Mental health struggles affect people who have suffered from COVID for a long time

Amy Weishan, 48, of Canby, Oregon, is discussing her mental health issues while living with long-term COVID-19. (OHSU / Christine Torres Hicks)

For Amy Weishan, the long COVID-19 is much more than brain fog and extreme fatigue that make simple tasks seem insurmountable. It was also a constant emotional train ride that made her see a mental health professional for the first time.

“If you had seen me right now, you wouldn’t have believed my story,” said Weishan, 48, of Kenby. “I don’t look like a person who fights every day. I don’t have a band-aid. My struggle is inside, and the daily inner struggle is really challenging. I’m always in a situation of crying and falling apart. “

Mental health and emotional well-being are often overlooked aspects of long-term COVID-19, leading between 10 and 30% of those infected with COVID-19 to continue experiencing countless disabling symptoms for three months or more after their initial infection. The onset of physical conditions can lead to anxiety, depression, panic attacks and other mood disorders.

“Those who have a more severe or complex case of prolonged COVID-19 may experience a deep sense of helplessness,” they said. Jordan Anderson, DOassistant professor of psychiatry and neurology at the University of Oregon School of Health and Human Services.

Depression and anxiety are the way the brain responds to the limitations of a new health condition. “The longer someone experiences a health challenge, the more a person’s mental health can deteriorate,” Anderson said. “Some long-term patients with COVID-19 have not been well since 2020 and are struggling both emotionally and physically.

The federal government estimates that between 7.7 and 23 million Americans have had COVID for a long time. Mental health is among the many issues mentioned in President Joe Biden’s April 5 memorandum, which ordered the federal government to coordinate the United States’ response to the situation. Yet Anderson does not know another psychiatrist who spends most of his time caring for patients with chronic COVID, as he does as part of the OHSU Long COVID-19 program.

Emotional challenges

Weishan and her family contracted COVID in July 2020, before vaccines became available and before research showed that vaccination reduced the risk of long-term COVID. She was having difficulty breathing, severe joint pain, and was so weak that she felt as if she had just run a marathon without prior training. While her family was recovering, Weishan still had some long-term problems. In October 2020, she tested positive again and experienced a new round of terrible symptoms: cough, stroke and fever.

Successive clashes with COVID-19 prompted Weishan to seek refuge in her bedroom alone. She longed for rest and silence and was easily exhausted by others, including her own family. The continuing brain fog meant that she had trouble gathering her own thoughts, let alone explaining them to others. Whereas she used to be casual and sociable, Weishan began to worry about clutter and preferred solitude to company. She had to take six months off work.

Once she was forced to leave the house for a simple task: to go to a gas station to fill the family car. When the tank was full and it was time to leave, she could not restart the car and was immediately overloaded.

“I was happy and I had to call my husband,” Weishan said. “He came to the station and found that I had forgotten to park the car. He followed me home to make sure I was okay. Then all I could do was go to bed and sleep. ”

That almost became too much in November 2021, when she attempted suicide.

“I remember thinking it was a nasty thing, but it’s better than what I feel now,” Weishan recalled. “But I didn’t feel anything. So I pressed harder until I broke the surface of my skin. “

She stopped before causing serious damage and went to her husband for help.

Empathic listening makes a difference

Weishan heard about the OHSU Long COVID-19 program through an online support group. Her first appointment was in April 2021; she was later referred to a mental health specialist.

“I was unable to get effective help until I met Dr. Anderson at OHSU,” she said. “I had the feeling that my whole body and mind had turned to me and I no longer recognized myself. He helped me figure out what was going on. “

As a neuropsychiatrist who specializes in studying the connections between mental health problems and the brain as a physical organ, Anderson explains from a biological point of view what happens in her body and brain and how they are related. Weishan was prescribed medication to help control her severe anger and other mood swings.

To date, Anderson has treated approximately 50 of the approximately 800 patients who received care through the OHSU Long COVID-19 program. It targets patients who are very anxious about depression, anxiety or panic attacks, or who have suicidal thoughts. Most of his long-term patients with COVID are struggling with mental health for the first time in their lives. And for those who have had mental health problems before, long COVID can make them worse.

“The long-term COVID itself is a new form of trauma that is long-lasting and has not stopped for more than two years for some patients,” Anderson said, adding that many patients are struggling to adjust to their new, lower level. of functioning as their body. slowly fights the long COVID.

Like Weishan, some people need to take time off work when they are initially affected by prolonged COVID. However, most of Anderson’s patients have been able to return to at least part-time work after about a year of gradual recovery.

Anderson focuses on each patient’s symptoms and recognizes that some may be caused by a physical illness rather than a mental one. For example, some long-term patients with COVID also experience postural orthostatic tachycardia or POTS, a circulatory disorder that can cause something like a panic attack. In these cases, he and other OHSU providers have long recommended simple steps to COVID, such as emphasizing hydration and consuming enough nutrients and electrolytes, instead of prescribing panic drugs.

Where appropriate, Anderson prescribes some common psychiatric medications, including propanol or benzodiazepines for anxiety. But perhaps the greatest help he offers is to be an empathetic listener who really hears what his patients share.

“Mental health problems get worse when patients feel invalid,” he explains. “Their suffering can be reduced when their loved ones and health care providers are more supportive and make a sincere effort to understand what they are feeling.

To further support long-term COVID patients with mental health problems, the OHSU program organizes support groups. Up to 20 patients met almost once a month to share their experiences. Weishan participated in two such groups and found that hearing the stories of others helped her realize that she was not alone.

Anderson says health care providers of all specialties should be aware of long-term COVID and be open to referring patients with more complex cases to a specialized clinic if necessary. It also encourages providers to check patients not only for physical symptoms but also for their mental health.

Another kind of joy

Many things have changed in almost two years since Weishan first contracted COVID-19. She still has a headache, her sense of smell is often turned off and she is separated from her husband. She mourns how long COVID-19 has changed her world.

But not all is lost. Over the past year, Weishan has found confidence as he dives into a new job. She mainly works from home, where she can better control her daily rhythm. She feels good about her work, which helps healthcare providers get insurance coverage for prescription drugs, and uses her analytical and critical thinking skills.

“Finding my happiness looks very different these days,” she said. “I don’t know what the future looks like, but I am focused on what I do and I strive for more victories every day. I keep trying and putting one foot in front of the other. Some days are easier than others. ”

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