Long COVID & Mental Health: Tips for Compassionate Messaging

Positive support is crucial when dealing with loved ones who exhibit symptoms of long COVID. What you say to them, and how you interact with them, are key elements in addressing mental health concerns and helping them move forward with the goal of thriving instead of merely surviving.

By James “Jim” Jackson

Dr. James “Jim” Jackson, a renowned expert on long COVID and its effects on cognitive and mental health functioning, is the author of Clearing the Fog: From Surviving to Thriving with Long Covid—A Practical Guide. In writing the book, Dr. Jackson offers people suffering from long COVID, and their families, a road map to help them manage their “new normal,” focusing on cognitive impairment and mental health issues. In this excerpt from his book, Dr. Jackson offers advice on how to support someone with symptoms of mental illness.

How to Support Someone With Symptoms of Mental Illness

Mental health conditions can present in confusing and complex ways for both the person experiencing the illness and their family and friends. It can be difficult to understand why someone may be behaving in a certain way or even to accept that their symptoms constitute an illness. Ameera’s family [one of Dr. Jackson’s patients] loved her greatly and yet their responses to her new behaviors—lying on the couch and eating comfort foods—were neither kind nor helpful. Instead, they added to her feelings of shame and hopelessness.

When someone exhibits signs of mental illness, it is important to show compassion while encouraging them to get treatment. In my experience, nagging people with mental illness to change their behavior results in worse outcomes when compared to offering positive support, so be aware of the way you are interacting.

Try to Avoid the Following:

Minimizing—e.g., “I know you’re worried about things but trust me, I don’t think it’s that big of a deal. Everything will be just fine.”

Moralizing—e.g., “Ameera, if you’d just stop eating all that junk food, you’d feel a lot better. No wonder you want to lie around all day. Let’s get you eating salads and sleeping at the proper time.”

Spiritualizing—e.g., “Honey, if you start living for God, I think He’ll take the desire for alcohol away—you just have to surrender.”

Blaming—e.g., “If you had just talked to your doctor about this a few months ago like I suggested, I don’t think you would be in this situation now.”

Shaming—e.g., “What are my mom and dad, let alone my partners at work and the neighbors, going to say if we have to admit you to the psych ward? That’s the last place you need to go, Sharon—that would be a major embarrassment.”

Try a Different Approach:

My long COVID patients often tell me of the destructive words their family members or friends have said while trying to be helpful. They contrast starkly with the responses that are needed. Let’s explore more effective ways of relating:

Listen carefully/nonjudgmentally. Don’t be quick to interject your opinions or to frame things as “good” or “bad.” Repeat back the things you think you’ve heard, to communicate that you understand. “What I’m hearing you say is that you’re sure your boss is going to fire you.”

Empathize. Even if you’ve never experienced similar symptoms, you can likely identify with what it’s like to feel sad, or down, or out of control. Relate from an empathic place of understanding. “That sounds really difficult. I’m sorry you’re going through this.”

Offer honest feedback if given the chance. Frequently, family members or friends are asked by patients of they have noticed any changes in their personalities or behaviors and if they have any concerns. If you’ve been asked this question, think of it as a privilege. Step up and share kindly and honestly. If you’ve observed issues of concern, highlight how they have impacted you. Often, these sincere accounts help people understand the reality of their problems and result in people seeking help.

Don’t overreact. It often takes an act of great courage for someone to be vulnerable about their mental health concerns, and meeting such disclosures with bewilderment, disbelief, or fear can cause people to retreat and shut down a potential conversation. Recently, I was having lunch with a new friend at a popular restaurant near the medical center and, in the middle of an honest conversation, I decided to share that I had OCD. She listened, nodded her head, thanked me for sharing, and kept on eating, gently normalizing this and showing me that it wasn’t too big an admission for her to handle. May we all relate with such grace.

Decrease stigma by sharing your own stories. Not long ago I met with a patient who clearly suffered from depression. He was in counseling but had made little headway and his therapist had suggested that he consider taking an antidepressant. He explained that he was resistant to do this. I offered my own story, that I, too, had been on the fence about psychiatric medication but had reluctantly agreed to take Prozac and found it very helpful. This simple truth—that other people relied on medication as part of their mental health toolkit—gave him an extra piece of information to consider. Later, he told me he’d decided to give medication a try.

Offer help in finding support rather than try to diagnose. You’re likely not a mental health specialist, and acting as if you are will usually engender defensiveness. Displaying a willingness to provide support, however, is helpful. Support could mean being available to join a doctor’s visit or researching different therapists.