Each morning, I scroll through my daily patient schedule and glance at the flood of problems coming my way: High blood pressure, weight gain, headaches, low back pain, insomnia. As a primary care doctor, I am well versed in these kinds of medical issues. But what’s new — and what has become blindingly obvious over the last year — is the cloak of distress patients wear into my office and its clear connection to their medical problems.
We have been laser-focused on treating and preventing the physical symptoms of COVID-19 for over a year. Yet the full scope of suffering is only now unveiling itself.
We already know that trauma affects us, particularly if the trauma is sustained. We know that people who experience adverse childhood events are at significantly higher risk for developing subsequent health problems like obesity, diabetes, and heart disease. Well before COVID-19, health care providers have been helping people manage the physical manifestations of despair.
The social, economic, and political upheaval of the last year combined with the uncertainty and fear of COVID-19 is nothing short of trauma. Pile on postponed doctor visits and unhealthy coping mechanisms, and a bad problem is made worse.
As expected, primary care doctors have witnessed a deluge of anxiety and depression. Now, the physical manifestations of cumulative trauma are washing ashore. Underlying health conditions are flaring, new medical problems have been unleashed, and our emotions are making us sick.
When faced with a threat like COVID-19 and robbed of our normal coping strategies, our bodies and minds naturally go on high-alert. We are sleepless, irritable, anxious, and easily startled. When fear overtakes us, we behave in ways that our rational brains wouldn’t normally allow. We eat high-calorie comfort food. We gravitate to alcohol, marijuana, and other substances to cope.
I see it in my office every day. And my patients are not alone. Two in five Americans report an average weight gain of 29 pounds during the pandemic. They don’t need fast fixes or a lecture on how to lose weight. They need tools to manage stress, emotional eating, and sleep issues — the real sources of their physical ailments.
Weight gain, for example, can be reframed not as a diagnosis but rather as a symptom of stress and dysregulated behavior. Instead of absolutist advice from articles, friends — or yourself — doctors can give more nuanced guidance and help patients address individual root causes. After all, every number on every scale has a story behind it.
The prescription for our patients’ recovery is clear: it is to name, normalize, and help navigate mental health issues as an essential part of overall health. It is to provide a safe, non-judgmental space for listening and healing. It is to treat the high blood pressure and the anxiety that drives it.
After a year in distress, we are wired and tired. We need nuanced medical guidance and someone to trust. We need a dose of reassurance and a plan for recovery. We need science under our feet and doctors at our back.
The first steps toward post-pandemic health are seemingly simple yet vexingly hard for most of us. They are to reflect on our mental health, to draw connections to our habits, to find a primary care doctor, and to show up to our doctor exactly as we are: naturally flawed, predictably unsettled, and willing to be seen.
We have every reason to be hopeful. COVID-related deaths and hospitalizations are falling fast, and real world data confirms the stunning efficacy of our vaccines. The medical community has its hands on the science we need for reentry. To fully recoup from COVID, we now need our arms around our patients. The doctor is in; are you?
Dr. Lucy McBride, an internist in Washington, D.C., is a health care educator, mental health advocate, Bloomberg New Voices fellow and author of a COVID-19 newsletter.Learn more about her website and connect with her on Twitter, Facebook, Instagram, and LinkedIn.