集体创伤 ：新冠一直影响着许多病人的心理健康
概要
加利福尼亚大学欧文分校的心理学家罗克珊-科恩-西尔弗将新冠大流行病描述为一种“集体创伤”。
虽然有迹象表明，至少在美国成年人中，焦虑症和抑郁症的发病率已经从大流行病第一年的高峰中下降，但它们仍然比新冠大流行之前高，而且仍然没有足够的精神病医生和治疗师。一方面，根据美国国家卫生统计中心的数据，在2019年，美国有11%的成年人报告了焦虑或抑郁的症状。在2021年1月，这个数字是41%。2022年，该数字已经下降到32%，但仍然大大高于大流行病之前的数据。
另一方面，根据凯撒家庭基金会的数据，超过四分之一的美国人口生活在治疗师和精神病学家短缺的地区。
简而言之，虽然大流行病不再是新闻头条，但它带来的连锁反应仍然是许多美国人的心头大事。
同时，美国国家卫生统计中心的数据显示，在6月份，几乎有五分之一的美国成年人曾患过新冠，并出现后遗症。华盛顿大学临床流行病学家齐亚德-阿利博士认为，患有新冠的人出现心理健康问题的风险更高。
‘A collective trauma’: Covid keeps its grip on mental health of many patients
Rates of anxiety and depression have decreased since first year of the pandemic but there still aren’t enough therapists
For some people, the end of lockdown didn’t bring the end of anxiety and depression. Photograph: Sarah Meyssonnier/Reuters
Eric Wood, a mental health professional who leads virtual support groups for Indiana judges and attorneys, can look at a screen full of heads nodding in reaction to what someone said and know that the meeting is providing some relief for participants who have struggled during the Covid-19 pandemic.
Wood, who lives in Indianapolis, can also see how his wife, Diane Keller Wood, has made gradual improvements in her recovery from long Covid’s significant effects on her mental and physical health.
“This was probably me being more of a therapist than a husband, but I would really try to get her to focus on the positive aspects and not to see everything with kind of a negative filter,” said Wood, a clinical case manager for the Indiana Judges and Lawyers Assistance Program. “And then eventually, she started coming home” from doctor’s appointments “saying, ‘You know, I think I’m getting better’”.
Still, Keller Wood and the jurists, like millions of other Americans, have not fully recovered from the mental health problems connected to the pandemic and the surrounding societal upheaval over the last two and a half years.
While there are indications that, at least among US adults, the rates of anxiety and depression have decreased from the spikes seen during the first year of the pandemic, they still remain higher than before Covid, and there still aren’t enough psychiatrists and therapists.
In short, while the pandemic is no longer the top story in the news each night, its ripple effects remain top of the mind for many Americans.
In addition to those who died from Covid or lost a loved one to the virus, “there are personal stressors that people have had to encounter, on and off with restrictions in their activities, on and off with the possibility of getting ill, and all of those things have now been chronic”, said Roxane Cohen Silver, a University of California at Irvine psychologist who has described the pandemic as a “collective trauma”.
In 2019, 11% of adults in the United States reported symptoms of anxiety or depression, according to the National Center for Health Statistics. In January 2021, the number was 41%. A year later, it had fallen to 32%, which was still significantly higher than before the pandemic.
Before the pandemic, the Lawyers Assistance Program operated monthly support groups for people struggling with problems such as addiction or grief. When much of the country entered lockdown because of the virus, the organization launched a weekly program, Connection Group, to help people grapple with the isolation.
“We have got some folks in the group that identify themselves as extroverts, and the pandemic was particularly difficult for them,” said Wood. “Working from home really changed their sense of activity with other people; conversations were cut. Anything social was just gone out of their lives.”
But even once the litigators started again working in person, their mental health challenges did not evaporate, Wood said. In some cases, they got worse.
“When people started returning to the offices, attorneys in particular were just starting to fall apart,” Wood said. “Substance use for many really went out of control over that two-year period. Depressive disorders, also on the rise.”
Still, despite the mounting concerns and the novelty of meeting virtually, the support groups appeared to work, Wood said. People who previously might not have driven two hours to attend a support group could now do so from home.
The Connections group “has created its own kind of sense of community”, said Wood. “We have had people that came in when a crisis was particularly relevant for them and then things settle down and then they stopped coming to group, but it’s really met a need.”
Once Covid restrictions eased, Wood and his colleagues considered stopping the Connections group or meeting less regularly, but participants asked to keep the same schedule.
After many people had stopped worrying about Covid, Diane Keller Wood, a hearing aid attendant, contracted the virus in February 2022, despite remaining vigilant about wearing a mask.
And then she developed long Covid symptoms, including difficulty breathing, fatigue, brain fog, loss of balance and eye twitching.
Almost one in five US adults who have had Covid continued to have long Covid symptoms in June, according to the National Center for Health Statistics.
Keller Wood has seen a long list of providers, including an ear, nose and throat doctor; a neurologist; a physical therapist; a psychiatrist; and an ophthalmologist.
For about a month, she experienced suicidal ideation, which is more common among people who have had Covid, according to a study conducted at Washington University in St Louis.
Keller Wood described it as the “worst despair you have ever been in, with really no reason”.
“People with Covid-19 unfortunately have a much higher risk of having mental health issues,” said Dr Ziyad Al-Aly, clinical epidemiologist at Washington University, who has studied the impact of the virus and long Covid on people’s mental health.
The psychiatrist prescribed Keller Wood a mood stabilizer, which “helped me tremendously”, she said.
Keller Wood also connected with a member of a Covid survivors support group who recommended she try the over-the-counter drugs Pepcid and Zyrtec, which studies have shown can help with some Covid symptoms. They helped ease Keller Wood’s brain fog, she said.
But some days, she still has trouble forming words.
“If I can just have quality of life and see some improvement, I think I will remain positive, but I don’t know what my life is going to look like 10 years down the road,” she said.
Another challenge is the lack of therapists and psychiatrists. More than a quarter of the US population lives in an area where there is a shortage of mental health providers, according to Kaiser Family Foundation data.
To address the swell of mental health problems, “we need to be creative”, said Al-Aly. That could mean the healthcare system forming support groups and social workers providing mental health care, he said.
“The government has to do a whole lot more, and also the public has to be aware of this and restore some social ties and restore some sense of normalcy of checking on each other,” Al-Aly said.
Tim Bostwick, an opera singer and doctoral candidate in music at the University of Illinois at Urbana-Champaign, is working on a creative solution to his post-traumatic stress disorder.
He had never had significant anxiety or depression before being hospitalized for Covid in spring 2021 and developing long Covid symptoms. He also developed nodules on his vocal folds, which prevented him from singing for six months.
“Since recovering from Cov, I woke up with nightmares almost nightly, most of them being back in the hospital,” he said.
But his mental health has improved because of medications and cognitive behavioral therapy. And he is now working with a service dog organization to train his mini Aussiedoodle, Lift.
In public, Bostwick used to panic when he saw others not wearing masks. Now Lift notices when his breathing pattern changes and paws at him.
“It helps me focus on something besides all the people who aren’t wearing masks around me,” he said. “That’s not my responsibility. I can’t really deal with that. But I have to try and address my own psychological issue.”
He is now preparing to perform for the first time since the pandemic began. He will be singing in La Jetée at Chicago Fringe Opera.
“Losing my voice … was like losing an old friend, and we’re not the same. We’re never going to be the same. There’s no going back to normal,” he said. “But it’s like getting to know an old friend again.”
Source:
The Guardian
Publised on August 27 2022
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