Do you remember this meme that made the rounds on social media at the start of lockdown? The one that simply said: “Your grandparents were called to war, you’re being called to sit on your couch. You can do this.” While it was meant to lift our spirits, no one knew at the time that the world was dealing with one of the greatest long-term threats facing humanity.
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More than a year later and with almost four million lives lost, we are a far cry from normal. In fact, according to the World Health Organisation, the Covid-19 pandemic has caused more ‘mass trauma’ on a larger scale than the second world war and the mental health toll of the coronavirus pandemic will last “for many years to come”. This trauma is what some medical professionals are calling post-pandemic stress disorder, a form of Covid-19-induced PTSD. While PPSD is not (yet) a recognised mental health condition, experts strongly believe it should be.
“Over the past year, many people have been exposed to varying degrees of trauma,” psychotherapist Owen O’Kane, who coined the term PPSD, tells Vogue. “The main problem is, it’s been relentless, and this is why I believe post-pandemic stress disorder will explode. At present, this won’t be recognised as a significant problem because we are normalising the circumstances. However, like all traumas, the impact will show when the pandemic is over.”
What are the signs of post-pandemic stress disorder?
According to O’Kane, symptoms of PPSD are similar to PTSD and can vary from person to person. These might include increased anxiety, low motivation, feeling hopeless or powerless, disrupted sleep, changes in appetite, feeling numb, being increasingly angry or irritated, negative or catastrophic thinking, withdrawing socially, feelings of struggling to cope and ‘I can’t be bothered with anything’.
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“If you previously experienced anxiety or depression, the symptoms may be worse,” he adds. “If you were functioning well before the pandemic and are now experiencing these symptoms, it is likely you are experiencing PPSD.” He advises if these or other symptoms are occurring regularly and ‘bad days’ are starting to outnumber ‘good days’, then it might be best to seek help.
American psychologist Dr Justine Grosso says it is crucial to check in with yourself and become aware of shifts in physiology, emotions, thinking and behaviour because these are the building blocks of good physical and emotional health. Trauma doesn’t just change the mind (beliefs and thinking patterns), but also the brain, nervous system and stress hormones.
Meanwhile, Dr Dan Chisholm, a mental health specialist for the WHO in Copenhagen, Denmark, says: “Covid-19 has had a number of effects on people’s mental health and wellbeing, ranging from worries about becoming infected, or the stress brought about by infection prevention and lockdown, self-isolation and quarantine, or the detrimental effect on mental health associated with lost jobs, income, education or socialising.”
“The cumulative effect of these measures has led to increases in stress and anxiety, as well as depression and loneliness,” he adds. “For many, the symptoms associated with these conditions will diminish as the public health situation improves and restrictions are eased, but for others, the experience of having had Covid-19, or living through the pandemic will have long-lasting effects, in particular for frontline health care workers or bereaved family members.”
One also has to think of children and adolescents, who, as Andrea Raballo, associate professor of psychiatry at the University of Perugia in Italy, points out have been exposed to “potentially destabilising facets of the pandemic in such delicate transition years,” the effects of which “still have to be properly appreciated and discerned, since the effects might emerge in time.”
Dublin-based Eliana Colantonio, 30, was diagnosed with PTSD earlier this year after suffering a severe case of Covid-19 on sabbatical leave in Italy last October. “I was afraid I was going to stop breathing and would die alone, away from my family and friends back home in Argentina.” Her agonising pain lasted 20 days until she got better, but unsurprisingly she was traumatised by the experience, leading to fears of getting it again and not being able to survive it a second time.
“Everyone I met on the street would immediately trigger my fight or flight response: ‘Am I too close? Is my mask enough? How many people have they met this week?’ A month ago, I started developing physical symptoms, but the doctors found nothing. The following day, I decided to discuss it with my therapist and she diagnosed me with PTSD triggered by [Covid-19] trauma.”
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How to cope with PPSD
The effects of any trauma can be debilitating, but there are ways to manage them. Sundas Pasha, a California-based clinical psychologist, says that over the past year she has noticed an increase in the number of people both seeking and providing psychological support in relation to pandemic-related trauma. “Since it’s a newer subset of trauma, people are looking for ways to bond and support each other through these uncertain times, and for the times ahead. It’s been great to see people coming together and sharing resources and information for those struggling.”
She highly recommends therapy as a resource. “A lot of practitioners have geared up with coping mechanisms and strategies to help those working through the aftermath and effects of the pandemic. We are a long way from overcoming the mental health impact of this past year, but having a place to talk about it and work through any issues or struggles is a great way to get back on track.” Meanwhile, O’Kane suggests cognitive behavioural therapy (CBT) – widely used for PTSD, anxiety and depression – certain medications, fitness programmes and support groups.
As some countries move towards relaxing Covid-19 restrictions, neuroscience researcher-turned-writer Mithu Storoni suggests socialising with upbeat, positive friends with whom you feel safe and secure as a way of minimising stressful situations. To improve resilience, mental performance, and focus, Storoni also suggests creating as much structure, order and certainty around you, which means clear communication and transparency both at home and at work, maintaining routines or creating new ones, exercising daily, getting out in nature, prioritising quality sleep and even starting a new project.
Regardless of whether you are suffering from PPSD or not, Dr Grosso suggests we can benefit from individual or group psychotherapy. These are, she says, “wonderful resources to process feelings and thoughts from the past year. Psychotherapy can be helpful regardless of whether someone has a ‘disorder’ because it is a non-judgmental space to discuss reactions, worries and barriers in relationships and life.”
It is worth remembering that there is nothing abnormal about experiencing psychological difficulties after going through a traumatic life event. There is help out there. Always seek the guidance of a professional if in any doubt and if you ever feel desperate or in need of urgent support contact the Samaritans, join a local support group, look at this mental health directory or this list of helplines in various countries.