As I write this, I would say I have a steady awareness of my self in the midst of this explosive pandemic; however, there have been moments that I’ve re-experienced high levels of anxiety symptoms related to my post-traumatic stress disorder. The psychological effects of the pandemic are not unlike those of my childhood and marital domestic traumas. In the past year I've had overwhelming feeling of fear, loss, sadness, anger, irritability, and a sense of grief and other difficulties-too many to mention. Over the past year I've lost a few patients related to Covid 19 which has me feeling a sort of survivor's guilt.
I fully understand and appreciate that this phenomenon is not just limited to me.
The global psychological effects of COVID 19 will continue to result in a global mental health crisis that is considerably worse than any disaster that most of us have experienced- this event will continue to be ongoing.
Mayo Clinic defines post-traumatic stress disorder as “a condition that’s triggered by a terrifying event-either experiencing it or witnessing it.” Many individuals suffer from anxiety that develops in some people after extremely traumatic events, such as abuse, combat, crime, accidents, or significant natural disasters.
Many people suffer from depression and anxiety disorders that are often precipitated or triggered by an experience of trauma. Traumatic events such as childhood sexual abuse, childhood physical abuse, childhood mental abuse, and domestic abuses are similar to that of traumas suffered by those in combat, a major car accident, or with survivors of significant natural disasters. All these traumatic events can lead to post-traumatic stress disorder in many individuals.
PTSD symptoms can be delayed—with only subtle signs appearing initially and severe symptoms appearing months, or in some cases even years, post-event—it’s important that we implement and focus on extra self-care and protective stress, depression and anxiety reduction techniques now.
Beyond healing the psychological suffering that effects survivors it's crucial to become aware of the physical effects of trauma and post-traumatic stress on the brain and in the body. There are structural changes in the brain that take place due to trauma and psychological stress. Research demonstrates changes in brain structures in patients with PTSD. The hippocampus, a structure deep within our brains involved in regulating emotion, motivation, learning, and memory has been shown to have a reduced volume in people with PTSD.
We also know that trauma causes widespread inflammation in the body and can be a huge contributing factor to those suffering from chronic pain or from conditions such as fibromyalgia or IBS as well as other diseases later in life.
The first step is to distinguish your mind from your body. It’s important to remember you are not your thoughts. Separation of thoughts from self is an important first step to wellness.
How do I start to heal?
A person’s experience of time tends to be subjective and heavily influenced by their emotional state. Fears and insecurities about the past and the future can make it difficult to fully appreciate the present. Some of you may feel depressed from thinking about the past due to guilt or misfortune while others are fearful of the future which can lead to anxiety. The key is learning how to be conscious and fully aware of your present state. Not thinking of the past and not thinking of the future- Essential awareness is paying attention and being present in the NOW.
Mindfulness can take place through mediation sessions or smaller moments throughout the day. Mediation is essentially pausing during your day to focus on your breaths thus cultivating an awareness of self. Essentially, finding joy in being with one's self.
To cultivate a state of mindfulness, you can begin by sitting down and taking deep breaths. Focus on each breath and the sensations of the moment, such as sounds, scents, the temperature, and the feeling of air passing in and out of the body.
How do I practice mindfulness?
Shift your attention, then, to the thoughts and emotions that you’re experiencing. Allow each thought to exist without judging it or ascribing negativity to it. Sit with those thoughts. The experience may evoke a strong emotional reaction. Exploring that response can be an opportunity to address or resolve underlying challenges.
To cultivate awareness, observe your thoughts and emotions and explore why those specific ideas might be surfacing. To cultivate acceptance avoid judging or pushing away unpleasant thoughts. Emotions are natural and everyone has them—acknowledging them can help you understand yourself better and move forward.
Mindfulness can help bring you into the present moment during the day. As you wake up, you can focus on your breathing and the way your body gradually becomes more energized. You can incorporate a brief meditation into your work day, perhaps on your lunch break, and focus and appreciate the experience of being in the now. *R A I N technique is a useful tool to help process thoughts-good and bad.
Treatments for PTSD
In addition to practicing mindfulness, there are many different PTSD treatment options including talking to a qualified therapist as well as your primary care provider. Psychotherapy or “talk therapy” is a type of therapy used to help people with their PTSD symptoms. Eye movement desensitization and reprocessing (EMDR) is another PTSD treatment option where sounds or eye movement help patients work through their trauma. Aside from one-on-one therapy there are also medications patients can use to help combat symptoms of PTSD. SSRI or Selective serotonin reuptake inhibitor and SNRI Serotonin norepinephrine reuptake inhibitors can curb PTSD symptoms.
If you or a loved one is suffering from symptoms such as anxiety or depression, make an appointment with your health care provider to discuss what treatment options are best for you. If you need immediate help, you can contact the SAMHSA National Helpline at, 1-800-662-HELP (4357). This is a confidential and free 24 hour a day 365-day per year service in English and Spanish for individuals and families facing mental and or substance use disorders.
*For more information on the RAIN technique visit: https://www.psychologytoday.com/us/blog/changepower/201202/manage-emotional-pains-rains