Coping With Long COVID

According to the National Institutes of Health (NIH), most people fully recover from COVID-19 within days or weeks of being infected. Yet, some people have symptoms that last for weeks, months, or even years, and in some cases, a person may initially recover and then have symptoms reappear. Long COVID is generally defined as signs, symptoms, or conditions that continue or develop after acute COVID-19 infection, per the Centers for Disease Control and Prevention (CDC).

Symptoms of long COVID include fatigue, fever, feeling poorly after physical or mental exertion, respiratory problems (e.g., shortness of breath, cough), neurological symptoms (e.g., difficulty concentrating, headache), digestive symptoms, and aches and pains. The nature and extent of symptoms vary and symptoms can fluctuate day-to-day. The effects of long COVID can have a large impact on one’s life and make getting through the day much more challenging. Moreover, long COVID is still a relatively new condition, and managing a chronic condition amid limited information can be emotionally difficult.

Long COVID can create a loss in physical functioning, role changes, relationship changes, and perhaps changes to one’s sense of identity. The symptoms of long COVID, plus associated loss, can lead to mood symptoms such as anxiety and depression. Below are some tips for how to manage common long COVID concerns.

Fatigue

Chronic fatigue is a common symptom of long COVID. You may feel constantly worn out even from seemingly small activities such as taking a shower, which can be frustrating. While it may not be possible to eliminate fatigue, it is possible to manage it by doing the following:

Pace activities

Pacing involves engaging in activities based on time, not your energy level. Before starting an activity, estimate the amount of time you can engage in it without experiencing a major increase in fatigue. Then, engage in the activity for that amount of time, followed by an intentional break. Take a break for as long as needed to not exacerbate your fatigue and then resume the activity for another set period until it is complete or you decide to stop.  For example, if you need to vacuum the house, you may determine that you can vacuum for 15 minutes before your fatigue increases and then you need to rest for about 10 minutes before continuing to vacuum for another 15 minutes.

Relaxation

Relaxation is not simply sitting on the couch and resting. It is about using a relaxation technique to activate your body’s relaxation response which can lower heart rate and blood pressure and relieve stress and anxiety. For example, deep breathing and progressive muscle relaxation are two common relaxation exercises. This brief YouTube video from Johns Hopkins Rheumatology will lead you through a deep breathing exercise.

Physical movement

As possible, it is important to engage in physical movement as a way to manage fatigue as being overly inactive can worsen fatigue. You may not be able to engage in strenuous activity, and it may be frustrating to not be able to exercise in the manner you have historically, yet pacing activities and engaging in consistent physical movement are beneficial. For example, you might work up to walking for 15 minutes, 3 times a week.

Sleep problems

Poor quality sleep is common with long COVID. This may include trouble falling and staying asleep, lack of restful sleep, or oversleeping. It is no surprise that poor sleep can increase tiredness and fatigue, worsen concentration, and exacerbate mood symptoms such as irritability, anxiety, and depression. Fortunately, cognitive behavioral therapy for insomnia (CBT-I) is an evidence-based treatment for sleep problems and can help improve sleep within the context of long COVID. You can read a recent CBTDenver blog post about CBT-I here to learn more.

Stress, anxiety and depression

Living with long COVID is stressful and high levels of stress can contribute to anxiety, depression, and other mood concerns. While stress may seem like a given when coping with long COVID, managing stress is possible and beneficial. For example, it can be helpful to identify specific sources of stress, limit unnecessary stress, set realistic expectations for yourself, take effective action when possible (limit avoidance-based behaviors), and cultivate acceptance of things that cannot change (at least not in the present moment).

Uncertainty is a part of long COVID and can lead to worry and concern about the future. For example, you may worry about how long it will take to recover or if your symptoms may worsen. There are many effective techniques to manage anxiety such as learning how to effectively challenge anxious thoughts, scheduling specific worry periods, interrupting the cycle of worry, and practicing mindfulness.

Similarly, it is natural to feel depressed when coping with a life-altering and chronic condition. Some evidence-based strategies for managing depression include scheduling pleasant activities (motivation to engage in activity decreases when depressed), staying connected to others, challenging unhelpful thinking, and moving your body.

To learn more about coping with long COVID, please contact us at CBTDenver.