Masks Off, Anxiety Up: Dealing with No-Mask Anxiety

After over a year of covering their faces, Americans across the country were told they could breathe freely earlier this year as mask mandates were lifted. 

Unfortunately, the return to “normal” life hasn’t been smooth sailing for everyone. In fact, nearly half of Americans admit they have concerns about resuming in-person interactions, according to the American Psychological Association.  

It appears as though the mental health issues brought about by the pandemic aren’t going away anytime soon. 

Indeed, “no-mask anxiety” is real, and folks all over America are worried about life returning to the way it was before the pandemic. 

What Is No-Mask Anxiety? 

Like the name suggests, no-mask anxiety is a condition where people are scared about the prospect of taking off their masks in public.  

Those affected by no-mask anxiety feel uneasy when they themselves don’t wear a face covering, and they can also be uncomfortable around others who are not wearing masks. 

People of all ages can suffer from no-mask anxiety, including kids who are not yet vaccinated. 

Worried you might be suffering from no-mask anxiety? Don’t be. Doctors say it’s completely normal — and will likely be an increasingly common diagnosis as we move further into the post-pandemic world.  

The Why Behind No-Mask Anxiety  

On top of general uncertainty about the future, there are a few reasons why folks might develop no-mask anxiety: 

It’s become a habit.  

Imagine Henry, a 45-year-old father of two.  

For the first 44 years of his life, Henry never wore a mask. All of a sudden, in 2020, he wore a mask every day, each time he stepped out of his house.  

Since research says it takes an average of 66 days to develop a new habit, it comes as no surprise that Henry now feels more or less “naked” without a mask on. 

It feels like a security blanket. 

Throughout the pandemic, masks have served as our front line of protection against the virus. While vaccinations are helping the world safely move past the pandemic, many still feel comforted by wearing a mask and were planning on wearing them for the foreseeable future. 

Then, suddenly, the CDC updated its guidelines and said that folks who were fully vaccinated could return to pre-pandemic life. Expecting to wear a mask for some time and being told it was no longer required has been a difficult adjustment for many people. 

“The only time I don’t have mine up is when I’m at home or driving my car,” Jenny Krislov, a resident of Madison, Wisconsin, told Spectrum News 1. “It almost feels like my security blanket.”  

Krislov doesn’t only wear the mask to protect herself. She also wears it to protect her loved ones. 

Unmasking can exacerbate social anxiety. 

Those who have social anxiety live in fear that their peers will judge them for awkward or abnormal behavior in social settings. Simply put, people with social anxiety do everything they can to act “normal” and fit in with the crowd. 

As the pandemic began, these individuals might have been hesitant to put their masks on in the first place out of concern they’d get weird looks. However, ever since masks were mandated and the vast majority of people complied, they were happy to mask up.  

Now, as we transition to a post-pandemic world, social anxiety may be a bit higher than normal, according to David Moscovitch, a professor at the University of Waterloo. People who were nervous to be in public might have felt some comfort in being able to hide their faces. But in order to fit in now, they need to reveal their faces — which is causing some people to develop no-mask anxiety.  

“Many people who didn’t struggle with social anxiety before the pandemic may find themselves feeling more anxious than usual as we emerge out of the pandemic and into a more uncertain future — especially within social situations where our social skills are rusty and the new rules for social engagement are yet to be written,” Moscovitch wrote in a recent paper. 

Social anxiety got you shut down and isolated, hyper-vigilant and self-critical, or any other way that is blocking your path to a peaceful, full life? Don’t let anxiety define you. Reach out to a therapist near you today for help.

Resilience and Growing Through Change: How to Conquer No-Mask Anxiety 

If you’re impacted by no-mask anxiety, you need to remember there’s nothing to be ashamed about. None of us have ever lived through a pandemic at the scale of COVID-19 before, so we will all need to adapt to varying degrees. 

If you’re looking to conquer your no-mask anxiety, here are a few tips to keep in mind:

1. Take your time.

Just because other people aren’t wearing masks doesn’t mean you have to take yours off, too. 

Doctors say there’s nothing wrong with taking your time to ease back into a more open world. 

“You can pick a safe place with safe people, and just gradually go from there,” Dr. Eric Berko of MetroHealth Medical Center told Cleveland’s Fox 8 News. “Keep a mask in your pocket. It’s OK if you feel uncomfortable, just put it on. There’s no harm or shame in any of that. Gradually get yourself out there, and I think you’ll start to feel better and better.”

2. Force yourself to be social.

As Robert Frost once wrote, the only way out is through. 

If you find yourself saying no to social gatherings or wanting to keep your face mask on in supermarkets and retail shops, try to force yourself to do the opposite. 

“Catch yourself when you’re choosing to avoid even when you aren’t being forced to do so by pandemic-related restrictions,” Moscovitch said. “Do your very best to summon the courage to push yourself to enter those situations and confront your anxiety.” 

3. Find resilience.

According to Brené Brown, people who are resilient in the face of trauma tend to practice three specific acts: 

• The Reckoning, where they admit that they’re feeling different feelings 
• The Rumble, where they conduct a reality check on the narratives surrounding their struggles 
• The Revolution, where they rewrite their stories and transform their mindset on a foundational level 

If you’re struggling with no-mask anxiety — or any other effect of the pandemic — remember that you don’t have to wrestle the issue entirely on your own. 

Start your search for a therapist who can guide you through your struggle and help you live a more fulfilling life today. 

Dear GoodTherapy.org,

I’m a 27-year-old dental student with no serious medical issues other than sports injuries. Over the past few years, I have developed these thoughts about getting/being sick. I am constantly paying attention to my body. Any little thing I notice, I freak out. I am frequently going to the doctor for one thing after another and can’t seem to control my brain immediately thinking the worst. And every time I go, I am perfectly healthy.

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I also think that because I am believing in these fake ailments, it’s causing my brain to create symptoms! It’s frustrating because I don’t know how to stop feeling like this even though I know it’s mostly in my head. At this point, my girlfriend and family are getting sick of me asking things like “This isn’t cancer, right?” or “I’m going to be okay, right? It’s not going to kill me or anything?”

My main question is why am I always thinking of the worst-case scenario with my health? Why can’t I just have a sore throat and think “I must have a cold” instead of “I must have a rare infection that’s going to eventually kill me”? Any help would be awesome because as of now I feel myself worrying about being sick more than actually enjoying my life. Thank you. —Worried Sick

Submit Your Own Question to a Therapist

Dear Worried Sick,

You’ve asked a great question, and you are not alone in asking it: Why do you seem to always think of the worst-case scenario when it comes to your health, and what can you do differently so you are not immediately thinking the worst? The answer to this question is very much tied to understanding what may be behind this in the first place.

How you describe your concerns is consistent with what is conceptualized in the DSM-5 (the most recent version of the Diagnostic and Statistical Manual) as illness anxiety, as well as what prior to this would have been considered hypochondriasis (debilitating worry about having a serious illness). Regardless, please know there are things you can do to keep the worry from getting the better of you.

It’s worth stating this about anxiety more generally: some people are more prone to either anxiety or hypervigilance (heightened awareness about small sensations or possible threats, in this case health-related symptoms) than others. This can happen for any number of reasons, and it’s okay if you tend to be that way. What you are doing, essentially, is making sense of your experiences and protecting yourself from perceived threats of danger. While this can be adaptive—as doing so can tune you in to something that is wrong—it may become a problem when your interpretations are in overdrive. Furthermore, when you worry excessively, there is a negative filter operating on your thoughts which further intensifies and reinforces the worry.

You can learn how to modify your thoughts through psychotherapy. By seeking help for this, you can learn and practice skills to help you reduce hypervigilance and significantly reduce the tendency to immediately think the worst.

The bottom line is thoughts are powerful. When we experience a symptom such as pain, fatigue, or bloating, many people try to better understand and make sense of the experience, and depending on our thoughts, this may work for us or it may signal our thoughts are in overdrive. Additionally, constantly paying attention to bodily symptoms—and perhaps even creating symptoms, as you indicated—is a pattern worth changing. When we think the worst, this sends us down a dark path leading to debilitating anxiety. Furthermore, the way we think significantly affects the way we feel. So it makes sense that if we are thinking the worst about our health, we will feel bad. We are focusing on even the slightest discomfort or sensation and then feeling distressed over the worry around what it could mean. Clearly, you have realized that health-related anxiety or worry can become extremely uncomfortable.

By modifying the thoughts you have around bodily sensations, you can change your level of comfort. You will, in fact, be able to do just as you want—to be able to enjoy your life. Imagine how powerful a small shift in a thought can be. Instead of “This means I have a rare infection that will kill me,” try something else. Perhaps, “It is possible this is something that warrants medical attention, but it is also possible this will go away on its own.” You can learn how to modify your thoughts through psychotherapy. By seeking help for this, you can learn and practice skills to help you reduce hypervigilance and significantly reduce the tendency to immediately think the worst.

Here are some other tips that are important to consider:

• Beware of conducting your own health-related research. Many individuals who experience illness anxiety find they spend a lot of time online researching suspected conditions or symptoms. I suspect you know this already, being a dental student, but sometimes reading about things that “could” happen serves as an unnecessary trigger for anxiety. Be mindful of the amount of time you spend conducting such research, as well as how you feel while reading information (especially compared to times when you are not reading about symptoms). I suspect such information may spike anxiety in you. If so, consider whether this is useful for you to do.
• Consider new ways of coping and reframing. You mentioned you gather that the people close to you are already getting annoyed by you regularly seeking reassurance. This is one mechanism you have developed as a pattern to manage anxiety. Another is to frequently make medical appointments for these symptoms, which is essentially doing the same thing. You want reassurance that everything is okay. Because neither of these practices is sustainable in the long run, you’ll have to learn additional coping and reframing skills so you can adequately assess when it may be appropriate to seek reassurance.
• Implement relaxation as a regular practice. What usually helps you reduce anxiety? Finding a healthy outlet for stress and anxiety can be a useful tool to have at your disposal, regardless of the stressors you face.

Glad you’ve reached out!

Best wishes,

Marni Amsellem, PhD