A New Emerging Pandemic post-pandemic - Acute Stress/PTSD

Post Traumatic Stress Disorder (PTSD) is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape, or those who have been threatened with death, sexual violence or serious injury (American Psychiatric Association, 2020).

In a recent survey conducted by The Ontario Nurses Association, 3,300 nurses working in long-term care homes reported over 60% of nurses working in such environments with COVID19 outbreaks were experiencing PTSD symptoms. According to the survey, 43% of the nurses indicated they received no training on how to care for someone with COVID19. Many also reported the pandemic negatively affected their health and finances. Moreover, 33% felt inadequately protected. (Katawazi, M (2021). Majority of nurses working in long-term care homes report PTSD symptoms, survey finds. https://toronto.ctvnews.ca/majority-of-nurses-working-in-ontario-long-term-care-homes-report-ptsd-symptoms-survey-finds-1.5356274.

In addition to front-line healthcare workers who are at great risk of developing PTSD symptoms due to their regular exposure and contact with COVID19 patients, they are also the first point of contact when it comes to witnessing other forms of illnesses, deaths, and crisis situations. In another study published by Janiri, Carfi, and Kotzalidis in 2021 (https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2776722), the researchers surveyed 381 patients between April 21 to Oct 15, 2020, and concluded that 30.2% of their sample fulfilled the criteria of PTSD. Although patients may have successfully recovered from COVID19 from a physical perspective, their psychological sequelae linger. For example, it is not uncommon for survivors of COVID19 to continue to experience anxiety of falling ill or dying, feeling isolated and alone, in particular, during the time when they were in need of intensive hospital treatments and the feeling of guilt that they may have/had infected others.

Four categories of PTSD Symptoms:

Intrusive memories
Recurrent, unwanted distressing memories of the traumatic event

• Reliving the traumatic event as if it were happening again (flashbacks)

• Upsetting dreams or nightmares about the traumatic event

• Severe emotional distress or physical reactions to something that reminds you of the traumatic event

Avoidance

• Trying to avoid thinking or talking about the traumatic event

• Avoiding places, activities, or people that remind you of the traumatic event

Negative Changes in Mood and Thoughts
Negative thoughts about yourself, other people, or the world

• Hopelessness about the future

• Memory problems, including not remembering important aspects of the traumatic event

• Difficulty maintaining close relationships

• Feeling detached from family and friends

• Lack of interest in activities you once enjoyed

• Difficulty experiencing positive emotions

• Feeling emotionally numb

Altered Physical and Emotional Responses
Being easily startled or frightened

• Always being on guard for danger

• Self-destructive behavior, such as drinking too much or driving too fast

• Trouble sleeping

• Trouble concentrating

• Irritability, angry outbursts, or aggressive behavior

• Overwhelming guilt or shame

Treating PTSD:

Although the list of symptoms one might experience if they are diagnosed with PTSD can seem daunting, PTSD is a treatable condition and may require the help of external resources such as a doctor or mental health professional. In the interim, the following strategies may be applied while the search for therapy is in place:

1. Practicing Self-Care:
   P.L.E.A.S.E Skill:
   Physical Health Care (Treat Physical Illness)
   Eating balanced and nutritional meals
   Avoid mood-altering drugs
   Balanced sleep
   Get exercise

2. Engage in relaxation or calming techniques
   Deep Breathing, Diaphragmic breathing, Yoga, listen to calming music, mindfulness. There are apps available on mobile which may offer additional resources to assist with guided breathing or mindfulness exercises.
   

3. Identify or create your safe space - This could be a place you identify as calming or using visual imagery to create one where you may decompress when need be.
   

4. Reaching out to someone you trust and feel safe with to stay connected while avoiding potential triggers. If being in crowds or socially engaging with others is triggering to you, then seeking out a professional to address this concern may be beneficial.

References:

Janiri, D. (2021, February 18). Posttraumatic Stress Disorder in Patients After Severe COVID-19 Infection. JAMA Psychiatry | JAMA Network. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2776722

Miriam Katawazi. (2021, March 21). Majority of nurses working in Ontario long-term care homes report PTSD symptoms, survey finds. Toronto. https://toronto.ctvnews.ca/majority-of-nurses-working-in-ontario-long-term-care-homes-report-ptsd-symptoms-survey-finds-1.5356274

Posttraumatic Stress Disorder during COVID-19 | Psychiatry | Michigan. (2020, May 4). Psychiatry. https://medicine.umich.edu/dept/psychiatry/michigan-psychiatry-resources-covid-19/specific-mental-health-conditions/posttraumatic-stress-disorder-during-covid-19