COVID-19’s Impact on Frontline Health Workers’ Mental Health

Long hours, harsh environments, and demanding workloads have brought an onslaught of mental health issues to the world’s frontline health workers during COVID-19.

It is an understatement to say COVID-19 forever changed the lives of billions around the globe, but frontline health workers experienced a situation unlike any other group. These tireless workers sacrificed their time, safety and other responsibilities to provide excellent care to the people in need.

Sadly, this sacrifice resulted in a terrible toll on their physical and mental health. Because of the complexity of COVID, it may take decades to fully understand the negative influence on frontline health workers.

How COVID-19 Changed the Medical Field

Frontline health workers agree that COVID’s impact on the medical field is far-reaching and profound. For many workers, nearly every facet of their job has changed since early 2020 due to the restrictions and precautions put in place for COVID.

Healthcare workers experienced a unique situation marked by: 

• Increased work stress: The pandemic brought longer hours, higher caseloads, poorer patient outcomes, more death and increased discomfort from wearing additional protective gear. 
• Higher risk of infection: Healthcare workers were knowingly coming in contact with infected people, and with limited understanding of transmission during the early days, many feared becoming infected themselves. For healthcare workers, each workday felt like walking into a burning building.
• Fears of infecting family, friends, and loved ones: Home is normally a place of comfort and relaxation, but many healthcare workers avoided their family and support system to limit the risk of infecting others during the pandemic. 

As time progresses, many changes will diminish, while others may become permanent.

Consequences of Medical Work During COVID

Medical workers were encouraged, and in some cases forced, into stressful and uncertain situations as part of their job. Some of the greatest hardships they faced included:

Long Hours and Sleep Deprivation

During the pandemic, many healthcare workers saw the quantity and quality of their work change. Not only did they have to work more, but the work they did was more demanding, difficult and dangerous. 

As work increases, the time available to get restful sleep diminishes. As shifts expand and change, establishing a regular routine and appropriate sleep hygiene becomes much more challenging.

Necessary Quarantine Isolations

When coming home after a 12, 16, or 24-hour shift, healthcare workers typically want some food, rest and contact with their loved ones. The mandatory isolations made this routine impossible as workers were forced to quarantine from their friends and family. 

Imagine a new mother who comes home after a long shift only to stay separated from her child by a window or door. Quarantines require people to choose the well-being of others over their immediate need for love and physical contact, which puts people in unenviable positions.

Constant Exposure to Trauma and Loss

Healthcare workers in certain parts of the country saw dramatic increases in people being ill and dying under their care. The stress and trauma of these losses will not affect everyone similarly, but being around so much poor health can take a toll on the worker’s mental and physical well-being.

What Kind of Mental Disorders Have Frontline Workers Encountered Because of COVID

Because of COVID, frontline workers have been exposed to more stress while losing contact with their healthy supports and coping skills. This combination puts people at great risk of various mental health disorders.

Post-Traumatic Stress and Other Stress-Related Disorders

People exposed to death and dying are regularly at higher risk of post-traumatic stress disorder (PTSD) and other stress-related disorders.

PTSD can create a number of unwanted symptoms like:

• Intrusive thoughts and images of the trauma
• A strong urge to avoid people, places and things connected to the trauma
• Significant mood changes involving fear, horror, shame, guilt and anger
• Thinking problems linked to memory, self-esteem and trust
• An experience of numbness or an inability to feel desired emotions

PTSD is often associated with one significant experience, but chronic exposure to dangerous or fearful situations can create symptoms. For frontline health workers, each workday could include a traumatic experience. 

Depression 

High stress levels commonly produce a range of depressive symptoms. Some health workers saw an emergenceof new depressive symptoms or a worsening of preexisting symptoms like:

• Low mood
• Irritability
• Sleep, diet, and weight changes
• Low energy and motivation
• Poor attention and decision-making skills
• Low self-esteem
• Thoughts of death and dying

As depressive symptoms increase, they can begin to affect a worker’s job performance, concentration and motivation to attend their next shift.

Anxiety Disorders

In addition to depression, high levels of stress can also create new or worsening anxious conditions. Diagnoses like generalized anxiety disorder, panic disorder, agoraphobia and other specific phobias may develop from intense work stress.

With an anxiety disorder in place, a person could feel:

• Nervous and worried
• Restless
• Easily tired and fatigued
• Concentration problems
• Irritability
• Physical tension
• Panic attacks marked by sweating, trouble breathing and feeling dizzy
• Sleeping problems

Somatic Symptoms

Because of the strong connection between the mind and the body, a frontline health worker could note the onset of physical symptoms stemming from their high stress.

The presence of somatic symptoms at such high levels illustrates the cause and effect relationship between high stress and poorer physical health.

Insomnia

Whether from PTSD, depression, anxiety or somatic complaints, a theme with frontline health workers is poorer sleep. Sleep issues can come when there is difficulty falling asleep, staying asleep, or waking in the morning feeling drained and unrefreshed. In a recent study, 60% of frontline health workers experienced poor sleep quality during the COVID-19 outbreak. 

Not only can insomnia come from other mental health conditions, but lack of sleep can also make underlying psychological conditions worse. Without restful sleep, frontline health workers will struggle to feel well or function normally at work.

Getting Psychological Help for Frontline Healthcare Workers

During the coronavirus pandemic, frontline healthcare workers have been placed into stressful conditions that have drained their physical and mental health and well-being. Some frontline health workers will come out of COVID relatively unscathed, while many others will greatly benefit from professional psychological help.

Psychological help comes in many forms, with therapy and medication treatments at the forefront. Health workers who note changes in their mood, sleep, patience, concentration or irritability should consider seeking a mental health evaluation as soon as possible. Ideally, employers would facilitate access to care, but workers will have to start the process in many cases.

Due to their busy schedules, healthcare workers may benefit from some introductory webinars to explain the risks and provide some basic solutions. If you or a loved one need help to manage substance use disorders or co-occurring mental health conditions that have emerged during the high stress of COVID, contact The Recovery Village for treatment options tailored to your unique needs.