Post-lockdown anxiety: why returning to normal may feel impossible

By Nina Bryant, Medical Copywriter at Numan | Medically reviewed by Dr Luke Pratsides

It’s no secret that the COVID-19 pandemic may have seen a rise in symptoms of anxiety amongst the UK population. Basic human needs such as social contact, personal freedom, and a degree of certainty in knowing what the future may bring have suddenly been taken away, and we have simply been forced to adjust to adversity.

It’s no wonder that so many people seem to eagerly await the return to normal, and are already making plans for when lockdown lifts.

But is it more complex than that? Although many excitedly anticipate our newfound collective freedom, some of the damage done by the COVID-19 pandemic may not be so quick to reverse itself, despite the upcoming unveiling of normality.

Over the past year, the world has suddenly validated and encouraged behaviours that in some situations could once have been seen as pathological: excessive hand washing and fears about contamination are no longer symptoms confined solely to conditions like OCD, but something we must all adhere to. Staying indoors because you’re afraid of other people is no longer confined to agoraphobia but something to be commended. How can this mentality suddenly reverse? And is a return to ‘normal’ even more worrying for those who find normal a distressing place to be, where their anxieties are not so widely accepted?

Although we don’t yet know how the COVID-19 pandemic has affected us, studies using brain imaging techniques to look at social isolation can illuminate what a profound effect 3 nationwide lockdowns may have had on our brains.

One recent study suggested that differences in brain regions associated with perceptual, attentional, and emotional processing of social information were associated with the experience of loneliness. Interestingly, these scientists also observed these relationships between loneliness and brain function to be stronger in men than in women.

It should be noted that this study investigated perceived social isolation rather than actual social isolation, meaning we don’t really know what the long term effects of the COVID-19 pandemic will be.

In terms of actual social isolation, studies looking at the psychological effects of the SARS outbreaks in the early 2000s can provide valuable insight into the potential long term psychological effects of being quarantined.

One study investigating hospital employees in China found that those who were quarantined were 2 to 3 times more likely to have post-traumatic stress symptoms. With many of us having had to self-isolate at some point, it’s no wonder that some of us can’t see a return to normal where everything goes back to how it was. Not to mention, it feels like society is telling us we have to feel better once lockdown is over, which can be invalidating to people who may have experienced long term psychological damage.

Another study investigating SARS-related quarantining in Canada found that 26% of participants avoided crowded, enclosed public spaces, even after their quarantine had ended, and 20% avoided public spaces altogether. This is quite a high proportion if you look at the number of people in the UK who have had to self-isolate or shield at some point during the pandemic, so just know that it’s perfectly normal if you find these avoidance behaviours hard to shake.

But there is some good news: one study looking at 2-week isolation during the MERS epidemic compared anxiety levels during isolation and 4 to 6 months later, and found them to be reduced by just over half. This is by no means predictive of what might happen after the COVID-19 lockdown, but it does offer some hope that anxiety induced by social isolation may reduce with time, albeit not immediately. This reduction in anxiety was less prominent in those with pre-existing mental health conditions, so try to be extra kind and patient with yourself if you struggled with mental ill-health before the pandemic started.

With that said, when is it important to get help when you’re feeling anxious?

Occasionally, stress hormones can be beneficial for protection. Stressful situations cause our sympathetic nervous system to release adrenaline and noradrenaline, which in turn causes a number of temporary physical changes to help us fight or run away faster (commonly known as your ‘fight or flight’ response). This is what’s known as an evolutionary hangover: something which was once beneficial to survival but is no longer helpful in a modern-day world.

Many of us may experience this fight or flight response at times when our survival is not at stake, but some people may be burdened by it frequently, which could be a sign of a clinical disorder such as generalised anxiety disorder, OCD, panic disorder or PTSD. If you feel like your symptoms of anxiety have either gotten worse or developed into something that impacts your functioning, it’s important to seek help from your GP.

It’s crucial to note that something can affect your functioning without being visible to other people: you may still be performing well at work, going to the supermarket, having video calls with friends. In some cases, anxiety may feel like the engine that’s propelling all these things, but that doesn’t mean you shouldn’t seek professional help.

You may feel like your anxiety is about certain aspects of post-lockdown life: a general lack of clarity over what might happen, fears around safety, suddenly being thrown into the deep end with rusty social skills. You may feel as though the problem is located in the uncertain environment we find ourselves in, rather than the way you see and experience the world. Symptoms of anxiety often arise in the face of uncertainty; if you’re feeling anxious about the return to normal, that makes sense, because we’re still living in uncertain times despite the rumble of change on the horizon.

As long as those feelings don’t hinder your day-to-day functioning (remember this does not have to be visible), then it can be a case of accepting the way that you feel as completely valid. Try doing things to combat the physiological sensations of anxiety, rather than trying to change what’s worrying you in your external environment.

One thing you can do to cope with these feelings is to try to keep socialising, even if you’re tired of being on Zoom. Humans are sociable beings, and although the amount will vary drastically from person to person, we need social interaction to keep going.

Talking to your friends about how you feel can be helpful for some, but for others just talking generally can help refocus their attention from internal anguish or rumination. If you do decide to speak to someone about how you’re feeling, make sure that you choose someone who will respond in a way that makes you feel better, not worse. Likewise, if you offer a listening ear, do so because you mean it, and try to listen without judgement.

If you don’t feel like you can socialise, that’s okay too. Research has shown that humour can sometimes be effective in reducing anxiety, so try listening to funny podcasts or watching your favourite comedies.

Exercise can also be a great tool for people coping with feelings of anxiety – and even for those with fully-fledged anxiety disorders. For some people exercise can be a healthy way of releasing endorphins,  which can act as a pain reliever, and can help to combat those physiological sensations of anxiety.

If you do feel like the pandemic has exacerbated or changed the way that you think and feel, it can be hard to see how this will go away just because lockdown ends. One thing that we can all do as a collective is to reduce our expectations, of ourselves and of others. We don’t yet know what the psychological aftermath of the pandemic will be, so the best we can do is be aware that our brains have the potential to be highly responsive to stress, and to know what to do if this gets out of control.

Remember you can access mental health support anytime, you can contact your NHS GP or if you feel you need help in an emergency or crisis situation you can telephone NHS 111 or attend your nearest accident and emergency department 24 hours a day.