In the Era of COVID-19: Living With Pre-existing PTSD & Grief

Give InKind is grateful for the expertise of Julie Bindeman, Psy-D.

“Nobody realizes that some people expend tremendous energy merely to be normal," wrote Albert Camus, author of The Plague. The shockwaves of the COVID-19/Coronavirus virus pandemic reverberate, precipitously and temporarily changing the way we live in every way. As millions of Americans live under some form of self-quarantine, shelter in place, or social distancing advisories, they’re all grappling with a new normal — at least for the time being.

Right now we are in a time of crisis; crisis, in and of itself, breeds trauma. These times are unusual in the sense that we are all experiencing trauma at the same time. At the root of trauma is a palpable loss of a sense of safety. Importantly, one must also consider that  are coming back and amplifying.

Julie Bindeman, Psy-D

The anxiety and fear that is normal in a pandemic may also be profoundly triggering to those who have experienced prior loss or trauma. Post-traumatic stress that pre-existed the pandemic (often called complex PTSD) is a bear on a good day. In a pandemic, it rapidly scales all the way up. And, let’s be real, life is very hard in different ways for everyone. I read somewhere (but I cannot find the attribution): “[If] you do not have post-traumatic stress disorder, you have pre-traumatic stress disorder."

Dr. Bindeman cautions against a one-size-fits-all approach to managing traumatic stress, recent or ongoing trauma, retrospective grief, and anxiety triggers in a pandemic. These times are far too complicated to offer up anything that could be perceived as trite. Everyone has a different story, a different response, and different actual access to relief. Dr. Bindeman encourages people to find what makes them feel better and make it a point to do those things. Listen to podcasts, listen to music, stretch, follow a guided meditation from your living room (or whatever space in your house is not overrun by other members of your family).

Also, remember that teletherapy can be useful. If you have an existing relationship with a therapist, perhaps try to find a payment plan if finances have changed. There are also supportive platforms for all ages – some specializing in specific areas, such as new motherhood. These platforms can be very helpful in acute situations.

It’s hard to feel safe right now. And then there is the tragic paradox that support systems must now operate differently. To be safe, millions are advised to self-quarantine or social distance. This may maximize our chances of remaining physically safe. Ironically, it also maximizes our chances of ratcheting the loneliness and anxiety up too.

For people who carry traumatic memory or grief with them, these pandemic times can be challenging. Those grappling with complex PTSD, such a loss in the past, may experience a resurgence of sadness as a result of hearing about thousands of people now dead of Coronavirus. The muscle memory of loss will recall symptoms that can cause deep anxiety, sleeplessness (or the opposite), a loss of appetite (or the opposite), or feelings of hopelessness.

Pandemics are far from ordinary events. Makeshift hospitals are being erected in urban parks, school dormitories, and such – these things are frightening. When one is experiencing grief from a retrospective loss, it can be hard to give oneself permission to ask for help when present circumstances are so grim, and our living situations so disparate.

To add to the complexity, if a loss occurred in the midst of a pandemic from a non-Coronavirus cause, it can be hard to feel heard when most of our traditional mourning rituals cannot take place. The pace of work at funeral homes is frantic. At the time of writing is blog, funerals are restricted. Some services offer drive-by processions or very small gatherings, but a minimum of six feet between a defined and select group of people is enforced. I am aware of a family who sat Shiva recently, using Zoom. Physical contact, so important in providing solace, is off the table. This may be necessary from a public health point of view, but that does little to stem the agony of the recently bereaved.

Trauma survivors often cope with their PTSD with specific regimens – exercise, therapy, yoga, cognitive-behavioral therapy. We are socialized (and educated) to create goals for ourselves. We have visions and we have plans – New Year’s resolutions are a thing we celebrate even if we don’t always follow through. However, during the pandemic, we are all living in a kind of suspended animation.

Even without death, there is a more macro sense of loss happening now. For instance, we tend to function around our goals, they scaffold our sense of self. For many, there is a loss of financial security. The careers they worked hard to build may be very much in question at this time. While many will bounce back, others will be forced to reinvent themselves. If one has a family to care for this can be a painful and cutting loss. Retirement accounts have cratered. Feelings of helplessness and inadequacy are normal.  

Says Dr. Bindeman, one of the difficulties in providing actionable advice is that the different state and regional responses to COVID-19 effectively limit services that are actually available to everyone, making services contingent on where one lives. In other words, essential services are not standard.

What I tell people a lot is to . Everyone has the ability to practice deep breathing. Practice slow breathing exercises –  1,2,3 and  1,2,3. Repeat this as necessary. The science is clear. It calms your sympathetic nervous system and helps with the fight or flight impulse.

Julie Bindeman, Psy-D

I myself have been triggered by these events. The ghosts of the losses I have experienced in my own life — those tangible and intangible — are very present in this pandemic landscape. There is a sharp contrast between the before and after. I have more time to think than I have in a while. My anxiety is set to high a fair bit of the time. My normal coping mechanisms are not currently available to me. So I have had to make some up. I check in with my doctor.

Still, my mind has wandered into vivid terrains, like those of lucid dreams. I think about things with unusual amounts of memory and detail. Not coincidentally, I have been missing my grandmother. I trace small memories of her to soothe myself — things like the view of a night sky with an open window at her house. How she, being from the Canadian prairie, always turned the heat down at night and heaped blankets on the bed. There was the sound of a tumbling waterfall below. There was wood smoke from her fireplace that, no matter what, really never did draw right. These things make me feel better.

We will get through this, but we must be gentle with ourselves. And let it not be forgotten that Albert Camus also wrote: “In the midst of winter, I found there was, within me, an invincible summer."

This the second in a series of articles to provide guidance as to navigating situations we continue to navigate during the COVID-19/Coronavirus pandemic. We recognize that life continues in all aspects, even the pandemic impacts all of us in profound ways. We are on your team now as well as post-pandemic – and beyond. We invite you to visit our library of situationally specific articles here.

Give InKind does not provide medical advice, diagnosis, or treatment. We have an affiliate relationship with many of the advertisers on our site, and may receive a commission from any products purchased from links in this article. See Terms & Conditions.

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