Priyam Mahajan, a 20-year-old who lives in India, has struggled with social anxiety disorder most of her life. In public, that plays out as a difficulty in making eye contact with strangers. Her face often tenses up in conversations or she’ll bite her lip, which only makes her more self-conscious around others.
“When half my face is covered it helps me almost not be perceived fully,” she told HuffPost. “I can relax and be anonymous.”
Now that states in India have started to lift mask mandates, Mahajan said she’s trying to push through her anxiety and let go of the mask.
“I have noticed I really start missing the mask when I get into a pickle or a situation where my social anxiety piques,” she said. “For instance, the bus was really chaotic and crowded this morning and I wished I had my mask on so that no one could see me get anxious.”
Like many women have noted during the pandemic, facial coverings have also given Mahajan a break from the leers and requests to “smile more” from men.
“I feel safer with the mask,” she said. “I feel like I’m going to always keep my mask on hand for anxiety-inducing situations.”
Seth, a 27-year-old health care worker in Massachusetts who has anxiety and autism, has also found comfort in masking. No one could look at his face and misinterpret what he was feeling. (Studies suggest that many neurotypical people find it challenging to read and interpret the facial expressions and body movements of autistic people.)
“My face often doesn’t move in a way that suggests my mood,” said Seth, who like a few others in this story asked to use his first name only to protect his privacy.
“With a mask, that’s not as big of an issue because there’s already an expectation with people at work that they will not be able to read my face as well and it diverts their attention elsewhere,” he told HuffPost. “It’s also kept my acne hidden and stopped me from picking at it.”
As mask mandates have lifted throughout the U.S. in the last few months, Seth has felt grateful to work in a field where masks are still very much in use.
“The mask feels like a security blanket in so many ways,” he said.
Seth and Mahajan are not the only ones feeling conflicted and a little uneasy about reentering an increasingly maskless world. There are the obvious health concerns about unmasking ― coronavirus cases are once again on the rise due to the spread of the highly transmissible BA.2 variant.
But there’s extra reluctance to give up the masks among people who have social anxiety disorder or who feel self-conscious about their appearance. For more than two years, masks have given them a reprieve from having to engage with others.
Social anxiety disorder, a condition that affects an estimated 15 million Americans, is an intense, persistent fear of being watched, judged or scrutinized by others.
“Without a mask, someone is more exposed to others seeing physical signs of social anxiety, like flushed skin or sweating,” said Rebecca Leslie, a psychologist in Atlanta.
“A mask can make you a bit harder to recognize, particularly from afar,” she told HuffPost. “That provides a sense of protection to someone who is socially anxious or just does not want to run into people.”
“I remember taking my mask off in front of a co-worker for the first time, and he said, ‘Oh wow, I’ve got to get used to seeing your face,’ which I obviously took in the worst connotation possible.”
– Brianna Plato, a 22-year-old in Florida who’s reluctant to go mask-free
Masks have been a blessing to those who have body dysmorphia, a disorder affecting nearly 8 million Americans that causes people to dwell on one or more perceived flaws in their appearance.
Leslie specializes in body image issues and said she’s had many clients speak about how liberating covering up has been.
“A mask has a way of making people insecure about their looks feel just a bit more invisible,” Leslie said. “And without a mask, there can feel like there is more of a need to wear makeup or cover up perceived imperfections previously covered by a mask.”
Brianna Plato, a 22-year-old in Florida who often feels insecure about her looks ― her nose especially ― said she’s certain she aced a job interview because she was masked up.
“This was mid-pandemic and I was praying that the hiring manager wouldn’t ask me to take my mask off for the interview,” she told HuffPost. “I felt much more confident in it. I truly believe it’s one of the main reasons I got the job.”
Florida was one of the first states to lift mask mandates, and Plato said she thinks going maskless has increased her body dysmorphia.
Lately, “mask fishing” has been a concern for the 22-year-old. The term ― “presumably coined by my generation,” Plato joked ― is the idea that someone might be concealing facial flaws under a mask. It first emerged on dating apps and then trended on TikTok.
“For instance, I remember taking my mask off in front of a co-worker for the first time, and he said, ‘Oh wow, I’ve got to get used to seeing your face,’ which I obviously took in the worst connotation possible.”
Plato said taking photos sans mask can be triggering.
“I’ll look at a photo and think, ‘There’s no way I really look like that?’” she said. “I feel as if having to wear a mask for so long and then all of a sudden not having to has worsened my insecurities tenfold.”
The mask has also been a powerful protective tool for trans people undergoing hormone therapy or surgical procedures to change their physical characteristics.
Social anxiety plays a role in Alexis Vandom’s reluctance to unmask, but most of her negative feelings about unmasking derive from potential threats to her physical well-being and her gender dysphoria. Vandom, 25, is trans, and masks have helped keep her jawline and Adam’s apple hidden.
“I’m mostly concerned about the possibility of the wrong person noticing that I am transgender and lashing out at me,” she told HuffPost. “Public hostility toward my demographic is soaring on a national level, and although I am safer now that I live in Washington state instead of central Texas, I would prefer to be able to go about my day in relative anonymity.”
Vandom is currently undergoing facial electrolysis and intends to keep her mask on until she gets facial feminization surgery later this year. Once she has healed from her operations, she’ll likely start going out without it.
“After that point, I won’t be anywhere near as worried about transphobic people recognizing or confronting me,” she said.
Why shifting mask mandates are so complicated for those with social anxiety or other insecurities
David Moscovitch, a psychologist at the University of Waterloo and a leading researcher in the treatment of adult anxiety, has been studying the effect of mask-wearing among those with social anxiety since the start of the pandemic.
Masks have allowed people to hide their vulnerabilities, Moscovitch said, but shifting mask protocols during the pandemic have actually increased struggles with social anxiety.
“While masks might help socially anxious people to feel safer and avoid the fear of scrutiny and evaluation, this kind of self-concealment is harmful in the long run because these behaviors keep anxiety going by preventing people from learning that their fears are exaggerated,” he said.
Social anxiety arises out of the perception that one’s appearance or behavior doesn’t match social norms. Moscovitch’s research shows that shifting norms on mask-wearing ― fluctuating mask mandates, for instance ― heighten the fear of making a mistake and being judged negatively by others.
“In regions where the majority of other people are no longer wearing masks, socially anxious people face a difficult decision: drop the mask and the associated self-concealment it provides or keep the mask and risk sticking out and calling attention to themselves by virtue of defying social norms,” he said.
They may feel stuck in a lose-lose situation, Moscovitch said, and conclude that it’s easier for them to just avoid people and stay home altogether.
That’s been the case for Chris, a 39-year-old from Alberta, Canada, who said he has a general phobia about being looked at or noticed.
“The mask really made me feel less obligated to engage in mindless small talk,” he told HuffPost. “I’m still masking, but it’s hard because I live in a highly conservative area where people seem to disapprove of masking.”
Chris’ facial covering garners a lot of attention.
“It seems like people actively go out of their way to say something to me about it,” he said. “I had to go to the post office a week or so back and the only people I saw with masks were the employees. It felt like every eye in the store was on me and I felt incredibly uncomfortable.”
The plethora of delivery services and curbside pickup options has made being a “shut-in incredibly easy.”
“Now I can’t even go inside the corner store without anxiety and panic,” he said.
How to deal with anxiety around not wearing a mask
Adjusting to the new normal of mask-wearing was a big hurdle for many of us. Readjusting to not wearing one ― when it’s safe to do so ― is going to take some getting used to, too, even for those who never struggled with social anxiety or insecurities about their appearance before this.
Experts we spoke to have some advice for getting through it.
Think about why you’re so resistant to unmasking.
While facing old anxieties about your appearance or new ones, it’s important to acknowledge why you’re leaning so hard into wearing a mask, Moscovitch said.
“Be honest with yourself about why you’re still wearing your mask: Is it to avoid contagion or is it because you’re socially anxious and it’s hard to let go of that security blanket?” he said.
If you’re not anxious about catching COVID-19 and there are no public health restrictions preventing you from going out without your mask and you believe it’s safe to do so, challenge yourself to experiment with dropping the mask in social situations, Moscovitch said.
“See how you feel,” he said. “You may be surprised to discover that dropping the mask enables you to feel more authentic and connected with others, happier and less lonely.”
Try removing your mask first in comfortable settings or with people who feel safe, said Sheva Rajaee, the director of the Center for Anxiety and OCD.
Maybe you start by going maskless in less crowded places like a vaccinated friend’s house, or try showing your full face around people you trust and who you feel will not judge you.
“These exposures will allow you to take small, confidence-building steps that can then build to bigger leaps, like going maskless to a party, or wearing bright lipstick to draw attention to the unmasked portion of your face,” Rajaee said.
See if you can come up with a self statement to say to yourself to help reduce anxiety when you leave home without a mask, Leslie said.
“Remind yourself that you lived your life without a mask before and we’re OK. See if you have data from your past to challenge some fears,” she said.
If removing the mask is due to body image concerns, remind yourself you are more than your appearance.
If you’re using your mask to cover up what you really look like, try to remind yourself that your worth is tied up in so much more than your looks, Leslie said.
“Your body is there so you can live your life. We don’t want life to be focused on striving for this ‘perfect’ physical appearance,” she said. “You are human, humans have wrinkles, pimples and skin with pores. Give yourself permission to be human.”
Work on reframing negative thoughts and distortions about yourself, said Monica Vermani, a psychologist and the author of “A Deeper Wellness: Conquering Stress, Mood, Anxiety and Traumas.”
“For people with physical insecurities, reframing negative thoughts about their face, their weight gain, and their sense of unattractiveness can be a game-changer,” she said. “Rather than judge and self-scrutinize, have the same compassion for yourself that you have for others.”
Reach out for help if you need it.
Don’t hesitate to ask for help from your support network or from professionals, Moscovitch said. If you seek professional help, he said, know that cognitive behavioral therapy, also known as CBT, is a proven form of psychological treatment for social anxiety that helps people confront their fears and change their negative perceptions of themselves and others.
Remember: Compassion is key.
During times of uncertainty and transition, we need to have compassion for other people, and for ourselves.
“We need to stay connected to how we are feeling and treat ourselves with kindness,” Vermani said. “And while we can’t know what someone else may be going through or dealing with in their life, we can choose to treat others with respect and kindness.”
https://www.huffpost.com/entry/anxiety-covid-mask-mental-health_l_625097c6e4b066ecde063889 For People With Anxiety Or Insecurities, It’s Hard To Lose The Mask