I have suffered from generalised anxiety disorder with depression (‘anxious depression’) and obsessive–compulsive traits, first diagnosed at age 18 in my first medical school year. I have been on four courses of selective serotonin reuptake inhibitor antidepressants, sometimes along with clonazepam and buspirone: sertraline in 2006, fluvoxamine in 2009, escitalopram in 2012–2013 and 2017–2018. I have been off psychiatric medication since March 2018.
I am a physician and an adult infectious diseases specialist by training – a training completed in April 2020, just as the COVID-19 pandemic began to hit.
For people like me with anxiety issues, COVID-19 has made an already challenging condition worse. The hardest part of working in the front line, treating patients with COVID-19, was the constant daily angst and dread of being infected with a disease with an unpredictable clinical course and no definite cure.
I survived 2020 without being infected. In late January 2021, three days before my scheduled vaccination, I tested positive for SARS-CoV-2.
The initial symptoms were mild but distressing, with low-grade fever, malaise and a throbbing headache. The most unpleasant were palpitations and what I can now recognise as ‘brain fog’, being unable to focus or concentrate. Unfortunately, all this triggered a massive anxiety episode. I had trouble sleeping because of tachycardia and palpitations. Worrisome, intrusive thoughts filled my mind: What if I die? What if I require admission into the intensive therapy unit (ITU)? Having treated hundreds of patients, I had envisioned for myself five worsening clinical states: the need for admission into the hospital, need for supplemental oxygen, admission to the ITU, invasive mechanical ventilation and death. I kept pacing around in anxious tension, and a relapse seemed imminent.
However, then I realised I was only repeating the same old cycle. I decided then that, come what may, I would not let fear dominate me. I had academic assignments to complete and would focus on them. If my mind wandered and my heart pounded, and I felt anxious, so be it. I reread portions of Paul David's books At Last A Life and At Last A Life and Beyond, two books that have helped me immensely. I have also found valuable insights in the book You Are Not Your Brain, by Drs Jeffrey M. Schwartz and Rebecca Gladding. I had previously found success with mindfulness and acceptance, and cognitive–behavioural therapy, and I knew this episode was no exception.
I gradually improved, made a complete and uneventful recovery, and took the first dose of the vaccine two weeks later.
The COVID-19 pandemic is an opportunity to bring into the limelight the importance of mental health and well-being. We need to be strong advocates for breaking barriers and increasing access to mental health resources.
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