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As the COVID-19 pandemic evolved, so have our anxieties. 

Editor's Note: This story was originally published on May 24, 2020.

Anxiety ran rampant at the beginning of the COVID-19 pandemic.

We were reminded repeatedly how unprecedented the moment was. The unknown was a massive weight on the collective American psyche.

Eight weeks later, there are still a lot of unknowns. That anxiety is still hanging around, but is now compounded by grief, hopelessness and oftentimes anger.

As we progress toward a reopening, a new set of mental health challenges may emerge. Here, Lancaster County counselors and therapists share insight via email on how we can manage during this next chapter.

How anxiety has changed

When schools, workplaces and non-essential businesses shut down in mid-March, many of us began asking questions that simply had no answers: Will I contract COVID-19? Will I lose someone I love to the virus? Will I lose my job? When will life return to normal?

Many of those questions are still unanswered. The associated anxiety is now combined with additional feelings, says Gerald Ressler, licensed clinical social worker at Samaritan Counseling Center.

“The same anxieties are likely continuing, but these are now accentuated by some new feelings of weariness, anger or depression, and maybe even a loss of hope,” Ressler says. “We are weary because the changes to our lives have gone on longer than what most of us expected at the beginning of the stay-at-home order.”

That uncertainty is at the heart of what many individuals are experiencing, says Karen Carnabucci, an alternative psychotherapist who practices in Lancaster city. (Carnabucci was a features editor for the former Intelligencer Journal, now LNP | LancasterOnline.)

“It’s easier to manage a difficult experience when we know there’s an end to the experience,” Carnabucci says. “With this pandemic, the stay-at-home order may be modified and eventually lifted, but the coronavirus hasn’t gone anywhere. We are still asked to face this highly infectious virus with lots of uncertainties.”

Be proactive and reasonable

Deborah Miller, a licensed counselor and Ressler’s colleague at Samaritan Counseling Center, says she’s spending a lot of time reminding clients to focus on what they can control.

“Much of my time is spent reminding clients to focus on those areas they can control — which coping mechanism to choose, how to care for themselves, when to disengage from a news feed or social media — and, as a result, how to react in a way that can benefit their mental health,” Miller says.

Ressler suggests a twofold approach — being active in what individuals can do, and “reminding oneself about what is true.”

“Together our emotions and our reason can assist us to know if our feelings are truly appropriate to the situation and how best to respond,” Ressler says.

And it goes a long way to be kind with yourself, too.

“It takes a huge amount of energy to live with uncertainty,” Carnabucci says. “The suggested safety measures take additional energy to carry out. We need to take it easy with ourselves, especially if we tend toward perfectionism.”

On anger

Judith A. Kennedy, another licensed professional counselor at Samaritan, says people may be feeling angry for a variety of reasons. Many are angry about missing out on something over the past few weeks, whether it be a wedding, graduation or concert. Maybe they’re angry they cannot return to work and provide for their family, or they’re angry individuals aren’t following safety guidelines.

“Both sources of anger are a kind of ‘mama bear’ or ‘papa bear’ anger that comes from a desire to protect,” Kennedy says. “This kind of anger carries a lot of energy. It is felt in the body like a revved up engine. One has choices about what to do with this anger. Does one just let the revved up engine drive the car with the driver following the lead of the engine? Or does the driver take control of the energy of the car?”

Carnabucci encourages individuals to take this time for self-reflection and consider why they are feeling so angry.

“When we look, we often find deep disappointment, grief, loss and loneliness,” Carnabucci says. “We also may discover and name personal needs that have not been met that are crying out for resolution.”

Anxiety about reopening

As we move toward a reopening, some people may be feeling excited to reunite with loved ones or return to familiar habits. Others might feel an increase of anxiety, if they feel an opening is happening too soon.

“The main thing I would urge is tolerance for differing views. ... It is mentally healthy to honor those differences as long as the behaviors are not directly detrimental to someone else,” Ressler says.

And Ressler says it’s OK if your timeline moves at a slower pace than others’ for readjusting to the next phase of the pandemic.

“If one is anxious about reopening and has the ability to maintain their current protective practices, there is nothing wrong with honoring this feeling and being slower than others to become involved in reopening,” Ressler says.

Frontline workers need special care

It’s important to remember that some individuals have been on the frontlines for the duration of the pandemic. In those communities, self-care and rest are now more important than ever.

“There is much to honor in the selfless acts of those on the frontlines, but they also need to take care of themselves,” Ressler says. “It is the same as the frequently repeated guidance that is given before the airplane takes off: ‘In case of loss of pressure, put the mask (for accessing air) on yourself first before assisting someone who needs your help.’ If we are not taking care of ourselves, we cannot be of assistance to others.”

Carnabucci recommends mutual support groups. She notes that Jennie Kristel, an expressive arts therapist based in Massachusetts, hosts an online program specifically for doctors and mental health practitioners. (bit.ly/KristelGroup.)

Grief is not a fast process

People who have lost a loved one during the COVID-19 pandemic require special care.

“Grief is always painful, and what is extra difficult now is that the pandemic and social distancing has robbed grieving people of the comfort of others because funeral services are delayed or shortened,” Carnabucci says.

Ressler says this type of grief will persist for a long time, so giving oneself the time and opportunity necessary to grieve is necessary.

“As things begin to reopen, I would expect people who have had such losses to experience some anger at wondering why they and their loved one were the ones to have experienced this loss when they see so many people who they presume have not been affected in this way,” Ressler says.

“This anger is a normal part of grief, but when the loss occurs in the midst of what feels like a once-in-a-lifetime experience (the pandemic), the anger is apt to be a more predominant aspect of the grief experience,” he continues. “Seeking for and being open to emotional support from others is important in dealing with any loss, and is particularly important in this time.”

How we might be changed

Will we still shake hands? Will people still blow out candles on their birthday cake, or refrain for fear of spreading a virus? The ways in which we'll be changed by the COVID-19 pandemic largely remain to be seen.

“We are not going back to normal,” Carnabucci says. “There is no more normal. There is only new territory, and we will be learning how to navigate this territory.”

There are the difficult and aforementioned ways in which we might be changed: grief, trauma and existential despair. And while the pandemic is most certainly not something to be taken lightly, it’s possible this difficult time in history will give people more perspective about what matters in life.

Delphine Martin, a licensed professional counselor at Samaritan, envisions some of these positive effects might be an increased desire to invest in relationships, gratitude for simple things, a deeper connection with nature, improved work-life balance and maybe even a greater awareness of mental health, and less stigma for seeking help.

“We may all feel more vulnerable initially,” Martin says, “but over time we will adapt to this new reality as we learn how to balance our own version of safety with the pursuit of a full life.”