What a trauma and PTSD psychologist tells us about dealing with the coronavirus pandemic

by Chia-Yi Hou | Apr. 10, 2020

anxiety supermarket grocery store workers, anxiety health care workers, anxiety from coronavirus

Grocery store workers unload food items in front of the Best World supermarket on April 1, 2020 in the Mount Pleasant neighborhood in Washington, DC. Getty Images

Story at a glance

People at the front lines, whether in the hospital or supermarket, are experiencing trauma and may be experiencing anxiety and depression.
Individuals who have suicidal thoughts are especially vulnerable.
Overexposure can lead to fatigue and heightened anxiety.

You might feel an uptick in anxiety each time you see a coronavirus headline. You might have stopped watching the news because it’s too much to handle. Or you may feel frustration and anger whenever you go outside and notice people being terrible at practicing social distancing. We’re all experiencing some level of trauma related to the COVID-19 pandemic, and for some people it may be the first time they’ve really thought about their mental health.

To understand more, I spoke with Andrew Schwehm, a clinical psychologist based at Bellevue Hospital in New York who specializes in trauma and post traumatic stress disorder (PTSD).

The different levels of pandemic-related trauma

“This virus is impacting people on different levels,” says Schwehm. “There’s a lot of different types of trauma that can happen as a result of this.”

The first group of people that comes to mind are the people at the front lines of fighting the coronavirus. These are the health care workers who continue to show up and work long hours day after day. These are also the people working at grocery stores. Schwehm tells Changing America that he’s heard stories from his clients working in supermarkets “who have been just absolutely breaking down, not only because of just the anxiety of working in a place where you can very easily contract the virus, but from what they’re seeing out of humanity.” They have seen some of the worst of humanity, like folks fighting over items in the aisles where they work.

For health care workers who are dealing intimately with COVID-19 patients and who may be experiencing the highest levels of trauma, there’s a higher likelihood that they’re going to be showing symptoms of anxiety and depression, Schwehm notes. It can eventually lead to post traumatic stress disorder.

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For the rest of us, we may be experiencing lower levels of trauma related to having the disease, fearing getting infected, dealing with job or financial loss, learning how to homeschool children, uncertainty about the future and a whole host of additional worries. With 17 million people who’ve filed for unemployment in the last three weeks, this is a unique situation that’s unprecedented. “With that many people going through it at the same time, what you’re experiencing is heightened stress,” says Schwehm. His clients have told him that the process of filing for unemployment has been stressful, with websites crashing and phone lines overwhelmed. “It might be too much to handle,” he continues. “That’s when you can start to see those people…might be experiencing panic attacks or might be having ‘breakdowns.’”

How long this’ll last

This is potentially the most asked question with no answer in sight. Most experts will refrain from making any predictions about how long this pandemic will last. The general understanding is that it will be months before it’ll really die out, but this depends on so many factors that are interrelated and complicated.

I asked Schwehm about dealing with the reality that this is long term and uncertainty about everything. He says that it’s important to think of it both as a day-by-day time scale and months ahead. If you are trying to create new habits or starting new projects now, think about whether they are sustainable for after you are not home all the time, Schwehm suggests. For example, instead of picking up your phone to scroll through Instagram, you could pick up a book and read a few pages. “Those are the things that you want to kind of do to kind of help you be forward thinking and think about what can I do for the longer term to help keep my sanity,” says Schwehm. But on the other hand, in the short term, if you spend a day on the couch, it’s ok to just get through a day.

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What he’s most worried about

Schwehm says he’s most worried about people who have or have had suicidal thoughts. Being isolated can mean that individuals who are prone to suicidal thoughts are sitting with them longer and may be more likely to act on them. For people with anxiety, they’ll have more time to sit with their anxiety and potentially less access to the people they can talk to about it. For his clients who are health care workers, he’s concerned that they are not only exposed to the virus, but death that’s happening around them and overall overexposure to what’s going on.

If you or someone you know may be vulnerable to suicidal thoughts, make sure they know about the National Suicide Prevention Lifeline and other resources available.

Signs for you to look for and what you can do

As we may be in some form of stay-at-home orders for the long haul, we will need to care for our mental health for even longer. Think years from now, not months.

For example, in 2001, I was attending a high school that was near the World Trade Center. That was a traumatic event. But without awareness about the psychological effects or access to mental health care, I didn’t understand the depth of how it affected (and is still affecting) me until much later, at least 10 years later. I can’t say that I am more mentally prepared this time with the COVID-19 pandemic, but I’m much more aware and doing all that I can in the moment.

For some people, the signs may come in the form of sleeping too much or not sleeping well. Some people may turn to food for comfort. “If you start noticing that you aren’t able to concentrate on your work or your other duties as well as you used to if you’ve noticed that perhaps bills are going unpaid or dishes are going unwashed, or the dog isn’t getting walked or the groceries aren’t getting picked up,” says Schwehm. “Those are good signs that something is off.” You need to be your own mental health watchdog.

Many people may not have access to therapy or mental health services. Schwehm says that it may be helpful to practice meditation or breathing exercises. Meditation can be as simple as paying attention to what you are eating for the whole process, and it can be as small as a raisin, for example. You can try to be aware of your moods and physical state, basically keeping tabs on how you are responding both mentally and physically. Check in with yourself multiple times a day.

And don’t let yourself get overexposed to what’s happening with the COVID-19 pandemic. “It’s really important for people to limit the amount of exposure that they have to the news because of what it can really do to your mental health,” says Schwehm. “You can experience fatigue.” If news and social media are triggers for increased anxiety, put a time limit on how much you scroll or set specific time periods during the day to check your feeds. Maybe set a timer for five minutes for each of those sessions.

If you aren’t sleeping well, another thing to pay attention to is your sleep hygiene. Are you using screens up until the time you are going to bed? That will make it harder to fall asleep. If you think it would help, think about trying to sleep with a weighted blanket. Dim the lights in your room and take a hot shower before getting in bed.

For conditions like PTSD, that’s not typically diagnosed until weeks or months have passed with symptoms. But if you are concerned, Schwehm says, “you might want to take a look at how you are coping. And take a step back to look at the bigger picture and say, ‘What do I need to change in my life to find a better state of relaxation?’”

For a list of mental health resources, check out my article about the psychological effects of being in quarantine.

For up-to-date information about COVID-19, check the websites of the Centers for Disease Control and Prevention and the World Health Organization. For updated global case counts, check this page maintained by Johns Hopkins University.

You can follow Chia-Yi Hou on Twitter.

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