24 Jan The Mental Health Implications of Dealing with Long COVID

It’s not an understatement to say that most people have been affected by COVID-19 in some way. It has been a fact of life for almost two years, and even now, many areas of the globe are not equipped to effectively treat those who need help.

While the numbers of individuals who have contracted COVID grow every day, another number is steadily increasing – patients who develop long COVID. According to the CDC, long COVID, also called post-COVID conditions, is defined as “a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes COVID-19”.  As of July 2021, it has officially been added to the list of conditions considered a disability under the Americans with Disabilities Act.

According to multiple recent studies, it’s estimated that roughly 10% of patients who contract COVID-19 will develop some form of long COVID. In the United States alone, that could be as many as 3.2 million people – and counting. While some experience just one symptom, others live with a host of physical, neurological, and mental health symptoms that affect every aspect of their lives. 

Here’s a brief synopsis of what one can expect when dealing with long COVID, and helpful suggestions for clinicians about how to treat the psychological and mental health symptoms their clients are experiencing, for improved behavioral health outcomes. 

The Three Categories of Long COVID

One of the reasons why long COVID is so troublesome is because it has such a wide variety of symptoms that can affect almost every aspect of a person’s life. Sometimes these symptoms last for days or weeks, while other times, it can take months or even years for the individual to recover. 

The American Medical Association has broken down long COVID into three categories:

• The first is long COVID that’s directly related to cell damage caused by the initial viral infection. In this condition, the person’s longer-term symptoms are a direct result of this early cell damage.
• The second type of long COVID is when a person’s symptoms are determined to be a result of long-term hospitalization. This is similar to post-ICU syndrome, where an individual’s long-term symptoms are the result of an extended bed-bound hospital stay.
• The third type of long COVID is characterized by symptoms that appear after the individual has recovered from the initial infection. This is the most complex type of long COVID, and research is still ongoing to determine what causes these symptoms.

 
Common Physical Symptoms of Long COVID

Even though there are three distinct categories of long COVID that are currently identified, many of the symptoms are similar. Some of the most common long COVID symptoms include:

• Fatigue
• Shortness of breath
• Continuing cough
• Muscle pain
• Joint pain
• Loss of taste or smell
• Dizziness
• Organ damage
• Blood clots
• Brain fog
• Fast-beating or pounding heart
• Sleep problems
• Mood changes 

 
Long COVID’s Effect on Mental Health

In addition to physical symptoms, many individuals experiencing long COVID also develop a variety of psychological and mental health issues that impact their life and hinder their recovery.

The most common conditions that clinicians have been seeing as these long COVID patients seek treatment are anxiety, depression, and post-traumatic stress disorder (PTSD). According to a study conducted by one hospital in China, 23% of patients with COVID developed anxiety or depression within 6 months of their diagnosis. Another global study from May 2021 found an even greater number. One-third of patients with COVID were later diagnosed with either anxiety, depression, or PTSD.

The sheer scale of these numbers and the fact that they’re increasing demonstrates that our knowledge of long COVID and its mental health implications is still in the very early stages 

How Clinicians Can Help Clients Deal with Long COVID Mental Health Issues

Fortunately, there are still things that clinicians can do to improve behavioral health outcomes for their clients with long COVID, even as we learn more about its impact on mental health. Here are some suggestions for how to get started:

Focus on holistic recovery. One of the realities of COVID’s mental health symptoms is that they’re typically related to either the infection or the experience of having COVID. As other physical and neurological symptoms improve, these mental health symptoms are typically alleviated as well. Focusing on physical and mental health recovery together can help clients increase their awareness of their experience and lead to more positive outcomes universally. A great example would be instructing a client on self-soothing or coping techniques they can use if their pounding heart or dizziness brings on feelings of anxiety. 

Use proven tools and techniques. While the mental health symptoms related to COVID may feel new and unusual for some clients, the truth is these conditions can be treated just like any other mental health issue. Clinicians should trust their existing processes, treatments, and tools that they’ve been using for anxiety, depression, and PTSD.

Provide patients with the right resources. When a patient is dealing with a variety of physical and mental health symptoms that are caused by the same condition, it’s important to ensure that they have excellent care across the board. This means providing them with local contacts for a primary care physician or specialist – such as an occupational or speech therapist. Or help them find a telehealth option for specialists who may not be readily accessible in your area.

Use a behavioral health EHR to track symptoms and client progress. When dealing with a long-term condition like long COVID, tracking symptoms is a great way to show patients just how far they’ve come in their recovery. Clinicians should use a behavioral health EHR, which has the ability to track clinical outcome measures and client progress.

 By considering a client’s holistic health and working with them to treat their existing mental health conditions, clinicians can help patients better deal with the frustrating and enigmatic symptoms of long COVID.