As the Coronavirus continues to spread across the globe, for some people, having to wear a face mask, has seen their anxiety risen to new heights and my office phone is constantly ringing with people wishing to address this issue.

Knowing the health benefits doesn’t necessarily make us feel more comfortable about wearing face masks, as the reasons behind our anxiety can vary greatly. Some of these reasons can include feelings of claustrophobia, a gagging sensation, often our health anxiety kicks in because it’s a visual reminder of the pandemic, many people have fears around their oxygen levels and not being able to breathe.

During our lifetime, phobias can be developed at any time and can be triggered by a wide variety of factors. For some people, wearing a face mask can trigger feelings of suffocation or claustrophobia (the fear of confined spaces) which can be experienced as mild symptoms of anxiety, or extreme symptoms such as panic attacks. This is not unique to wearing medical masks or face coverings— this is true of wearing sleep apnea masks or Hallowe’en masks too!

Some people have a highly sensitive “false suffocation alarm”, this causes people to believe they are suffocating when they aren’t. It can be triggered by small changes in our breathing patterns as a reaction to our anxiety.

Therefore someone with anxiety will sense a change in their breathing pattern, that they experience as being short of breath, and they feel anxious, think catastrophic thoughts (“I’m suffocating”) and they start breathing harder and faster.

This maladaptive reaction to feeling short of breath sets off the panic cycle. Adrenaline starts pumping, anxiety is through the roof, and you are convinced you are dying. You whip your mask off…. And relief…. therefore, you naturally conclude the mask is killing you.

It is really important, that we support people in wearing masks, for them and for public health to prevent the spread of coronavirus. To do this, we need to validate their experience and educate, you are not in danger from wearing a mask.

Fear of suffocation, anxiety and panic are common. They happen because you happen to have a brain that is highly sensitive to sensations of suffocation, and you are prone to having an anxious reaction to these sensations. But you are not in danger from wearing a mask.

Psychologists can help people remove this false suffocation sensation and reaction and to learn to feel comfortable wearing a mask, using an evidence-based therapy called exposure therapy. 

Briefly, you learn to get rid of your fear reaction that arises when you feel like your breathing is obstructed. When we feel fear, we often take too many deep in breaths, too quickly, this causes hyperventilation. This decreases the amount of oxygen-rich blood that flows to your brain.  So we need to start by practicing a type of breathing that counteracts the air gasping breathing that happens when you feel you are suffocating.

Here is a breathing exercise you could try:

Equal breathing, this  stems from the ancient practice of pranayama yoga is equal breathing. This means you are inhaling for the same amount of time as you’re exhaling.

Shut your eyes and pay attention to the way you normally breathe for several breaths.

Then, slowly count 1-2-3-4 as you inhale through your nose.

Exhale for the same four-second count.

As you inhale and exhale, be mindful of the feelings of fullness and emptiness in your lungs.

As you continue practicing equal breathing, your second count might vary. Be sure to keep your inhale and exhale the same.

When you start to feel confident you can master you breathing technique, gradually, start by holding the mask in front of your face, but not on your face. Breath slowly and deeply. Continue with this until you don’t feel any anxiety, for at least 5 minutes. Next time bring the mask a bit closer and repeat.

If you feel your anxiety or sense of suffocation increasing, first remind yourself that you are not suffocating. You are not in danger. Keep breathing slowly and deeply. Wait until your anxiety has completely resolved. Then repeat.

Continue this process until you have the mask on your face, with your ear loops on. Keep breathing slowly and deeply until your anxiety has resolved. Then keep wearing the mask, breathing normally. Whenever you feel your anxiety ramping up, do your equal breathing again.

 You might like to practice wearing the mask around the house—especially if you are afraid of panicking in public. Try not to take off the mask when you feel your anxiety is rising as this reinforces the fear. Keep breathing through the anxiety and take off the mask when the anxiety has gone.

I hope this blog helps you to make wearing your face mask more comfortable. If you would like some more help, there is a complimentary audio download in the resources section of my website https://www.apaininthemind.co.uk/resources/

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