Life After COVID-19: Are We Going To See A Spike In PTSD Cases?

You'd be hard-pressed to find anyone who is completely unaffected by the COVID-19 pandemic and the kinds of changes it's leading to. Many healthcare systems have established mental health hotlines right alongside numbers you can call if you think you are experiencing coronavirus symptoms, and that's for good reason.

COVID-19 is pretty universally stressful, in one way or another. It's stressful right now, and it can be very stressful to allow your mind to speculate what the world might be like by the time humanity emerges from the pandemic, too. 

Does the COVID-19 pandemic qualify as a trauma?

Let's get real here. We're all stuck in this pandemic right now, but we are certainly not all facing the same situation. Too many people whose writings I've had the displeasure of encountering conveniently forget about that — when they accuse anyone who's not learning a new skill right now of lacking discipline rather than time, for instance. 

If you are, like me, in lockdown in a relatively comfortable home, with an internet connection, with a job you don't need to go out to do, with food on the table (even if you're not sure it's still going to be there in a month), and you're relatively healthy and haven't lost a loved one to the pandemic, you're one of the lucky ones. If you think the idea that the COVID-19 pandemic is going to leave a wave of post-traumatic stress disorder cases in its wake is Millennial and spezial-znowflakey, you're definitely one of the lucky ones. 

So, what's trauma, exactly?

No matter which definition of trauma you go with, people the world over are living through trauma as a result of COVID-19. Plenty of people are exposed to "actual or threatened death, serious injury, or sexual violence" because of the pandemic:

• People who have developed serious cases of COVID-19, and required artificial ventilation to make it through to the other side. 
• People who suddenly lost loved ones to COVID-19, in many cases unable to say good bye or even attend a funeral. 
• The "front line" workers we keep on praising include healthcare staff like doctors and nurses, of course, who are driven to exhaustion while battling for others' lives in extraordinary circumstances and while low on basically everything they need. Let's not forget that they also include cashiers, janitors, garbage collectors, delivery staff, and law enforcement officers. Much of the front line consists of minimum wage workers who risk their very lives every time they ring up our groceries. Many of these people, too, see things the rest of us mostly only read about on the news.
• The millions of people who have lost their jobs or still will include those who have no social safety net in place, and for whom job loss can mean the real risk of starvation for them and their families. This, too, is traumatic.
• The people for whom "shelter in place" orders mean being confined to a makeshift prison with their abusers in domestic violence situations.

What has China taught us about COVID-19-related post-traumatic stress disorder?

Only a portion of people exposed to trauma will go on to develop post-traumatic stress disorder, while others will build up resilience and coping mechanisms. You're more vulnerable to PTSD if you have already suffered trauma in the past, if you aren't getting the social support that would help you nurture your coping skills, and if the trauma is followed by other kinds of stress that constantly deplete your ability to deal and heal.  

PTSD isn't diagnosed until at least a month after a trauma. It's too early to tell what COVID-19 is going to do to PTSD rates yet, but early research from China suggests that seven percent of (a sample of) folks from some of the hardest-hit areas during the time of the outbreak developed symptoms of post-traumatic stress disorder. Women, people in Wuhan, and those who were sleep deprived as they battled the pandemic seem so far to be more likely to develop PTSD. This is consistent with previous research as well. 

Numbers will rise, though — over 40 percent of people who survived SARS had PTSD symptoms, and mental health symptoms (including PTSD and depression) hit at least a fifth of people whose loved ones had SARS, who worked in high-risk professions, or who were quarantined following exposure.

How do people deal with trauma? What can you do to cope right now?

Post-traumatic stress disorder has that name for a reason — this trauma-related anxiety disorder is usually diagnosed after a person's traumatic experiences have come to an end. The situation many of us are actively dealing with right now is better likened to a non-clinical but nonetheless well-recognized phenomenon, combat stress. Uniquely associated with active combat, I think many people who are putting their lives at risk to save others every day can benefit from learning about it. 

The US military can teach us a thing or two about combat stress, including how to monitor your own mental health with a "traffic-light system":

• In the green zone, you're good to go — though you are facing stress, you are handling it well, taking steps to care for your mental health, and are functional and generally in good spirits. 
• The yellow zone is the first sign of emotional danger — you're losing some control, as the situation changes too fast for you to successfully adapt. If this continues, you could enter the orange zone. 
• The orange zone signifies combat stress. You may suffer physical symptoms of stress, like nausea, trouble sleeping, excessive sweating, an inability to concentrate well, loss of appetite, and reduced functioning. At this point, you really benefit from help, or your functioning is likely to further decrease. 
• The red zone means serious trouble. When soldiers hit the red zone, they're no longer functional. They need professional help to recover. 

Try:

• Making sure you eat nutritious food every day. 
• Leaving some time for recreation, however short and in whatever form. This means something that relaxes you, whether it's a bath or an online game. 
• Making sleep priority.
• Connecting with loved ones in whatever way you can. Make sure they know you care, and let them care for you in whatever way they can. 
• Breathing exercises. Yes, they help. So do other forms of meditation. 
• Exercising regularly, in whatever way you can right now. 

Though it's too early to diagnose PTSD at the moment, signs you're headed there include emotional numbness, more severe dissociation, and chronic feelings of distress without a break. If this is you, no matter who and where you are, seek help. If your country has a mental health hotline, call it. If you have a therapist, book a tele-session. If you live with supportive people, talk to them. If you have an internet connection, reach out for help. 

In conclusion

The COVID-19 pandemic is inflicting collective stress on a massive scale. For a significant portion of people, the experience is indeed traumatic. We are likely to see a spike in PTSD cases when the world emerges from the pandemic, and healthcare systems will have an added challenge to deal with as that happens.

Right now, though, we're not there yet. For the many people who are, in some way, "active duty personnel", looking to resources designed to help soldiers cope with combat stress may be the best bet.