As the number of coronavirus cases drop, people’s mental health is not mirroring the positive trend. Anxiety, previously sparked by the fear of contracting the virus, is now ignited by a different fear – the fear of going back to the life we were forced to leave behind 15 months ago when the pandemic struck. Christine Spiteri talks to experts about this psychological adjustment called re-entry anxiety.

Fifteen months ago, Malta registered its first case of COVID-19. Helpline operators listened to our concerns — our fear for our loved ones’ safety, our anxieties about the economy, our feelings of loneliness. 

“Over the past year, we all had to adapt to a new reality,” Richmond Foundation’s Manager of Psychological Support Services, Lynn Sammut says. “The pandemic presented us with circumstances that people have never experienced before. Everyone I know has struggled in some way or another.”

The effects of a turbulent year are well documented. Studies revealed how between April and May last year, more than nine in every 10 people experienced feelings of loneliness. Admissions to Mount Carmel Hospital doubled in a week during that same period. Meanwhile, calls to Richmond’s support services quadrupled last year alone. 

Going back to our previous ways of life would require another process of psychological adjustment, what psychologists call ‘re-entry anxiety.’

“Last year, the fear of the unknown was very pronounced. The fear of not knowing what’s going to happen. People were asking: ‘how is it going to end?’”

Now that over half the population has been vaccinated, the end of the pandemic seems to be on the horizon — yet, a sense of uncertainty lingers. There is still a sense of not knowing how it would feel to go back to ‘normal’. For over a year we’ve followed certain routines: working and socialising from home when possible, wearing a mask, and keeping our distance when around others. Going back to our previous ways of life would require another process of psychological adjustment, what psychologists call ‘re-entry anxiety.’

Dealing with more change

Organisational psychologist and academic Gottfried Catania says it is entirely possible that some might be experiencing anxiety at the thought of meeting people again, especially in large groups. “The pandemic has meant that many of our ways of working has changed, and some might experience stress when getting life back to a previous routine, after a change has been present for a long time.

“The anxiety, in this case, can be due to both emotional reasons, such as fear (which might not be rational) of the increased risk of contracting the disease because of being around others, as well as practical reasons, such as having to adapt to different childcare arrangements, or the increased stress due to the daily commute, and being stuck in traffic.”

The pandemic has affected us all in different ways and many people’s ways of working and socialising have changed. We’re still learning how to live with the virus. While the majority may feel excited at the prospect of reopening, others might prefer to take things slower. Catania explains that it is still too early to determine the prevalence of re-entry anxiety, but given the current scenario, it is expected to be quite common.

Ripple effects of the pandemic

"We’re currently not seeing a lot of cases with re-entry anxiety,” says Sammut. “This could be because not all companies have fully transitioned to physical office spaces. Those who did, still allow for some flexibility and people tend to feel safer now than they did initially. Overall people seem to have adjusted to the initial fear around contagion". What people are experiencing now is primarily burnout. There’s a lot of stress and fatigue.” 

Given the unpredictability of the past year, Sammut acknowledges that this response is completely understandable. We adapted to a loss of routine. We mourned the loss of our loved ones. Those lucky enough to still have a job and work remotely, felt the loss of being around colleagues. Our children suffered the lack of social interaction as schools went online. There were no graduations, no weddings, no funerals. We suffered the pain of isolation, the stress of confinement, and juggled multiple roles. 

We’re still processing what we’ve gone through, while still having to wake up each morning, to do it all over again. People are also finding it hard to cope because coronavirus made many of the activities we loved dangerous or impossible — travel, gym, even going out to dinner or hanging out friends. All these factors continue to weigh us down. 

The sight of crowds may spark anxiety in some. Photo: Chris Sant Fournier

“People won’t tell you: ‘I’m feeling this way because of COVID’. But we know that these issues are all the ripple effects of the pandemic. Calls to our helpline have decreased in the last months, but they have become longer in duration, and more intense. There’s more depression, more thoughts about suicide, concerns around jobs and people’s financial situation, and overall lack of support. Some people have even lost proper contact with their circle of friends…”

Coronavirus cases may be on the decline, but the effects of the pandemic on our social and mental health persist. The rate of vaccine take-up gives a sense of hope that we will be able to feel a semblance of normality soon. But this can only be achieved if we prioritise our mental health alongside our physical health at a national level. “Everyone’s not been feeling great in some way or another, and mental health problems will continue emerging as a consequence of what we’ve experienced in the past year. This is why it’s so important that we normalise what we’re going through, as unfortunately, people tend to wait until they’ve reached a critical point before reaching out. Prevention is better than cure.”

How to cope with re-entry anxiety

- Focus on what you can control
- Make a bucket list of things you’re excited to do again
- Accept whatever you’re feeling
- Reintroduce activities slowly
- Stay informed, but disconnect when you need to
- Accept that life may have changed quite a bit during the pandemic
- Reach out for help when you need to

If you would like to chat with someone you can trust, olli.chat is a free and confidential mental health 24/7 chat service by Richmond Foundation or call on freephone 1770. 

This story was first published in Sunday Circle, a Times of Malta publication. Read the full issue here: http://sundaycircle.tom-mag.com/34/index.html#issue/1