Coronavirus anxiety: How to cope with life after lockdown
As some countries ease coronavirus restrictions, mental health experts are noticing an emerging phenomenon; anxiety about life after lockdown.
Meanwhile people who remain living under the most stringent measures are fearful about what will happen when these rules are lifted.
"It is going to be uncomfortable for most of us," says Akanksha Bhatia.
The 25-year-old writer and advocate for mental health and women's rights lived with anxiety before the lockdown.
Akanksha posts on social media about living with anxiety and has been talking with her followers about how the condition impacts her life in isolation. She lives and works in Delhi but has moved back to Chennai to live with her parents while India is in lockdown.
"It's not been that easy," she says. A month into lockdown, she had a particularly bad day and cried a lot.
"All you can do is tell yourself that this will end eventually."
Life under lockdown
Like many people, Akanksha has had some struggles during lockdown. But there has also been respite from some of the things that triggered her anxiety in her life pre-coronavirus, because she's able to be at home with her parents, who help her to feel safe.
Akanksha describes herself as an introvert and says that socialising is one of the things that made her more anxious.
She feels relaxed and comfortable spending time with her family and so this has been much less of a problem in recent weeks. Now her concerns centre on how she will return to her previous life.
"Stepping out of the house, for someone with anxiety, is already something you overthink," she says.
"You'll have to get used to that all over again, because you've been desensitised."
Many people are concerned about whether their leaders might be lifting lockdown too early, increasing the rate of infection. But some are also worried about returning to a more normal life.
Effects of lockdown
It won't necessarily just be people with an existing mental health condition who will be affected either.
"After you've been inside for a long time, it can feel very strange to go outside," says Nicky Lidbetter, CEO of Anxiety UK, a charity that supports people with mental health conditions.
"You perhaps lose your confidence to do things you haven't had to in a while."
She gives examples of face-to-face work meetings or using cramped public transport - situations that might have stressed or worried people even before they were concerned about the risk of infection.
"These things might have been difficult in the first place and having to return to them after having quite a sustained break might actually be very challenging," she says.
While some people have been safe in the relative comfort of their own home, others have faced difficult and upsetting situations.
From the medical workers on the front lines, to the people trying to stop their businesses from failing, for them last few weeks may have been incredibly busy and stressful.
But one common factor we all share is the amount of change we have all gone through, in a very short space of time.
"It's very stressful for people," says Dr Steven Taylor, a professor in the psychiatry department at the University of British Columbia, in Canada.
"People are trying to cope by loving being in lockdown, by creating a cocoon of safety, a haven, to make the whole experience more tolerable.
"Ironically that can create problems later on because people can love their lockdown too much and become anxious about going outside."
Dr Taylor is the author of The Psychology of Pandemic, a book published just a few weeks before coronavirus emerged in China in late 2019.
"The spreading and containment of contagion in the case of a pandemic is very much a psychological phenomenon," he says.
"It's not just some bug that's going at random around the world. It's people's behaviour that determines whether or not a virus will spread."
When governments come to relax lockdown rules, Dr Taylor says good leadership will be crucial to helping people feel safe and confident in the change of policy.
"To help reintegrate people into a post-pandemic world, there needs to be clear communication from leaders, [saying] 'It's OK now to hug people. It's OK to go to restaurants.'
"The guidelines need to be clear in people's minds and that can help to reduce uncertainty, which will reduce anxiety."
Some people are describing the emotions they are feeling as symptomatic of agoraphobia, but this isn't accurate.
"What people are describing as agoraphobia is similar superficially in some ways to agoraphobia, in that they're frightened of going outside," says Dr Taylor, "but the motivation is different."
Typically, people with agoraphobia will avoid certain situations, because they are frightened of having a panic attack.
"These people [anxious about life after lockdown] aren't frightened of having panic attacks, they're frightened of infection," says Dr Taylor.
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How to deal with coronavirus anxiety
Whether you already live with an anxiety disorder, or have experienced anxiety for the first time due to the pandemic, there are things you can do to help you cope with lockdown and the inevitable readjustment that has to take place once restrictions are lifted.
"People find change quite difficult," says Ms Lidbetter. "It's not about expecting yourself to go from 0 to 100 in one day. Don't be hard on yourself if you're finding it difficult to get back into a routine.
"We found it difficult to get into the routine of lockdown, so it stands to reason that we'll find it difficult to get out of the routine of lockdown as well."
As we start to leave the home more, she says we should be aware that it will be a "physiological process" as well as a mental one.
"When we go outside, we have all this stimuli hitting us and it can lead to a bit of a sensory overload."
She encourages people to be "gentle and kind with themselves" throughout this time.
"If people are really struggling with anxiety and they've found this whole experience of the lockdown and the pandemic has really heightened their anxiety, then there is help.
"People should go to their doctor and not struggle alone."
She also advises people to talk to a trusted friend or family member about their worries, if they can.
Dr Taylor says the anxiety many people feel now will pass.
"The good news is people are resilient," he says. "I expect that most of the people who are anxious right now will recover in the weeks, perhaps months, after lockdown restrictions have been lifted.
"That said, some people will have lingering psychological problems."
Akanksha has already started thinking about how she will cope when lockdown in India lifts.
"Though there are a lot of people looking forward to it, I don't understand those people," she says.
Akanksha's going to do some of the things that experts say are good for our mental health, like eating well and doing regular exercise.
"Keep it as simple as you can," she adds, "and don't overwhelm yourself with anything new suddenly. I won't be going crazy with parties every day."
But she will continue with a hobby that she started during lockdown, to maintain her routine as the world around her changes yet again, and give her an ongoing sense of achievement.
"I'm learning Korean right now," she says. "I want to watch my K-dramas without subtitles."
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