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Mask-Induced Anxiety Is Real

Lessons learned after a panic attack at Trader Joe’s

Credit: Malte Mueller/Getty Images

When I recently opened my refrigerator to discover all that was left inside was a bottle of champagne, a couple of eggs, and a jar of mustard that predated the Trump administration, I knew I could no longer put off a trip to the grocery store. Sadly, a woman cannot live on bubbles alone. Believe me, I’ve tried.

The revelation came shortly after San Francisco Mayor London Breed announced that face coverings are now mandatory when shopping, taking transit, or entering essential businesses. The order was based on updated guidelines from the Centers for Disease Control and Prevention to slow the spread of Covid-19.

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I’d been to Trader Joe’s a few times since the shelter-in-place order started, so I knew the drill. The standing six feet apart in line. The sanitizing of the carts. To not forget the reusable bags. The only difference this time is that I’d be going in with a mask.

No problem, I thought. Whatever I need to do to keep people safe.

After parking, I slipped the elastic bands of my black mask over my ears for the first time, checking in the rearview mirror that my nose and mouth were properly covered. I had a fleeting thought that, although the mask made my blue eyes stand out, I should probably get one in a color that would be more flattering. (Vanity never stops being a nuisance, not even during times of pandemic.) I joined the long line of people snaking around the parking lot standing on painter’s tape intended to take the guesswork out of social distancing.

The wait in the line was fine. There were a few awkward moments. Like when people were too distracted by their phones to realize the line had moved. Or when the man in front of me tried to start up a conversation, but I couldn’t make out a word he was saying, given the mask situation and the distance between us. Mostly, I just people-watched, enjoying the presence of other humans, even if they were strangers doing nothing. I barely noticed the mask on my face.

But 10 minutes into shopping inside of the store, things took a turn.

I quickly realized I had forgotten my list. Couldn’t remember a single item on it. Out went the recipe for the Szechuan green beans and in came the ingredients for tacos from the box. I felt myself get frustrated and flustered.

I was doing my best to keep distance from people and my cart out of their way, but it was difficult as I maneuvered the aisles on alert. It was hard to stay focused on the task at hand, procuring food, when I was so worried about my proximity to others.

By the time I got to the wine aisle, the last (but most important) stop before the cash register, I felt uncomfortably warm. And ready to get out of there.

While in line to pay, beads of sweat rapidly multiplied on my forehead. As I watched the checker (what felt to be) laboriously scanning every item (why hadn’t I shopped for two weeks?!), I became so overwhelmed that I could barely breathe.

My chest became tight. My arms were completely numb. I was certain I was about to faint. Right there in front of the cashier and the bagger. Neither of whom, I realized, would be able to help me since they weren’t allowed to come near me.

My mind raced. The paramedics would have to come. I’d have to go in the ambulance, which I couldn’t afford. And when I finally got home, there wouldn’t even be any wine to drink.

Somehow, I stayed upright. I tried to breathe my muffled breaths. I paid, then sanitized. My entire body was drenched in sweat, and I was so off-balance I was barely able to make it to my car. But I did. At which point, I ripped off the face mask. Tore off my jacket. And gulped in glorious breaths of fresh fog-filled San Francisco air.

Soon, I was able to load my groceries into the trunk and drive home. I was exhausted, overwhelmed, and ready for a nap. To be fair, I’m often all of those things, but despite countless late nights paired with looming deadlines, I’ve never almost keeled over. Not in the privacy of my own home and certainly not in a grocery store.

Later, I casually posted in my Instagram stories that mask claustrophobia was intense — both a true statement and a great excuse to post a photo of myself in a mask. (What? I said it made my eyes pop!) The DMs started coming in from others telling me they’d experienced the exact same thing: extreme anxiety when they had to put on their mask.

These weren’t people who protest against mask requirements or feel like their civil liberties are being attacked. They’re not going to turn to violence or protest. They are sane, rational folks who understood the importance of wearing a mask and were doing so when required, but who also experienced anxiety-inducing personal discomfort to unsettling degrees as a result.

People shared with me that they’d almost blacked out, that they can only go into a store long enough to grab a few things before becoming too physically and mentally uncomfortable. I started to feel a little better that it wasn’t just me. But I also wondered why no one was sharing this phenomenon, especially considering that wearing masks indoors is the new normal for the foreseeable future.

I soon discovered that, for me, even putting on a mask for a quick trip to the corner store sparks an intense panic that leaves my clothing soaked with sweat. It’s a terrible feeling.

I’m grateful that I’m not required to wear a mask outside all the time. My solo adventures outside where I’m able to breathe without a face covering are what keep all of the other anxiety at bay. Walking to Ocean Beach, discovering hidden staircases, climbing to the top of Twin Peaks — these are the things that make existing during these times of isolation tolerable for me. That helps me sleep at night. That gives me joy. And I wouldn’t be able to do any of them if I had to wear a mask.

If you have a Facebook or NextDoor account — or just the ability to hear other people talking — you’ll know there are people out there who are livid if anyone dares to go out in public without a mask covering their nose and mouth, even outside in uncrowded areas. All of the grievances people used to post about before — cars blocking driveways, people making too much noise, and how the breakfast burrito at the local market is not the same as it used to be — have been replaced with a brand-new obsession: mask-shaming.

Some recent posts from my NextDoor neighborhood include:

“When I see people without masks outside, I say very loudly to my son, ‘Stay away from that man. People without masks are super rude and inconsiderate.”

“Sometimes I yell, ‘Wear a mask!’ to people without them on. It unsettles them.”

“People should stop freaking out about wearing masks. Just do it.”

Even my favorite podcaster said she recently yelled at two power-walkers without masks, “Making my five-year-old wear one; you can too!”

On the other side, a woman recently wrote, “I’m not going outside anymore because comments like this make me feel anxious that someone will yell at me if my mask slips. The hyper-vigilance is exhausting.”

Here’s the thing: This anxiety some of us experience when we put on a mask — the sweating, the tight chest, the dizziness, the fear of fainting or death — that’s not imagined. That’s very, very real. I understand that if I’m in an essential business (or waiting in line to enter one) with other people, I should put on my mask, but if I’m farther than six feet from another human while outdoors, I can choose not to wear one.

I spoke to Katie Keech, an Oakland-based therapist with experience working with complex trauma and dissociative disorders, to get a professional’s opinion. She says it’s not surprising that so many people have a strong aversion to wearing face masks.

“It’s really common for people who have to wear CPAP masks [which don’t restrict breathing like many cloth masks] to have panic attacks, anxiety attacks, and feel like they’re in a claustrophobic space,” she said. “I’m sure the cloth masks cause a very similar reaction.”

If wearing a mask causes you anxiety, she suggests a few things to try to alleviate that feeling. Start by trying out different types of masks to see which you’re most comfortable in and then wear one in your home for brief periods of time to get the feel of it on your face with the freedom of being able to take it off whenever you want.

“Try it for one minute, and if that’s too much, try it for 30 seconds,” Keech says. “Just keep trying until it feels safe and is a normal sensation you can at least tolerate.”

While anyone could feel anxiety from a mask, it can be especially bad for those with asthma or personal trauma that involves not being able to breathe. Anything that simulates that feeling can cause a panic attack, she says, to a point where some people simply might not be able to endure wearing a mask at all.

In addition to practicing wearing a mask in the house, Keech also suggests trying to be more aware of your breath.

“When you start to get anxious, your breathing starts to get restricted. That can cause you to start breathing high and tight in your chest, which can trigger even more anxiety and panic,” she says. “If that happens, try to focus your breathing on your stomach because that will make your anxiety levels go down, something that will be easier to do if you’ve practiced it before you’re in public and feel trapped because you have to keep your mask on.”

If it does get to the point of a full-blown mask-induced panic attack, but you need to keep it on, Keech says it can help to try to accept that the panic attack is happening. Trying to push it away tends to accelerate the feeling.

“It’s a really hard thing to do, but if you know a panic attack only lasts a short amount of time, tell yourself that if you’re still breathing, you’re not dying and it’s probably a panic attack,” she says. “Count to 10. If you can get past that initial moment, it’s easier to roll with it and not fight against it.”

As for those who bristle, become enraged, or suffer anxiety of their own when they see people outside without masks, Keech says that reaction also makes sense. She has a hunch that feeling comes from a lack of control in so many areas of life right now.

This reasoning helps me find patience for people who scoff at others for not wearing masks in areas where they’re not required. I realize their anger likely comes from a well-intentioned place.

Ultimately, Keech said, we can’t control what others do (especially if it’s perfectly legal), so worrying about those without masks outside can turn into needless suffering.

“Somebody might not be wearing a mask for a selfish reason, but someone might also not be wearing a mask for a good reason,” Keech says. “If instead of expending all of this energy trying to control the people not wearing masks, you can focus on figuring out your own safety, it’s going to be a lot less stressful and exhausting for your life overall.”

As for me, I’ll continue to do my best. I’ll practice wearing a mask at home, hope it becomes more bearable and wear one when required. I’ll take care of my mental health by getting outside as often as possible with a mask readily available in my pocket or around my neck to put on if I get near people. I’ll try to remember that we all handle stress and fear differently, that we are lucky to be alive and breathing air, and that if I see an orange mask, I should buy it because if I’m going to be dripping with sweat every time I go into a building, maybe people won’t notice if my blue eyes really pop.

Editor’s note: If you or someone you know is struggling with mental health, contact a trained mental health professional for help. For serious circumstances of life-threatening depression, please contact the National Suicide Prevention Lifeline (800–273–8255).

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