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Long Covid Psychiatry

Dr. Re'em has unique expertise in Long Covid.

 

He has written on the topic in the Wall Street Journal, The Lancet Psychiatry, and Stat News, and contributed to The Long Covid Survival Guide. He has also been involved in research with Patient-Led Research Collaborative for Long COVID, co-authoring one of the first detailed publications to characterize symptoms in Long Covid.

His blog on Psychology Today, Long Covid Lessons, discusses pertinent issues related to Long Covid.

 

He treats individuals with Long Covid-associated psychiatric and psychological symptoms using a treatment approach that is informed by his own experience as a Long Covid patient in 2020, his involvement with patient-led research and advocacy groups, and his psychiatry and psychotherapy training.

What is Long Covid?

The World Health Organization defines Long Covid as a condition that:

  • Occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19.

  • Lasts for at least 2 months and cannot be explained by an alternative diagnosis.

  • Has symptoms that impact everyday functioning, fluctuate over time, and may be new in onset following initial recovery from an acute COVID-19 episode or persist from the initial illness.

What are some common Long Covid symptoms?​

  • Post-exertional malaise / post-exertional symptom exacerbation: you may experience a "crash" of crushing fatigue, or a worsening in your symptoms, following physical or mental exertion. This may be immediate or delayed. Some individuals meet criteria for myalgic encephalomyelitis / chronic fatigue syndrome.

  • Brain fog, including poor attention, concentration, and memory

  • Fatigue

  • Numbness, tingling, and vibrating sensations

  • Heart palpitations

  • Chest pain

  • Fast heartbeat

  • Dizziness & lightheadedness

  • Gastrointestinal symptoms, including diarrhea, constipation, nausea, and changes in appetite

  • Disrupted sleep

  • Headache & migraine

  • & others

What are some common Long Covid psychiatric symptoms?​

  • Depression

  • Anxiety

  • Post-Traumatic Stress Disorder

  • Panic attacks

  • Suicidal thoughts

  • Changes in mood, including but not limited to tearfullness, euphoria, anger/irritability, and flattening of your mood

What is a psychiatrist's role in treating Long Covid?

A psychiatrist can offer treatment with medications or psychotherapy in order to help with psychiatric & psychological symptoms in Long Covid. Certain psychiatric medications may also be prescribed to help manage some of the non-psychiatric symptoms in Long Covid due to their anti-inflammatory or side-effect profiles. A psychiatrist should always be a secondary treatment provider who works alongside a primary care provider (PCP) or general practitioner (GP).

 

 What does psychotherapy look like in Long Covid?

Long Covid - focused psychotherapy is uniquely tailored to the individual and their concerns. Some common themes are: 

  • Confronting a new identity as a medically ill individual

  • Navigating disbelief and stigma from other medical providers, friends, family, employers

  • Exploring & addressing hopelessness and suicidal thoughts

  • Accepting one's position without giving up or giving in

  • Learning to tolerate the unknown

  • Understanding powerlessness

  • Making meaning in life