Are you ready to come out from isolation? Do you think you have lost any functions? Being in isolation may have affected your social skills or comfort. When I came out of isolation I was uncomfortable with crowds, wondering, is anyone around me a carrier of COVID? Why are people not wearing masks? Is it that they have had the vaccine? When exactly? I had to depend on and trust my neighbor, but, with all the news programs telling me there was a 30% group who refused to get vaccinated, whom could I trust? Should I ask everyone not masked if they were vaccinated? Would they be angry or insulted? Should I care? My life depends on the answer. How do I handle the unvaccinated? How close should I get to the vaccinated? Should I allow them to hug me, kiss me? So many questions and yet in public there is not much time to decide. These questions need to be thought about before going out into public. You are going to be confronted with these situations as you go outside your comfort zone.
Making an assessment of oneself is important. Check your cognitive skills. Were you specifically using all of them daily? Be honest. These will come back with stimulation and interaction. Be safe, not impulsive! Slowly return to your outside routines assessing your anxiety. Many people became depressed in isolation. Often, there is a worsening of underlying conditions. People with underlying conditions are more susceptible and less resilient. We are now seeing this group in treatment. However, we are also seeing people who developed Anxiety Disorders as a result of the isolation and pandemic. Many people are afraid to resume old activities. Some have lost family and friends and were not able to fully mourn because of the isolation. No funerals, and the inability to visit and support loved ones. Many felt guilty. Some felt survivor's guilt. Had they contributed in some way to someone getting sick, or caused someone to die? Were they not there for their relatives and friends?
Many people with anxiety started to have breathing problems as they made their way out of isolation. These made them fear COVID. Calming these fears with a COVID test help some depending on the severity of the anxiety. Often, these responded to reassurance and breathing meditations. Headspace App and Calming Breadth were particularly helpful. Sometimes I used CBD or Tryptophane instead of medication. When medication was needed, Buspar was quite effective. It has few side effects and is safe. If this did not work, then I went up to Alprazolam or Lorazepam. I did not use antipsychotics because it was not necessary and I did not want to increase somatic symptoms. When patients had longer problems, I then used an SSRI for the Obsessions and Compulsions.
Some people have gotten vaccinations and yet, still fear COVID. They show many of the signs of PTSD. The experiences were too much for them and overwhelmed their coping. Some who had COVID are long haulers with symptoms of severe lethargy, muscle aches, headaches, GI disturbance, cognitive impairment, sleep disturbances, depression, and anxiety. Recent research has shown that many responded to a vaccine. Others have responded to Vitamin D, Vitamin C, and B complex, while others have needed steroids.
At the Tarnow Center, we have assessed and treated these problems. We have used some easily accessible online cognitive tests, rating scales, and qEEG for more severe problems. The qEEG’s have been very helpful to define COVID’s effects on the brain-slowing areas. The use of Neurotherapy with a stimulation pattern has shown improvement.
However, a most important new treatment, ART (Accelerated Resolution Therapy), has been very helpful, if not miraculous, for my COVID PTSD cases. ART is a newer updated version of EMDR and is very helpful in people that could not use EMDR. It does not require verbalizations. The work is internal, thus, patients who are too scared or embarrassed to discuss their inner thoughts were more receptive to this treatment. It has shown success with children and adolescents. We have even been able to adapt this method for videoconferencing. This treatment method is excellent for those who are going back into the world feeling all the anxieties I mentioned above. We cannot allow our fears to retard our growth and development. Every age group can be affected, delaying development further. Parents need to be strong for their children since the child imitates them and experiences their anxiety.
I am most concerned about the effects of the Pandemic on children with Comorbid conditions such as ADHD, Anxiety Disorders, OCD, Depression, Learning Disorders, Autistic Spectrum Disorder, and Tourette’s Disorder. These children need our special attention as they move out into the world again. ART may be very helpful in decreasing their symptoms and restarting their developmental processes.
To be able to grow and thrive while exiting isolation, we should be self-aware, cater to our symptoms, and remain responsible; responsible for our own health, and for the health of the community. Be honest with yourself if you feel a psychological evaluation is necessary. It is okay to need help. The Tarnow Center provides many treatment options and is eager to help the community push towards healing.
Tarnow Center for Self-Management
Jay D Tarnow, MD
Child, Adolescent, & Adult Psychiatrist