Panic attacks triggered by PPE at work

[Cloudyblue]

I work in healthcare and since the onset of Covid have struggled with the constant need for wearing masks for entire shifts at work. I have struggled, mostly silently, but have also been socially isolating myself as as a way to avoid masks wearing any more than absolutely necessary. I have always been somewhat claustrophobic but masks have become very triggering for a crappy incident in the past that I had (so I thought) effectively buried. More recently with the increase need at work for full PPE and now having to always wear a N95 instead of the slightly less restrictive surgical masks, with minimal opportunity for breaks to remove the masks, my distress has increased. Firstly nightmares and worsening depression and mild (mostly controllable) panic attacks until more recently I had a major panic attack during work and was unable to carry on working. It was very distressing and embarrassing for me and now I'm almost having panic attacks about having another panic attack at work. My anxiety about going to work has increased dramatically. I am mentally exhausted from living on edge for such a long time and physically drained from ongoing palpitations whenever my anxiety gets on top of me. Mindfulness and meditations in the past have helped me, but don't seem to have the same effect anymore. Focussed breathing techniques have been my go to previously, but when in N95 masks and wearing all the associated PPE it feels near impossible to get a breath in let alone focussed deep breathing. All this PPE is here to stay for the foreseeable future given my job and I just can't seem to see a way out from where I am. Until now I have avoided medication, hoping therapy would help me through, but the anxiety is now crippling and in turn my depression has reached new lows. I'm not sure what I'm after...I guess I'm wanting to know if there are other healthcare workers who have similar issues and how they are managing to continue working under these circumstances. Working in an area without PPE is simply not an option for me, so I have to find a way to make it work. Thanks for any thoughts.

[Sophie_M]

Dear Cloudblue,
We’re so grateful to have you reach out to our community this morning and are so sorry to hear everything you have going on at the moment. Times like this can get overwhelming. We hope that you find our forums to be a safe and supportive space to talk through your thoughts and feelings. Our community is here for you. 

We hope you know that there is always help available to you, whether it's from our professional mental health counsellors Beyond Blue (available 24/7/365 on 1300 22 4636) or our friends at Lifeline (13 11 14) or the Suicide Call Back Service (1300 659 467).
Keep checking back in with us whenever you feel up to it. 
 

[romantic_thi3f]

Hi Cloudyblue,

Welcome to the forums and thank you for joining us! I'm sorry to hear how difficult things have been for you. People with anxiety can struggle to wear simple cloth masks, let alone full PPE. Hopefully another healthcare worker will jump in soon as I know that you're not alone in this.

I'm assuming from your post that you are in therapy but haven't taken medication and were hoping to avoid it? How are you finding therapy?

Focused breathing techniques can be a really good idea, but I can imagine how that would feel worse. I wonder if there are other things that feel calming to you that you can use as tools? Maybe that could be the smell/taste/feel of something that relaxes you both before and after, and grounding yourself with your feet rather than your breath. Sometimes when my own anxiety goes through the roof I'll just try and wiggle my toes a bit to feel my feet on the ground, or focus on my breathing through my belly. I think it might just be about finding what's going to work for you.

rt

[therising]

Hi Cloudyblue

I feel so much for you as you not only face the challenges that come with breathing through a mask but also the anxiety that comes from that in relation to your past experience.

While I only face the challenge of wearing a mask, without the anxiety, I'd come to question a lot about the masks. I work in aged care. At first it was just the mask, which was challenging enough, and then the face shields were added to that. The challenge with breathing while not feeling like you're suffocating, the challenge with the heat and the mental challenges that comes with those 2 factors combined was pretty mind altering to a degree. Working in the kitchen there meant that (we) the kitchen staff became exempt from wearing the shields. I feel deeply for everyone else who is left with the challenges of both the mask and the shield together. It really is horrible and quite suffocating when the harder you work/the faster you move, the more you feel the need to breath freely.

While a lot of the experts advise 'The masks don't change or impact your breathing' I beg to differ. Took me a while to discover I'd gone from being a nose breather to a mouth breather while I was wearing the mask. It was a completely different way of breathing for me, as I'd always been someone who breathed through my nose. My breathing also became more shallow. So, basically, I wasn't breathing 'properly' or easily. While those experts say the masks don't impact your oxygen levels, changing the way you breath behind a mask can. Mouth breathing vs nose breathing is some interesting research. I found it was handy to take a couple of toilet breaks outside of normal breaks. Just a minute or so for each one. It's a chance to take the mask away from your nose and mouth while you're sitting on the toilet. They're not really toilet breaks, they're breathing breaks. As long as this is managed carefully, such as with not sneezing or coughing and you're not picking up any sneezes or coughs someone else has left behind in the cubicle, it's a chance to literally take a breather.

I figure, considering we're not born with masks on our face, wearing a mask is simply not natural and we feel what's not natural. Not only is it not natural but you're doing what's not natural for an entire 3rd of the day (if you work an 8 hour shift). That's a long time to be doing what's far from natural. Btw, I found greater hydration makes a bit of a difference.

I hope you find what makes a big difference to you 🙂

[Cloudyblue]

Thanks RT for your thoughts,

I have reached a point I think I am going to have to try medication as I'm shutting down. I'm not really sure how I'm finding therapy....it certain is helpful knowing I have someone to talk to, but in many ways I feel it's making me worse because of the things that are being brought up. I'm currently working on the theory that I may get worse before I get better as there's a lot to deal with that I have previously ignored. It's been confronting for sure. I like your thought about wriggling the toes to try and ground myself. My therapist has suggested a few key phrases I can keep saying to myself when I start feeling panicked but can't do the breathing thing due to the masks...it has helped a little in conjunction with breathing techniques so far...but I have not yet been back in full PPE to see if it helps me in that situation.. time will tell as a full return to work is inevitable. Thanks for your kindness.

[Cloudyblue]

Thankyou Therising for your understanding.

Working in a hot kitchen with masks and shields would be extremely difficult...I'm glad to hear you've been granted exemption in that situation. The overheating is another aspect of the PPE that just adds to the anxiety...some nights I am literally dripping in sweat due to the hot plastic gowns we need to wear as well as masks googles and face shields. It's been overwhelming enough over the winter months, but as it's warming up, with the daunting prospect of the expected covid surge over the next few hotter summer months I'm feeling fairly hopeless about it all. 8hrs is hard enough but I predominantly work 10.5 hr shifts. When it is busy it is often next to impossible to get off the floor for a toilet break and with the high risk infection issue it is even harder to have a moment to even take a sip of water...just popping the mask off to do this is a risk. You need to pretty much take off all PPE and leave the floor simply to have a drink. Dehydration is real and certainly doesn't help with the anxiety. Previously taking the time in a "toilet break" has been the only way I've been able to keep my "mini" panic attacks controlled. The time I had this major panic attack was because it had been so busy I hadn't had any chance to get out to "breathe" and it all just got on top of me. As we get busier I fear this happening more frequently. I definitely agree with you regarding mouth breathing, it's the only way I can breath with masks on, it's not natural and I find I end up with a very stiff and sore jaw from doing this for extended times. Thanks for your care, and stay safe.

[therising]

Hi Cloudyblue

With you mentioning full PPE, I can't help but think 'You poor thing'. I gotta say it's insanity when you consider how much of an occupational health and safety issue this is for workers, in regard to a number of reasons. I can't help but wonder whether this issue has been officially raised in some way, especially with the summer months approaching.

Personally, I'm not a union member but still I'd be looking into whether this issue has been raised with them over the months or whether a union can offer any advice when it comes to possibly negotiating extra health related breaks with management. Even if you're not a member, they may still offer advice. I think it's crazy that no changes (regarding PPE and added breaks) have been put in place by now. Hopefully it doesn't take a number of healthcare workers collapsing to set the ball in motion for change.

Healthcare workers deserve far greater consideration, especially under the circumstances 🙂