One of the most frustrating things medical professionals (or friends, family colleagues, etc.) can tell someone when they complain of an ailment is that it is "all in your head". This response causes feelings of invalidation and even distrust of those who we expect to listen and to support us when we are struggling. One of my favorite quotes from the sitcom Boy Meets World is from Season 7, Episode 14, when Cory Matthews thinks he is terminally ill and goes to the doctor. When he comes home, he gives his wife, Topanga, the news that his doctor diagnosed him with hypochondria and gave him placebos to take to treat his illness. When Topanga tells him that hypochondria is what it's called when crazy people think they're sick when it's really all in their heads, and his best friend, Shawn, tells him placebos are pills to make crazy people think they are being treated for illnesses they don't really have, he gives the impassioned response that he has to be on them for the rest of his life.
But, sometimes it really IS all in our heads. Literally.
The impact trauma has on a person physically, mentally, and emotionally is difficult to describe if you haven't experienced it firsthand. You can think you understand, offer sympathy, and even make jokes about being forgetful too, but the trauma response in those who have experienced either mental or physical trauma is much different than simply forgetting if you turned off a light or forgetting to pick up milk on your way home from work. It impacts every single aspect of your life.
Research published by both the University of Denver and the National Library of Medicine shows very similar patterns among those suffering from Post-Traumatic Stress Disorder (PTSD), people with Traumatic Brain Injury (TBI), and Long Covid patients. The impacts of PTSD on Long Covid patients were very similar in both those who were hospitalized with more severe symptoms and those who had more mild symptoms and were never hospitalized during the duration of their Covid infection. The trauma responses aligning with PTSD are because of the impact Covid has on their lives following the illness. TBI symptoms are due to inflammation caused by the Covid virus, similar to the inflammation caused by a concussion injury. This inflammation found in Long Covid sufferers typically affects the brain stem, just as is the typical area of inflammation in concussion patients.
The American Psychiatric Association describes PTSD as an anxiety disorder that must include five major criteria. In terms of Long Covid, the five criteria are met based on the experiences of Covid-19 and its lasting impacts. The five criteria in my own personal situation are: 1.) Exposure to an event that threatens safety, triggering a response of fear or helplessness. In this case, that event is being infected by Covid-19. 2.) Psychological distress when reminded of my trauma; 3.) At least three avoidance symptoms; My personal avoidance symptoms are active avoidance of reminders, withdrawal from others, and emotional numbing. 4.) Marked arousal; Mine include insomnia, difficulty with concentration, and a heightened startle response. 5.) These symptoms must cause considerable functional impairment at least 1 month after the initial trauma event. I first began to notice concerning cognitive symptoms in mid-November, 2021, which was 4-5 weeks after my positive Covid test.
Treatments for the mental and emotional areas of Long Covid look very similar to the cognitive behavioral therapy used for TBI and PTSD patients. This therapy can be difficult and extensive. Working through the traumas that brought me to the place I am at today means digging deep and first facing those triggers and traumas I had kept tucked away in deep, dark places in my brain. It means knowing that there is some actual physical damage caused to my brain because of the initial infection, and learning how to accommodate for those things that don't work the way they used to work. It means finding a way to accept that this is my new reality and trying to move forward, even when the future is scary and unknown after thinking I had the whole rest of my life all figured out. It means living one day at a time and remembering that every teeny, tiny baby step forward is still forward motion and needs to be celebrated.
References
Anschuetz, Nika. “DU Study Finds Similarities in Diagnosis and Treatment for Concussions and Long Covid.” University of Denver, 20 Feb. 2023, www.du.edu/news/du-study-finds-similarities-diagnosis-and-treatment-concussions-and-long-covid#:~:text=There’s%20a%20deficit%20between%20acute,they%20could%20involve%20similar%20treatments.
Bryant, Richard. “Post-traumatic stress disorder vs traumatic brain injury.” Dialogues in clinical neuroscience vol. 13,3 (2011): 251-62. doi:10.31887/DCNS.2011.13.2/rbryant
Houben-Wilke, Sarah et al. “The Impact of Long COVID-19 on Mental Health: Observational 6-Month Follow-Up Study.” JMIR mental health vol. 9,2 e33704. 24 Feb. 2022, doi:10.2196/33704
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