30% of COVID survivors may have PTSD: 'This is a very scary experience for the patients'

COVID-19 is leaving a mark on survivors that goes beyond the “long-haul” symptoms some experience — it is also taking a serious toll on their mental health.

A new study published in JAMA Psychiatry found that more than 30 percent of COVID-19 survivors may develop PTSD (posttraumatic stress disorder) — a mental health condition that is triggered by a traumatic event and hallmarked by flashbacks of the trauma, nightmares and severe anxiety, according to the Mayo Clinic.

In the study, researchers evaluated more than 380 COVID-19 survivors who had been admitted to the emergency department in Rome, recovered from the illness and then received medical and psychiatric assessments from April to October 2020. They found that 115 of the survivors (more than 30 percent) were diagnosed with PTSD.

Arianna Galligher, social worker supervisor and the associate director of the STAR Trauma Recovery Center at the Ohio State University Wexner Medical Center, tells Yahoo Life that the study results are “largely consistent with other research that has found a higher incidence rate of PTSD among individuals requiring ICU intervention in a hospital setting.”

Women were more likely to be diagnosed with PTSD, according to the latest study. Having a history of depression and anxiety or experiencing more than three COVID symptoms that persisted postrecovery also increased the likelihood of a PTSD diagnosis. “PTSD is seen in greater numbers in women, so it is no surprise that they also made up the larger portion of the cases in this study,” Sanam Hafeez, a neuropsychologist and the founder of Comprehensive Consultation Psychological Services in New York City, tells Yahoo Life. “Further, PTSD is classified as an anxiety disorder. Those already diagnosed with or prone to other conditions such as anxiety or depression are far more likely to develop PTSD than those without that predisposition.”

Dr. Maja Artandi, medical director of the Stanford CROWN clinic, which treats nonhospitalized COVID-19 patients, agrees, telling Yahoo Life: “It makes sense to me that someone with underlying psychiatric disorders has a higher risk of developing PTSD. I can only hypothesize why women were affected more from PTSD. In my experience, women often worry much more about their families than about themselves. Being isolated in a hospital bed, not being able to connect with the family and worrying about the future of the family and who will take care of them might significantly increase the stress and raise the possibility of developing PTSD.”

The severity of the illness may also play a role in whether a COVID-19 survivor develops PTSD. “For those whose illness was mild to moderate, they may feel fortunate that they were able to recover,” says Galligher. “Some may also feel what’s known as ‘survivor guilt’ related to the fact that they were able to recover when so many others have experienced serious consequences, including loss of life.”

However, for those whose symptoms were more severe or who continue to experience lasting complications related to COVID-19, “they may feel anxious about whether or not they’ll be able to fully recover,” says Galligher. “Some may also experience feelings of grief related to lost time or abilities. Still others may feel angry that they became ill in the first place. They may wonder, ‘Why me?’”

But for some, having COVID-19 is a “very traumatic experience, especially in hospitalized patients,” says Artandi. “Patients who are in the hospital with COVID-19 are very sick, often having significant problems breathing. They don't know what to expect, if they will be getting worse, [and] the potential of losing their life.”

In addition, patients hospitalized for COVID are often isolated and experience a lack of human touch, notes Artandi. “Patients cannot have any visitors, and the medical providers have to wear protective equipment, including gloves and face masks, so the patient cannot even see the face of the person taking care of them,” Artandi says. “This is a very scary experience for the patients.”

Hafeez agrees and points out that a COVID-19 diagnosis can be a “terrifying experience even if you don’t have severe symptoms.” She adds: “There has been a substantial amount of information about the symptoms and deaths from COVID, which are likely to be foremost in anyone’s mind who has a COVID diagnosis. Breathing difficulties are often the most distressing, as anyone with asthma or sleep apnea knows. A person feels gripped by fear, often seen in panic attacks, where the person feels that they are going to die. So when a COVID patient has experienced that level of distress, they might start to monitor their breathing more closely, or fear falling asleep. They may obsessively start checking their oxygen or heart rate for fear that it may be falling again. The loss of familial and social support and the isolation associated with having COVID makes all these experiences that much harder.”

Experts say the study exemplifies why mental health also needs to be addressed when treating COVID patients. “This study adds to the growing wealth of evidence that supports the importance of employing trauma-informed care protocols while a person is accessing treatment in the hospital,” says Galligher, “as well as the importance of access to psychosocial support — including mental health therapy as needed — following discharge.”

Hafeez explains that PTSD can be “debilitating” and can “make getting back to life much harder.” That’s why it’s important for people diagnosed with the mental health condition to receive treatment, such as medication and cognitive behavioral therapy or exposure therapy, which Hafeez says are “empirically proven treatments for PTSD.”

Adds Galligher: “Without treatment, symptoms of PTSD can make it difficult for individuals to function in their daily lives. Fortunately, there’s no need to suffer with symptoms of PTSD. Effective, evidence-based treatment is available.”

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