Dr. El

In my role as a long-term care psychologist in New York City, I try to ensure that each of the residents on my caseload makes the most of the time they have left in life and that they have a “good” death when the time comes. Instead of their last years surrounded by love and support, however, COVID-19 pushed a whole swath of people off a proverbial cliff. I was devastated.

The devastation was compounded by the fear of getting sick, worries about my own family, the secrecy around the numbers of residents who fell ill, the lack of attention from leadership to the plight of LTC elders, living in a hard-hit neighborhood, and witnessing the level of support given to hospital workers while LTC was ignored.

I became aware that I had signs of Post-Traumatic Stress Disorder. 

I woke up in the middle of the night thinking about the first residents who got COVID, their frightened eyes, their sudden disappearances. My mind leaped from floor to floor of the nursing home, cataloguing the losses until my mind went blank from overwhelm.

On days at home, I obsessively checked the facility census online, watching the transfers to the hospital and the in-house “expirations.” No, not him. Not her.

I withdrew from others, not wanting to tell “civilians” outside of the nursing home world about what was going on. I wanted to protect them (and the nursing home), but I also felt like they wouldn’t understand. Friends were complaining about the boredom of quarantine; I was on the front lines of a COVID war. I felt like a total downer no one would want to talk to.

All my energy was directed toward the crisis on the job. I had little left for home. My spouse took over tasks I normally handled easily. 

I was irritable and indecisive. I stood in front of the flower display at Trader Joe’s wanting something to brighten my mood, but I couldn’t choose among the colorful assortment of blossoms. I left the store without flowers. I didn’t really care.

I thought of myself as having “symptoms” of PTSD, not wanting to believe that I couldn’t tough this out on my own. 

The honk of a car horn on the street broke my denial. 

I screamed aloud at the noise and when I looked around, the people near me seemed more surprised at my shout than they were at the horn. I realized I was experiencing the “exaggerated startle response” I’d read about and had heard patients discuss. The symptom was disturbing, but it allowed me to see that I was in need of help. For weeks it reminded me that I was still broken and required extra care. 

I started by calling LTC psychologist friends and comparing notes on what we were experiencing. 

I changed how I conducted my work because I was worried that I’d inadvertently say something wrong. Being a compassionate witness is an essential component of psychotherapy, so I turned up the volume on witnessing and turned down the volume on advice. I lowered my expectations of how many patients I could see in a day and what I could do to help them when we were all vulnerable and disempowered.

I limited phone calls with anyone attending Zoom Pilates in quarantine and checked in with my nurse pals instead.

I kept up with my daily meditation and added “fall back to sleep” meditations during insomnia nights. I attended a couple of online grief groups that were surprisingly helpful. I listened to Simon Sinek’s video on “How combat veterans cope with stress.” I promised myself I’d get my own psychotherapist if I didn’t start to improve.

I admitted to more people in my orbit that I was dealing with PTSD.

I decided that I was going to be one of the sufferers who got over it. 

I gave myself permission to be fragile and to not get everything done. 

It was OK that the 90 days free of the Peloton exercise app came and went without my taking a single class. Pre-pandemic, I’d agreed to write a chapter for a book on global aging issues, but the project had become an unscalable mountain. I enlisted the help of a colleague to co-author the contribution. I switched my wardrobe from “nice psychologist outfits” to comfortable scrubs and clogs. Pre-COVID, I chose jewelry to match my attire; post-COVID, I’m unadorned.

I took a day by myself at the beach and wrote down my thoughts for five hours. I spaced out about sunscreen and got a burn that troubled me for two weeks, but it was still worth it. The beach is where I can put things in perspective.

I’m writing to you from the other side of PTSD but I’m still monitoring myself for evidence of a relapse, for signs I need to take it easier. I’m sharing my experience because I know I’m not alone in my reaction to this crisis — I’ve seen the shine come off my formerly light-hearted coworkers. 

Perhaps readers will recognize themselves in what I’ve written and reach out to professionals and their loved ones for help. It gets better when we caregivers realize we need to take care of ourselves.

For more information about post-traumatic stress disorder, visit the National Center for PTSD.

Eleanor Feldman Barbera, Ph.D., author of The Savvy Resident’s Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is a Bronze Medalist for Best Blog in the American Society of Business Publication Editors national competition andGold Medalist in the Blog-How To/Tips/Service category in their Midwest Regional competition. To contact her for speaking engagements and/or content writing, visit her at EleanorFeldmanBarbera.com.