Post-Vaccine, Your Body Is Safer, but Your Mind Can’t Catch Up

Vaccination offers protection against the viral threat, but your brain needs time to reset after a year living with the fear

Multicolored photo of covid-19 vaccine.
Photo: Andriy Onufriyenko/Getty Images

Rachel Gersten is a licensed mental health and wellness counselor and, as she says, a believer in science. All throughout the Covid-19 pandemic, the co-founder of a New York–based wellness company followed official public health guidance on safe behavior and avoided illness. She’s on the other side of peak risk now because she is fully vaccinated. Even so, having reached this stage, the 34-year-old is experiencing dissonance: Gersten’s foundation in science tells her on an intellectual level that she’s largely protected from the coronavirus; emotionally, however, her brain can’t catch up.

“If you fall off a horse, you get back on,” she says. “I understand that, but in this case it’s tough to make the mental switch after a year of living in fear.”

Gersten will likely find herself in good company as more people get their shots. Although some may be ready to jump back into pre-pandemic lifestyles, many others will not. “For an entire year, our brains have operated in fight-or-flight mode,” says Annie Miller, LCSW-C, of Washington, D.C.–based D.C. Metro Sleep and Psychotherapy. “We’ve been programmed to sense being around people as a threat, and it’s only normal to be fearful of returning to that scenario.”

This dissonance doesn’t quite fit the clinical definition of PTSD, but it has shades of the disorder, says Steven Taylor, a professor in the Department of Psychiatry at the University of British Columbia. He co-authored a July 2020 study published in Depression & Anxiety that looked into five facets of Covid-related distress: fear of the disease, worry about its socioeconomic costs, xenophobic fears that foreigners are spreading the disease, traumatic stress symptoms associated with exposure to the virus, and compulsive reassurance checking, which involves repetitive, frequent checks to ensure you are virus-free.

“You don’t need to have experienced one particular traumatic event to experience this syndrome,” Taylor says. “Covid stress has been a long, pervasive event.”

A study published in January 2021 in PLOS One reinforces this idea. “Our findings support emerging research that Covid can be understood as a traumatic stressor event capable of eliciting PTSD-like responses and exacerbating other related mental health problems,” the authors wrote.

These findings support what Gersten is experiencing, even after full vaccination. Collectively, while we all continue following public health guidance and await maximum vaccine uptake, we have other work to do. As post-vaccination life approaches, the trick becomes reprogramming our brains to feel safe again and embrace a (new) normal.

This is your brain on fear

If that new normal for you involves fear, you’re not alone. Jennifer Pett, a 47-year-old university lecturer from Maryland, understands well the extended fear of threat, perceived or otherwise. Just prior to the pandemic, she had been allowing her brain to relax and feel safe again after two years of vigilant behavior to protect her immune-compromised husband. Then the pandemic arrived, and she felt “sucker punched” by the virus.

“I had put in the work to understand that there’s only so much I could control and that living in a sustained state of fear was harmful,” Pett says. “It wasn’t that I became more reckless, but I was letting go a bit,” she says about just starting to relax right before the pandemic.

Now that both Pett and her husband are vaccinated, she recognizes that it’s time to turn her attention toward relaxing her threat response once again. She’s returning to a mixture of tools that proved useful during her husband’s illness, including therapy and what Pett calls “faking it until you make it” immersion. “If a friend invites me to lunch, for instance, I will carefully evaluate risk levels, remind myself of the emotional benefits, and go,” she says.

Pett’s approach is sound, according to Miller, who recommends a bit of exposure therapy if you’re struggling to move forward with what once were commonplace activities, like meeting a friend for coffee. “If you avoid the activity you’re afraid of, you only strengthen the fear,” she explains. “But if you allow yourself to gradually ease into situations, to push yourself to the edge of your comfort zone, you can make progress.”

An example of this approach applies to the classic fear of flying: First, you visit the airport and return home. Next, you get on a plane but don’t take a flight. Eventually, you board, ticket in hand, and fly to a destination.

Like Pett, Gersten is working with herself to slowly let her guard down. “A close friend who is also vaccinated invited me to fly in for a visit and celebrate her birthday,” Gersten says. “My knee-jerk reaction was not to go. But I reminded myself that I was in panic mode, and that in reality, this was now a safe activity for me.”

Gersten took the measures that would make her feel comfortable traveling — including wearing a mask and ensuring that she had the only seat in her row — and decided to visit her friend. “Step one is recognizing that this is hard and treating yourself accordingly,” she says of venturing out after being fully vaccinated. “You’re going to feel anxious returning to a restaurant, for instance, and that’s okay. Stick your toe in the water to start, perhaps with outdoor dining.”

If you recognize that you’re anxious about resuming certain activities, get a leg up and start therapy to address it before you’ve even received a vaccine, Gersten says. And avoid self-criticism when fear arises. “Use energy positively,” she recommends. “If you’re not ready for an experience now, it doesn’t mean you won’t be eventually.”

Revisit your toolkit

What worked well for you to cope throughout the past year will also work well for you in the post-pandemic stage, experts say. “Basic stress management tools can help,” Taylor says. “Simple things like exercise, meditation, sleep, and limited doses of media are all applicable post-pandemic.”

If you find yourself stuck and unable to progress with your usual go-to comfort measures, it might be time to ratchet up your care. Signs pointing to this step include sleep struggles, gastrointestinal distress, and skin issues, which are all indicators of stress. “Your brain can get caught in this fear reaction, and that leads to a heightened nervous response with physical manifestations,” Miller says. “Seek professional help if you can’t move forward to simple activities like joining a friend for a walk outside.”

That said, assume reentry will be hard. “If it feels easy, great,” Gersten says. “But it’s our default to find this a challenging process. You can’t snap your fingers and expect everything to feel as comfortable as it did pre-pandemic.”

Pett understands this struggle, having lived through a version of reentry in the past. “I don’t know if I’ll ever come down to a normal level of risk acceptance again,” she admits. “But I do know it’s worthy of putting in the work, because living as we have over the past year is not healthy or sustainable.” For Pett, the first foray into “normal” will include drinks and appetizers with friends outdoors at a restaurant. For all of us, the vaccines now make this possible. We just have to figure out how to walk out the door.

Amanda Loudin is a freelance writer providing content for both B2B and B2C. Bylines include the Washington Post, ESPN, Outside magazine and many others.

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