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Managing the long-term effects of coronavirus

November 23, 2020

One in 20 people who’ve had coronavirus are likely to end up suffering from ‘Long COVID’, according to data from ZOE’s COVID Symptom Study. Long COVID is a term used to describe cases where patients are still experiencing symptoms weeks and even months later.

These lingering symptoms can include physical complications, such as difficulties with breathing, fatigue or weakness. Psychological symptoms are also common, including anxiety, low mood, and reduced concentration and memory.

Patients who spent time in the ICU could find they experience particular problems that are linked to a stay in intensive care. Two out of three patients get delirium, according to the CIBS Centre – a severe state of confusion thought to be due to a change in the way the brain is working. This can have effects months after the patient has returned home, including:

  • cognitive impairment – difficulties in thinking
  • PTSD – a condition triggered by exposure to a traumatic and extremely disturbing event, which might include flashbacks and nightmares, and
  • depression.

For those with continuing symptoms, it can be frightening, frustrating and worrying, and lead to low mood. Not only is their quality of life and ability to do things affected, but there’s also a lot of uncertainty about how the situation will pan out. Coronavirus is so new, the effects are still being understood, which means currently there may be less information, support or advice than we might hope.

However, the NHS has developed a good online resource called Your Covid recovery, which is designed to help patients and their family and friends understand the recovery process and symptoms that may occur, and offers guidance on when to contact your GP, and tips on wellbeing. There’s also a dedicated page on recovering after a stay in the ICU.

People who experience long-term effects of coronavirus might think about and respond to their situation in different ways. Those who’ve survived the illness are considered ‘fortunate’ – but you might not feel very lucky if you’re still not well. You might wonder ‘why me?’ or feel down about the fact you had it in the first place. Some may dwell on the things they’ve lost as a result – such as fitness, energy, time or income, or key events they’ve missed.

Sometimes, thoughts and feelings can spiral into a ‘vicious cycle’ which can make any difficulties worse.

Breaking the cycle

Everyone’s vicious cycle will look different – but as an example, somebody who is worrying a lot about their symptoms might have negative thoughts as a result, such as “this is never going to get better”. This might make them less inclined to do the activities they did before becoming ill, which could make them more focused on their symptoms, leading to even more fear and worry.

It is possible to break this cycle by intentionally thinking differently. In this situation, the person might challenge the thought that they’ll never get better, and change it to “recovering completely might take time – but there are things I can do to help myself”.

Planning, Pacing and Prioritising

The best approach to getting back into a routine is to take it gradually, setting small, achievable goals. Plan to do a manageable amount each day, rather than exhausting yourself by going for ‘boom and bust’, building your activity levels up step by step. This is particularly important if you’ve been told you can start exercising again – start slowly and steadily increase what you do.

Don’t try to do everything; you might need to prioritise tasks, tackling those that are most important first and leaving others till later.

Managing expectations

You may find that family, friends and colleagues expect that you should be doing things normally again. They might not understand that you still frequently feel exhausted, for example. If this is the case, you may need to be assertive: let people know how you feel physically and emotionally and tell them what’s possible for you right now.

Be kind to yourself, too. If you’re thinking “I should be better by now,” or beating yourself up about not being back up to full speed, ask yourself what you’d say to a friend in the same situation.

It’s not helpful to compare yourself with others, either – everyone’s experience of coronavirus and their recovery progress is different. Avoid comparing your current abilities and activity levels with how they were before you were ill. Instead, look back to the worst point of your illness and ask yourself how far you’ve come since then.

If you’re experiencing ongoing symptoms following coronavirus, whether they’re physical or psychological or both, and these are affecting your mood or you’re becoming anxious about how you are feeling, CBT may be able to help break the cycle. Find out more here.

ieso Online Therapy
This blog has been written by a member of the clinical team at ieso.
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