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Traumatic Stress in the Age of Covid-19

By Lauren A. Salani, LCSW, BCB

The Covid-19 pandemic has all the characteristics of a potentially psychologically traumatic event (unpredictable, extreme, prolonged, based on unknown/familiar danger, and posing a threat of death).

During this time, many people have been dealing with this virus first hand, such as our “hero” health care workers and our first responders. Researchers who have studied outcomes from previous epidemics, such as SARS 2, state it is highly likely that these first-hand experiences may develop into post-traumatic stress reactions following recovery. These first-hand exposures can lead to PTSD, “Large T Traumas.”

Struggling with PTSD can be distressing. It is important to note that PTSD is not a character flaw or a sign of weakness. The National Institute of Health (NIH) defines PTSD symptoms as occurring for at least one month to include:

Re-experiencing symptoms:

Intense recollections, such as flashbacks and reoccurring memories or dreams, distressing thoughts related to the event(s)

Avoidance Symptoms:

Staying away from people, places or things that are reminders of the experience(s), avoiding thoughts or feelings related to the event(s)

Arousal and Reactivity Symptoms:

Being easily startled, feeling tense on guard or “on edge,” having difficulty falling or staying asleep, feeling irritable and having angry or aggressive outbursts, engaging in risky, reckless, or destructive behavior

Cognition and Mood Symptoms:

Trouble remembering key features of the traumatic event

Negative thoughts about one’s self or the world

Distorted thoughts about the event that cause feelings of blame

Ongoing negative emotions, such as fear, anger, guilt or shame

Loss of interest in previous activities

Feelings of isolation

Difficulty feeling emotions, such as happiness or satisfaction

It is only normal to fear a life-threatening virus, the loss of a loved one, mandatory and drastic changes to one’s daily functioning. Living through these prevalent experiences makes us feel unsafe, disconnected from others, suffering from losses, failures, without control or hope. The current state of the world has been “uncertainty and disconnection.”

These prolonged experiences should also be perceived as being traumatic as they have posed a significant burden on people’s psychological health, functioning and relationships. For those whose symptoms may not meet the full criteria for a diagnosis in the DSM-5, (“Large T Trauma”), they would still be experiencing trauma symptoms, but identified as trauma with a (“Small t”). The point is to not overlook the smaller events as being significant and highly disruptive to health and well-being.

Resilience Factors that may reduce the likelihood of developing PTSD (T and t) include:

· Seeking support from family, friends, or support groups

· Learning to feel okay with one’s actions in response to a traumatic event

· Having a coping strategy for getting through and learning from the traumatic event

· Being prepared and able to respond to upsetting events as they occur, despite feeling fear

It may take some time to heal. Here are some guides to help yourself:

· Talk with your health care provider about treatment options and follow your treatment plan.

· Engage in exercise, mindfulness, or other activities that help reduce stress.

· Try to maintain routines for meals, exercise, and sleep.

· Set realistic goals and do what you can as you are able.

· Spend time with trusted friends or relatives and tell them about things that may trigger symptoms.

· Expect your symptoms to improve gradually, not immediately

· Avoid use of alcohol or drugs.

If you are experiencing symptoms that are holding you back, reaching out to your healthcare provider or a therapist is highly encouraged. There is a light at the end of the tunnel.


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