The coronavirus or COVID-19 pandemic has caused fears, distress, worry and pessimism all over the world. According to a non-profit academic medical centre in the United States, Mayo Clinic, when an outbreak is caused by a new virus, rumours and misinformation usually run rampant.
Stereotypes quickly arise about people who have or may have the disease. This occurs even among survivors.
In a report, the Massachusetts Institute of Technology said patients admitted to the intensive care unit and put on a ventilator often suffered depression, anxiety, and post-traumatic stress disorder.
The virus has recorded thousands of deaths, affected millions with over two million recoveries. But the MIT report stated that for those who had recovered, their stay in intensive care was likely to be one of the most traumatic things they would ever experience.The report said:
“Being able to breathe is something we take for granted. But patients who have such difficulty breathing that they need to be intubated (which involves having a tube inserted into their mouth and down their airway) often believe they are going to die at some point during their stay in intensive care.
“Anecdotally, ICU doctors say patients with COVID-19 tend to need a particularly large amount of sedation, which damages muscles and nerves, especially in the lungs. That damage can be permanent, which can, in turn, undermine the patient’s mental health.”
A psychologist based in the US, Megan Hosey, said of COVID-19 survivors:
“Their lives will never look exactly as they were before. Being admitted to an ICU is one of those ‘before and after’ life events, like having a child, or a parent dying.”
Another report by Webmd stated that the ordeal faced by critically ill COVID-19 patients would not likely end even when they pulled through and survived their life-threatening infection.
Experts said some of these survivors would be emotionally scarred by their time spent in the ICU, even as they were at increased risk of psychological problems, such as anxiety, depression and PTSD.
A former President and CEO of Beth Israel Medical Centre in New York City, Dr David Shulkin, said, unfortunately, such was one of the expected unintended consequences of the pandemic.
“In almost every other pandemic that’s been studied, there have been associated behavioural health issues that have been not only short-term but long-term in standing, and this one is no different,” he told WebMD.
Shulkin noted one study from Wuhan, China, in which more than 700 COVID-19 survivors were given a standardised test for symptoms of PTSD. Shulkin added:
“Over 96 per cent of those respondents indicated they were suffering from post-traumatic stress. I do think this is something we have to give a serious evaluation to and make sure we are addressing these issues.”
In another report, researchers at the University College London, United Kingdom, stated that one in four COVID-19 survivors could suffer from long-lasting mental health problems.
The researchers found that a third of people who survived previous disease outbreaks such as the Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome went on to develop PTSD after an average of almost three years.
In lieu of these, all the various studies highlighted the importance of mental health support for COVID-19 survivors across the world in the months and years after the current health crisis eases.
Experts have, therefore, suggested the following seven ways through which COVID-19 survivors can be supported.
Don’t stigmatise them
According to a report by The Bangkok Post, in some countries, especially in sub-Saharan Africa, some COVID-19 survivors have been subjected to ostracisation in their communities.
In some cases, some patients continue to be shamed even after they have recovered from the coronavirus, with many believing they are still endangering public health. Some survivors are nicknamed as ‘corona,’ a development that has psychologically disturbed them.
An assistant professor of human development and family sciences at the University of Delaware, US, Valerie Earnshaw, said decades of research showed that stigma could harm the mental and physical health of the COVID-19 survivors.
“This stigma can take the forms of social rejection, gossip, physical violence and denial of services. Experiencing stigma from others can lead to elevated depressive symptoms, stress, and substance use,” he told the Harvard Business Review.
Speaking to Saturday PUNCH, Lagos-based psychiatrist, Mrs Bola Omololu, advised people to desist from stigmatisation of COVID-19 survivors. She added,
“It is inhumane, pathetic and saddening to stigmatise anyone who bravely fought the coronavirus. These people need our support, not stigmatisation. I think when some people think they are not immune against the coronavirus, they would treat the survivors, and even patients, better.”
Reach out to them
The Chairman of the American Psychiatric Association’s Committee on the Psychiatric Dimensions of Disaster, Dr Joshua Morganstein, said COVID-19 patients could find comfort when their family, friends and neighbours checked on them.
He said listening to people could help them feel calm. He stated,
“Things we know help people during a disaster and adverse events that help them feel safer and calmer include enhancing feelings of social connection, improving our sense of community reliance, and improving our sense of hope and optimism.”
Morganstein added that people who believed they lived in stronger communities usually had lower rates of PTSD after disasters.
“Building strong communities can really have a significant mental health impact in a positive way for all of society,” he said.
Use right words when talking to them
Authors Melinda Smith, Lawrence Robinson, and Dr Jeanne Segal, said sometimes it might be hard to know what to say when speaking to someone with depression.
Someone might fear that if they brought up their worries, the person might get angry, feel insulted or ignore the concerns. Someone might be unsure what questions to ask or how to be supportive.
The authors said someone did not have to try to ‘fix’ a friend or family member who was depressed, but someone just needed to be a good listener. The authors wrote on helpguide.org:
“Often, the simple act of talking face-to-face can be an enormous help to someone suffering from depression. Encourage the depressed person to talk about their feelings, and be willing to listen without judgment.
Don’t expect a single conversation to be the end of it. Depressed people tend to withdraw from others and isolate themselves. You may need to express your concern and willingness to listen over and over again. Be gentle, yet persistent.”
They suggested using conversation starters such as ‘I have been feeling concerned about you lately,’ ‘Recently, I have noticed some differences in you and wondered how you are doing,’ or ‘I wanted to check in with you because you have seemed pretty down lately.’
Questions you can ask a depressed person include ‘When did you begin feeling like this?’ ‘How can I best support you right now?’ ‘Have you thought about getting help?’
You can also tell any COVID-19 survivor passing through depression words such as ‘You’re not alone. I’m here for you during this tough time,’ ‘It may be hard to believe right now, but the way you’re feeling will change,’ ‘Please tell me what I can do now to help you,’ ‘Even if I’m not able to understand exactly how you feel, I care about you and want to help,’ and ‘You’re important to me. Your life is important to me.’
However, you should never utter the following words to a depressed COVID-19 survivor: ‘This is all in your head,’ ‘Everyone goes through tough times,’ ‘Try to look on the bright side,’ ‘Why do you want to die when you have so much to live for?’ ‘I can’t do anything about your situation,’ ‘Just snap out of it’ and ‘You should be feeling better by now.’
Take them out
A psychologist in Ibadan, Dr Femi Johnson, said helping COVID-19 survivors could be in form of activities that could improve their mental health. He said,
“If you know someone who recently survived the COVID-19, you can take them out on a date. Thankfully, restaurants are allowed to open within a specified time period. Taking them out could improve their mind rest.”
Johnson also suggested that people could help survivors practise self-care activities like meditation, yoga, mindfulness, taking walks, listening to music, cooking a beautiful meal, or reading a book. He said these were healthy coping strategies that could help survivors avoid mental illness.
Engage them in exercise, others
An Abuja-based wellness coach and psychologist, Mrs Kike Alawe, said helping COVID-19 survivors to stay active could be therapeutic for them and make them avoid depression. Alawe stated,
“Survivors should not be made to sit down all day long; it could worsen their mental health. Of course, they could watch movies, listen to music and others. These are better alternatives to drinking, drugs, etc. However, we can encourage them to exercise. This will not only help them stay physically strong; it will also boost their mental health. Exercise is therapeutic.”
Let them do a project that brings joy
Writer Maisha Johnson said being stuck at home did not have to be all bad for survivors, saying it could be an opportunity to make them dive into home projects – new or long-forgotten hobbies – and other activities with the potential to light them up.
“Gardening, crafting and creating art can all have potential mental health benefits like soothing stress,” she wrote on healthline.com.
Introduce them to a therapist
Depression is a serious mental health condition, but it is treatable. The two key components of treatment for depression are medication and psychotherapy. Although people can opt for one without the other, experts said combining the two provided the best results.
According to experts, a survivor should be encouraged to seek professional help if the following signs are noticed over a prolonged period:
- Constant feelings of sadness or emptiness
- Sleeping significantly more or less than usual
- Eating significantly more or less than usual
- A deep lack of energy
- Irritability and pessimism
- Loss of interest in things that formerly brought pleasure
- Inability to concentrate
- Suicidal thoughts.