Sepsis Survivors, Mental Health, and the COVID-19 Pandemic

Sepsis and septic shock survivors know what it’s like to battle a life-threatening illness. Many are left with long-lasting mental health issues like depression, anxiety, and post-traumatic stress disorder (PTSD). These can make the COVID-19 pandemic even more scary. Not only are they constantly hearing and reading news about the virus, but the very idea of self-isolation is difficult for many people, especially if they are already fragile.

Social isolation versus physical isolation

We’ve been hearing the terms social isolation and social distancing to reduce the risk of spreading the novel coronavirus that causes COVID-19. We must maintain physical distances from others and stay isolated in our homes as much as possible. Many introverts, people who prefer to be alone much of the time, joke that this is perfect for them. But people who don’t like to be alone, who thrive on face-to-face interaction, can find isolation difficult. It can lead to worsening of mental health issues that already exist or trigger new ones. Some experts are saying we shouldn’t be using the terms “social distancing” or “social isolation”. They suggest we say “physical distancing” or “physical isolation” instead.

“Depression happens when we socially isolate,” said Stephen M. Scheinthal, DO, Professor and Chair of the Department of Psychiatry at Rowan University School of Osteopathic Medicine in Mt. Laurel, NJ. A good example of social isolation includes people who live alone, don’t have family or friends to visit, and don’t have access to the internet. They may go out and about to run errands, but they are essentially alone. Physical distancing, recommended during the pandemic, is different from social distancing. We have the means to stay in contact with others, reducing social isolation. “With FaceTime, Skype, Google platforms and all the video platforms that are available, you don’t have to socially distance,” Dr. Scheinthal explained. “You can physically distance but even if someone lives across town or around the corner you can still see them visually; you just can’t be physically in the same space with them.”

News can trigger mental health issues

The non-stop availability of social media and 24-hour news cycles has some advantages but also disadvantages. Social media allows us to connect with each other in ways that were impossible just one generation before. Ever present news gives us the opportunity to stay up-to-date with the latest developments from anywhere in the world. The flip side is the headlines and constant news is overwhelming and social media can easily and quickly spread incorrect news. Anxiety may abound when people feel that they have no control over everything they read. Sepsis survivors may also find that this increases their fear of becoming ill again, triggering PTSD symptoms.

“Turn off the news,” Dr. Scheinthal said. “I think that is a big problem in any type of crisis. Whether it was 9/11, where it was just oversaturation on every channel, or hurricanes. This is unique because we don’t often get disease broadcast the way this is being covered. So I think it promotes more anxiety.”

How to reduce depression and anxiety during this time

If you are the type of person who really needs to learn the latest news, there are ways to stay up to date without having the news on all the time. Dr. Scheinthal suggests picking one news outlet and restricting the amount of time a day you watch it. The danger with some cable news networks is they carry the stories in loops, so the same stories are played over and over again.  This can reinforce the fear. And for those who feel they are addicted to the TV, Dr. Scheinthal suggested finding channels that feed their interest. For example, some channels stream old comedy shows or movies that bring viewers back to another time. Streaming services can provide you with new or familiar movies or TV series. Watching these shows not only entertain you, they keep you from watching the news.

Other things you can do to help ease anxiety or depression

Everyone responds to crises in different ways. Some people like to hunker down at home and just be alone. Others need specific actions and tasks to help maintain a sense of normalcy. Here are some ideas that may help you:

• Keep a schedule. If you are someone who does better with a schedule, you can keep one at home. Outline what tasks and fun things you need or can do and draw up a plan to follow.
• Keep your night/sleep schedule. While it’s tempting to nap all day or sleep in really late, drastically changing your sleep schedule for more than a day or two can end up causing other problems.
• Stay active. If you’re used to going to the gym or playing sports, isolation can be particularly difficult. Many organizations are offering online classes for dance, exercise, yoga, and more. Maybe this is a good time to start an activity you’ve not tried before. Get outside for walks if you can.
• Limit alcohol and/or recreational drug usage.
• Set up regular check ins with family, friends, and neighbors. They can be one-on-one calls or social media outreach, or you can do group gatherings, using various apps and software.
• Learn a new skill. Perhaps you’ve always wanted to take better photos on with your smartphone or you want to improve your skills so you can apply for new jobs. Many universities and organizations are offering free or discounted courses. YouTube has thousands of videos that can teach you how to knit, fix a dripping tap, and more.

Mental health after the crisis is over

It will be a while before the all-clear is sounded. Stores and businesses will gradually reopen and people will start circulating again. Although they may be more cautious, not going out as often as before, eventually life will start looking normal again. But that doesn’t mean that the mental health issues go away as quickly as they may have surfaced. “I think there’s going to be fear, certainly,” said Dr. Scheinthal. “[There is] anxiety that you’re already hearing that there could be a second wave, like there was with Spanish flu. I think there’s a lot of anxiety around that. There’s also, I think, the PTSD that people may have if they’ve been exposed, or if they have loved ones were exposed.” There may also be anxiety about traveling, especially among those who became ill after being overseas. “So there’s a significant risk of that coming on.”

Ask for help

Whether it’s now or after the virus has been contained, if you need help for your mental health, ask for it. If you don’t have a counselor or therapist, contact your doctor’s office or local health authority to find out how to get help. Reach out and talk to family and friends. Find online groups that you feel comfortable with. Talk about it. Keeping stresses bottled up only makes things worse in the long run.

 

Visit our Sepsis and… library to learn more about sepsis and COVID-19.

The National Institutes of Health has a page with mental health resources available to the public. Please consult it if you or someone you know is struggling.