COVID Q&A: Posttraumatic Stress Disorder (PTSD)

We spoke to Yuval Neria, PhD, Professor of Medical Psychology in the Departments of Psychiatry and Epidemiology at Columbia University Irving Medical Center, and Director of Trauma and PTSD at the New York State Psychiatric Institute, about PTSD during the COVID-19 pandemic.

Columbia Psychiatry: What is PTSD?

Dr. Neria: According to the American Psychological Association, Posttraumatic Stress Disorder (PTSD) is a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape or other violent personal assault. PTSD could occur in an individual learning about the violent death of a close family member. It can also occur as a result of repeated exposure to horrible details of trauma such as police officers exposed to details of child abuse cases.

PTSD has been known by many names in the past, such as “shell shock” during the years of World War I and “combat fatigue” after World War II. But PTSD is not limited to combat trauma. It can develop in the aftermath of any trauma, and occur in people of any ethnicity, nationality or culture, and at any age. PTSD affects approximately 3.5% of U.S. adults and 5% of U.S children and adolescents. An estimated one in 11 people will be diagnosed PTSD in their lifetime. Women are twice as likely as men to have PTSD.

Columbia Psychiatry: Why would people develop PTSD during this pandemic? Is it just medical professionals on the front lines or could anyone get it?

Dr. Neria: The rapid rate of infection of the COVID-19 outbreak, financial difficulties, social isolation, and reliance on social and digital media are likely resulting in increased rates of anxiety, PTSD, and depression. The COVID-19 pandemic may have an impact on the population, hence everyone is susceptible to develop PTSD.

Columbia Psychiatry: If people do develop PTSD as a result of the COVID-19 pandemic, what would that look like? When could we expect to see signs of this?

Dr. Neria: People with PTSD may have intense, disturbing thoughts and feelings related to their experience that last long after the traumatic event has ended. They may relive the event through flashbacks or nightmares; they may feel sadness, fear or anger; and they may feel detached or estranged from other people. People with PTSD may avoid situations or people that remind them of the traumatic event, and they may have strong negative reactions to something as ordinary as a loud noise or a startled reaction to accidental touch.

Columbia Psychiatry: What can those on the frontlines of the COVID-19 pandemic do to prevent experiencing PTSD in the future?

Dr. Neria: As described, these days everyone is on frontlines. 

• First, we suggest using online social support such as contacting relatives and friends frequently via telephone, video-based chats, or social media. 
• Second, we encourage maintaining a healthy lifestyle (e.g., physical exercise, a balanced diet) and maintaining activities that can reduce anxiety (e.g., meditation). 
• Third, an overwhelming amount of information and recommendations are transmitted by numerous media outlets, some inaccurately, creating confusion and mistrust. Thus, it is critical to consume information via credible sources such as local public health authorities and public health organizations (e.g., WHO, CDC). 
• Fourth, limiting media exposure time is advisable. Graphic imagery and worrisome messages can increase stress and anxiety and may reduce overall wellbeing. Although staying informed is essential, one should minimize exposure to media outlets and be aware of the time that is consumed by news reports and even reduce it to the minimum if necessary. 

Columbia Psychiatry: How can those who already suffer from PTSD care for themselves during the COVID-19 pandemic?

Dr. Neria: The first and maybe the most important suggestion is to maintain their routine as much as possible. All of the recommendations above are relevant to people with PTSD. For further instructions we advise you to contact your primary care provider.