What doctors wish patients knew about post-COVID anxiety (2022)

Mental health has been negatively impacted during the pandemic. And as states begin to transition back to a pre-pandemic life, it may cause increased anxiety about reopening for many. While stress, fear, worry, sadness, exhaustion and numbness are normal—and expected—emotional responses to a health crisis such as the COVID-19 pandemic, the impact on mental health cannot go ignored.

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In addition, physical distancing and remote work have been necessary to cut the spread of COVID-19, but those measures can take a toll on people’s mental health by making them feel isolated and lonely, further increasing stress and anxiety. As more people become fully vaccinated and states begin to reopen, it is important to learn how to cope, to improve mental health and well-being.

“People are feeling overwhelmed, uncertain, anxious, helpless, frustrated, stressed and exhausted,” said AMA member Lisa MacLean, MD, a psychiatrist at Henry Ford Health System, anAMA Health System Program Partner. “With the worsening of—and gradual decline in mental health—we are also seeing anger, depression, insomnia and increased substance abuse as well as a reported increase in isolation and loneliness.”

In a recent discussion, Dr. MacLean shared what physicians wish patients knew about the pandemic’s effect on mental health and how to cope with this added stress.

Navigate anxiety about reopening

Navigate anxiety about reopening

“Some people can’t wait to finally feel free and go back to the way we were living without masks. However, for many, the lifting of the mask mandates creates fear and anxiety,” said Dr. MacLean. That’s because “for over a year we’ve been told that masks protect each other. We’ve been trained to fear the virus and that is not something that is going to go away overnight.

“We’ve also been told to distance ourselves from people, so it is going to create stress,” she added, noting that “not knowing who has been vaccinated or not adds additional anxiety.”

(Video) Stress, worry and anxiety post COVID-19 – Part 1

To overcome anxiety about reopening, “step back and pause,” but remember to stay up to date on the latest guidance from the Centers for Disease Control and Prevention “and then give yourself permission to take it slow,” Dr. MacLean recommended, emphasizing the need to “respect that everyone might be in a different place when it comes to wearing masks,” but to “be open and try not to fold under social pressure.”

“It’s going to take time for people to feel comfortable again and, for some, they may continue to wear masks indefinitely,” she said. “It’s only with time and people seeing the COVID numbers continue to drop that anxiety will be reduced and people will get more comfortable.”

“We are going to have to go through an uncomfortable stage before we get comfortable again,” Dr. MacLean said.

Discover what doctors wish patients knew about life after vaccination.

Recognize the mental health impact

Recognize the mental health impact

Some of the mental health conditions experienced during the pandemic are “anxiety, trauma-related disorders, depression, domestic violence, substance abuse disorders and even suicide,” said Dr. MacLean, adding that “it’s critical right now that people acknowledge the stress of the pandemic.”

But what are the symptoms of stress and how does it affect mental health? They include:

  • Anxiety.
  • Feeling powerless.
  • Low motivation.
  • Feeling tired or burned out.
  • Sadness.
  • Poor concentration.
  • Insomnia.

“For some front-line workers who have witnessed high death volumes, you might see acute stress disorder, post-traumatic stress disorder [PTSD] or secondary traumatic stress,” she said. “We are also seeing compassion fatigue and burnout from chronic workplace stress and exposure to traumatic events related to the COVID-19 pandemic.”

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Pay attention to PTSD

Even after the pandemic ends, “the mental health fallout from the pandemic will continue to grow,” said Dr. MacLean. “History has shown that the mental health impact of disaster outlasts the physical impact, suggesting that today’s elevated mental health need will continue well beyond the coronavirus outbreak itself.”

Additionally, “many communities are seeing an increase in domestic violence, drug overdose and suicide,” she said, adding that “in some areas, mental health and suicide-hotline use have dramatically increased.”

Not all patients affected equally

Not all patients affected equally

“Women and people of color seem to be more negatively impacted,” said Dr. MacLean, adding that “the impact of the pandemic on the social determinants of health such as employment, income levels, housing and food security have threatened people’s basic survival.”

“The exacerbation of the social determinants of health will last for years and have a long-term negative implication for mental health,” she said.

“People are getting tired of physical distancing, mask wearing and other pandemic-mitigation behaviors,” said Dr. MacLean. “Many are feeling exhaustion after months of spending extra time and energy dealing with our new pandemic lifestyle and all the struggles it’s brought on.

“Finding effective ways to address this fatigue and reinvigorate public vigilance is a growing challenge in controlling the spread of the virus,” she added. “Unfortunately, this fatigue can also lead to stress, which over times can result in exhaustion, anger and anxiety.”

Read about what doctors wish patients knew about pandemic fatigue.

Sleep can be disrupted

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Sleep can be disrupted

“The problem with coronasomnia is real and widespread—it appears to be impacting people across all ages,” said Dr. MacLean. “Some experts say the coronavirus has caused a secondary pandemic of insomnia. This worsening is likely related to stress and anxiety.

“Another contributor is the loss of normal routines. We barely go out and the many things that connected us to the greater world like movies, restaurants and other social places have been negatively impacted,” she added. “For many, our lives have become repetitive. We lack stimulation and activities, and this contributes to our poor sleep.”

“Unfortunately, the more you can’t sleep, the more you worry and the more you don’t sleep,” Dr. MacLean said. “More than ever, it’s important to have good sleep hygiene to manage and prevent insomnia.”

Discover the six things doctors wish patients knew about coronasomnia.

It’s possible to cope with pandemic anger

It’s possible to cope with pandemic anger

“We are all frustrated that after a year of following the rules, the pandemic is still here and has significantly changed our lives,” said Dr. MacLean. “This change is difficult to accept and, for many, has caused significant distress and suffering.”

“It’s important for us to acknowledge our anger but also take a step back—anger is often a secondary emotion that stems from fear, helplessness, depression and anxiety,” Dr. MacLean said. “We need be aware of and learn to be comfortable with angry feelings but to not lash out in aggressive ways that only makes things worse.”

“Right now, is when you need to lean into self-care,” Dr. MacLean said, noting that “techniques like distraction, giving yourself a break from the endless to do list and exercise are all good ways to manage your negative feelings.”

Read about what doctors wish patients knew about coping with pandemic anger.

All age groups are affected

All age groups are affected

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“Children have been impacted by the lack of structure related to home schooling—they need schedules, predictable rules and set expectations,” said Dr. MacLean. “It’s not uncommon to see an exacerbation of behavioral issues when routines are disrupted.

“For kids in high school and college, there is growing concern about the loss of connection as these young adults try to navigate graduation and early college experiences,” she added. “The closing of campuses and online learning has impacted people’s sense of belonging, which can result in increased anxiety and depression.”

Additionally, “for adults, there is the stress of trying to support a family, homeschool children and financial stress,” Dr. MacLean said, adding that “many have experienced job loss or income insecurity” and “the rates of depression and anxiety appear to be worse for mothers with children than for fathers.”

“In terms of our elderly, many report increased loneliness and isolation,” which is “particularly difficult for our older adults,” she said.

Find ways to cope

Find ways to cope

“Don’t be afraid to reach out for help if needed,” said Dr. MacLean, adding that “physical distancing doesn’t mean you can’t go outside” because “feeling the sunshine on your face and breathing in fresh air can be rejuvenating.”

Other coping mechanisms include connecting with others, taking a break from the news, sticking to a schedule or routine, being kind to yourself and focusing “on the basics like exercise, hydration and good nutrition,” she explained. “The silver lining is that the pandemic has created space in our lives to slow down, spend time with our immediate family, refocus on what’s important and connect with one another in new ways.

“For some there is post-traumatic growth, where we see people becoming more resilient, dealing with effectively with challenges, and finding new resources they didn’t know existed,” Dr. MacLean added.

Help others who are struggling

Help others who are struggling

“The most important thing you can do to take care of others is make time to take care of you,” said Dr. MacLean, adding that “a few things aren’t canceled: empathy, caring, thoughtfulness, kindness and faith in humanity.”

(Video) Doctor caught on camera laughing and cursing at a patient

“Make sure to reach out and stay connected. Consider elderly neighbors and help out when you can,” she said. “Deliver meals, help with lawn care or even help a neighbor take their garbage to the street—find ways to be of service to others.”

Table of Contents

  1. Navigate anxiety about reopening
  2. Recognize the mental health impact
  3. Pay attention to PTSD
  4. Not all patients affected equally
  5. Be mindful of pandemic fatigue
  6. Sleep can be disrupted
  7. It’s possible to cope with pandemic anger
  8. All age groups are affected
  9. Find ways to cope
  10. Help others who are struggling


How do I get rid of anxiety after COVID-19? ›

  1. Stay connected with people. Maintaining healthy relationships with people we trust is important for our mental wellbeing. ...
  2. Talk about your worries. ...
  3. Support and help others. ...
  4. Look after your body. ...
  5. Stick to the facts. ...
  6. Stay on top of difficult feelings. ...
  7. Do things you enjoy. ...
  8. Focus on the present.

Is anxiety a post Covid symptom? ›

The most common symptoms of post-COVID conditions are below. You may have one or more of these: Anxiety. Chest pain.

What is the best coping mechanism for anxiety? ›

Here are 11 tips for coping with an anxiety disorder:
  • Keep physically active. ...
  • Avoid alcohol and recreational drugs. ...
  • Quit smoking, and cut back or quit drinking caffeinated beverages. ...
  • Use stress management and relaxation techniques. ...
  • Make sleep a priority. ...
  • Eat healthy foods. ...
  • Learn about your disorder.
20 Jul 2021

How do you deal with anxiety on your own? ›

How can I help myself?
  1. Talk to someone you trust add. Talking to someone you trust about what's making you anxious could be a relief. ...
  2. Try to manage your worries add. ...
  3. Look after your physical health add. ...
  4. Try breathing exercises add. ...
  5. Keep a diary add. ...
  6. Complementary and alternative therapies add.

How do you overcome post Covid syndrome? ›

Here are some steps you can do to help manage and cope with stress:
  1. Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the COVID-19 pandemic repeatedly can be upsetting.
  2. Take care of your body. ...
  3. Make time to unwind. ...
  4. Connect with others.

How do you recover from Covid mentally? ›

Seek support from people who care about you.

Social support is crucial in healing from trauma and sharing your story can be a powerful way to process your thoughts and feelings. Find people who will empathize with you – they can be other HCWs, close friends, or anyone who you trust and feel safe with.

Can Covid make anxiety worse? ›

During the COVID-19 pandemic, you may experience stress, anxiety, fear, sadness and loneliness. And mental health disorders, including anxiety and depression, can worsen.

What is Post Covid syndrome mental health? ›

Anxiety. Depression or other mood changes. Concentration or memory problems (“brain fog”) Sleep disturbance.

Can Covid infection increase anxiety? ›

A recent analysis of 1112 subjects experiencing probable COVID-19 symptoms suggested a positive association between COVID-19 and anxiety/depression symptoms 1-7 months after suggested infection (OR 1.31 - 1.47)23.

What are 4 suggestions for treating anxiety? ›

Here's what you can do:
  • Keep physically active. Develop a routine so that you're physically active most days of the week. ...
  • Avoid alcohol and recreational drugs. ...
  • Quit smoking and cut back or quit drinking caffeinated beverages. ...
  • Use stress management and relaxation techniques. ...
  • Make sleep a priority. ...
  • Eat healthy.

What are the Big 5 ideas to assist with anxiety? ›

Here are 5 strategies that can help make anxiety easier to deal with:
  • Challenge anxious thoughts.
  • Recognize some negative thinking patterns that foster worry, fear, and anxiety.
  • Cultivate optimistic thinking.
  • Take a timeout.
  • Create an anxiety toolbox.
25 Feb 2017

How do you treat anxiety without medication? ›

Anxiety Treatment Without Medication: 7 Holistic Ways to Cope
  1. Keep Your Blood Sugar in Check. ...
  2. Avoid Stimulants. ...
  3. Get Enough Sleep. ...
  4. Just Breathe. ...
  5. Practice Mindfulness. ...
  6. Exercise. ...
  7. Do What You Enjoy. ...
  8. Where to Get Help.
6 Dec 2017

What is the main symptoms of anxiety? ›

Common anxiety signs and symptoms include:
  • Feeling nervous, restless or tense.
  • Having a sense of impending danger, panic or doom.
  • Having an increased heart rate.
  • Breathing rapidly (hyperventilation)
  • Sweating.
  • Trembling.
  • Feeling weak or tired.
  • Trouble concentrating or thinking about anything other than the present worry.

How do I break my anxiety cycle? ›

One important step in reversing the anxiety cycle is gradually confronting feared situations. If you do this, it will lead to an improved sense of confidence, which will help reduce your anxiety and allow you to go into situations that are important to you.

Can you come out of anxiety on your own? ›

Anxiety is a beast, but it is possible to win the battle without medication. Sometimes, overcoming worry and nervousness is simply a matter of modifying your behavior, thoughts, and lifestyle. You can start with a drug-free approach, and then speak with a doctor if your symptoms don't improve or worsen.

Does post-Covid syndrome ever go away? ›

People with post-COVID conditions can have a wide range of symptoms that can last more than four weeks or even months after infection. Sometimes the symptoms can even go away or come back again. Post-COVID conditions may not affect everyone the same way.

Is post-Covid syndrome autoimmune? ›

Introduction: Post-COVID syndrome (PCS) is recognized as a new entity in the context of SARS-CoV-2 infection. Though its pathogenesis is not completely understood, persistent inflammation from acute illness and the development of autoimmunity play a critical role in its development.

How long does it take to recover from post-Covid? ›

How long it takes to recover from COVID-19 is different for everybody. Many people feel better in a few days or weeks and most will make a full recovery within 12 weeks. But for some people, symptoms can last longer.

Is depression a post-COVID symptom? ›

Being unwell can have an impact on your mental health. It's not unusual to experience lower mood after being through a significant event such as coronavirus (COVID-19). It can take a while to process what you've been through and the impact this has had and may still be having on your life.

Does COVID cause long term neurological problems? ›

A comprehensive analysis of federal data by researchers at Washington University School of Medicine in St. Louis shows people who have had COVID-19 are at an elevated risk of developing neurological conditions within the first year after infection.

Can having COVID affect your mental health? ›

Plenty of us became more anxious; but for some COVID-19 has sparked or amplified much more serious mental health problems. A great number of people have reported psychological distress and symptoms of depression, anxiety or post-traumatic stress.

How much does Covid increase anxiety? ›

Wake-up call to all countries to step up mental health services and support. In the first year of the COVID-19 pandemic, global prevalence of anxiety and depression increased by a massive 25%, according to a scientific brief released by the World Health Organization (WHO) today.

How long does anxiety usually last? ›

From the time of diagnosis, an anxiety disorder can last from a few months to many years. Most people will have symptoms of an anxiety disorder for a long time before seeking professional help, sometimes up to 15 years³.

Can COVID cause post traumatic stress disorder? ›

In the case of COVID-19, the symptoms of PTSD may arise in response to the invasive measures needed to treat the patients, including intubation and ventilation, which can be traumatic for fearful patients.

What is post pandemic stress disorder? ›

These may include a fear of infection, exposure to quarantine and isolation, fear of job loss, lockdown, loneliness, and loss of social life [19,20]. In many countries around the world, there are currently two classifications of post-traumatic stress disorder on which the diagnosis of PPSD is based.

What is the drug of choice for anxiety? ›

SSRIs and SNRIs are often the first-line treatment for anxiety. Common SSRI brands are Celexa, Lexapro, Luvox, Paxil, and Zoloft. Common SNRI brands are Pristiq, Cymbalta, and Effexor XR. Pros: They are effective for a lot of people and they have a solid safety profile.

What are 3 treatments for anxiety? ›

Stress management techniques, such as exercise, mindfulness, and meditation, also can reduce anxiety symptoms and enhance the effects of psychotherapy. You can learn more about how these techniques benefit your treatment by talking with a health care provider.

What is the first-line of treatment for anxiety? ›

First-line drugs are the selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. Benzodiazepines are not recommended for routine use. Other treatment options include pregabalin, tricyclic antidepressants, buspirone, moclobemide, and others.

How do I deal with anxiety and overthinking? ›

Tips for addressing ruminating thoughts
  1. Distract yourself. When you realize you're starting to ruminate, finding a distraction can break your thought cycle. ...
  2. Plan to take action. ...
  3. Take action. ...
  4. Question your thoughts. ...
  5. Readjust your life's goals. ...
  6. Work on enhancing your self-esteem. ...
  7. Try meditation. ...
  8. Understand your triggers.
15 Nov 2019

What is high function anxiety? ›

Instead, high-functioning anxiety typically refers to someone who experiences anxiety while still managing daily life quite well. Generally, a person with high-functioning anxiety may appear put together and well- accomplished on the outside, yet experience worry, stress or have obsessive thoughts on the inside.

Can drinking water help anxiety? ›

Water has been shown to have natural calming properties, likely as a result of addressing dehydration's effects on the body and brain. Drinking enough water is an important step in managing your anxiety. Even if you're not experiencing anxiety, drinking sufficient water can create feelings of relaxation.

What vitamins should I take for anxiety? ›

B-complex, vitamin E, vitamin C, GABA, and 5-HTP are 5 vitamins commonly used to help with anxiety and stress.

What does severe anxiety look like? ›

feeling tense, nervous or unable to relax. having a sense of dread, or fearing the worst. feeling like the world is speeding up or slowing down. feeling like other people can see you're anxious and are looking at you.

What chemical in the brain causes anxiety? ›

Epinephrine is just one chemical involved in your body's response to anxiety. Other chemicals may also play a role. For example, a serotonin imbalance¹ may contribute to anxiety, as can high cortisol levels. However, epinephrine is the primary chemical because it is directly involved in your anxiety symptoms.

What are four physical symptoms of anxiety? ›

Physical symptoms of anxiety
  • stomach pain, nausea, or digestive trouble.
  • headache.
  • insomnia or other sleep issues (waking up frequently, for example)
  • weakness or fatigue.
  • rapid breathing or shortness of breath.
  • pounding heart or increased heart rate.
  • sweating.
  • trembling or shaking.

What happens in your brain with anxiety? ›

Anxiety happens when a part of the brain, the amygdala, senses trouble. When it senses threat, real or imagined, it surges the body with hormones (including cortisol, the stress hormone) and adrenaline to make the body strong, fast and powerful.

When does anxiety become too much? ›

If your anxiety, or the anxiety of a loved one, starts to cause problems in everyday life—such as at school, at work, or with friends and family—it's time to seek professional help. Talk to a health care provider about your mental health.

What is the most effective coping method? ›

Relaxation. Engaging in relaxing activities, or practicing calming techniques, can help to manage stress and improve overall coping. Physical recreation. Regular exercise, such as running, or team sports, is a good way to handle the stress of given situation.

What are the 4 types of coping mechanisms? ›

Weiten has identified four types of coping strategies: appraisal-focused (adaptive cognitive), problem-focused (adaptive behavioral), emotion-focused, and occupation-focused coping. Billings and Moos added avoidance coping as one of the emotion-focused coping.

What is the healthiest coping mechanism? ›

Take brief rest periods during the day to relax. Take vacations away from home and work. Engage in pleasurable or fun activities every day. Practice relaxation exercises such as yoga, prayer, meditation or progressive muscle relaxation.

What is the most popular coping mechanism? ›

Top 10 Coping Skills
  1. Deep Breathing. Often when faced with a stressful situation or feeling, our breathing changes. ...
  2. Writing. Writing can be an effective means of working through stress. ...
  3. Physical Activity. ...
  4. Self-Talk. ...
  5. Art. ...
  6. Meditation. ...
  7. Puzzles. ...
  8. Music.
22 Oct 2019

What are three physical symptoms of stress? ›

Physical signs of stress
  • Diffculty breathing.
  • Panic attacks.
  • Blurred eyesight or sore eyes.
  • Sleep problems.
  • Fatigue.
  • Muscle aches and headaches.
  • Chest pains and high blood pressure.
  • Indigestion or heartburn.

What are the three A's of coping? ›

In this decision-making process, it is helpful to approach the situation from the perspective of the three "A's" --- alter, avoid, and accept. Look at each stress-producing situation and ask, "Can I alter this situation, can I avoid it, or must I accept it?"

What are 5 unhealthy coping strategies? ›

Some of the most common unhealthy coping mechanisms are:
  • Avoiding issues. ...
  • Sleeping too much. ...
  • Excessive drug or alcohol use. ...
  • Impulsive spending. ...
  • Over or under eating.

Is crying a coping mechanism? ›

In times of deep pain, anger and stress, crying can be a healthy coping option. Though more often associated with negative emotions, crying is more than just a symptom of sadness. Research suggests crying is an emotional release mechanism useful to your mental health for a number of reasons.

What are 3 unhelpful coping strategies? ›

Below are some examples of these: Unhelpful coping strategies examples: social withdrawal overeating or eating unhealthily sleep too much or too little · · • • self-harm.

What are unhealthy coping skills? ›

A maladaptive coping mechanism may include avoiding a person or a situation which causes you stress, becoming defensive or harming yourself in some way. While adaptive coping mechanisms are healthy and positive, maladaptive ones are negative and could harm your health in the long run.

What is a natural coping mechanism? ›

Relaxation: Any number of relaxing activities can help people cope with stress. Relaxing activities may include practicing meditation, progressive muscle relaxation or other calming techniques, sitting in nature, or listening to soft music.

What are two positive coping strategies? ›

Taking care of yourself – getting enough sleep, eating well, being physically active, making time for activities that you enjoy, and avoiding the overuse of alcohol and or “recreational” drugs – will improve your ability to tolerate stress better and recover from stress.


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