For both kids and adults alike, wearing a mask can take some getting used to and can lead to feelings of anxiety.
While the term “mask anxiety” isn’t an official diagnosis, it’s a way of explaining feelings of emotional discomfort that may come along with having to wear a mask or face covering.
“It’s important to remember that having some anxiety in situations that are seen as challenging is part of the normal human experience. However, we need to look at the context and see if the anxiety is excessive, or causing dysfunction,” says Dr. Joanna Mansfield, a psychiatrist at Sunnybrook’s Women’s Mood and Anxiety Clinic, and Cognitive Behavioural Therapy Clinic.
“There can be positive aspects to anxiety. For example, it can help us prepare for things and be more alert and aware, which may encourage us to remember to bring a mask with us and wear it. In other cases, feeling anxious about wearing a mask could lead to excessive fear or worry and avoidance of situations that require mask wearing. Other symptoms could include feelings of losing control, trouble concentrating, and increased physical reactions relative to the situation, such as muscle tension, heart racing, sweating and shortness of breath,” explains Dr. Mansfield.
How do you know if there’s a greater mental health concern around wearing a mask?
If wearing a mask is causing increased anxiety to the point where it is negatively affecting a person’s ability to function in their daily lives or at work, Dr. Mansfield says this may be a sign of a mental health disorder or phobia and it is important to reach out to your health-care team to determine next steps.
Wearing a face mask isn’t always easy, but during the COVID-19 pandemic, wearing a mask is an important way for everyone to help prevent droplets from their mouth and nose from reaching others and shared surfaces. There are also steps that kids and adults can take that can help them gradually get used to wearing masks
Tips to help ease anxiety
Dr. Mansfield explains some ways to help children and adults cope with wearing a mask when anxiety strikes.
First, being knowledgeable about anxiety and understanding what it is can help.
“Anxiety is the emotional response to a real or perceived threat. We are worried about something bad happening in the future and because of this concern, we can experience physical changes (sweating, shortness of breath), changes in how we think (trouble with concentration and thinking we are out of control), and changes in how we behave (avoidance behaviours or seeking reassurance, protective behaviours),” says Dr. Mansfield.
Let’s use the example of feeling short of breath.
When feeling anxious, pay attention to what is happening in the body. “Having the understanding and awareness of the anxiety response to a perceived threat and the initiation of the fight or flight response can actually play a role in helping reduce it,” says Dr. Mansfield.
Positive self talk
“Telling yourself that you can breathe and talking yourself through your anxiety can help to correct catastrophic thinking,” explains Dr. Mansfield. “Think about factual evidence. For example, while wearing a mask can trigger a response that is uncomfortable, we know that wearing a mask properly is safe.”
Imagine yourself in a calm place
Close your eyes and use this visualization strategy to help take your attention away from the anxious feelings. Focus instead on picturing a place that makes you happy or calms you. Describe the setting to yourself in detail as if you were sitting in this calm place.
Sit down in a chair with your feet on the ground and your back against the chair and repeat soothing phrases to yourself, “This doesn’t feel good but I’m going to be okay.”
Using your breath can help calm your feelings, steady the rhythm of your breathing and slow your heart rate. It can also help refocus your attention away from what is causing the distress. One example is Box Breathing. With this technique, just picture a box or rectangle, and visualize going up one side of the box as you breathe in gradually. When you reach the top, pause and hold your breath as you imagine going across the top of the box. Then, breathe out as you go down the other side. Pause and hold when you reach the bottom and go along it to the other side. Repeat seven to 10 times.
Progressive muscle relaxation
Tense and relax each muscle group starting from your feet and gradually work your way up the body to your face. This kind of exercise has been shown to reduce stress and anxiety.View more tips: Practical cognitive behavioural strategies to manage your mental health during COVID-19
Tips to help you and your child get used to wearing a mask
Whether kids are wearing masks to prepare for back-to-school or adults wearing them in the workplace, it may take some time to get used to this change.
Dr. Mansfield suggests taking a step-by-step approach by wearing masks in various situations and over longer periods of time to help adapt to wearing them.
Learn how to put a mask on and take it off
Take some time as a family to learn how to wear a mask, how to safely store it and properly wash or discard a mask (this link also has a helpful infographic).
Talk and listen to children
Having a family discussion about wearing masks can help everyone understand why doing this is important and how masks can help during the pandemic. Dr. Mansfield says listening to a child’s concerns and validating their emotions is key.
“Often when children say, ‘I can’t wear a mask’ or ‘I don’t want to do it,’ the parental instinct may be to reassure or say something along the lines of, ‘You’re going to be okay. Don’t worry.’” But Dr. Mansfield adds, “It’s important to help children have space to express how they’re feeling and also show a child that they are being heard. You don’t have to agree with what is being said but you can affirm that you hear their concerns. Parents can paraphrase back to their children saying something like, ‘I hear what you are saying, that sounds tough, tell me more about how you are feeling and what you think about it’. Or ‘when you talk about it that way, it sounds like it can cause a lot of worry. That can be really hard. I hear you.’”
Focus on what you can control
Review the anxious thoughts you are having, or those your child is having. Write them down and then divide them into two categories: things you can control and things you can not control, recommends Dr. Mansfield. Help discuss and put energy into the column of things that you can control, such as: choosing a mask, practicing wearing a mask, being able to take breaks from wearing a mask in private safe places, and talking about wearing a mask.
Start at home. Wear the mask in the comfort of home and allow yourself to take breaks when it feels uncomfortable. When feelings of anxiety arise, recognize how you’re feeling, but try to continue wearing the mask. This is a technique called exposure, where you actually do the action that is causing the anxiety. “Every time you will be able to tolerate wearing the mask a little longer,” says Dr. Mansfield.
Wear masks in calming situations
Try wearing a mask in situations that aren’t anxiety provoking. For example, both kids and adults can wear their masks while watching television, a more calming and relaxing situation. Try to keep the mask on for a little longer each time. “As this gradual wearing of the masks in relaxing situations continues, kids and adults start associating the masks with those everyday types of settings rather than more anxiety provoking situations, such as being in a crowded public space,” says Dr. Mansfield.
Take it step-by-step
Start wearing the mask at home. Then try wearing it outside. Then with someone you trust, wear your mask in a more public space with other people while maintaining physical distancing where possible.
Involve your child
Give children the opportunity to be part of the process when choosing masks. They could try on different masks for style and comfort. Allow them to choose a colour or design if their school is allowing designs on masks.
Masks and hearing loss
Learn how to help support family and friends with hearing loss. Individuals who are living with hearing loss may rely on lip-reading or assistive devices for hearing. Wearing masks with clear windows so the mouth can be seen and/or speaking more clearly and loudly through a cloth mask may help as well. Being patient can also go a long way.
Strategies help build resilience
Empowering you and your child with these strategies can help build resilience.
“Resilience is not about avoiding a setback or challenge, it’s about how you recover from it”, explains Dr. Mansfield. Building resilience can also help kids realize what they are capable of and how they can deal with difficult situations throughout the pandemic.
It’s also helpful for kids and parents alike to realize that the things they can control, such as wearing a mask, washing their hands and maintaining appropriate physical distancing make a big difference in protecting each other and the community throughout the COVID-19 pandemic.