Mask anxiety, face coverings and mental health

On this page:

• What are the laws for masks in England and Wales?
• Why masks can cause difficult feelings
• Can I be exempt from wearing a mask?
• Tips for coping with masks and face coverings
• Being supportive to others

Why masks can cause difficult feelings

Many of us have been wearing masks to help stop the spread of coronavirus during the pandemic. But masks are not easy for everyone, especially those of us with mental health problems.

Challenges with wearing a mask yourself

These are some ways in which you may struggle with wearing a face mask or covering:

• You might feel anxious or panicky, as covering your mouth and nose might affect the air you breathe. This can cause symptoms like feeling dizzy or sick, which you may then associate with your mask.
• You might feel trapped or claustrophobic.
• Covering your face changes the way you look, which may cause negative feelings around your identity or body image.
• Certain materials touching your skin might feel very hard to cope with, which may create sensory overload.
• If you wear glasses, they might steam up so you can't see clearly. This might add to feeling overwhelmed.

If you don't wear a mask because you are exempt, there may also be things that you are worried about:

• You might feel anxious about being judged, shamed or stigmatised in public. You might feel upset if people assume you are avoiding wearing a mask for the 'wrong' reasons. This may feel especially hard if the reason you can't wear a mask is linked to your mental health.
• You may also feel worried about being turned away from places where a mask is required. Or you may worry about being asked to pay a fine, in situations where masks are required by law.

“I get very anxious about all the people who wear masks, they make me feel like I am full of dirt and germs.”

Challenges with masks and other people

You might worry about seeing other people wearing masks when you are out in public. For example:

• Seeing people with covered faces might make you feel uneasy or scared of others. They might seem threatening, sinister or dehumanised.
• Masks are a visual reminder of the virus, so seeing masks might make you feel on edge or unable to relax. It might seem like danger is everywhere, especially if coronavirus is also in the news.
• Wearing or seeing people wear masks might trigger a memory of a traumatic event. If this is the case for you, there is further guidance on the Victim Support website.

You may also feel anxious or upset around people who are not wearing masks:

• Being around people without masks might make you feel less safe from the spread of coronavirus. This might make you feel uncomfortable, even if you know that some people are exempt from wearing a mask for good reasons.
• If you cannot wear a mask yourself, you may feel even less protected. So you may feel especially nervous being around others who don't wear masks, even if they may have similar reasons to you.
• These different emotions might leave you feeling confused or unsure of how to act. You may worry about how to deal with going to places you can't avoid, like shops or public transport.
• You might also feel like you want to avoid some places or situations completely, including things you would usually enjoy. Our page on coronavirus and your wellbeing has tips which may help if you are spending lots of time at home during the pandemic, including ways to keep in touch with others.

Can I be exempt from wearing a mask?

Some people may be 'exempt' from wearing a mask, or have a 'mask exemption'. This means having a reasonable excuse not to wear a mask, including certain physical and mental health problems.

To read the full guidance on who is exempt from wearing a mask, visit:

• the UK Government's information on who does not have to wear face coverings in England.
• the Welsh Government's information on who does not have to wear face coverings in Wales.

If you have disability which prevents you from wearing a mask and you are treated worse because of this, you may also be protected by the Equality Act.

How do I prove I am exempt from wearing a mask?

You do not need to prove that you are exempt from wearing a mask. There is no legal document or proof that you need to carry on you.

If you are challenged about not wearing a mask, you could:

• Tell the person why, if you feel able to. Try saying "I am exempt for health reasons", or "I have a good reason that you can't see. Please be kind".
• Write down your reason and show it to people. This could be written on a piece of paper, or displayed on your phone.
• Consider printing or downloading an exemption card. These are not required at all, but might make you feel more at ease when explaining to others.

Unfortunately, you might find that not everyone understands, or is supportive. This can be hard to cope with, but you're not alone. Consider trying some self-care tips and ideas to help look after yourself.

Tips for coping with masks and face coverings

You may never feel totally comfortable with masks. And if you are exempt, you do not need to wear one. But if you wish to wear a mask or face covering, the tips below may help to make your experience feel a little easier.

You will also find tips to try if you struggle being around other people wearing face masks.

Anxiety, panic and breathing issues

If wearing a mask makes you feel panicky or like it's harder to breathe, you could:

• Get some fresh air. You can try breathing in air outside before and after you need to wear your mask.
• Do something to relax before and after wearing your mask. For example, you could do a short breathing exercise. We have some relaxation exercises you could try.
• Choose a face covering that fits differently. Try one that hangs down your neck, rather than fitting around your jaw. This type of covering is called a 'neck gaiter'. It might feel breezier.
• Keep your body as cool as possible. For example, by wearing loose-fitting clothes or sitting by an open window on the bus.
• Add a comforting scent to your mask. It might help to use a familiar fragrance, like your own perfume or aftershave. Or you could try a smell that reminds you of someone else. A few drops of lavender oil can also be soothing.
• Reduce the time you spend with your mask on. For example, try planning your shopping in advance before going out. This can help you cut down the time you spend browsing in shops.

“It's so hard to wear a mask and carry on all day when underneath I feel sheer panic.”

Physical discomfort

If wearing a particular material creates sensory overload, you could:

• Experiment with various fabrics. Try making your face covering from an old t-shirt that you don't mind the feel of. You can search for mask-making tutorials online. The UK Government also has instructions on how to make your own mask.
• Try securing your mask in a different way. Some fit round the ears, some tie behind your head. You could try attaching buttons to a hat or hair band, so the mask doesn't irritate your skin.
• Choose another type of face covering. Try using one that doesn't touch your face in the same way, like a neck gaiter.

“I feel very claustrophobic and the masks make my face sore.”

If wearing a mask steams up your glasses and makes it hard to see, you could:

• Wash your glasses with soapy water. You can polish them with a tissue after. A thin layer of soapy film may make it harder for the lenses to steam up.
• Sit your glasses on top of the fabric. Do this by raising the top of your mask up onto your nose. Then place your glasses on top of the material.
• Line your mask with a tissue. The tissue helps to absorb some of the moisture from your breath.

Body and identity issues

If covering part of your face makes you feel uncomfortable in your body image or identity, you could:

• Think of your mask as a fashion accessory. A mask or face covering with a design or pattern might better express who you are. You could use a scarf or bandana. Or try to find a selection of colours that you can match your outfits with.
• Choose a transparent mask or see-through face covering. This way, the fabric doesn't hide your face in the same way.

Anxiety around other people wearing masks

If seeing other people in masks makes you feel uneasy or afraid, these are some ideas which may help:

• Shift your focus away from someone's face. While talking to someone, try switching the angle of your body. It might feel better if you're not directly opposite them. You can be side-by-side and both look ahead in the same direction.
• Try to pay extra attention to non-human surroundings. This might be trees, traffic, shop windows, or the sounds and smells you notice. It may not be possible to avoid looking at people entirely. But by balancing it with other things that feel more familiar, you might feel calmer.
• Distract yourself while you're out. For example, listen to music or podcasts through headphones or call someone you enjoy chatting to. Or try something simpler like focusing on breathing, or picturing yourself elsewhere. See our page on tips for relaxation for more ideas.
• Let the person wearing a mask know how you feel. Someone you have to see often, such as a friend or housemate, might wear a mask that you find scary. If so, you could try gently telling them how it makes you feel. They might be able to change it or cover it up in your presence, to help you.

Being supportive to others

There are many ways we can be supportive to people who might be struggling with masks:

• If you are comfortable wearing masks, you could offer to put on a mask in situations where it is unclear if it is required, or if some people are wearing masks but others aren't. Others might be wearing masks because they feel uncomfortable and prefer to be socially distant. If you notice this, it is kind to offer to put yours on too, or ask if you can do anything else to help them feel comfortable.
• Don't judge people who aren't wearing masks. Don't assume that by not wearing a mask, someone is 'just being selfish' or 'breaking the rules'. Someone's reasons for being exempt might not be obvious.
• Acknowledge people in a friendly way while you are wearing a mask. You could say a friendly "hello" or "good morning" as you pass them, or wave your hand. Some people who can't wear masks might feel like others are avoiding or ignoring them.
• Communicate with people in other ways. Try using your voice, eyes, hand gestures and body language. This could help to make up for what you're unable to show through smiles or other facial expressions while your mask is on.
• Ask people what would help. If you see someone regularly who is uncomfortable with people wearing masks, ask how you can help. For example, you could get a transparent mask to wear when you are with them.
• If someone tells you they're exempt, accept their word for it. It might be difficult for some people to go into detail about their reasons. 

Minding your 'mask manners'

If you are out in public and around other people, these are some questions you could ask to ‘mind your mask manners’ and help others feel comfortable:

• "Would you like me to wear a mask?"
• "Would you prefer it if I took my mask off?"
• "Is it ok if I take my mask off?"
• "Shall we spread out a bit? I could sit or stand over here."
• "Shall we open this window?"
• "Is it ok if I leave the door open?"
• "Would you like some of my hand sanitiser?"

It's also OK to state your own needs and ask for support from people around you, so that you feel more comfortable. But if you are unsure whether others will observe coronavirus guidance, these requests might feel awkward.

Here are some suggestions on ways to speak up about what you need:

• "I find it difficult to be around people who aren't wearing masks. Is it OK if you step back, put on a mask or come outside with me?"
• "When we meet, I'll be wearing my mask – could you do the same? It would help me to relax and focus on enjoying spending time with you."
• "I'm not yet ready to start socialising indoors just now. Can we find an outdoor alternative?"

This information was last updated on 2 December 2021.

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