What is Long Covid

Although rarely mentioned in the US by the media or in PSAs, at least 10% of people with mild acute covid infection are now thought to fail to make a full recovery from their symptoms and return to their pre-existing level of functioning. Long Covid as its often called in Europe, Long haulers as they have been colloquially named by the peer community in the US, or Post Acute Sequelae of Covid 19 (PASC) as the CDC is now referring to it, are all synonymous terms and refer to the multi symptom, multi system post viral syndrome.  Many have found that although their initial infection was relatively mild, Long Covid itself is anything but. It can be completely debilitating and cause extreme discomfort and disability. 

Make no mistake, Long Covid is undoubtedly a biological, organic illness. If you are looking for a clinician who takes the approach that it is "Functional Neurological Disorder" and that you need "Brain Retraining" you are in the wrong place. I do not endorse any of those more psychological explanations, despite being a psychologist myself (the research evidence is pretty clear here). However living with Long Covid is tough, and so completely understandable that you might need psychological support with that. 

From paper published in Nature (2021)

Psychological support for living with and recovering from Long Covid

  • Are you feeling down or hopeless about your treatment and future potential for recovery?
  • Are you struggling psychologically as a result of the significant loss of functioning and quality of life?
  • Have you experienced gaslighting from medical professionals/friends and/or family claiming there's nothing wrong with you or your symptoms are just in your mind?
  • Are you feeling lonely as a result of isolation or abandonment by your social network after so many months of being sick?
  • Do friends tell you you should "think positive" or "practice gratitude" but you just can't seem to access those feelings because you feel so angry, irritable or sad?
  • Does brain fog make you feel like you are swimming through soup?​
Psychotherapy can be enormously helpful in managing all these emotional responses to being sick and the ongoing trauma you are experiencing. In turn when you feel stronger emotionally you will have more resources available to actively pursue your medical treatment. 

Fight or flight versus rest and digest

There is growing evidence that Long Covid is driven by several interrelated mechanisms, including viral persistence, immune system dysfunction, microclotting and vascular issues, mitochondrial dysfunction, and autonomic nervous system dysregulation. Talking specifically about the nervous system—one of the only mechanisms that is amenable to both biological and psychological intervention--many individuals experience a prolonged state of sympathetic overactivation as a result of the acute viral trauma to the body. This overactivation--being stuck in fight-or-flight mode—can prevent the body from shifting back into a parasympathetic state of rest and repair, which is necessary for healing and recovery.

Psychological interventions can play a crucial role in supporting nervous system regulation and restoring balance between the sympathetic and parasympathetic systems. However, because each person’s experience of Long Covid is shaped by their unique physiology, history, and prior trauma, different interventions will be effective for different individuals. I can help you navigate these options and find the strategies that work best for you.