Forty hours after treating her first coronavirus patient, on March 30, Angela Aston came home to her family with a cough. “Gosh, your throat is scratchy,” her husband told her. Right away she knew she had likely been infected with Covid-19. As a nurse practitioner, Ms. Aston, 50, was confident she knew how to handle her symptoms, and disappeared to her bedroom to quarantine and rest.
By day 50 of her illness, that confidence had disappeared. In late May, she was still experiencing daily fevers and fatigue. She went to bed each evening worried that her breathing would deteriorate overnight. Particularly frustrating was the difficulty she felt explaining to her colleagues, friends and family that after eight weeks she was still sick.
“I felt this stigma like, ‘I’ve got this thing nobody wants to be around,’” Ms. Aston said. “It makes you depressed, anxious that it’s never going to go away. People would say to my husband, ‘She’s not better yet?’ They start to think you’re making it up.”
Ms. Aston found psychological comfort in an online support group, founded by the wellness organization Body Politic, where more than 7,000 people share their experiences as Covid-19 “long-haulers,” whose sicknesses have persisted for months.
Along with sharing their physical symptoms, many in the support group have opened up about how their mental health has suffered because of the disease. Dozens wrote that their months of illness have contributed to anxiety and depression, exacerbated by the difficulties of accessing medical services and disruptions to their work, social and exercise routines.
Early on in the pandemic, a pervasive myth among patients and some health authorities was the idea that Covid-19 was a short-term illness. Only in recent months has more attention been given to long-haulers. In online support groups like Body Politic and Survivor Corps, long-haulers have produced informal surveys and reports to study their course of illness.
Natalie Lambert, a health researcher at Indiana University School of Medicine, recently surveyed more than 1,500 long-haul patients through the Survivor Corps Facebook page and found a number of common psychological symptoms. She found that anxiety was the eighth most common long-haul symptom, cited by more than 700 respondents. Difficulty concentrating was also high on the list, and more than 400 reported feeling “sadness.”
Dr. Teodor Postolache, a psychiatrist at the University of Maryland School of Medicine, estimates that between one-third and one-half of Covid-19 patients experienced some form of mental health problem including anxiety, depression, fatigue or abnormal sleeping.
Those without Covid-19 infections are also seeing their mental health suffer amid the pandemic. A study published in June by the Centers for Disease Control and Prevention found that symptoms of anxiety and depression nationwide increased significantly during April through June of 2020 compared with the same period last year. This study found that adverse mental health symptoms were disproportionately reported in young adults, Black and Hispanic adults and essential workers. The National Alliance on Mental Illness, a nonprofit organization, has seen a 65 percent increase in people reaching out to its help line for mental health resources since the onset of the pandemic.
“The public health response to the Covid-19 pandemic needs to include addressing its mental health consequences,” said Mark Czeisler, an author of the C.D.C. study.
Chimére Smith, 38, a middle-school teacher in Baltimore, marked her sixth month of Covid-19 symptoms in September. On March 22 Ms. Smith was on the phone with her therapist when she began to feel a tickle in her throat, which turned into a burn by the evening. Her symptoms became a “wheel of misfortune,” vacillating daily between nausea, diarrhea and headaches, she said.
Since then, she has gone to the emergency room a dozen times. In mid-April she rewrote her will. A persistent mental fog has made it difficult to put together sentences, she said, whereas before the pandemic she had functioned “like a walking thesaurus.” When she realized that could not return to teaching seventh and eighth grade English this autumn because of fatigue, she cried.
By the fourth month of her illness, Ms. Smith had contemplated taking her own life. “I said, ‘Who in the world would want to live like this?’” she said. “I wanted to jump out of my own body.”
Ms. Smith is one of many long-haulers who, like Ms. Aston, said her mental health improved when she joined the online support groups Body Politic and Survivor Corps, where she exchanges tips for managing mental and physical symptoms. Members of these groups supported Ms. Smith in overcoming her thoughts of suicide, she said.
Other Covid-19 patients turned to peers on such groups for reassurance that their symptoms were not imagined. “Every single symptom I’ve experienced is echoed…