on changes to bodily functioning and interpreting any body sensation as indicative of illness. However, anxiety and stress can also impact body function. Stress can cause muscle tension, changes

to appetite and sleep patterns, headaches, even gastrointestinal distress. Being hyper aware of these changes brings your attention to them, causing stress, which can exacerbate the symptoms, resulting in a cycle of increasing psychological/somatic symptoms.

6- Increases in anxiety disorders, social phobia, OCD, eating disorders (both bingeing and restrictive types), and increases in purging behavior, including overexercising and vomiting. This has been covered elsewhere.

7- Increases in substance use, especially THC: prolonged uncertainty and stress taxes our coping abilities. People are looking for other ways to cope and some have turned to THC and other drugs. Cannabis can negatively impact memory and can increase anxiety in some. People are

surprised to learn that their attentional difficulties and anxiety may be related to Cannabis use.

8- Fear of interacting with others. This one breaks my heart. I see young children afraid to talk or interact to with others because “What if they have Covid and I get it and I give it to xxx and they go on a ventilator and die alone?”

9- Making sure their parents aren’t anxious: I hear this a lot. Children and teens want to interact with their peers but they recognize their parents are afraid of Covid. So they don’t ask because they don’t want to cause their parents stress.

Children are remarkably perceptive.

10- only seeking out information that confirms beliefs and saying anyone who disagrees is (insert derogatory term here). People are staying in their echo chambers and it is further dividing society, making a joint response to the changing pandemic difficult, if not impossible.

This isn’t everything but gives a good overview. Unfortunately, the anxiety is not going to disappear quickly for some. This is something mental health and medical systems will be working with for years.

#MentalHealthMatters