With more of New Jersey reopening as we emerge from the COVID-19 pandemic, many people are excited to enjoy the things that have been off limits for months. Whether it’s a trip down the Shore, shopping at a mall, going out to eat, getting a haircut or going to an amusement park, there are risks to these activities.

With help from some of New Jersey top medical experts, I’ve explored the risks of typical behaviors in a previous article found here.

But not everyone is ready to break quarantine and rush out into a public setting, and that’s OK.

Everyone’s risk tolerance is going to be different as we move through different phases of a recovery that may take a year or more to complete. Each person is unique, and some may have an underlying medical condition that impacts the level of risk they are willing to take.

While a certain level of anxiety is normal, however, it can rise to a level that can also adversely impact your physical and mental health.

Dr. Michael Bizzarro is a crisis counselor with Princeton House and has appeared as an expert on the New Jersey 101.5 Town Hall Series. He says we must first understand how fear and anxiety work.

“There is a myth that anxiety and/or stress is a bad thing, when in actuality they both work to prepare us for uncertainty," according to Bizzarro.

There is a great deal of uncertainty right now. There is still much we do not know about novel coronavirus. The information and advice we receive is constantly changing. That in itself can lead to a heightened anxiety. While the risk of contracting the virus and having serious complications is still very low, Dr. Bizzarro believes it is helpful to not only understand the source of your anxiety, but what the body’s response is to that anxiety.

If you believe you or a loved one is in crisis, there are multiple resources available right now, or call 911 and they can connect you to the help you need at the bottom of this post. Additionally, dialing 211 will connect you with a NJ 211 specialist that can direct you to specific areas of treatment. You can also text your area code to 898-211.

We have compiled a list of common situations that can cause anxiety and suggestions on how best to deal with it. Keep in mind this is a general guide, and each individual is unique.

I just don’t feel safe leaving my house, yet.

It is okay to stay home until you feel safe.

However, you do need to ask yourself what you need to make yourself feel safe, and have a plan to provide that comfort.

Dr. Bizzarro says you also need to ask yourself, “Is my fear based in real evidence?”

If you choose to leave your home, it is comforting to take the necessary precautions to ensure your safety. Whether that is wearing a mask, social distancing or some other precautions, having a plan to provide those things can give you peace of mind.
For many, leaving the home for short periods of time to take a walk or a drive can help ease into longer outings.

I have a hard time trusting any of the information I am hearing from the government and media or reading on the internet.

Endless news coverage and often conflicting perspectives and analysis can cause confusion, frustration an anxiety. If you find yourself overwhelmed by this, it may be time to give your brain a break and tune out for a while.

Bizzarro notes that “science does not play politics,” and suggested paying attention to the health professionals you have entrusted with your well-being.

If you have a healthcare provider you trust, use them as your best source of information. Your doctor also knows you and any associated risk factors that are relevant to you personally.

All my friends are going out to eat, but I’m still nervous about it.

This is OK.

There may be a lot of peer pressure from friends of family to “get out of the house” now that restrictions have been lifted. However, restrictions are in place for a reason. Dining, even outside, still carries certain risks. Bizzarro notes that this is often due to an emotional response to danger, and “the emotional mind does not typically incorporate logic or reasoning.”

The challenge, he says, is to access the ‘wise mind,’ which will present logic and reasoning. For example, by following the proper precautions such as social distancing, wearing a mask, and following proper hygiene can reduce the level of anxiety.

Talk to your friends about your anxiety, and what they can do to make you feel more comfortable going to a restaurant. Bizzarro also suggests positive self-talk which he says can be an asset, while negative self-talk is a liability.

"Whichever one you invest in will prevail,” he says.

It’s also important to remember if you feel unsafe or overwhelmed by the experience, you can always leave.

My kids want to go to a park or to the beach, but I don’t feel safe taking them there.

This is a personal choice issue, and whatever you choose is O.K.

As a parent, we want to protect our kids. Playgrounds are reopening in New Jersey, and it’s natural our kids will want to go there to play and be with their friends. Medical experts say outside play is better than inside play, so if you decide to take your kids to a playground, explain to them the precautions that need to be taken for their own safety. Make sure you have the supplies you need. For example, a bottle of hand sanitizer and wipes in case soap and water are not available. Bring a water bottle or individual juice boxes that only your child can use.

Dr. Bizzarro suggests you assess the situation to determine whether or not there is a real or imagined danger, and have an exit strategy.

When I go out to a store, and see someone not wearing a mask, it makes me angry and/or anxious.

This is a common concern for many, especially since masks are required in most public places and in all retail businesses as a condition of entering.

Anxiety and fear increase when we do not feel in control of a situation. Dr. Bizzarro explains your belief system and how you perceive the threat of COVID-19 which influences your perception. The message is then sent to your brain once you see someone not wearing a mask, your brain identifies this as a potentially dangerous situation. This initiates your “fight or flight” instinct.

The best advice is to say something to store management, and let them handle the situation rather than get into a conflict with the individual not wearing a mask. You also have the option to leave the establishment.

I want to say something to someone when I see them not wearing a mask, but I don’t know how.

This can be a tricky proposition. Use caution.

Did the person just forget to wear a mask, or is he/she making a statement by being defiant? The danger in confronting a stranger, especially when you already have heightened anxiety, is real.

Ultimately, the responsibility to ensure safety rests on the establishment, and speaking to a manager is the best course of action.

Bizzarro suggests a scenario where you carry an extra mask, and politely offer it to someone who does not have a face covering. If this gesture is rebuffed, however, it is best to walk away and not escalate the situation.

If you do not feel safe, and management does not address the issue, you always have the option to leave.

Tips to control anxiety:

Again, it is perfectly normal to feel anxiety and fear in uncertain situations. It’s healthy to recognize it, and have a plan for dealing with it.

• Focus on the now, time traveling to the future or past will likely increase your anxiety.
• Question how realistic a situation is and the likelihood of that situation happening.
• Calming visualizations.
• Breathing techniques are extremely helpful along with meditation.
• Yoga and exercise.
• Positive self-talk.

When to seek help:

Bizzarro says generally, “when anxiety interferes with the ability to function and causes marked distress and impairment in important areas of your life that is an indication that a person would benefit from professional help.”

He describes anxiety as “a tree with many branches,” meaning there are many different ways anxiety will manifest itself, and each person is unique.

In general, there are five types of anxiety disorder identified by the U.S. Department of Health and Human Services:

  • Generalized Anxiety Disorder: Generalized Anxiety Disorder, GAD, is an anxiety disorder characterized by chronic anxiety, exaggerated worry and tension, even when there is little or nothing to provoke it.
  • Obsessive-Compulsive Disorder (OCD): Obsessive-Compulsive Disorder, OCD, is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as hand washing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety.
  • Panic Disorder: Panic disorder is an anxiety disorder and is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress.
  • Post-Traumatic Stress Disorder (PTSD): Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.
  • Social Phobia (or Social Anxiety Disorder): Social Phobia, or Social Anxiety Disorder, is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. Social phobia can be limited to only one type of situation - such as a fear of speaking in formal or informal situations, or eating or drinking in front of others - or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people.

Resources:

In an emergency, please dial 911

The New Jersey Department of Health lists these resources for those dealing with anxiety and other mental health issues:

  • NJ Hope Line (suicide prevention): 855-654-6735
  • ReachNJ: 844-732-2465
  • IME Addictions Access Center: 844-276-2777
  • NJ Connect for Recovery: 855-652-3737
  • The Peer Recovery Warmline: 877-292-5588
  • National Suicide Hotline: 800-273-8255
  • NJ Mental Health Cares: 866-202-HELP (4357) or help@njmentalhealthcares.org
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