Neurological COVID-19 symptoms like depression, anxiety, and brain fog impact mental health. However, the psychological toll of ongoing symptoms and lack of concrete answers can increase mental health risks. "We can experience an intense sense of isolation and deep anxiety when we experience uncertainty," says S Anandavalli, PhD, an assistant professor in the Clinical Mental Health Counseling program at Southern Oregon University. "Prolonged exposure to uncertainty can certainly elevate our anxiety levels, hypervigilance, and just a general sense of worry."
Many long-COVID patients, especially those in the first wave, reported that healthcare professionals ignored or minimized their symptoms. Some patients say they were denied testing or treatment, which lead to severe mental health repercussions, including post-traumatic stress disorder.
Additionally, long COVID patients might experience ableism, which can impact mental health. "When you are disabled, you have to adjust how you operate because you are not able to do things you could do before," says Lauren Nichols, long COVID activist and vice president of Body Politic, a hub for resources and support groups. Missing past hobbies and not being able to go through life, in the same way, can increase distress. "Every single symptom of long COVID has a mental health risk," Nichols explains. Below, therapists weigh in on how to manage the mental health implications of long COVID.
1. Explore mental health treatment options
There are many options that patients with long COVID have found helpful when it comes to mental health. Figuring out the best path might take a bit of trial and error, but many long COVID patients have had success with different therapies. Psychotherapy, cognitive behavior therapy (CBT), or any other type of talk-based intervention might be helpful to anyone experiencing mental illness. Additionally, you can work with a provider to determine whether a pharmaceutical intervention might be beneficial.
2. Lean on your friends and family system
Surround yourself with people who love you and believe you. "While being safe is a top priority, isolation is mentally unhealthy. Withdrawing from people and spending time alone can enhance loneliness, anger, and sadness and distort your thinking. Interaction with others keeps us balanced," says Kristin Francis, MD, a psychiatrist at Huntsman Mental Health Institute. How ever possible, "Stay connected with those you love," she says.
3. Explore support groups
Support groups have popped up as a result of long COVID. Besides Body Politic, there is also #MeAction, which existed before the pandemic as a support and resource for people with chronic fatigue syndrome or myalgic encephalomyelitis (ME). Since long COVID often includes ME/CFS, #MeAction has created support groups for people with long COVID. "Listening to each other's stories right now is very important," says Dr. Francis.
Nichols says of her work with the Body Politic support groups: "That sense of community, that solidarity, that being able to bounce your symptoms off someone else, being able to share data with someone who also is interested in the data and wants to talk through it—that is the most empowering and validating mental health service I could ever, ever get." Nichols is now a patient advocate and believes firmly that "only patients can understand and relate to patients."
4. Give yourself grace
In our society, it's hard to slow down and pace ourselves, but people with long COVID may need to take mental health breaks. "Allow yourself to slow down, sleep, and rest as much as you need," says Anandavalli. #MeAction has a pacing guide they recommend for people with long COVID.
"The most important thing is to bring self-awareness to your feelings and recognize they are valid. Awareness and acceptance of your feelings are the first steps toward taking action to impact your situation," says Dr. Francis. "Keeping schedules, maintaining routines, practicing breathing and relaxation exercises, moving your body, and getting outside—these are a few things we can do to keep moving forward. Disconnecting from the news and negative stories on TV and social media will help, too." While long COVID can be rife with mental health challenges, there are ways to deal with it while we continue to raise awareness and advocate for more treatment options.
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