COVID, anxiety and the return to ‘normal’

Adjustment takes time, but you can do it

Adjustment takes time, but you can do it

Local Expert

THE EXPERT: Karyn L. O’Brien-Flannagan, Psy.D., clinical psychologist and senior director of diversity and inclusion at Novant Health UVA Health System Behavioral Health. For more information about behavioral health services at Novant Health UVA Health System, visit

If you’ve searched online for some version of, “What do I do if I’m freaking out?” you’ve got lots of company. Google searches on “panic attack” and “anxiety attack” hit a record last spring.

The last year has been hard for many. Between concerns of contracting the virus to feelings of isolation, many have experienced symptoms of anxiety.

Similarly, many people still feel anxious even as the COVID-19 vaccines roll out. Although it may seem as though we’re returning to a “pre-pandemic normal,” there are still several unknowns, and many feel apprehensive about going out in public again.

Karyn O’Brien-Flannagan, Psy.D., clinical psychologist at Novant Health UVA Health System Behavioral Health and senior director of diversity and inclusion, discusses managing anxiety and how to overcome the qualms or “scaries” of the new normal.

Have more people come to you for help with anxiety during the pandemic?

When the pandemic started, I already had patients who suffered from debilitating anxiety, like agoraphobia or obsessive-compulsive disorder. After COVID happened, they stopped feeling anxious because the worst happened and they were still here, alive and fine. It encouraged them to do more.

I had a second influx of patients who had never struggled with anxiety or their anxiety was very manageable, but all of a sudden it was really debilitating.

You mentioned agoraphobia. What’s the difference between agoraphobia and social anxiety?

Agoraphobia means you don’t want to go out at all. You don’t want to leave your house.

With social anxiety, you’ll go out and do things on your own. You don’t necessarily like to be in a gathering of people that you don’t know. You might use counterproductive coping skills, like having an extra glass of wine.

Is it normal to feel anxious about leaving the house after months at home, even if you’ve gotten the COVID-19 vaccine?

If someone is able to do their routines, like grocery shopping or visiting with friends outdoors, it’s normal anxiety even if they’re extremely uncomfortable. There is a pandemic going on. Being concerned is normal.

What can people do on their own to ease their feelings of anxiety?

During the situation that makes you anxious, it might feel like your skin is crawling, like doom is imminent. Instead of beating yourself up, be accepting of how you feel. Tell yourself, “It’s OK to feel this way.”

For example, if you feel nervous about going back into the office after a year of working from home, you’re going to white knuckle it a few times on your drive in. Chances are after the fifth or sixth time, you’ll be OK.

What’s an example of anxiety that might need treatment?

For a diagnosis like generalized anxiety disorder or agoraphobia, there has to be a functional impairment in your professional or personal life.

If folks can’t go out or if they used to be able to drive and now cannot get in the car when they’re supposed to be somewhere, that’s a functional impairment. They’re unable to do what they need to do in order to function in society.

Describe the process to treat anxiety disorders.

When I have patients with OCD or agoraphobia, we start by acknowledging their feelings and adding coping skills like controlled breathing. I’ll ask them to reward themselves in a small way when they expose themselves to things they fear. The idea is to do it gradually and consistently.

Nobody suddenly wakes up one day and never wants to leave the house. It’s a gradual progression to agoraphobia or social anxiety. Something negative must have happened and so the brain shied away from it. The answer is about teaching your brain, ‘Aha, look! You didn’t die!’

How common are anxiety disorders?

More common than you realize. It’s one of the most common diagnoses I see now.

Sounds like the most important message for anxious people is that there’s hope.

Whenever somebody comes to me with an anxiety disorder so severe they think they’ll never get better, I love being able to say, “Give me six months. I promise things will get better.”

I love seeing them go out and have positive experiences. They realize they have resources that they weren’t even aware of because they weren’t using them.

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