{"id":63318,"date":"2022-04-04T10:36:39","date_gmt":"2022-04-04T16:36:39","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=63318"},"modified":"2024-07-18T14:37:21","modified_gmt":"2024-07-18T20:37:21","slug":"long-covid-mental-health-challenges-require-specialized-treatment","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/long-covid-mental-health-challenges-require-specialized-treatment\/","title":{"rendered":"Long COVID mental health challenges require specialized treatment"},"content":{"rendered":"
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Depression, anxiety and other mental health challenges frequently affect patients battling long COVID. Photo by Getty Images.<\/figcaption><\/figure>\n

Even as the number of people hospitalized has plummeted, many people are still coping with long COVID, defined by the CDC<\/a> as symptoms people experience four weeks or longer after the original viral infection.<\/p>\n

COVID \u201clong haulers\u201d face an array of challenges, including an invisible but no less formidable foe: mental health burdens, in the form of anxiety, depression, mood disorders, post-traumatic stress disorder (PTSD) and more. These issues are often entwined with physical issues<\/a>. Other symptoms may include\u00a0chronic fatigue; shortness of breath; brain fog; and nerve, joint and muscle pain, just to name a few.<\/p>\n

These patients benefit from multidisciplinary care, which is available at the UCHealth Post-COVID Clinic<\/a>. As part of an ongoing series on long COVID and its treatments, UCHealth Today spoke with Dr. Thida Thant<\/a>, assistant professor of psychiatry<\/a> at the University of Colorado School of Medicine, and her colleague, senior instructor Dr. Heather Murray<\/a>. Both provide mental health care to patients referred through the UCHealth Post-COVID Clinic.<\/p>\n

Are medical and mental health issues sometimes connected in long COVID patients?<\/strong><\/h2>\n

They are.<\/p>\n

As Murray puts it, \u201cThe reality is our brains don\u2019t exist in a bubble. So if you have systemic inflammation problems or viral syndromes that are affecting other organs, it makes sense that they would also affect the brain and cause other psychological symptoms. It\u2019s unfortunately something that patients with chronic fatigue syndrome<\/a> and fibromyalgia<\/a>, for example, have experienced for years.\u201d<\/p>\n

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Dr. Thida Thant<\/figcaption><\/figure>\n

The interconnection of medical and mental health issues highlights the importance of the Post-COVID Clinic, Murray added. \u201cPatients may have shortness of breath, tachycardia [irregular heart rhythms] or brain fog without a lot of lab changes that are abnormal,\u201d she said.<\/p>\n

Can long COVID exacerbate existing mental health symptoms \u2013 and vice versa?<\/strong><\/h2>\n

Yes. \u201cThe reality is that depression is very common, and a lot of people with COVID have a history of depression,\u201d Murray said. \u201cThey\u2019re going through a horrible time of their life, not to mention society is going through a horrible time.\u201d She noted a significant increase in the prevalence of depressive symptoms reported since the pandemic began \u2013 perhaps as much as threefold<\/a>.<\/p>\n

Where do you provide mental health care for long COVID patients?<\/strong><\/h2>\n

The hub is the Psychiatric Clinic for the Medically Complex, which predated the pandemic and is housed in the UCHealth Outpatient Psychiatric Clinic<\/a>. Thant is the director and Murray is an attending physician. \u201cWe\u2019ve been seeing long COVID patients since the summer of 2020,\u201d Murray said.<\/p>\n

How does the clinic help patients with the mental health symptoms of long COVID?<\/strong><\/h2>\n

To begin, Murray said, \u201cWe do a whole psychological evaluation, as well as more specific psychological or cognitive screenings.\u201d The evaluations and screenings help identify symptoms like depression, anxiety, PTSD, insomnia, fatigue, short-term memory deficits, brain fog \u2013 aka \u201cCOVID brain \u2013 and problems with attention and process, Murray added.<\/p>\n

Explain how that information is useful for those recovering from COVID-19<\/strong><\/h2>\n

Murray said that gathering in-depth psychological and cognitive information helps the team to determine if there is something more at play in a patient who exhibits long COVID symptoms.<\/p>\n

\u201cThere could be an underlying personality disorder or major depressive disorder that could be informing the cognitive symptoms from COVID or making them worse,\u201d she said. \u201cClearly, the past year and a half has been a really rough time for people. We try to see if there is something going on that is treatable to help them have a higher quality of life.\u201d<\/p>\n

What are some of the mental health treatments you provide?<\/strong><\/h2>\n

In addition to providing individual psychotherapy and assistance with techniques like cognitive behavioral therapy, the clinic runs post-COVID survivors\u2019 groups, one specifically for patients who were in intensive care units and another for all other patients struggling with long haul symptoms, Thant said.<\/p>\n

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Dr. Heather Murray<\/figcaption><\/figure>\n

The clinic also collaborates with speech language pathologists who provide cognitive rehabilitation and help patients struggling with attention, focus, short-term memory loss and other cognitive issues to \u201cretrain their brains,\u201d Thant added. Medications like Wellbutrin, an anti-depressant, can also help to boost focus and energy for patients facing these problems, she said, while other medications treat mood, anxiety, trouble sleeping and other symptoms.<\/p>\n

What have been the most formidable mental health challenges for long COVID patients?<\/strong><\/h2>\n

\u201cWhat we\u2019re learning is that a lot of folks are coping with it as a chronic illness,\u201d Murray said. \u201cIt\u2019s not something they get over in a couple of days. We\u2019re learning from the shared experience of being a COVID patient about how hard it is to deal with it day to day.\u201d<\/p>\n

That experience often leads to patients facing doubt from others, Thant added. \u201cBecause there is a lot we don\u2019t understand, there are people who question those who have these symptoms about how true it all is and how much is all in their head,\u201d she said. \u201cThere is also frustration with the lack of treatment options.\u201d<\/p>\n

How do those frustrations with long COVID mental health symptoms play out in daily life?<\/strong><\/h2>\n

Brain fog, or COVID brain, which exacerbates the focus and concentration problems mentioned earlier, is probably the \u201cbiggest symptom\u201d reported by long COVID patients, Murray said. \u201cIt is really detrimental in daily life, especially when people are trying to return to work at the levels they were before. We have patients who just wear out cognitively. They can\u2019t do the full day\u2019s work they used to.\u201d<\/p>\n

Some patients suffer insomnia related to PTSD and medical trauma they endured during COVID treatment, Thant added. \u201cThey come in saying they\u2019ve had nightmares or weird dreams and are afraid to go to sleep.\u201d<\/p>\n

Long COVID can also make people reluctant to return to the lives they had led, Thant noted. \u201cPeople may be afraid to be around other people who had COVID,\u201d she said. \u201cThey have fears of reinfection, as well as of resurgences and recurrent lockdowns.\u201d<\/p>\n

The group sessions can help to allay that uneasiness, Thant said. \u201cIn group you meet other people who understand your experience and are on that journey with you,\u201d she said. \u201cPeople identify that as one of the most helpful things we offer \u2013 being able to share the fear of the unknown together.\u201d<\/p>\n

Are there resources long COVID patients can use to manage symptoms themselves?<\/strong><\/h2>\n

Yes. Dr. Melanie Dae<\/a>, a senior instructor of psychology at CU, recommends several apps for help with sleep and relaxation techniques. Some examples:<\/p>\n