Crowds might be anxiety-inducing after Covid-19. Here’s how to manage it. – Vox.com

It can be fun to fantasize about a Covid-free future. Gathering in large groups, finally vaccinated, partying and traveling and dining with strangers, completely safe.

But the reality might be a little nerve-wracking too.

What will being back in crowded concert halls and on college campuses be like? Will planes and public transportation feel gross forever? Will we never again feel comfortable shouting over people, food, and drinks in a dive bar?

For those who intensely miss crowds, going “back to normal” might be easier than for those who do not. According to Dr. Tamar Chansky, a Philadelphia-based licensed psychologist and anxiety therapist and founder of the Children’s and Adult Center for OCD and Anxiety, being nervous about what post-pandemic life will be like is normal, since we’re still in the midst of it all. But by managing healthy fears now, we can help stave off possible future anxieties and ease the transition. Vox spoke with Chansky about how we can manage our worries and make emotional room for what a world after Covid-19 might look like.

This interview has been lightly edited for length and clarity.

What are some of the effects right now that we’re seeing on people, concerning the pandemic?

There was a statistic recently that the rate of depression has tripled since pre-pandemic times. I think that the combination of people just hitting the wall of isolation, a lack of social contact, and without other experiences to engage in, there’s just more negative feelings onto the self. People are really struggling with hopelessness, just feeling like because things have been so, so hard, real challenges to whatever extent everyone’s affected. Some people have lost loved ones, others have lost their jobs and their homes. Those are really stressors that would be stressors at any time.

In addition to that, everyone is just experiencing the change in not being able to be close to people, to see people. So that’s the depression continuum there, of feeling bad about oneself and feeling hopeless. And in an anxiety direction, because of the isolation, [any] preexisting anxiety symptoms are greatly exacerbated. Also, people who’ve never had anxiety before are dealing with this — not a single event kind of stressor, but a protracted, “no end in sight” uncertainty that leads to a lot of anxiety.

Worry runs the gamut of thinking about things in all realms of life. Where we can help ourselves is really sticking with the facts as much as possible, rather than going with the feelings we have as if they are facts.

Personally, being around crowds makes me nervous. And seeing people on TV without masks and huge crowds on screen feels so odd. Do you think that will be a lasting feeling for people? If so, how can we manage that as we transition back, hopefully sometime soon?

Precautions are recommended by the government and the CDC. And so seeing people who aren’t doing the things that are recommended, on some level should trigger a feeling of being unsafe. I think that’s a reasonable and healthy response.

There’s a difference, though, between fear and anxiety. Fear is a very adaptive response to a threat. At this point, [so much of] transmission is asymptomatic, and the vaccine is happening but it’s slow. And testing is happening and it’s slow. If you see somebody who isn’t masked, it would make sense to be concerned and do things to make yourself safe. Anxiety would be exaggerating the risk in a situation. That’s not what’s going on now.

And how might this pandemic psychologically affect future generations? For example, I know that Depression-era children and their families were taught a lot about saving money for a rainy day, and that they adopted certain types of habits based on that of their parents and what they experienced in their childhood. Do you think this pandemic will affect us generationally?

My immediate thought is the ongoing effects of poverty. The practical and psychological effects of poverty absolutely go from generation to generation. There are people who’ve lost their livelihoods. It’s likely that the emotional and practical effects of that will be felt for generations.

If we’re talking about people who are fortunate enough to have not lost their jobs but are just struggling through this time, then I think of the stress of people who are parenting at this time — parents [who do not have] access to mental health services, who have to multitask between working and parenting full time. Those kinds of risk factors are significant for that generation and beyond.

I think that we really are adaptable as a species. We probably can’t envision what exactly [safety] will look like. Everything kind of changes to ensure safety, just solutions that we can’t imagine. We will adapt to whatever circumstances we’re faced with.

While we might hesitate and need to give ourselves room to feel uncomfortable and try things, provided that we understand that they are safe, we will be able to adapt to those situations as they improve. It may be that some people need to do that practice more intentionally. I think that we would pretty quickly adapt to those new circumstances because we want them so badly.

I’m more concerned, really, about what is the narrative now. People are feeling pushed to go back to doing things. But it’s really premature because we’re not in the clear. That’s my greater concern at this point.

It’s hard to imagine how things will look after this is over when we’re still in the midst of it. But do you think that the way we react to crowds or our anxieties about crowds will increase because of this pandemic? The way we react to large groups of people and pre-pandemic life, do you think that’s something we’ll end up being nostalgic for? Do you think that’s something that will feel separate? On a larger psychological level, will we ever feel comfortable in the exact same way we were before?

It’s interesting that you used the word nostalgic, because I was thinking last night, this is really about an imprint of fear about our survival. And it’s going to take some time to relinquish that. We would only do that when we’re told that it’s safe to do that. So it’s a healthy caution.

That all-clear signal will not be a trumpet. This is a gradual process. But then, as it is safe to reapproach a movie theater, each person really needs to work with themselves and be compassionate with themselves about what their process is going to look like. Someone who lost a loved one from Covid will probably have a different process than someone who seemed to be less affected by this historic, unprecedented event.

So, thinking ahead about the mental health pressures that we can really be proactive about, [my advice is] don’t feel pressured to do something until you’re ready to do it. This is a pretty important piece of advice across the board for people in life. It makes sense here that everyone’s going to have their process of reacclimating to things like movie theaters or concerts. And some people may decide that they never want to do that. I think the final word here is really having a good quality of life, where anxiety is not making the decisions for you. If someone says, “I don’t want to do that anymore,” and they’re not conflicted about it, they’re going to have some peace of mind. Everybody has to decide that for themselves.

How can people prepare to get back out in the real world?

I was looking at how people prepared to be in the audience of SNL, because they started live audiences again in pods. You have to really want to be in a crowd, I think, to safely be in a crowd now. There was a lot of work that went into that — quarantining, testing. It was worth it for those people because they wanted what was on the other side. Other people may feel differently about that. It may be that, for somebody else, just being able to go in a restaurant or go in a grocery store is what’s on the other side of this for them. That’s what they’ve missed.

With little kids, parents are going to decide what’s safe or not. Anxiety is really common in kids, so they may need some direct coaching from their parents to say, “Yep, you’re right. Before, it wasn’t safe to go to the birthday party. Remember, we’ve talked about how things are different now, and it is safe.” And so you may have to help some reluctant kids make their way into a birthday party, kind of like inching into a pool bit by bit. But the parents will decide if that’s a safe thing to do. And if they do deem that it is safe, then it would be important for them to help their kids to do that.

I do imagine that some people will say after the pandemic, years down the line, “Oh, well, we’re never doing live concerts again. That was way too unsanitary,” or not letting their kids attend those kinds of things. And maybe their children will adopt those sentiments about crowds, or some of the things we used to do.

Right. On some level, what this distills down to is good decision-making, and that is a life skill. So as much as it’s an unprecedented context, what it comes down to is each of us needing to make decisions that we feel comfortable with, that don’t endanger ourselves or anyone else, and that aren’t led by distorted perceptions of risk. Life’s hard enough. We want to try to live within the realm of what is realistic and what is actually a risk, versus what we might imagine would be.