Managing Post-Pandemic Re-entry Anxiety

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Trauma is an event that overwhelms the mind, body and soul. Traumatic events can result from natural disasters, wars, accidents, sexual assaults and abusive experiences, just to name a few.

COVID-19 is a traumatic event, a seismic global crisis that continues to shake the core of our safety and wellbeing. COVID-19 is categorized as a mass trauma, whereby many people experienced the same traumatic event.

Safety

There are 3 stages individuals move through when in recovery from trauma. The first goal is to establish safety. This stage was attempted during the onset of COVID-19, with experts recommending the use of PPEs, social distancing, education about contagion and hygiene - and mandatory lockdowns around the world.

While many may have been able to establish a sense of safety and security by putting into action effective routines for physical and emotional self-care, others around the world - and even in our own country - did not have access to PPEs, adequate healthcare, food, water and other essentials for weeks at a time. Furthermore, misinformation about COVID-19, how to test for it, treat it and live with its threatening presence was a convoluted mess of politics, science, power and money. Broadcasted death rates and sensational media showed the gory overflow from COVID-19 day after day after day, undermining any sense of security for the general public. This media blitz also re-traumatized children and adults who were already experiencing acute and post traumatic disorders from COVID-19.

In my opinion, safety and security were not fully experienced by all people during the pandemic. In fact, I'd argue that research will show us the lingering physical and psychological fallout of not collectively achieving this vital stage of recovery for decades to come. And to this end, medical and healthcare professionals will need to be aware that many of their patients will struggle with re-entry post pandemic. Fear, distress, mistrust, depression and anxiety in social and public places will likely be noted and reported. Also, worries about reinfection despite being vaccinated, exposure to other illnesses, death, and future disasters may increase absenteeism, social avoidance and self imposed isolation.

Remembrance and Mourning

The second task of recovery is remembrance and mourning. This stage is where we make sense of the trauma and how it has changed our lives. We mourn the old life before the disaster and try to create meaning for the new-normal to come. COVID-19 challenges many individuals to remember and mourn, because there has been so very much loss. Death and long haul illnesses were not the only losses mourned from this pandemic. Other ambiguous losses like employment, school, graduations, weddings, financial security, social connection, human touch and freedom to move about in the world. COVID-19 also has shaken our assumptive world – the set of core beliefs that make us feel safe and hopeful in daily life.

This second stage in trauma recovery is about moving from helplessness to hopefulness. And for many, moving into a post pandemic world will be shadowed by significant insecurity and despair. Health professionals need to be aware that even the most resilient of people may have had their strength tested. And that vulnerable patients may emerge post pandemic with anticipatory anxiety and generalized worries for a while to come.

Reconnection

Anytime you experience a traumatic event, your return to the everyday world after healing is called re-entry. This stage in often called reconnection, where you bond with others again. While some people can shift from a traumatic event with moderate ease, there will be many who experience re-entry anxiety - where the adjustment to the new-normal causes anxiety, insecurity, depression and perhaps even re-traumatization. The general public needs to realize that a certain amount of re-entry anxiety after a traumatic event is expected - and even healthy. Being vigilant about COVID-19 can help others engage in appropriate preventive behaviors and exercise needed caution.

However, if sleep disturbances eating difficulties, intrusive thoughts, worries, preoccupation with safety, recurring fears about death, diminished school or work performance, irritability, apathy, sadness flashbacks of memories or traumatic experiences continue for two weeks or more, this may not just be re-entry issue. A more formal clinical mental health disorder may be operating - and further assessment is recommended.

5 Trauma Informed Tips

Using trauma-informed tips to achieve safety, remembrance and reconnection will reduce re-entry anxiety. Here are a few to use:

1. Make sure you communicate your needs to others as you begin your re-entry to your work, school, home and community post-pandemic (This is the trauma goal for safety).
2. Continue to use CDC recommended preventative measures to keep yourself and others safe (This is another trauma goal for safety).
3. Recognize the need to talk about your lockdown experiences (This is the trauma goal for remembrance). Share your experiences of loss, fear and worry to special friends and family members (This is the trauma goal for mourning).
4. Understand that others will likely spend a great deal of time sharing their own COVID lockdown experiences as well (This is the trauma goal for remembrance and mourning).
5. Finally, be mindful about how you want to return to the shared world as boundaries and restrictions open up. Reflect on what's important to you - and to your family. Find meaning and purpose in the post-pandemic that is life affirming (This is the trauma goal for reconnection).