Dr. Suzana Guedes 

Brainspotting
e Neurofeedback
Clinical psychologist
PhD in Health, Personality and Individual Differences
Therapist in EMDR, Brainspotting and Neurofeedback

Mental and emotional health after covid?

HPA Magazine 17

COVID-19, is a well-known name worldwide. It was the name given by the World Health Organization to the disease caused by the new SARS-COV-2 coronavirus. This virus was first identified in humans at the end of 2019, in the Chinese city of Wuhan, Hubei province, and since then cases have been confirmed in almost every country in the world, leading to a pandemic situation with an impact on an unprecedented scale.

Memories of the first news are still very much alive in everyone’s minds. An invisible enemy that decimates lives and opens so many graves. Even those who have not had COVID so far, continue to live a situation of chronic stress. Not only does our brain keep the memory of images seen on television, our body also keeps the memory of the emotional impact of what was experienced, all over the world.
Professionals that work with trauma patients are well aware of the effect of stress on the brain and the chemical and electrical changes that take place in it.  These alarm and danger signals sensed by the brain continue to this day. Many people have not yet managed to come out of a state of alertness. There are many fears: of contracting the virus, fear of death, of not having access to health care or fear of hospitalization. There are those who are also afraid of the vaccine.
The first major emotional impact is related to the diagnosis. Receiving a positive diagnosis for COVID-19 can be truly traumatic. Uncertainty, fear of contagion from family members, uncertainty about the evolution of the disease, anxiety and time spent in isolation. These symptoms only correspond to the initial phase of the entire process. And the stress caused by this prolonged situation inevitably has a greater impact if accompanied by loneliness and social isolation.
Almost two years later, COVID-19 insists on not leaving us. For this reason, there are many doubts concerning the future. Consequently, with all this uncertainly in our live, fear and anxiety increases.
From an emotional point of view, for some people mentioning the name COVID is frightening enough. Although symptoms may be residual, it can ultimately cause a serious respiratory infection, such as pneumonia, and even lead to death. Perhaps for this reason, the impact of a positive COVID-19 diagnosis and the fear related to the prognosis are unavoidable. Patients may have to deal for a long time with resulting symptoms after the disease. In Portugal, it is estimated that around 80 thousand people may suffer in the long term from sequelae of the disease to a greater or lesser degree.
 

But even in less severe cases, reports of breathing difficulties, muscular pain, inability to perform physical exercise, among others, are frequent. The sequelae left by COVID-19 may be relevant and effects may occur not only on a pulmonary level but also on a haematological, cardiovascular, respiratory, neurological, emotional, renal, endocrine, gastrointestinal or even dermatological levels.
Although symptoms of COVID-19 may disappear after four weeks, there are cases of symptoms persisting beyond 12 weeks, (not attributable to other diagnoses).
This condition is known as Long COVID or Post-COVID Syndrome (the name given by experts to describe the long-term effects of the infection).
Studies in the United States or Europe (in France, Spain, Italy and the United Kingdom), where follow-up of post-COVID patients was carried out, symptoms of coughing (15.4%), breathing difficulties when climbing stairs (22.9%) were reported. Loss of taste or smell (13.1%), fatigue (53.1%), joint pain (27.3%) or chest pain (21.7%), with 55% of patients experiencing three or more symptoms. There is also a significant change in the quality of life. In Italy, for example, 44.1% of people reported a decline in their quality of life. 
In addition to physical symptoms, emotional damage is also of significant relevance. Many people are emotionally affected, symptoms of psychological stress persist, even 8 to 14 weeks after diagnosis. 
Post-traumatic stress disorder (PTSD), sleep disturbances, anxiety and depression are experienced in 30 to 40% of survivors.  The likelihood of a psychiatric diagnosis also increases. 
Cognitive symptoms are equally significant and manifest themselves mainly in relation to memory and the ability to concentrate.
The so-called brain fog or brain frog is one of the commonly reported symptoms.
Complaints of slower and less intuitive thinking, greater mental confusion and even organization and vocabulary difficulties have often been reported.
The battle now has to be fought on several fronts, not just physical health, but also brain and emotional health.
A multidisciplinary assessment is essential to provide an integrated response and the HPA has a multidisciplinary Post-COVID team ready to answer your questions and help you to overcome physical, cognitive and emotional sequelae.