Coronavirus masks have an unintended effect on socially anxious people

Months into the pandemic, people have seemingly broken into two camps: those who want to wear masks and those who do not. Recently, however, a subgroup has emerged: people who want to wear masks, especially because it helps with their social anxiety. The fact that wearing a mask reduces transmission of disease is an additional perk.

On the subreddit r/anxiety, individuals have opened up about the emotional comfort a mask can seemingly provide. Wearing a mask helps some people feel less judged and less self-conscious when they go into public.

“I feel much more comfortable in public and talking to people,” Reddit user u/OpenRoadDesign writes. “It does make me worry about when we have to stop wearing masks, that my anxiety is going to go through the roof.”

“It’s a bit of comfort when feeling anxious,” u/NaomiJD shares. “I put mine on as soon as I leave the house. I always worry about how people view me, my face tends to give away how I am feeling inside but wearing a mask gives me comfort knowing not as many people will be able to see me.”

Experts in the study and treatment of social anxiety aren’t necessarily surprised by this development. Masks allow for a sense of anonymity, and a desire for anonymity is a coping strategy for social anxiety.

David Moscovitch is a professor of psychology at the University of Waterloo. His research is geared towards answering questions about the nature of social anxiety and its treatment. Currently, he and a student are working on a paper on the potential effects of mask-wearing on social anxiety.

“It is not surprising to me that people who are socially anxious would feel more comfortable wearing masks since the core problem in social anxiety is concern about self-exposure,” Moscovitch tells me. “Masks certainly help with the desire to self-conceal, particularly for those individuals who believe that masks might help to conceal their imagined flaws in physical appearance, or showing signs of anxiety to others, thereby preventing negative evaluation.”

Vaile Wright, a psychologist and the senior director of Health Care Innovation in the Practice Directorate at the American Psychological Association, says this situation is reminiscent of social media, which has been shown to actually reduce social anxiety. Like a social media profile, masks give you the option to obscure yourself.

“I think [the mask] enables people to feel freer; to express themselves without that fear of being judged or criticized,” Wright tells me.

But are masks actually helping? — Social anxiety disorder, or social phobia, is the second most commonly diagnosed anxiety disorder and affects approximately 15 million Americans. It is characterized as the intense, persistent fear of being watched and judged by others, and it can be debilitating.

In a 2009 position paper, Moscovitch notes that while people may experience the nuances of social anxiety differently, people with it are “uniquely and primarily concerned about characteristics of self that they perceive as being deficient or contrary to perceived societal expectations or norms.” This point is made salient by the variety of reasons people list explaining why masks help them on Reddit, ranging from a desire to not have their appearance judged to not wanting to feel self-conscious when they employ soothing techniques like big breaths.

"It is not surprising to me that people who are socially anxious would feel more comfortable wearing masks since the core problem in social anxiety is concern about self-exposure."

Ultimately, Moscovitch describes the relief felt when mask-wearing acts as a “safety behavior” rather than a solution. Safety behaviors are the emotional action tendencies people turn to in an attempt to prevent the occurrence of feared consequences. Masks may reduce social anxiety in the short term, he says, but they could also have unexpected negative consequences in the long term.

It’s possible that, when it comes to people with high levels of social anxiety, the relief they experience might falsely indicate that they need the mask in order to not feel judged. That could be an issue when masks are no longer socially accepted as a necessary norm.

“The negative consequences of mask-wearing may also extend to interpersonal-relational contexts where socially anxious people may find that wearing masks may allow them to self-conceal but prevents them from forming deeper connections with others,” Moscovitch explains.

Curbing social anxiety, masks, or no masks — That’s not to say it’s bad that people are feeling some relief from anxiety while wearing masks. The issue is that they are not a permanent solution — and there’s a risk of developing a dependency.

Wright explains that, ideally, masks can be sort of like taking that first safe step into a pool when you’re nervous about swimming. “Ideally, they can help someone gain confidence in their ability to interact,” she says.

But it’s also crucial that, when they reflect on the day, they don’t attribute any social abilities to their mask, Wright stays. Instead, they must credit success to themselves and their ability to engage.

“It’s about exposure, and then countering the negative worries and thoughts that accompany social anxiety-like the fear of saying the wrong thing,” Wright says.

This jibes with established interventions for social anxiety that involve practicing social skills, paying hyper-attention to whether or not people are actually observing you, and taking progressively bigger steps towards social interactions. Currently, cognitive behavioral therapy is considered the most effective form of treatment for social anxiety. This typically includes exercises that challenge people to face their fears and learn how to improve self-perception.

“The key to dealing with social anxiety is learning to recognize that you can be your authentic self and the world will accept you as you are,” Moscovitch says. “So mask-wearing — while necessary for public health reasons right now — may prevent such learning from happening in the long run.”