Dealing with Post-Covid Anxiety Ms. Shirley Ra , Clinical Psychologist, Department of Psychiatry, KIMS

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I suddenly wake up in the middle of the night feeling that I am unable to breathe.’

‘I get frequent dreams of losing someone, then I wake up and thank God that it was a dream after all.’

‘I feel weak and low. I am no longer interested in work as before. Sometimes I suddenly feel that my heart is racing as if something bad is about to happen.’

–Covid-19 survivors at follow up.

The psychological impact seems to outlast the physical impact of Covid-19. Even after weeks of recovery, we find patients reporting nightmares, unknown fears, low mood, sleep disturbances, breathlessness, headache, forgetfulness, lack of concentration, extreme fatigue, etc.

A recent study reported at least one psychopathological problem in 56 per cent of the covid-19 survivors including anxiety (42%), insomnia (40%), depression (31%), post-traumatic stress disorder (28%) and OCD (20%).

A plethora of symptoms observed in these patients and exacerbation of previous psychiatric problems post recovery, calls for an immediate need for their management.

Why does one become anxious post recovery?

Fear and anxiety are Normal adaptive mechanisms. They prepare our body to respond to danger by either facing it or escaping it through a series of reactions that happen automatically, like increased heart rate, breathing faster, sweating, ‘butterflies’ sensation, tingling, chills, narrowing of attention.

The experiences that one lives while suffering from Covid-19, the fear of losing one’s life and that of their loved ones, the physical sensations like breathlessness, the sound of the machines, oxygen masks and other ICU equipment,  certain smells or taste, etc. can all be associated with danger and lead to fear response automatically. This association is quite common after any traumatic event and it gradually fades away with time.

What maintains our anxiety?

Avoiding the situations/objects which cause fear may further strengthen the fear response. For example, if using an oximeter reminds someone of a dreadful experience at the hospital, he/she might avoid using it and feel relaxed but the fear of it gets stronger until he/she uses it and finds that it is not associated with any danger!

Suppressing your thoughts may actually exacerbate them. Instead, try reassuring yourself that ‘All is well now’.

Excessive focus on body sensations may worsen our anxiety as we may notice normal sensations which usually go unnoticed and misinterpret them.

Seeking reassurance through multiple tests may feed our fear that probably something is missed and needs further investigation.

Moreover, browsing the internet may create more anxiety as it bombards us with information which may and or may not be relevant to a specific problem and may show you the worst case scenario.

What can we do?

·       Try not to avoid thoughts and situations that make you anxious. Face them gradually while reassuring yourself that you are safe now!

·       Instead of suppressing your thoughts, fix a particular time of the day to worry about them. Make a note of your worries and address them only at the set time.

·       Gently shift your focus away from your bodily sensations and excessive health concerns. Try talking to people on other topics of your interest, watch something, or revive an old hobby.

·       In case of any doubt regarding your treatment, try clarifying with your doctor about the nature and cause of your symptoms rather than going for further investigations. Knowing your problem better will help in reducing anxiety.

·       Stop browsing for your symptoms if it makes you more anxious. Limit the time spent on browsing Covid content. You can try using apps like practo, ask a doctor, 1mg for finding specific answers to your problems instead of diving into anything and everything.

·       Get back to your ‘Normal’ self as soon as possible. Start doing things which you have been avoiding due to health concerns.

·       Incorporate relaxation exercises like guided meditation and mindfulness into your daily routine to deal with stress.

·       Besides this, eating sufficiently and healthily and getting enough sleep is important for your overall wellbeing.

·       Gradually and safely increase your physical activity as this reduces stress and can reduce the chance of depression.

·       Staying socially connected is important for your mental wellbeing. Talking with others can help to reduce stress and may also help you in finding solutions for challenges in your recovery journey.

When to seek professional help?

After trying the above strategies, if you still experience a high level of anxiety that interferes with your daily life and stops you from returning to your normal self, do get further help. You can visit Post-Covid Care Centers or directly consult a mental health professional. These symptoms can best be managed with a combination of medication and therapy.

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