了解长期COVID与精神健康状况之间的联系

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研究人员早就知道，患有慢性疾病的人, 比如心脏病, 患抑郁症的风险增加了吗. The same may be true for people with COVID-19 symptoms that linger for months and sometimes years.

据估计，28%的美国人.S. adults who have had acute COVID-19 infections say they have experienced long COVID at some point, 根据最新的 调查数据 来自美国.S. 人口普查局. Long COVID occurs when a constellation of symptoms persist following the initial illness. 它在老年人、女性、住院和未接种疫苗的人群中更为普遍. 症状 变化，但可能包括疲劳, 脑雾, 头晕, 肠道问题, 心悸, 性问题, 嗅觉或味觉的变化, 渴, 慢性咳嗽, 胸部疼痛, muscle twitching and the worsening of symptoms after any type of physical or mental exertion.

美国.S. 六月，美国卫生与公众服务部发布了一份 咨询 warning that long COVID can have "devastating effects on the mental health of those who experience it, 还有他们的家人,“源于疾病本身, 社会隔离, 金融不安全, 照顾者倦怠和悲伤. 它与疲劳有关, 睡眠障碍, 抑郁症, 焦虑, 认知障碍和创伤后应激障碍, 在其他条件中.

抑郁是我们看到的最突出的症状. 约旦安德森, a neuropsychiatrist and assistant professor in the department of psychiatry and neurology at Oregon Health and Science University in Portland.

Diagnosing 抑郁症 in someone with long COVID takes a more nuanced approach than diagnosing the condition in the general population, 安德森说. 这是因为通常与抑郁症有关的症状——比如睡眠障碍, 乏力, 食欲和注意力的变化——也与长期COVID有关.

他说，这些症状本身“可能并不能真正反映一个人的抑郁程度”. 而不是, he looks for signs a person is no longer deriving joy from things they used to enjoy and are still capable of enjoying. 他还询问了绝望的感觉或自杀的想法.

Dr. 安娜·迪克, chief of consultation-liaison psychiatry and associate professor of clinical psychiatry at New York-Presbyterian Hospital/Weill Cornell Medicine in New York City, said rates of 抑郁症 and 焦虑 in people with long COVID appear to be higher than in the general population, 就像患有其他慢性疾病的人一样.

The virus that causes COVID-19 may be contributing to a person's mental state in a variety of ways, 她说. The person may have experienced prolonged isolation or they may be dealing with physical limitations directly related to their illness, 比如容易疲劳，不能正常工作. 这些限制甚至可能导致他们失去工作.

“这会影响你的日常生活，”迪克曼说. “如果一个人精力不足，他们可能想整天躺在床上. 但这样做可能会让你感到更加沮丧."

安德森说 suicidal ideation is present in about half the long COVID patients he sees at his clinic. “我问的问题非常具体,他说, which include whether the thoughts began after getting COVID or if they happened before.

安德森说 he sees two potential explanations for the high rate of suicidal thinking.

“一方面, it's intuitive to think having a chronic illness that limits your capacity so greatly for such a long time – and also causes stigmatization from family and others – would be demoralizing. 这可能是我从病人那里得到的最常见的解释。.

但一些研究表明，COVID可能会直接影响大脑. 这就提出了一个问题, 安德森说, 如果它进入大脑, 它是否影响了大脑中负责情绪的部分? 我们只是没有这些答案."

People with additional stressors from social determinants of health – such as discrimination, 较低的收入, limited access to health care and other resources – may experience even higher rates of 抑郁症, 迪克说.

“如果你有更大的压力, 如果你的社会支持较少, 所有这些都会对你产生负面影响,她说.

除了抑郁症, 安德森说，他看到了很多焦虑, 他治疗的长期COVID患者的恐慌发作和创伤后应激障碍.

PTSD occurs in patients who have had near-death experiences or hospitalizations related to their COVID infections, 对于那些因病毒失去亲人并可能有幸存者内疚的人来说, 安德森说.

"Having long COVID itself is a prolonged trauma that occurs over a period of many months. Someone might be triggered by anything invalidating or by any indication they might be sick again, 即使是普通的感冒. It's a terrible feeling that they are going to get worse again or have a life-threatening experience again."

Other long COVID symptoms, such as 心悸, can be confused with panic attacks, he said.

"A person's heart rate will drastically increase randomly without any provoking factors,他说. "That itself can be very unsettling and may be confused with or lead to a panic attack."

当这种情况发生时, someone may be treated with an antidepressant when what they really need is medication to control their heart rate, 或者转诊给心脏病专家, 安德森说.

There's no standardized treatment for mental health issues related to long COVID, 安德森说. Treatment could include medication or psychotherapy or both, based on an individual's symptoms. Group therapy can help people who need validation for their illness from others going through a similar experience. "When people feel like they have a community, that's worth its weight in gold,他说.

迪克曼说，除了药物治疗和心理治疗, 对焦虑有帮助的技巧包括冥想, 放松和呼吸练习, 以及根据个人能力量身定制的分级体育活动.

“以一种可以忍受的循序渐进的方式进行锻炼，”她说.

For those needing immediate help, a national mental health crisis line launched in July 2022. People can call or text 988 to talk with suicide prevention and mental health counselors. 聊天是可用的 988年自杀 & 危机生命线网站. 短信和聊天也是如此 有西班牙语版.