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Here's how to cope with anxiety as COVID-19 restrictions are lifted across Canada

As pandemic restrictions lift in many parts of the country, some of society's most vulnerable may be left feeling anxious about how to cope without that extra layer of security. Some psychologists advise doing a risk assessment before venturing into the world.

It's important to know when to seek mental health advice from a professional

A woman wearing a mask to limit the spread of COVID-19 walks in downtown Victoria last spring. As provinces and territories lift pandemic restrictions, millions of Canadians whose medical condition or age has increased their risk of developing complications from an infection are being forced to assess their risk tolerance. (Chad Hipolito/The Canadian Press)

Learning to live with COVID-19 is a message that's been repeated by provincial and territorial leaders across the country.

But learning to live with the virus isn't that simple for millions of Canadians whose medical condition or age has increased their risk of developing complications from a COVID-19 infection.

As provinces and territories lift pandemic restrictions such as mask mandates and vaccine passport programs, society's most vulnerable are being forced to assess their risk tolerance.

"For some people  — immunocompromised or the frail elderly, for example — it might be quite dangerous for them to get COVID. We shouldn't be cavalier," Dr. Steven Taylor, a clinical psychologist and professor in the department of psychiatry at the University of British Columbia in Vancouver, told Dr. Brian Goldman, host of CBC podcast The Dose.

"We should consider what it means for a particular person to get infected."

Those who are more vulnerable may be wondering: How can I navigate a world without pandemic restrictions?

Psychologists say there won't be a one-size-fits-all approach, but here's what they recommend.

Judge your risk tolerance

As restrictions begin to lift, psychologists say it can take time to adjust — and the speed with which people adjust can vary based on a variety of factors, such as health risks and vaccination.

Ideally, Taylor said, pandemic measures such as masking and physical distancing would be eased out to allow for that adjustment period.

"If you just suddenly lifted all the restrictions, that transition would be quite stressful for some people, particularly the people who are worried about getting infected," he said.

Dr. Steven Taylor, a professor and clinical psychologist at the University of British Columbia, says ideally, pandemic measures such as masking and physical distancing would be eased out to allow for an adjustment period and lessen stress for those who are vulnerable. (Submitted by Steven Taylor)

The easing of pandemic restrictions has varied across the country. Saskatchewan dropped its COVID-19 health restrictions on Monday, including the requirement to wear a mask. Alberta is lifting almost all of its remaining COVID-19 restrictions on Tuesday.

Nova Scotia will lift all of its restrictions by March 21.

Other provinces, including Ontario and B.C., have taken a more gradual approach to dismantle COVID-19 measures. B.C. officials have decided to keep the province's vaccine card system in place until the end of June.

One epidemiologist in Saskatchewan said we're at a crossroads.

"I think a majority of Canadians ... are still very cautious," said Nazeem Muhajarine, an epidemiologist and professor of community health and epidemiology at the University of Saskatchewan's College of Medicine in Saskatoon.

"On the one hand, they like to believe what the government's saying to them that maybe we need to learn to live with COVID, but on the other hand, deep down, not feeling entirely safe that now is the time to do it."

'We have learned a great deal about what measures are needed, how to stay safe, and we cannot throw them out the window,' says Nazeem Muhajarine, an epidemiologist at the University of Saskatchewan's College of Medicine. (Submitted by University of Saskatchewan)

With measures being lifted at different speeds from province to province, psychologists said deciding whether to venture out when fewer restrictions are in place becomes an exercise in risk tolerance.

"Some people have higher tolerance for uncertainty and higher tolerance for risk. That's a good thing to try and figure out about yourself," said Dr. Melanie Badali, a clinical psychologist at North Shore Stress and Anxiety Clinic in North Vancouver.

A key component of judging your risk tolerance is not to let yourself be ruled by your emotions and to do a reality check, she said.

To do that, she suggests that people first become familiar with their current provincial or territorial health guidelines.

From there, they should decide whether they're comfortable in a situation based on any "individualized personal recommendations from a family physician or care provider," said Badali, who is also a volunteer scientific adviser with Anxiety Canada.

She said following the science of what we know about the virus is also key.

Taylor said it's important people also pay attention to their comfort levels.

"Let's say mask-wearing mandates have been lifted, but you don't feel safe for whatever reason. I think it's OK that you wear a mask if you want to until you start to feel safer," he said. "Ultimately, it's a question of your own risk tolerance."

What about parents?

As some provinces begin lifting mask mandates in schools and other pandemic measures, some parents may be wondering how they can judge that risk tolerance for their children.

Taylor said just like for adults, it's a case-by-case basis. But parents should have a conversation with their child — if old enough — to determine any issues they may have.

"Perhaps if your child is very, very anxious, some simple encouragement can help if they're insisting on wearing their mask for the first little while for going back to school," Taylor said.

"If that creates no problems, then why not let them do that?"

Improve your tolerance for uncertainty

The University of Saskatchewan's Muhajarine said there are ways to stay protected from COVID-19:

  • Get a complete vaccine series and a booster shot if eligible, which is still the best way to stay safe from COVID-19.
  • Wear a high-quality, well-fitting mask. 
  • Aim for good ventilation when indoors, where possible. 

"We have learned a great deal about what measures are needed, how to stay safe, and we cannot throw them out the window," Muhajarine added.

Getting vaccinated, including a booster shot, and wearing a mask are still the best protections against COVID-19, one epidemiologist says. (Jason Franson/The Canadian Press)

Badali said when people are ready to start making changes, they can take small steps to improve their tolerance for uncertainty.

"The biggest thing that I've been helping people with is trying to figure out what are bite-sized behavioural changes they can make that are going to be in line with their values, are going to be healthy for them and get them a little outside their comfort zone, but not put them into a risk zone that doesn't make sense for their health status," she said.

As an example, Badali said if someone hasn't been outside of their home to see friends, they could take a walk outside.

"We figure out what is it that you would like to be doing and that is reasonable for you to be doing, and let's figure out some steps that you can do to get you moving towards that goal," she said.

Know when to seek out advice 

Badali said the emotional response to the lifting of restrictions can differ from person to person.

Some may be afraid of what's to come or are feeling anxious. But she said it's important to realize that there is a difference between fear and anxiety.

Dr. Melanie Badali, a clinical psychologist with North Shore Stress and Anxiety Clinic in North Vancouver, says a key component of judging your risk tolerance is not to let yourself be ruled by your emotions and to do a reality check. (http://www.nssac.ca/)

"Anxiety is our response to potential threat, and fear is our response to imminent, right-now-happening threat," she said. "And with COVID, there's a real dance there to try and figure out what's true danger and what's reasonable risk that we have to take to live our lives."

The difference between the two has been blurry for many, as news of the virus has evolved since the pandemic was declared just under two years ago.

Badali and Taylor said as we venture into this new stage of the pandemic, it's important that people recognize when their anxiety over the lifting of restrictions is a larger issue that needs to be addressed.

"If the anxiety is getting in the way of your life and it seems to be excessive, if friends or family said, 'Hey, you don't seem to be your usual self,' ... then that's the suggestion that you might benefit from seeing a mental health professional," Taylor said.

Badali emphasized that while there are other resources to help those who may be feeling anxious, people need to remember to be kind and supportive during this transition period.

"If we can work towards that compassionate environment, I think that would help people."

Written and produced by Stephanie Dubois