Staying home. Worrying about risks. Washing your hands — all the time. All are sensible steps in the midst of a global pandemic. They could also be seen as symptoms, if a person struggles with obsessive-compulsive disorder, agoraphobia, panic disorder or social phobia.
Are measures meant to curb coronavirus making those issues worse? Are people who’ve worked to overcome them taking backwards steps as social distancing becomes an important key to halting spread of the disease?
“Is there such a thing as COVID anxiety?” I asked Jennifer Yeh, a clinician with Seattle Anxiety Specialists, which provides therapy and counseling for people seeking help with stress or anxiety disorders.
“It’s a great question,” said Yeh, a master’s level clinician with the Seattle group. “The way we approach treatment, are the fears — the worries — based on reality?”
With COVID-19, fear is based on a real threat, rather than on something highly unlikely to happen.
The other day, it wasn’t hard to find people taking precautions to keep from getting sick, even as they went about their daily lives. They’re concerned, but not to the point of being housebound.
In a parking spot at Everett’s Harborview Park, Christina Chong had her own inventive way of relaxing in a safe space. With the rear hatch door of her Mazda SUV open, she sat comfortably with her back against a leopard-print pillow, reading from her Kindle and enjoying the Port Gardner view.
“I am very cautious,” Chong said. She works in project managing from home in Mukilteo, but spends much of her free time at the park. She reads, sips her coffee and breathes the fresh air. “This park is perfect,” said Chong, 60, whose safety supplies include a fashionable hat with a plastic face shield.
At Forest Park in Everett, Whidbey Island’s Mollie Leengran and Barbara Lindahl were out Thursday enjoying their fast-food lunch at a picnic table. Lindahl, 80, had just undergone cataract surgery. It had been delayed several times due to the virus.
Leengran, 83, has eaten outside at a restaurant recently but said “it’s going to be a long time” before she’s comfortable with an indoor dining experience.
Lindahl said the influx of “all the summer people” on the island has made them more careful about being out in public. “I live on a beach,” she said. With larger crowds arriving, “we just kind of stayed in.”
Snohomish County is in Phase 2 of Gov. Jay Inslee’s four-stage reopening plan, so restaurant dining and mall shopping are allowed.
“Personally, I’m going to stay away from people,” said Everett’s Larry Mather, 61, who was at Harborview Park with two grandsons Thursday. Rather than staying home, he’s still working as a sprinkler fitter, installing fire protection equipment. “It’s very hard to work with a mask,” he added.
Blake Thompson, executive director of Seattle Anxiety Specialists and a licensed mental health counselor, believes stay-home and social distancing measures have raised anxiety levels, especially for people affected by agoraphobia.
According to the Mayo Clinic website, agoraphobia is an anxiety disorder in which someone fears places or situations which might cause panic or a feeling of being trapped. Taking public transportation, being in wide open or enclosed spaces, or being in a crowd may cause such overwhelming fear that a sufferer feels unable to leave home.
“For many clients, managing agoraphobia means engaging in the ongoing work of challenging themselves to be out in public,” Thompson said. “Without exposure, it’s not uncommon for them to have a relapse.”
He offered tips for anyone anxious about going out, or even returning to a workplace.
“Make decisions about what types of risk you’re willing to take before you leave home. It can be inordinately stressful to have to make decisions about risk on the fly,” he said. Thompson suggests being clear with yourself about what you are and aren’t comfortable with ahead of time — and communicating those boundaries to friends and family.
If your job is at stake, he acknowledged that making those decisions might not be possible.
Addressing the idea that many fears are unfounded but COVID-19 is real, Thompson sees a different approach to treatment. “We’re having to think about this less in terms of ‘curing an irrational fear’ and more in terms of ‘stress management,’” he said by email.
“We don’t want people to be fearless, that wouldn’t be helpful in this situation,” he said. Stress, too, can be dangerous. Thompson listed cancer, cardiovascular disease, insomnia, substance abuse, even suicide as being linked to stress. “Luckily, you don’t have to believe that you’re 100% safe in order to manage your stress,” he said. Tools for that can be learned.
Thompson sees a worrisome flip side to virus-related fears that may trap people at home. There are those, he said, who “act like there’s nothing to worry about.”
“They overcompensate for their fears by pretending there’s nothing to be afraid of,” he said. “These are emotionally immature responses to a global pandemic.” That’s perhaps typical and developmentally appropriate for an adolescent, but also dangerous.
Yeh hasn’t yet seen a big increase in anxiety among clients, but expects it may be coming. “My suspicion is, yes. What’s happening is kind of traumatic,” she said. “It’s so new, a lot of my caseload is still at home.”
For any of us, she suggests asking if fears are valid and then seeking the best solutions. “Are you at high risk? Can you do your job from home?” she said.
When it comes to worry and the virus, counselors are not immune. Yeh recently took her 6-year-old daughter out for ice cream. “She was fine,” Yeh said. As a mom, though, she watched her child’s every move.
“Kids are much more resilient,” Yeh said.
Julie Muhlstein: 425-339-3460; firstname.lastname@example.org.
Snohomish County’s Human Services Department has created the Community COVID Outreach Counselors Program to provide emotional support services to county residents whose mental health has been affected by the virus. A partnership with Volunteers of America Western Washington, the program is supported by federal CARES Act money. Counselors will get direct referrals and referrals from 211, families, friends, co-workers, teachers and others concerned about how people are coping with changes related to the virus. To access the service, call 211.