Post-lockdown anxiety

As some COVID-19 restrictions begin to lift, you may be feeling anxious about what lies ahead. Will things return to normal, or will we have to adapt to a ‘new normal’ – a concept all too familiar for blood cancer patients. You may also continue to feel concerned about the risk of infection. This is entirely natural, but we want to ensure that your worries aren’t detrimentally affecting your mental health or day-to-day life. That’s why, in this article, we want to take a look at anxiety – what is it? How can you cope with it? – and how you can prepare yourself for the changes ahead, both in terms of COVID-19 restrictions and any other things that may be worrying you.

“Anxiety is always in the back of my mind.”

Let’s start with: what is anxiety?

Anxiety is what we feel when we are worried, tense, or afraid – particularly about things that are about to happen, or which we think could happen in the future. Anxiety is normal as it is our brain’s internal security system. When we are in danger, it is this primitive sense that helps us to get into flight, fight or freeze mode. Most people feel anxious at times, but it is particularly common to experience some anxiety while coping with stressful events or changes, especially if they could have a big impact on your life.

What is the ‘fight, flight or freeze’ response?

Like all animals, human beings have evolved ways to help us protect ourselves from danger. When we feel under threat our bodies react by releasing certain hormones, such as adrenaline and cortisol, which can be helpful. These hormones make us feel more alert, so we can act faster, and make our hearts beat faster, quickly sending blood to where it’s needed most.

After we feel the threat has passed, our bodies release other hormones to help our muscles relax. This can sometimes cause us to shake.

This ‘fight, flight or freeze’ response is something that happens automatically in our bodies, and we have no control over it. However, these feelings can sometimes become out of control and a person can feel anxious all the time, which can affect our daily lives.

“I developed anxiety and depression while fighting this disease and struggled with my diagnosis, worried that it would be incurable. Leukaemia Care threw me a lifeline and offered me funded counselling.”

Effects of anxiety on your body can include:

• A churning feeling in your stomach.
• Feeling light-headed or dizzy.
• Pins and needles.
• Feeling restless or unable to sit still.
• Headaches, backache or other aches and pains.
• Faster breathing.
• A fast, thumping or irregular heartbeat.
• Sweating or hot flushes.
• Sleep problems.
• Grinding your teeth, especially at night.
• Nausea (feeling sick).
• Needing the toilet more or less often.
• Changes in your sex drive.

And the effects of anxiety on your mind can include:

• Feeling tense, nervous or unable to relax.
• Having a sense of dread, or fearing the worst.
• Feeling like the world is speeding up or slowing down.
• Feeling like other people can see you’re anxious and are looking at you.
• Feeling like you can’t stop worrying, or that bad things will happen if you stop worrying.
• Wanting lots of reassurance from other people or worrying that people are angry or upset with you.
• Low mood and depression.
• Rumination – thinking a lot about bad experiences, or thinking over a situation again and again.

Even positive change can lead to anxiety, and it can take time to readjust to things we have not done for a while. Easing of lockdown will allow us to get back to the people and things we love, but it is OK if you feel worried about going back to something more “normal” as lockdown restrictions loosen. The coronavirus (COVID-19) outbreak has been hard for everyone, and we have all experienced the effects differently, including those who have been shielding. We all need to find ways to help us to adapt to our ‘new normal’ and this will be slightly different for everyone. But it is important for us to continue to take care of our mental health; be kind to yourself and remember, you may have been isolating, but you are not alone. There are helplines listed at the end of this article where you can find support and advice to help you get through this change. Your feelings are normal and valid, and no one should try to make you feel bad about those feelings; they are real to you and it may take some time to work through them.

“As a sufferer of depression and anxiety, I know how it can feel, being in that dark tunnel you think you can’t get out of. We have to try, no matter how hard life becomes.”

Here are our top tips for taking care of your mental health as things change:

Go at your own pace – there is no need to rush; take it step by step and only do what feels comfortable and safe. As your confidence returns you can adjust your pace accordingly.

Try not to avoid things entirely – avoiding things that make us anxious can feel like the easy option, but this can make it harder for us to face our fears in the long run. By avoiding things we don’t like to do, we are actually telling our subconscious brain that we were right to be anxious and there must be a danger, thus increasing the adrenaline levels further. Instead, set yourself manageable targets. It can also help to confide in someone close to you about your fears so they can support you.

Discuss how you feel with those around you – before meeting up with someone, tell them how you feel so they are aware of your concerns. It might be an idea to ask that person to take a rapid COVID-19 test before you meet up to put your mind at rest.

Plan ahead – make sure you know exactly where you are going and how you are going to get there. Do you know where the parking is? Do you have change to pay for parking? If relying on public transport, check times in advance. And most importantly know something about the place where you are meeting; is it possible to socially distance? Are the tables and chairs regularly sanitised and how many other people will be there? If possible, sit outside as the virus particles are more likely to be blown away.

Challenge negative thoughts – this is a useful exercise to practice in lots of different situations where you feel anxious and nervous. Often, we are not aware of our negative thoughts as they occur automatically and seem reasonable and believable. The worse we feel, the more likely we are to think negatively and believe these thoughts to be true, even though they are unreasonable and unrealistic. Negative thoughts are experienced by all of us at some time but are more prevalent and extreme whenever we feel stressed, anxious, irritable, or depressed. This form of negative thinking can lead to “thought traps” where your negative thoughts get caught in a vicious cycle. Try to identify your negative thoughts – work through them one at a time. Then write a list of the advantages and disadvantages of holding onto that thought. This will help to rationalise that thought.

Positive Self Talk – this is a strategy that we can use to help us to break stress up and involves focusing on positive rather than negative statements.

There are three key stages: preparation, coping and review.

Preparation

As we are about to enter a situation or face something we find daunting, we can help ourselves to prepare with positive statements such as:

“It’s not going to be as bad as I think.”

“It won’t last long and I can cope.”

“If I do get bad feelings, I know they won’t last long and I can cope with them.”

Coping

In order to help us cope and stay in the situation, we can use positive statements such as:

“Concentrate on what is going on, not how I feel.”

“Concentrate on what I have to do.”

“I know I am going to be ok.”

Review

Comments to help you review your achievement and give yourself praise:

“I coped with that.”

“I achieved that; I am getting better.”

“I handled that; it should be easier next time.”

“Learning to trust my body again after it failed me so significantly feels daunting and I often struggle with anxiety.”

Even when things do not go according to plan, you should still take time to review the situation and praise yourself for what you have achieved. Each small step is progress, so try to focus on the positives rather than the negatives.

And finally:

Make time to relax – feeling nervous and anxious can make you feel very tired. Make sure you continue to get plenty of rest and make time to do things that help you to relax like gardening, reading or baking.