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Mindfulness
Limping Into 2025: Mindfulness and the Post-COVID Brain
On the lingering effects of COVID. (Say what now? And your name, again?)
Posted January 4, 2025 Reviewed by Margaret Foley
Key points
- COVID has been a world-historical global trauma, with effects that persist both psychologically and medically.
- The severe, persistent state of lingering symptoms—long COVID—has received much attention in the media.
- However, the intermittent occurrence of a variety of post-COVID symptoms continues to impact many more of us.
This is the first post in a series about the lingering effects of COVID.
The age-honored trope of the transition from an old year to a brand-new one is the handoff from a husk of an aging, worn-down codger to a freshly swaddled and powdered babe. (Where that little cutie acquires the bespoke top hat and sash is the stuff of imagination.)
Whether this year's model is also wearing a self-satisfied grin or a tense grimace is more of a political affiliation issue, not covered in these posts. But for many of us, our new baby-day selves may still be carrying over some features of our creaky December selves: at least a few, or maybe more, of a constellation of symptoms that are related to having suffered a COVID infection since it made its awful, world-changing debut, five years ago this month.
As I reflect in a longer view, my clinical practice has been remarkably changed. The normalizing of virtual work is certainly there, but I'm really talking about the increasing presentation of "confus-a-ramas": mixed states of poor concentration and attention; edgy, "meh" rather than "boo-hoo" depressive states; waxing and waning fatigue and pain; and secondary anxiety about what the hell it all means. Chronic illness? The beginning of a slide into demented obsolescence? Some undiagnosed new monster?
This next series of posts is meant to address the impact of those effects on body, heart, head, and attention, including on mindfulness practices. We'll also look at how we can tinker with practices for our patients, students, and ourselves to help adapt to the lingering overhang of that traumatic period as we move forward into, well, again, who knows. First, let's briefly review some history.
It can be painful to return to just how shocking early 2020 was. A mutant virus swept most of the globe, shutting society down. Tens of millions were truly ill; millions lost their lives. A broader examination of that topic should include the societal trauma of that recent era and its impact on our subsequent collective civil consciousness, but we'll stick to the specifics of COVID's aftereffects here. For a really detailed picture, I refer you to the excellent Substack "Ground Truths," written by medical researcher and national treasure, Dr. Eric Topol.
For the two most fearsome early strains—alpha or "wild-type" and delta—the malevolent weirdness of those strains was mostly in their ability to supercharge our own immune systems to attack not just the virus but healthy "self" (mostly lung tissue) with an intense inflammatory response that often burned the village to save it. These earlier strains do also seem more likely to set up their sufferers, unfortunately, for post-COVID symptoms and syndromes.
The later strains—all variations of the "omicron" strain—have been for the most part less lethal, with the subsequent mutations differing via some variations in "stickiness." As a result, they're more contagious but arguably less dangerous, especially as treatments have improved. But infections of even these later variations can set us up for downstream post-COVID symptoms.
The dreaded, persistent "long COVID" tends toward a few cardinal symptoms that persist: fatigue, aches, unusual neurological stuff like loss of taste and smell; an edgy, "flat" mood; and especially the cognitive duo of word-finding troubles (dysnomia/expressive aphasia) and troubles with sequential tasks ("executive functioning"). Maybe 8 to 10 percent of COVID sufferers have persistent long COVID.
Yet going underreported is the strong speculation that post-COVID symptoms occur on a spectrum, with the long COVID folks at the severe end. Many of the rest of us—30 percent or more—have at least some revisiting of these symptoms, whether quietly simmering as cognitive and/or emotional blunting, a quickly triggered deep fatigue after stressful days, or even trivial inflammatory/infectious stuff (a cold, allergies, an injury) remarkably also serving up a side dish of post-COVID weirdness for days or weeks afterward. The additional uncertainty that this drives in many of us feels a bit like "gaslighting," to (over)use that trope: "It seems like nothing's wrong with me—how can I feel (and do) this crappy?"
These noxious add-on symptoms are pretty familiar to those of us who already suffer from autoimmune spectrum conditions of various flavors: rheumatoid arthritis, lupus, Sjögren's, Hashimoto's, and more. In all of these, one's very own immune system goes all Yosemite Sam at varmints both large and small. The developing hypothesis, simplified, is that COVID has been a strong enough alien that it's coaxed our immune systems into a kind of acquired autoimmune state.
Another apt metaphor is PTSD. Just as psychological trauma drives an overbuilt defense department in anticipation of future threats, so it appears that COVID has caused an overdriven, unpredictable response to subsequent bodily threats.
OK, that's the backstory; while there's no "mindfulness training" in this per se, some reality-testing of what is arguably a broad public health issue is a mindful act. We're not losing our minds, but something is definitely up. In my next post, I'll cover in more detail some speculations as to the cause, and then on to how we can adapt to, you know.
