Preserving doctors’ and nurses’ mental health during COVID-19

Many doctors and nurses on the front lines of COVID-19 care are under intense stress and feeling anxious and overwhelmed, says a Northwestern Medicine psychiatrist and expert on trauma disorders and physician health and wellness.

If clinicians have not had access to adequate resources to protect themselves and provide good care, they may feel frustrated and betrayed by government agencies, including the federal government. That sense of betrayal could increase trauma-related symptoms in health care providers once the crisis has passed, says Dr. Joan Anzia, a professor of psychiatry and behaviorial sciences at Northwestern University Feinberg School of Medicine. 

But health care providers also have the advantage of taking action to help patients and families, which is a boost to emotional health, Anzia notes.

Dr. Anzia is available to comment on the emotional challenges facing health care providers and the best strategies to take care of themselves during this crisis. Contact Marla Paul at marla-paul@northwestern.edu to speak to the doctor.

Quotes from Dr. Anzia: 

‘All my training has not prepared me for this’

“Patients flooding into the hospitals with an illness we have no cure for can feel overwhelming and frightening. Doctors may think ‘all my training has not prepared me for this.’ That can be disorienting. When doctors, nurses, physician assistants, respiratory therapists and EMTs can feel a sense of capacity and mastery — thinking ‘We can do this and handle this’ — that will be positive for them. When they don’t have the resources to help people, that’s demoralizing.” 

Perception of governmental agency failures can increase impact of trauma

“Usually humans have less anxiety and less depression in response to natural disasters because they feel those are acts of God. They think, ‘There was nothing we could have done about it.’ But in this situation, there are human made components. The federal government’s preparation for this has been inadequate. There have been some leadership failures, manifested in delayed testing and inadequate resources. Front-line workers don’t have time to think about that now; they are busy. But there will be anger about having to scrounge for basic equipment to protect oneself, and putting one’s own life at risk.

“That happened during Hurricane Katrina as well. The impact in rates of PTSD (post-traumatic stress disorder), depression and suicidal feelings were worse in New Orleans because of the poor government response.” 

Strategies for resilience and coping for health care providers and everyone

Anzia offered evidence-based strategies to promote resilience and mental health for health care providers: 

1. “First and foremost is sleep. We need to ensure people get at least seven hours of good sleep a night. Add to that 20 to 30 minutes a day of any exercise, staying hydrated and good nutrition.”
2. “It is tempting to want to have a drink at the end of the day. We know alcohol dependence goes up after every community disaster. One drink is fine. If you find you want to have more than one drink per day, or need to use alcohol to sleep or calm down, then you need to reach out for help.”
3. “Meditate to bring down your stress response and calm your body and mind. Even 10 to 15 minutes a day can bring down your heart rate.” Anzia recommends Headspace and Ten Percent Happier.
4. “Limit exposure to media news to less than one hour a day. We learned this after 9/11. People who spent more time watching videos of the Twin Towers falling had higher rates of PTSD and depression.”
5. “Pursue activities that bring you pleasure: listening to music you love, watching favorite old movies, reading fiction — something that will really take you away. The idea is to turn it off and give yourself a break.”