Information & tips for coping with mask anxiety in the midst of the Covid-19 pandemic

Masks. Whatever your past experience look like and whatever your personal views about Covid-19 might be, it’s likely you have some sort of emotional response to the topic of masks. Prior to Spring 2020, the type of masks we’re talking about here were mostly reserved for people with super compromised immune systems (I recall my dad wearing one during traveling when he was undergoing treatment for stage 4 cancer) or for healthcare settings. But for the average American, these masks weren’t a common thing.

For the past year and a half, masks have become a part of our daily life. This past Spring and even much of the summer it felt like masks were going away. Case numbers for Covid-19 were down, mask mandates were lifted and many people felt safer after getting a vaccine. We all hoped masks would soon be a distant memory.

But now? Masks are making a comeback. And not in the “they’re super cool and suddenly fun to wear” kind of way. No, they’re making a “comeback” because our case numbers are rising, the Delta variant is looking a little different than last year’s Covid and now the CDC is saying that in many parts of the country even the vaccinated should return to wearing masks. Many businesses (my own included) are again requiring masks and you may have friends or family that request you wear one when you get together.

For people with mask anxiety, this is a really difficult

Don’t get me wrong. This is emotional and difficult for everyone. But if you feel anxious about wearing a mask for any reason, this “return to masking” is a whole different level of awful.

Kristi, one of our Aspire Counseling therapists expressed it well when she recently told me, “It can be anxiety provoking to start wearing masks again. You finally hung up your masks only to have to get them out again. Hearing about a possible mask mandate in your city or county or even just your place of employment makes you feel anxious. “

And, let’s be honest here in saying that everyone with mask anxiety is experiencing something a little different. Some people want to wear a mask for various reasons (keep a loved one safe, be able to work somewhere requiring a mask, show respect to someone else) and others would prefer never to wear a mask again. Regardless, it can feel beyond tough right now. In preparation for writing this blog, I talked to a number of other mental health professionals. Universally, we all agreed that mask anxiety can be very real and very uncomfortable for people in today’s current climate.

Reasons for Mask Anxiety

Again, everyone may have a different reason for feeling anxious about wearing a mask. In fact, some people may not even be able to pin point a reason for their anxiety. Here are a couple thoughts someone may have underlying their mask anxiety:

• It’s harder to breathe with a mask on.

• I can’t recognize people when they’re wearing masks. How will I know if I’m safe? Or what if I pass someone I know without saying hi and offend them?

• If Covid is so bad we have to wear a mask, should we be out at all?

• If I wear a mask, people will assume I’m ________ and will impact my relationships with other people.

• Having something on my face reminds me of something traumatic in my past.

• What if I have a panic attack? What if I can’t breathe?

• I already feel anxious and can’t breathe. The mask is making that feeling worse!

Your underlying thought or concern may not even be in this list above. And that’s ok. Just know that people have a variety of reasons for feeling anxious around masks.

Tips for Coping With Mask Anxiety

I asked several other mental health clinicians for their best tips for someone with mask anxiety. Below are a combined list of tips from myself (Jessica) and two other clinicians (Kristi & Madison) who treat anxiety here at Aspire Counseling.

• Practice grounding techniques. Help move your focus away from the mask or Covid and instead intentionally move that attention to other things going on in your environment. Consider keeping a grounding stone in your pocket or use the 5-4-3-2-1 grounding technique when you start to feel anxious.

• Give yourself mask breaks. If you are somewhere that requires masks, find a way to get outside, away from the building (sit in your car even if you need to) so you can have a break from the mask.

• Madison highly recommends using paced breathing. Use paced breathing being mindful to draw a full “belly breath” each time. You can use an app on your phone, watch a Youtube video at home, etc. Then, once you get the hang of it this can be a really useful tool to quickly use no matter where you are to help slow your heart rate when you anxiety picks up in public.

• Kristi recommends using gradually exposure or slowly building up your emotional tolerance of wearing masks. She recommends, “Start by putting one on for a few minutes in the comfort of your home. Keep it on even when you feel anxious. Watch TV, play video games or do other relaxing activities. Gradually increase the amount of time you can wear it. As you wear it in a relaxing situation, you will associate it with relaxation rather than fear. Then, wear it outside and increase the amount of time until you can tolerate the anxiety. Then, wear it in public places and gradually increase the time until you can wear it with little anxiety.”

• Remind yourself that anxious thoughts are like clothing in a store: you don’t have to buy every thought that pops into your head. Ask yourself if this anxious thought might be confusing something that is theoretically possible with something that is likely? For example, if you have a thought “I might pass out,” ask yourself to put a percentage on how likely that is to happen. Then, ask yourself if it is realistic. Or if you have the anxious thought, “Wearing a mask will trigger an asthma attack,” ask yourself where that belief comes from (your own anxious feelings? something a friend said?) and consider getting additional information from a reliable, trusted source such as calling your own pulmonologist.

• Acknowledge the underlying reason for your anxiety. If it’s triggering a past trauma memory and you’re trying hard not to think about that past experience, your mere avoidance could be contributing to your current anxiety. Consider talking to someone (professional or non professional) about your experience.

• Use the “buddy system.” If you’re going in public and worried your anxiety will overwhelm you, consider telling a friend or family member you’ll be with that you’re experiencing mask anxiety. Maybe have them read our blog post about helping someone who’s having a panic attack and give them something specific they can do if you appear overwhelmed. For example, ask them to squeeze your hand, make an excuse for the two of you to step outside for a moment, whisper a mantra or anything else you think might be helpful.

More Tips for Mask Anxiety

I asked some colleagues from around the country recently for their thoughts about mask anxiety. Their thoughts were consistent with ours here at Aspire Counseling. Here were some of their comments:

• A colleague who has a large private counseling practice offering online therapy all over the USA shared, ““It’s not easy to put something over your nose and mouth for hours. It’s uncomfortable and feels harder to breathe. This can trigger a fear response which can increase your sympathetic nervous system (those icky feelings like shortness of breath, heart racing or panic) because it feels like danger (ie, I can’t breathe as well). We need to get used to something covering our face and know we are ok and can still breathe.

  Begin to wear the mask for little bits of time at first and practice calming techniques to reduce that fear response. Then increase the amount of time you wear the mask while you continue to reduce the anxiety response.

  This is also important for kids who struggle with wearing masks. Whether it’s sensory discomfort or anxiety, try different types of masks and wear them at home. Increase the time it’s on in order to get more used to them.”

• Another therapist with a counseling practice in New York, Connecticut & New Jersey said, “When you start to feel that familiar sense of panic creeping up while wearing a mask, try using a simple grounding technique like bringing awareness to your five senses. For example, ask yourself, ‘what do I see directly in front of me?’ or ‘what tastes do I have in my mouth right now?’ As you move through the senses of sight, taste, hearing, touch, and smell, you may realize how effectively you can shift away from the anxious feelings you were experiencing just minutes before.”

• A psychologist with a Florida practice offering EMDR for anxiety also normalized that anxiety about masking can be normal, but emphasized that sometimes it may be important to ask for professional support. She explains that if mask or other anxiety is, “causing you significant distress or interrupting your ability to function in any way then it can quickly shift to a more significant problem in your life. If that is the case then early intervention through therapy or even a targeted treatment such as EMDR or exposure therapy can be extremely helpful to help you learn how to manage that anxiety and not let it control your life.

Feeling Anxious About Mask Wearing is Very Understandable & There is Hope

To be honest, as a mental health provider who specializes in trauma & anxiety treatment, it’s disheartening to hear how many people would like to wear masks but experience intense anxiety in they do so. Why is it so disheartening? Because I know how treatable anxiety is. It’s not easy to face your fears, but it is possible for you to find some relief.

If you have a reason you want or need to wear a mask regularly right now, don’t just suffer in misery-get some support. Perhaps your job requires mask wearing. Or maybe you want to take a plane and know there’s a federal mask mandate in airports & on planes. Maybe you’re immunocompromised and worried about how Covid might impact you. Or perhaps you want to visit with a loved one who is more vulnerable to the virus. Whatever your reason, it IS possible to treat your anxiety.

As I said above, few Americans ever regularly wore masks prior to 2020. This means most of your life, you didn’t have this thing over your face. In fact, I’ve frequently mused how suspicious we would’ve been of someone wearing a cloth mask into a public space in the past. So, anxiety around this truly is understandable. And each person who is anxious wearing a mask will have a slightly different train of thoughts and responses.

What does treatment for mask anxiety look like?

Truly, everyone’s treatment will look slightly different. In general though, anxiety treatment usually involves working with a mental health provider like the ones at our practice, have medication provider prescribe medication or a combination.

Our therapists talked about treating mask anxiety at a recent meeting. We talked about using exposure principles, EMDR techniques when mask anxiety is related to your past experiences or CBT techniques to combat anxious thoughts. So, if you come to see one of our clinicians for help conquering your mask anxiety your counseling sessions will focus on one or more of those components based on your specific needs, but all of these are evidence based treatments for anxiety that can really help you find relief.

In some cases, it can be helpful to also talk to a medical provider (your family doctor, a psychiatrist or a psychiatric nurse practitioner) about your anxiety. Medication can be particularly helpful if you’re just needing to lower your anxiety around masks very short term for one very specific thing (example: just for flying on a single trip) or if you’re anxiety is so severe that you’re regularly having panic attacks when you try to wear a mask. In some cases, it may be helpful to both have medication available and participate in counseling. In these cases, you may want to sign a release of information so your counselor and medical provider can speak occasionally and coordinate your care so you get the best possible support all the way around.

Ready to Conquer Your Mask Anxiety?

While we know that mask anxiety is very common, it’s also important to know that it’s treatable. If you are anxious about wearing a mask but want to wear one for whatever reason (work, concern for your own health, so a loved one is comfortable visiting, etc), please know that anxiety responds really well to treatment and it is possible to get more comfortable wearing masks.

If you are motivated to feel less anxious when wearing a mask, our team wants to do absolutely everything we can to support you. Most of the therapists at Aspire Counseling specialize in anxiety treatment and we’re able to work with individuals living anywhere in the state of Missouri. Through the use of Telehealth, we’ve offered virtual counseling appointments to individuals everywhere from Springfield to St. Louis, rural areas of Northern Missouri and the Kansas City area. As long as you’re physically located in Missouri, our therapists are able to offer you counseling focused on helping you face some of this anxiety so that anxious thoughts play a much smaller role in your life.

Short Term, Discounted Mask Anxiety Treatment

The Aspire Counseling team has talked a lot about mask anxiety. In fact, a major focus of our team meeting this month was, “How can our team of counselors support people struggling with mask anxiety or covid anxiety in general right now?” From now through September 10th, we’re offering a very limited number of spots for reduced cost mask anxiety treatment. Three of our therapists have just a couple of openings. This will be limited to four (4) standard 45 minute counseling sessions (ideally two a week for two weeks to really get improvement for you) for only $250. If you did continue counseling beyond those four sessions, our therapists would then need to do our regular assessment process and normal fees would apply. Typically, this would cost $350-$600 depending on the therapist and such. In fact, we’ve never offered a promotion like this before because we believe strongly in the value of counseling. Furthermore, we believe in the power of psychotherapy to change lives while also allowing our therapists to make enough that they can afford to take time off when needed for self care, are able to attend continuing education trainings, etc. However, we understand how limiting mask anxiety can be for some people right now. And, it’s really important to us that if you’re really wanting to face this anxiety we make it as affordable as possible.

So, if you live anywhere in Missouri and want support conquering your mask anxiety, call our intake coordinator at 573-328-2288 to get started!