Have you been experiencing flashbacks, memories, distressing dreams, excessive anger/anxiety/irritability having to do with your experience during the COVID-19 pandemic? If so, you might be experiencing post traumatic stress disorder (PTSD). But wait. Some people tell me that this is only for war veterans. Not true. In the face of any traumatic event, it is possible to experience PTSD. This is a psychiatric disorder which can occur in people who have been involved in a serious accident, terrorist attack, school shooting, or physical assault, among other traumas. In my practice, I recently have seen numerous individuals who experience these symptoms from major fires. Yes, you may be more at risk being a medical worker directly working with COVID-19 patients. Additionally, being essential workers like police/fire personnel, grocery store personnel, may increase your risk. Even being self-quarantined may increase risk of PTSD. There were two useful recent articles on this topic from which I drew material. One is by Cory Stieg dated 4/18/20 titled “Could you get PTSD from your pandemic experience?” The other reviews some recent Chinese data on the effects of pandemic quarantine for COVID symptoms. It is by Jamie Alten from 4/4/20 titled “Are COVID-19 patients at risk for PTSD?”
Stieg noted that after the SARS outbreak in 2003, both healthcare workers and people who were self-quarantined exhibited symptoms of PTSD. According to experts, the Covid-19 pandemic could have a similar effect. Even if you aren’t clinically diagnosed with PTSD, you may have a strong emotional reaction to the trauma of COVID-19 that can last long after the incident. Dr. Luana Marques, clinical psychologist at Harvard Medical School, noted that a key element is what we think about the event and and what it means to us. This is the essence of the cognitive model. As Dr. Marques noted, use the acronym ‘TEB’ It stands for: thoughts, emotions, and behaviors. “People should be watching what they’re saying to themselves, and how that’s making them feel and what they do,” Marques says. “If you spend all day ruminating that you’re going to get sick or lose your job, then you might go home and drink to feel better and wake up feeling worse the next day. If your thought patterns tend to be ‘black and white or catastrophic,’ that’s not a good sign. That leads to distorted thinking and dysfunctional behavior”. Those who struggle with other mental health conditions, such as anxiety or depression, or who have a prior history of trauma, may be at increased risk of more ongoing distress. It is important that you stay aware of symptoms as noted earlier such as invasive thoughts, nightmares, upsetting memories of the experience, flashbacks, sleep problems, irritability. feeling stressed out. Most of us recover after time. However, if you are experiencing symptoms months after the pandemic subsides, if you still have trouble getting on with your life and work, it may be worth getting help from a therapist or mental health professional. Some useful tips in the Stieg article include finding a coping mechanism that can “anchor” you, like calling a friend or exercising. Also, you can lessen your involvement with the news. Studies suggest that simply watching news coverage of a traumatic event can trigger acute stress symptoms, according to Dr. Marques. Maintaining the strategies that you know tend to work is one way you can make sure you’re not suffering months down the road. Maintain strategies that support your resilience in coping with restrictions, anxiety, and fears associated with the pandemic. These are stressful times. For information on stress management, please read our book (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. For additional information about the book, authors, and stress in general, please visit our website at www.manageyourhealthandstress.com.
As we know, physical separation from others and social distancing have been key mitigation strategies during the last several months. While it is necessary, there may be consequences for those isolated—especially, perhaps, coupled with the experience of having the illness—that need attention. In his article, Alten reported that Chinese researchers have recently investigated if PTSD was prevalent within COVID-19 survivors. They studied the mental health status of those discharged from quarantine facilities. Their research paper, published in the journal Psychological Medicine on March 27th, noted: “Due to social isolation, perceived danger, uncertainty, physical discomfort, medication side effects, fear of virus transmission to others, and overwhelming negative news portrayal in mass media coverage, patients with COVID-19 may experience loneliness, anger, anxiety, depression, and insomnia, and posttraumatic stress symptoms.” The investigators asked COVID-19 patients to participate in an online questionnaire before their release from the five quarantine facilities constructed in Wuhan, Hubei province. The participants all needed to meet a criterion before taking part in the questionnaire. Alten reported that each person needed to be a clinically stable adult COVID-19 patient as verified by medical records. Of the 730 patients recruited to be in the study, 714 people averaging 50 years of age met standards to participate. They measured reported PTSD symptoms on a commonly used checklist for PTSD symptoms. Alten noted that the investigators found that based on the PTSD Checklist questionnaire, the prevalence of serious PTSD in the patients discharged from the quarantine facilities was at a staggeringly high 96.2%. While the investigators acknowledged that some other factors might contribute to PTSD symptoms, it was clear that a significant number of COVID-19 survivors suffered from PTSD before being released from quarantine. What this suggests to me is that treatment (including access to psychological care) needs to not stop once patients are discharged. Additionally, it could be that non-hospitalized patients with symptoms released from isolation also may need attention and intervention as well. There may be implications for non-patients in social isolation as well. While we do not how extensive those issues are at present, it is worthwhile to keep in mind the burgeoning knowledge we have over decades on the relationship between the mind and the body, including the immune system. It is important to stay connected to others even when physically separated.
So, stay connected to others as well as you can, whether by phone, text, video chats. Stay safe and healthy. Look for one another. Best of luck on your journey.
Dr. Paul Longobardi
For information on these and related topics, please visit my website at www.successandmindset.com