'Pandemic destroyed my marriage': the indirect traumas linked to covid-19

‘Pandemic destroyed my marriage’: the indirect traumas linked to covid-19

The terrified look of her co-workers at Hospital Estadual do Acre during the most critical phase of the pandemic is still alive in the memories of nurse Carla Bibiane, 46. There was the fear of dealing with a previously unknown disease and the anxiety about what could happen. happen every shift.

For her, however, the situation responsible for creating her most traumatic memories of the health crisis happened outside of work. “I remember in detail the day I took my husband, a person with cancer, to an appointment and the doctor advised us not to live together anymore”, she says. “We walked into the clinic hand in hand and left separately. After that day, we were never husband and wife again.”

According to Dorisdaia Humerez, coordinator of the National Commission on Mental Health at Cofen (Federal Nursing Council), health professionals experienced great mental suffering with the removal of their loved ones during the pandemic. Many only felt safe to share the same roof with their families again after the vaccination campaign began in Brazil, in January 2021. In other cases, however, the temporary removal became a permanent separation.

Once known for her caring personality at work, Carla found herself yelling at colleagues and being rude to patients after the event, as well as experiencing difficulties sleeping and changes in her weight. She, who is also administrative and care coordinator at the operating room at Hospital do Rim, in Acre, considered giving up her career.

I was very afraid of getting covid and killing my husband. This did not happened. Even so, the pandemic stole what was most precious to me, which is my family.

Nurse Carla Bibiane, 46, developed post-traumatic stress disorder during the pandemic

Image: Personal archive

The nurse considers that the disruption of the family arrangement was an indirect consequence of the pandemic and was more traumatic than her own professional experience during the health crisis.

While most nurses were impacted by the trauma of caring for patients with covid, death and grief were already a common experience for me in surgical centers. What was unusual was that I had nowhere to go back to at the end of the day, because being a nurse in the pandemic ended up increasing my absence from home and destroying my marriage.

Diagnosed with post-traumatic stress disorder, or PTSD, in January of this year, Carla is currently receiving psychiatric and psychological treatment to deal with some of the symptoms that still hamper her quality of life, such as recurring and disturbing memories about the pandemic. “If it wasn’t for the treatment, I would have reached the throes of suicide”, she analyzes.

Incidence of PTSD has increased

Psychiatrist Michel Haddad, from HSPE/IAMSPE (Hospital for the State Public Servant) and researcher at the psychiatry department at Unifesp (Federal University of São Paulo), says that the number of PTSD diagnoses has grown since the beginning of the covid-19 pandemic. .

The scenario was already predicted by experts: scientific evidence shows that, although about 80% of people recover in the first month after a traumatic event without long-term consequences, in a large-scale epidemic such as the coronavirus, lasting emotional trauma may arise, especially among health professionals.

The reactions will depend on how each one sees the traumatic situation, but the genetic predisposition to develop mental disorders also counts.

Overall, PTSD is characterized by symptoms such as:

  • Recurring, involuntary and disturbing memories of the traumatic event;
  • Recurring nightmares with the event;
  • Acting or feeling as if the event is happening all over again, from flashbacks to total loss of awareness of the current environment;
  • Avoiding people, places, activities and situations associated with the event or that trigger memories of the traumatic episode;
  • Negative changes in mood;
  • Changes in sleep, irritability and lack of appetite;
  • Hypervigilance (extreme alertness).

In the pandemic context, studies show a prevalence of 10 to 15% of PTSD in individuals who were hospitalized because of the disease, points out psychiatrist Rodolfo Furlan Damiano, from FMUSP (Faculty of Medicine, University of São Paulo).

But the virus infection is not the only factor that gave rise to the disorder associated with the pandemic. In February of last year, a study already warned that the anguish caused by the health crisis could also lead to symptoms of the problem. Examples cited by clinical research were the fear of catching the disease or passing it on and indirect contact with covid-19, such as excessive consumption of news and social isolation.

“A soldier who is in the war does not necessarily need to have been through combat or to have suffered a near death to develop post-traumatic stress. Just the fact that he was there in the war can already cause the condition”, compares Leonardo Tavares, professor at UFPE (Federal University of Pernambuco).

‘I still couldn’t stop sanitizing packaging’

Former app driver Cecília*, 43, and her loved ones did not catch covid-19. However, having closely followed the death of her sister-in-law by the H1N1 virus (causing the “swine flu”), in 2010, the self-employed professional panicked when the first cases of coronavirus were reported in Brazil, 12 years later.

“I was afraid of dying and leaving my son and my husband,” she says. “I found it difficult to sleep and was always focused on the number of deaths and the names of those killed by covid in my city.”

When she returned from her few trips to the market, both she and her husband and son left their shoes at the gate and showered before walking around the house. They also sanitized shopping with gel alcohol.

Two years after the beginning of the pandemic, however, habits still remain incorporated into Cecília’s routine, even though cleaning packages, for example, is no longer considered an effective method to prevent the disease — the most effective are vaccination and the use of masks indoors.

“I already let my son bring friends at home and we’ve also been to pizzerias and Festas Junina, but I haven’t abandoned the other habits yet”, he says.

According to Cecília, despite the challenges she still needs to overcome, fear does not paralyze her with the same intensity as before. The ex-driver, who was already being treated for depression before receiving the clinical diagnosis of PTSDattributes these advances in family life to the psychological treatment he received to better deal with the symptoms of the disorder.

Packaging - iStock - iStock

‘I still couldn’t stop sanitizing supermarket packaging’, says former app driver diagnosed with PTSD during the pandemic

Image: iStock

New approaches as treatment

Although treatment for PTSD often also involves medication, psychotherapy is considered the main option as it helps a person better cope with the trauma by reducing symptoms such as anxiety, stress and insomnia.

Researcher Erika Panzani, from the Institute of Health Sciences at UFBA, is trying to find out if there would be a more effective approach to treating people who developed the disorder because of the pandemic. His doctoral research, which began in 2021, wants to test three methods of psychotherapy (cognitive procedural therapy, mindfulness and positive psychotherapy) in this target group for three months and then evaluate the participants after one year.

Those who have lost loved ones to the disease tend to have the most severe symptoms, according to the psychotherapist. Factors indirectly associated with the pandemic, such as the increase in marital fights, separations and domestic violence, are also identified as possible triggers of the disorder.

If treated, PTSD is considered a reversible condition. “Sometimes it is difficult to seek help. But it is the only way to deal with the pain”, says nurse Carla Bibiane.

*O interviewee’s name has been changed to protect her identity.

Sources: Maria Amelia PenidoPtherapy teacher cognitive-behavioral at PUC-RJ (Pontifical Catholic University of Rio de Janeiro); irismar kingspsychiatrist and cognitive therapist, retired professor at the Department of Neurosciences and Mental Health at UFBA (Federal University of Bahia); Lina Sue Matsumotopsychologist and researcher at the USP Institute of Psychiatry (University of São Paulo.

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