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As a global pandemic ravages the nation’s healthcare system, concerns intensify for the welfare of our first responders.
Doctors, nurses, and hospital workers, police, EMTs, and firefighters, and the journalists who tell their stories, are on the frontlines of COVID-19 and must deal with intense emotions that arise in the face of widespread trauma and loss. The urgency of the work can make coping with feelings profoundly difficult.
Given the personalities of those in the helping professions—words like risk-tolerant and caretaker come to mind—many who are responding in this crisis rarely focus on or take steps to help themselves. What follows are red flags of common psychiatric disorders, with tips on what to watch for and when to ask for help with the inevitable strain and emotional overload:
Trauma reactions. Those called to the scene can feel helpless, horrified, and frightened by what they have witnessed. Even individuals who believe they are desensitized to trauma should take a personal inventory, paying particular attention to any of the following symptoms: Flashbacks, recurring nightmares, re-experiencing of trauma (this could take the form of repeatedly “seeing” dead bodies) or being reminded (seeing flashing lights or hearing sirens, for example).
Feelings of numbness, inability to recall or discuss major parts of a tragedy or trauma, and thoughts of a constricted future are also signs a professional might be having trouble coping with what they hear and see on the job.
Sleep problems, intense anger, startle responses, difficulty concentrating and thinking, and being excessively watchful, also indicate acute stress or PTSD.
Anyone suffering from several of these symptoms should seek professional help.
Emotional disturbances and Achilles' heels. Responding to and covering widespread and unprecedented illnesses as seen in a pandemic is obviously a difficult business that can trigger emotional struggles and reactivate once dormant problems.
Anxiety disorders such as panic attacks, OCD, and generalized anxiety can return full throttle when an individual is overwhelmed. Attacks take the form of a sudden intense surge of fear or terror with accompanying physical symptoms like palpitations, nausea, perspiration, and a belief one is dying or about to lose control. OCD is characterized by recurring intrusive thoughts and images that cannot be pushed away and plague the individual for hours on end, which can be accompanied by a compulsion to perform a certain behavior over and over. Generalized anxiety involves persistent worry about life in personal and professional arenas that impede daily functioning.
Signs and symptoms of depression include low mood, feelings of worthlessness, sensitivity to rejection, hopelessness, difficulty concentrating and making decisions, problems with sleep and appetite, thoughts of suicide, and impaired social and work functioning.
For those with symptoms of anxiety and depression, or any stress-induced problems like migraines or gastro-intestinal ills, there is help; consult with a licensed physician, psychologist, or mental health professional. If you are having thoughts of hurting yourself or taking your life, seek professional assistance immediately.
Substance abuse. Those called to the scene of tragic events commonly cope by denying their own reactions and by pushing through any feelings of fear, sadness, or helplessness. While this may get them through a tough day, it is dangerous in the long run. Thoughts and feelings that are denied almost always resurface in some way. Likewise, those who labor under difficult conditions long for an escape from the pressures or feel trapped in a rat race. As such they are vulnerable to acting on cravings to use drugs and alcohol.
Knowing one's triggers helps, and it is useful to talk to mental health professionals or attend meetings at the first sign of strain, or as soon as possible, once cravings begin.
Burnout (characterized by difficulties with motivation, intense malaise, fatigue) and fears of becoming ill—or worse—are also an issue for those on the frontlines.
And with some responders and healthcare workers self-quarantining from loved ones in the hopes of preventing the spread of COVID-19, many add the risk of isolation and loneliness to an already impossible daily struggle. It’s important to remain connected—everyone needs a lifeline during this unprecedented time.
Those working in a crisis will often be hit with an onslaught of emotions; they have to untangle feelings of survivors and family members and separate them from their own personal reactions. It is always difficult to make sense of exactly what is getting evoked and from whom the feelings are coming. Having a handle on what is “yours” as you debrief families can make it easier not to become overwhelmed by tragedy. Of course, this is easier said than done.
Knowing personal vulnerabilities and recognizing your own common reactions allows you to think more clearly, and puts you in a position to help others with their disturbing and painful thoughts and feelings. Knowing your own psychology makes you less likely to act on stressful, emotionally taxing feelings in harmful ways like drinking or using substances. If you find yourself unable to understand what you are experiencing, and you become overwhelmed by the situation, stepping out, taking a break or finding some way to get emotional support or relief can help you push through in the long run.
Bottom Line: Individuals in the trenches should not ignore their own needs—even in fast-moving, exigent circumstances.
References
For those in need, states have set up hotlines. In New York, the State Emotional Support Helpline is 844 863 9314.
