Dear Therapist:

I have heard that COVID-19 illness can have effects on mental health. Based on your knowledge and experience is there any truth to this? If yes, how can someone prevent and/or deal with this appropriately? 

Response:

Your question is a bit unclear. I don’t know whether you are referring to possible physical side effects that can medically adversely affect the brain, or if you are referring to the psychological effects of dealing with the virus.

As far as actual medical effects are concerned, I haven’t seen any research that points to physical changes that may affect the brain. The virus is very new, and it can take years for proper research to identify these types of effects. In addition, research focus is now being placed largely on treatment and discovery of a vaccine.

We know of various viruses and diseases that can have psychological side effects. However, it is difficult to distinguish between side effects that are related to physical changes and those purely caused by psychological factors. This is at least partly due to the fact that the mind and the body work together seamlessly. The brain effects changes in the body and vice-versa.

From a pragmatic perspective, unless there is a specific treatment for any medical factors, it doesn’t really matter whether the cause of a psychological reaction is based in the mind or in the body. In either case, treatment will be in the mental health arena.

With regard to the emotional impact of COVID-19, there can be direct and indirect consequences. There can also be immediate and delayed reactions. This is true for most stressors. Direct, immediate reactions can range from feelings of fear and insecurity to anxiety and depression, as well as many others. An example of an indirect response would be feelings of sadness and isolation due to changes in social circumstances. Some people deal well in the midst of crisis, only to exhibit symptoms once the crisis has passed.

For some people, fear of the unknown plays a large part in their emotional response to the pandemic. Generally speaking, anxiety is exacerbated by fear of the unknown. Since the virus is relatively new, there is little—and often conflicting—information available about its nature, course, and long-term effects. This can lead to a sense of uncertainty and confusion, which causes many people to feel that they have no control over the situation.

Some people may use defense mechanisms to avoid consciously dealing with their feelings. For example, they may be in denial about their fears. They may repress or intellectualize their emotions. Though this may help them to deal with the problem in its immediacy, they will need to deal with it, one way or the other, at some point. Often, when this occurs it becomes more difficult to resolve. This can be due to the fact that their emotions present themselves without a clear understanding of their cause. When this happens, they are left to deal with raw emotions without the ability to focus on the actual fears and insecurities. Although it would seem that once the immediate threat is gone the emotional impact would disappear, defense mechanisms often cause emotions to emerge without the benefit of the full context.

If you find that your emotional response to the current situation is in excess of what it should be, try to identify specific fears and concerns. When these are clearly acknowledged, obtaining an objective viewpoint can help to remove some of the excess emotion. One way of doing this is to imagine a conversation with a friend who presents to you these same fears. From your perspective as sounding board and adviser, it can be easier to view the situation dispassionately.

Some degree of concern is normal, but when there is a significant discrepancy between your logical understanding of a situation and your emotional response, separating the two and clearly delineating between the two can help you to better regulate your emotional responses.

-Yehuda Lieberman, LCSW

 psychotherapist in private practice

 Brooklyn, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317

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