White Coat Black Art·The Dose

The psychology of post-pandemic life — why you might feel anxious about re-entry

Feeling anxious about re-entering society when pandemic restrictions are lifted? Or are you looking forward to some "hypersociability?" Psychology Prof. Steven Taylor walks us through the psychology of post-pandemic life.

Some people will experience ‘post-traumatic growth’

An audience watches a movie in a darkened theatre.
It's normal to feel some trepidation about returning to increased social interaction once pandemic restrictions are lifted, such as going to see a movie in a theatre, says Steven Taylor, a professor and clinical psychologist in the department of psychiatry at UBC. This 2018 photo was taken at a special screening of Black Panther in Toronto. (Evan Mitsui/CBC)

Most people will be "exuberant" about entering post-pandemic life, according to Steven Taylor, the author The Psychology of Pandemics: Preparing for the Next Global Outbreak of Infectious Disease.

For many the pandemic has been a time of stress and isolation, and for some, worse — trauma and distress, particularly if they had COVID-19 or lost someone to it.

Taylor estimates approximately 20 per cent of Canadians will need some form of clinical help for mental health issues post-pandemic. He characterized that as a 'massive' increase. (Submitted by Steven Taylor)

When some semblance of normal life returns, most people will bounce back pretty quickly, said Taylor. But there's a significant minority who will feel the psychological impact of the pandemic long after restrictions are lifted. 

As Canada's third wave of COVID-19 slowly recedes and vaccination rates increase, there is a growing confidence that, over the next few months, pandemic restrictions will start to be lifted. In Quebec this week, for example, a timeline was unveiled for the gradual opening up of society.

"We're adaptable, human beings … we're like cockroaches," Taylor, a professor and clinical psychologist in the psychiatry department at UBC, told Dr. Brian Goldman, host of The Dose and White Coat, Black Art.

"We've survived countless pandemics. There have been about 20 pandemics in the past 200 years and we've survived them all. So most people will bounce back."

Most of us will adapt quickly to life post-pandemic and the lifting of COVID-19 restrictions, says Taylor, 'just like people rapidly adapted to wearing masks.' (Bobby Hristova/CBC)

Some anxiety is normal

Initially, Taylor expects to see a range of reactions, from exuberance and "hypersociability" to anxiety as people cautiously — or not-so-cautiously — resume regular life.

Taylor said it's normal to feel some trepidation about returning to our normal routines and increased social interaction. After all, we've been told that proximity to others comes with risk for more than a year.

He expects many people will go through an adjustment period when they feel anxious about things like sitting in a restaurant or going to a big sporting event.

His advice? Go at your own pace.

For some, returning to crowded spaces such as Raptors games post-pandemic may cause anxiety. In this June 2, 2019, file photo, the court is illuminated at Toronto's Scotiabank Arena ahead of Game 2 of the NBA Finals between the Raptors and the Golden State Warriors. (The Associated Press)

Over the days and weeks after restrictions are lifted, Taylor said the majority of us will adapt to the return to normal, just like most people rapidly adapted to wearing masks. 

'Cave syndrome'

For some, however, there may be a reluctance to leave their homes — something that's been dubbed "cave syndrome." It's not actually a syndrome but rather a symptom of anxiety, depression or another mental illness, Taylor said.

"We're a victim of our own success here. We were encouraged through 2020 to make our lockdown environment as comfortable and pleasant as possible," he said. "But in the aftermath, it's made it harder for people to leave their homes."

Some people may feel reluctant to leave our homes after the pandemic is over, something that's been dubbed 'cave syndrome.' (Markus Schwabe/CBC)

Taylor pointed to Wuhan, China, where some people stayed in lockdown for months after restrictions lifted because they didn't feel safe, and said he expects to see that happen here with a "minority" of people.

Mental health crisis

For some Canadians, however, the mental health effects of the pandemic will not improve without clinical help, said Taylor. That cohort includes:

  • People with a history of mental health prior to the pandemic who found their mental health issues exacerbated by the pandemic.
  • People who have lost someone to COVID-19 and are in a state of bereavement or depression.
  • People who have been infected and hospitalized with COVID-19. 

Taylor said they'll need treatment for a range of concerns including depression, anxiety, post-traumatic stress syndrome (PTSD) and substance abuse issues. 

He admits it's hard to know just how many Canadians will need help. His educated guess is "about 20 per cent of Canadians will require or would benefit from some kind of mental health counselling in the aftermath of the pandemic."

That represents a "massive" increase in demand on an already under-resourced mental healthcare system, he said.

According to Statistics Canada, in 2018, 17.8 per cent of Canadians aged 12 and older (roughly 5.3 million people) needed some help with their mental health in the previous year — and half of these either had their needs only partially met or fully unmet.

Statistics Canada figures show that Canadians are reporting higher levels of anxiety and overall declines in mental health during the pandemic. Young Canadians are the most likely to report a decline in their mental health. (Shutterstock)

"We didn't have the resources to address the mental health problems before the pandemic, and it's going to be even harder now."

Demand won't be equitably distributed, said Taylor; those with the least financial resources are most likely to have experienced stress and trauma during the pandemic. 

Post-traumatic growth 

There is some good news though. 

In a recent study, Taylor examined something called post-traumatic growth during the pandemic. 

It's the idea that traumatic events and experiences can actually have positive effects on people — that enduring pain and suffering can lead to personal growth, and some of us emerge stronger from bad times.

The study, published in the Journal of Anxiety Disorders, surveyed 893 people in Canada and the U.S. with high levels of COVID-related stress.

Approximately 77 per cent of participants reported moderate to high growth relative to COVID-19 in at least one of the following  — greater appreciation for the value of one's life, greater appreciation for friends and family, a shift in priorities about what's important in life and greater feelings of self-reliance.

Dr. Renée El-Gabalawy, an associate professor and clinical psychologist at the University of Manitoba, is researching post-traumatic growth and 'silver linings' during the pandemic. (Submitted by Renée El-Gabalawy)

This doesn't surprise Renée El-Gabalawy, an associate professor and clinical psychologist at the University of Manitoba.

She is also studying post-traumatic growth during the pandemic. she surveyed approximately 1,000 Canadians last spring and early summer, and then 400 of the same people again six months later. 

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Silver linings

El-Gabalawy, who is also the director of the university's Health, Anxiety and Trauma Laboratory, said she and her team asked respondents to describe "silver linings" — if any — of the pandemic. Although the research is ongoing, which means the findings have not yet been peer reviewed, more than 85 per cent of the participants identified at least one silver lining.

These fell roughly into five different themes:

  1. Gift of time — the benefits of slowing down.
  2. Finding a new appreciation for what truly matters — the importance of loved ones and social connection. 
  3. Enhanced creativity and learning new ways to connect — Zoom calls with friends and family.
  4. Sociocultural shifts— such as increased attention to the elderly and greater support for working from home.
  5. Positive health impacts — such as increased hygiene led to kids catching fewer illnesses. 

El-Gabalawy said post-traumatic growth generally occurs in those who experience a moderate level of stress.

A passenger arriving from Australia at the Wellington International Airport hugs a loved one in Wellington, New Zealand in April after travel between the two countries was allowed again. Canadians are most eager 'just to be together again' says pyschologist Renée El-Gabalawy. (AP)

If you experience extreme stress or trauma it's difficult to experience growth, she said.

But on the flip side, those who experience negligible stress during an event like this will have equally low post-traumatic growth. 

"Really it's the transformative power of suffering. And so someone needs to suffer to a certain degree to actually grow from that."

Written and produced by Willow Smith.

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