24 March 2021updated 21 Sep 2021 6:13am

Covid-19 and the anxiety epidemic

Why so many of us are struggling to imagine a return to the pre-coronavirus routine, and fear life after lockdown.

When I spoke to Laura, a 31-year-old events coordinator based in England, it had been 126 days since she left the house. It would have been nearer to 150, she said, but she remembered stepping into her garden in mid-November last year. She has only breached the perimeter of her home a few times since March 2020 and only once did this mean entering another building – her GP’s surgery.

Laura, who spoke to me on condition of anonymity, is not shielding from Covid-19 – her behaviour is driven by obsessive compulsive disorder (OCD). But before the pandemic, Laura’s life was routine. She worked in an office job, socialised regularly and even took night classes. She also travelled abroad for holidays. Her OCD was a condition she dealt with, not something that dictated her every moment.

The pandemic has had a devastating impact on people’s well-being owing to lockdowns, separation from friends and family, and unending mass death. A report from the Institute for Public Policy Research says that a £12m “booster shot” will be needed for social care to deal with the predicted 1.8 million additional people who will require mental health support over the next three years.

For the majority of people in the UK, the vaccination programme promises a much safer summertime, and perhaps a return to normal life. But for those suffering with disorders such as OCD and agoraphobia, or other forms of social and health anxiety, the end of lockdown means a continuation, and in some cases a worsening, of a paralysed reality.

Anxiety, in all forms, has risen across the country since March 2020. The charity Anxiety UK reports that the number of people who called its helpline increased to nearly 900 a week between March and December last year. That number has been steady ever since. The most common reasons for people calling include isolation, job security issues, health anxiety and agoraphobia.

Grace, a 26-year-old Londoner who suffers from agoraphobia, also spent the end of last year indoors – ten weeks from the start of the second English lockdown in November. Speaking anonymously, she told me that she had gone through exposure therapy in 2019, which enabled her to conquer her fear of crowds and gain more confidence. But the pandemic has undone all of that progress.

“This past year has made it feel impossible to get back to typical life,” she said. “My work won’t allow me to continue working remotely when restrictions are lifted… I am terrified of things returning to normal.”

This fear of a return to the pre-coronavirus routine is an acute source of anxiety for people who already suffered with it. For them, the end of the pandemic is just as terrifying a prospect as its continuation. Many people I spoke to with agoraphobia believe lockdowns have intensified their condition, but also find their homes to be the only place where they can feel less distressed. For those with OCD or health-related anxiety, home is the one place where they know they can avoid catching Covid-19.

But just as anxiety has risen across the UK, so have the barriers to professional help. A survey from the mental health charity Mind found that more than half of those with OCD had experienced more difficulty accessing mental health support since the first lockdown (of those surveyed who do not suffer with OCD, the rate was 30 per cent).

Britain’s mental health crisis may be even more severe than those figures suggest: anxiety does not only affect people in extreme ways, such as agoraphobia, but can manifest in other forms, such as chest pains, trouble sleeping, lack of focus or a permanent state of hyper-alertness. People who have these symptoms might not know that they are suffering from anxiety and so might not seek help.

Mind also found that more than one in five adults experiencing poor mental health in the pandemic had never had such problems before, meaning many suffering from low-grade anxiety may not think to find help. And with the severity of the pandemic, and the countless stories of people experiencing worse traumas, it is tempting to think “I don’t have it so bad”, but typically the recurrent denial of anxiety means it will get worse.

Staying positive while suffering from incapacitating anxiety can feel like an impossible endeavour – even if Covid-19 case numbers are falling, and vaccines are increasing immunity and reducing transmission.

For Laura, beating the virus through a vaccine “would mean feeling able to go outside more, worrying less about touching my face or washing my hands, and maybe socially distanced outdoor mixing… but not more than that”.

She struggles to picture a normal life, especially with the threat of new variants that might prove resistant to vaccines. “The government’s suggestion that we will have to ‘live with’ thousands more deaths makes it harder to see an end point – I’m not sure when I will become desensitised to the threat.”