The Negative Psychological Effects of Long COVID

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Long COVID can come with serious and harmful psychological effects. Four recent research studies illustrate the importance of recognizing and treating the negative psychological effects of COVID-19, especially for those with "long COVID."

A recent study in the Journal of the Academy of Consultation-Liaison Psychiatry has found that people with long COVID can experience anxiety, depression, and PTSD at higher rates than expected. People with long COVID report "brain fog," forgetfulness, fatigue, difficulty making decisions, focusing, and multitasking.

Researchers measured cognitive functioning using neuropsychological testing to better understand the impact of long COVID on cognition and executive functioning. They found that 62 percent of long COVID participants had significant impairment on neuropsychological testing. People who reported "brain fog" from long COVID had difficulty with attention, processing speed, memory, and executive function and reported higher levels of depression, fatigue, and PTSD.

These findings are consistent with an online survey of 787 people who recently had COVID-19, which found that a large proportion of people after COVID experienced depression, anxiety, and post-traumatic stress disorder. The most common symptoms were fatigue (76 percent), brain fog (68 percent), and concentration problems (61 percent).

Many people described problems with memory and slowed thinking as well as high levels of anxiety (42 percent) and depression (61 percent) and symptoms of PTSD (40 percent). Those who had been hospitalized with COVID had a greater risk of PTSD.

Researchers at Massachusetts General Hospital found that the most common neuropsychiatric symptoms after COVID were fatigue, brain fog, headache, anxiety, and sleep issues.

A study published in The Lancet Psychiatry found that dementia, mood, and anxiety symptoms were worse six months after COVID-19, even when compared to the impact of other similar respiratory infections.

The ongoing research on long COVID suggests that anxiety, depression, and PTSD symptoms can last for many months after COVID.

Here are some ways to address the negative psychological effects of long COVID:

1. Find clinicians and therapists who acknowledge and are aware of the serious psychological impact of COVID and long COVID. Therapists with background and experience in treating people dealing with chronic illness can be useful resources.

Many people with long COVID have found it challenging to find clinicians and therapists aware of long COVID and recognize the symptoms. It is helpful to connect with clinicians who take the psychological impact of COVID seriously.

2. Try adding a daily routine of mindfulness practices such as yoga, deep breathing, or meditation to help reduce stress and anxiety.

Research continues to suggest that mindfulness and mind-body practices like yoga and meditation can reduce the stress and anxiety of long COVID. Practicing meditation regularly has also been shown to help with mental clarity and focus. Try adding a routine of five to 15 minutes of mindfulness daily, whether it is slow-breathing exercises or listening audio guided meditations:

Breathing Exercises

Guided Meditations (Free from UCLA)

3. Show yourself self-compassion.

Dealing with brain fog and a major change in how one used to be able to feel and function is very challenging. It can lead to feelings of frustration, shame, and isolation. During this time, it is important to be gentle with yourself and continue to practice self-compassion and self-care. Here are some guided meditations to help you continue to remember to be kind to yourself:

Self Compassion Exercises by Kristin Neff

4. Prioritize self-care regularly. Consider scheduling self-care blocks on your calendar.

Self-care is essential throughout the week and merits being a priority since it reduces stress, anxiety, and depression symptoms. If it is tricky to think through the brain fog, take your time to write down a list of different and accessible types of self-care activities that you can do throughout the week so that you can use this list without having to think too much (anything from reading a book to listening to music or taking a bath).

Consider scheduling regular times for self-care on the calendar so that your time is blocked out already. The motivation to practice self-care may be missing at first, whether due to feeling down or lacking energy. This is when the concept of "smart feet" can be helpful. Instead of waiting to feel "motivated" to start the activity–take yourself using "smart feet" to the activity–and start with only one to two minutes of self-care, especially when it feels daunting to do things for longer. The motivation will likely follow.

5. Connect with local hospital-based long COVID (sometimes called "post-COVID") resources, including post-COVID specialty clinics. There are a growing number of local post-COVID clinics for people dealing with long COVID. For example:

Post-COVID Clinics in California

Post-COVID Clinics in New York City

Research continues to suggest that the harmful psychological consequences of COVID can last for months. These studies illustrate how important it is to find the right treatment and support.

Copyright © 2022 Marlynn Wei, MD, PLLC

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