Federal health officials have identified a number of mental health conditions associated with long COVID, prompting them to issue an advisory to help doctors treat patients suffering from the syndrome.
Conditions could include depression, anxiety, psychosis, obsessive-compulsive disorder and post-traumatic stress disorder. Other long COVID symptoms can include fatigue, trouble sleeping and cognitive impairment, according to the advisory from the Substance Abuse and Mental Health Services Administration — a branch of the U.S. Department of Health and Human Services.
It can be challenging to determine whether mental health illness is the result of long COVID or other factors. Whatever the reason, however, “treating symptoms is vital to recovery,” the advisory said.
“This long COVID epidemic is not over. We’re absolutely in the midst of it,” said Dr. Will Pittman, associate director of the UCLA Health Long COVID Program. “Psychiatric symptoms are some of the most common symptoms that we see in long COVID.”
The advisory is partly an acknowledgment that many healthcare providers need more education on long COVID, which has been linked to numerous symptoms affecting virtually every part of the body. Even in the post-emergency phase of the pandemic, it can be hard for long-haul sufferers to get the care they need, experts say.
Although long COVID clinics do exist, their capacity is limited.
“We know that people living with long COVID need help today, and providers need help understanding what long COVID is and how to treat it,” Dr. Rachel Levine, assistant secretary for health for the U.S. Department of Health and Human Services, said in a statement.
Because long COVID can be debilitating, the advisory suggests healthcare providers approach patients as having undergone trauma. Suggested interventions include individual and group psychotherapy, peer support groups, physical therapy, neuro-rehabilitation, medication to treat anxiety and depression, speech therapy for people whose language skills were affected and treatment for people suffering from substance abuse.
The advisory also urged healthcare providers to listen, and not dismiss, their patient’s stories, manage symptoms while sharing the uncertainty of prognosis and “provide hope while helping set realistic recovery goals.” Anyone with worsening anxiety or depression, or has thoughts of self-harm, warrant immediate action and referral to a mental health specialist.
Pittman said he’s seen patients who have long COVID but feel as though their other doctors haven’t listened to them — “they don’t feel like they’ve been taken seriously.”
Other times, some primary care physicians are linking symptoms like anxiety or depression to a long COVID diagnosis but then referring the patient to a specialty clinic instead of treating those mental health challenges.
“Primary care really needs to take the reins of treating this. And they absolutely can, and I think they do have tools at their disposal to treat this and to make patients better,” Pittman said.
The advisory notes that healthcare providers who aren’t familiar with the wide range of long COVID symptoms may misdiagnose patients. This can be another barrier to care, as patients may feel ashamed or discouraged from seeking treatment if a healthcare provider suggests symptoms are exaggerated or simply “in their head.”
