Mental and Psychological Effects of Covid 19

During my group psychotherapy sessions this week and last, we spent lots of time discussing how the COVID-19 pandemic is affecting people's lives. Ironically, many patients report that they have been in training for self-isolation for years. They are not finding the "stay at home" aspect of the pandemic difficult. Many shared that their friends and family now have a better understanding of what it is like to not be able to participate fully in society - an unanticipated positive consequence. 

Not surprisingly, many are directly impacted by illness in family members, difficulty accessing medical care for non-COVID concerns and of course job losses to themselves or family members. Worry about safety and security is widespread. Many people feel as if they can't keep up with so many changes coming so quickly. For people whose cognitive function is slowed by Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia (FM), there is worry about getting confused, missing important information or making bad decisions.

An increased level of background stress seems almost universal. Many people who had been coping well with depression or other emotional symptoms find themselves struggling now and needing to revisit the coping tools that have helped them in the past. Many people correctly sense that there could be a cumulative and delayed onset of mental health strain as the pandemic and the uncertainty it causes continues. Dr. Payal Kohli, a Denver cardiologist is calling this the 4th wave. Without recognition or attention, this could hit us some time after the physical danger is past.

The 4 Waves of COVID

Diagram by Dr. Payal Kohli, Cardiologist in Denver, Colorado

This blog post is all about identifying the signs of stress you are experiencing (we are all experiencing them though differently), labelling them as such and accessing strategies to lessen the impact.

Common signs of stress during an infectious disease outbreak include:

• Persistent fear and worry about your own health and the health of your loved ones
• Increased fatigue or lassitude
• The feeling of body tension
• Difficulty sleeping or concentrating
• Irritability or impatience
• Not looking after yourself
• Withdrawing from others
• Increased use of alcohol, drugs or other forms of escape

If you feel scared, sad, confused and overwhelmed about COVID, you are NORMAL. It is normal to have unsettled and unfamiliar feelings in a time of upheaval. It is normal to worry and have trouble sleeping if your security is threatened. It is normal for symptoms of fatigue and pain to increase. It is normal to be tempted to escape into your addiction of choice.

And there is a path through this. Just as it is very helpful to know that the physical symptoms you experience fit a known diagnosis like ME/CFS, FM or ES it is helpful to know that the emotions and physical symptoms you are experiencing are a normal reaction to stress and that you are not alone.

Managing your mental health during COVID

Knowledge is power. If you recognize signs of stress emerging, there are lots of things you can do to restore a sense of calm, stabilize health and mental health and be productive.

Noticing how your body is responding is the first step. See if you can linger for a while in non-judgmental awareness. Stay in the present moment. Notice without jumping to a conclusion that what you notice is good or bad. Emotions are neither good nor bad. They are communication from your body and/or mind. See if you can stay still long enough to receive the message. If you get the message is there anything you can to do address the need? For example, if you are tired, can you rest for sleep? If you are hungry would a snack or meal help? If you are sad is there a loss or potential loss that is asking to be acknowledged? If you are angry is there a threat?

See if you can avoid creating a story about your experience. If fear of the future arises, let it pass naturally. If you don’t react, hang onto or create a story around your sensations and emotions, they will pass more quickly. With practice, you may find you are able to tolerate, understand and even learn from your body's responses to the uncertainty in your life. It may sound annoying that a crisis can provide an opportunity for change but it is true.

Two Mental Health Tools

I have created a guide to non-judgmental awareness called the Diamond of Awareness. You can read more in the free download, “Chapter 1 Self-Management” from my upcoming book, More Light. Go to the bottom of my home page and subscribe to the eNewsletter to get your free download.

I came across a great tool called the COVID Anxiety Workbook written by a group called thewellnesssociety.org and funded by Jamma International, two groups I had not heard of before. The workbook is full of simple, practical suggestions to cope with increased stress due to the COVID-19 pandemic. It contains dozens of online resources - everything from mindfulness to humor. It was published to be shared and used. Please pass it on if you find it helpful.

Download the COVID Anxiety Workbook and take a look. Commit to trying one thing today. Take a baby step and then another and another. Before you know it, you will be feeling calmer and focused on the things that are important to you rather than the pandemic.

Author: Eleanor (Ellie) Stein MD FRCP(C)

I am a psychiatrist with a small private practice in Calgary and am an assistant clinical professor in the faculty of medicine at the University of Calgary. Since 2000, I have worked with over 1000 patients, all with ME/CFS, FM and ES. My passion for this field comes from my own struggle with these diseases, my desire to improve my health and then pass on what I learn. My goal is for every patient in Canada to have access to respectful, effective health care within the publicly funded system.

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