Expert Explainer: Dr. Arlene MacDougall on managing mental health in the next phase of the pandemic

Young woman wearing a mask outdoors in a public space

As vaccination rates rise, Canadians are starting to anticipate an end to the pandemic and a gradual return to work, school and social activities. With that comes elation and relief, but also feelings of anxiousness and trepidation.

Dr. Arlene MacDougall, Assistant Professor in Psychiatry who specializes in local and global mental health and mindfulness, says anxiety is often driven by uncertainty. She provides strategies to move through this anxiety and how to support one another as the country moves into this next phase of the pandemic.

In your work, how have you seen the pandemic impact people's mental health?

head and shoulders photo of Dr. Arelene MacDougallMacDougall:  As a psychiatrist, I have seen the pandemic exacerbate mental health concerns for those already struggling with mood disorders like depression, as well as general anxiety and social anxiety disorders.

People have really struggled with maintaining a healthy mood given the context of not being able to engage in activities that are meaningful to them, and grappling with changes in how they work, study or socialize.

As we are starting to think about re-entering the world - eventually heading back to the workplace, restaurants, social gatherings - is this causing mental health concerns as well?

MacDougall: While people are feeling relief, there is also a lot of trepidation and concern about the risk that still exists.

People may be feeling anxious about the reopening for a number of reasons.

Anxiety is driven by uncertainty, and there is still a lot of uncertainty as we move forward. For example, at this point we don’t know how long vaccine immunity will last, we’re unclear if there will be new and evolving variants of concern and how the vaccines will respond to those.  

Trying to manage that uncertainty is very challenging and is going to shift as we gather more science and research and known facts about the pandemic. We need to continue to have conversations with each other about risk tolerance and maintain an understanding that other people’s risk tolerance may be different than your own. This will help us find the middle ground where everyone can feel comfortable and safe whether it is in social, school or work environments.

Another factor driving discomfort around reopening is that some people may be feeling uncomfortable about socializing, having not been in a social setting for quite some time. They might feel anxious because they aren’t sure how to share the difficult challenges and losses they’ve experienced because of the pandemic. These are difficult topics and there may be discomfort about how to share that in a more social or public space.

Is there particular concern in terms of this reopening anxiety for those who have pre-existing mental health concerns?

MacDougall: There are certain groups of people who might feel more uncomfortable than others in terms of re-entering or reopening after this phase of the pandemic. For example, those with social anxiety disorder who tend to avoid social situations have been able to for the past year because of the restrictions. For them, it will be difficult to return back into public and social settings after this extended period.

They may have a heightened sense of fear or physical distress even thinking about what’s involved in being social again. For those with social anxiety, they can take smaller steps in terms of re-engaging in social activities, gradually and consistently increasing exposure instead of avoiding it completely.

How can we help support each other through this next phase of the pandemic?

MacDougall: It’s going to be critical that we support each other through this next phase of the pandemic; to be part of the recovery and healing process for each other. This means mindfully and intentionally listening to one another and ensuring others know you care about them.

Many of us have experienced different forms of loss and challenge during this pandemic. And we haven’t really had the opportunity to truly process and grieve those losses. We have to create the space to share what has happened to us and what we are still experiencing in terms of loss.

One of the most powerful ways to get through loss is to focus on the meaning that came through all of that difficulty. How has it led us to change, learn, grow or understand different aspects of ourselves or our lives? Having those conversations with others and having time to reflect yourself is going to be very important as we move through this pandemic.

We also need to continue to have respectful conversations with each other about our risk tolerance, the number of people gathering or the vaccination status of the people we’re gathering with, knowing that these conversations can be difficult.

What are some coping strategies for those who are struggling?

MacDougall: For those with mental health concerns that affect their ability to work or engage in school or interpersonal connections, I would encourage them to seek out care from their family physician, or look into seeing a regulated health professional that does cognitive behavioural therapy or other forms of psychotherapy. There are lots of resources in our community, and other resources online that are free and funded by the government of Ontario that provide mental health therapy and support including Mind Beacon and Bounce Back Ontario.  

How might mindfulness be helpful?

MacDougall: Given the difficulty, loss and sorrow we’ve experienced this past year, and the worry about what might happen next, it’s important to be present in this moment right now, and focus on what you can control right now.

Mindfulness involves bringing your attention to the present moment and doing it with openness and curiosity and without judgement. Many of us go through life without being truly present; we are either worrying about what might happen in the future, or rehashing and ruminating about what happened in the past. Mindfulness is about bringing yourself back to the moment and focusing on what’s happening around you, which often leads to a sense of peace, calm and even gratitude.