Building resiliency and facing the neurological impact of COVID-19

A recent public lecture highlighted the link between coronavirus and brain injury, examining both mental health issues and neurological symptoms.

The COVID-19 pandemic has had, and continues to have, an enormous impact on the health-care system. While many have heard of the respiratory symptoms, such as a dry cough, the virus also attacks the nervous system, creating neurological issues. Additionally, the changes to support networks and social structures caused by shelter-in-place orders and restrictions have negatively affected the mental health and well-being of many Albertans.

Last month, the Neuroscience and Mental Health Institute (NMHI) held a virtual public lecture that highlighted the neurological and mental health impacts COVID-19 can have on individuals, shedding light on what science says we can do to preserve our well-being. A panel of NMHI experts shared insights on how this virus acts on the brain and discussed how we can build resilience.

Jennifer McCombe, associate clinical professor in the Division of Neurology, opened the talk by discussing some of the neurological symptoms that are commonly mentioned, such as headaches and loss of the sense of smell. She also highlighted a few rare, but far more serious issues that have presented, such as strokes provoked by COVID-19. 

“The trouble is, when you have a rare complication in a common virus, we’re actually going to see significant numbers of them,” said McCombe.

McCombe and other clinical neurologists are trying to learn more about how some of the problems, such as fatigue and loss of the sense of smell, linger even after some individuals, often referred to as “long haulers,” recover. A study showed that even in a younger demographic of university students with COVID, 50 per cent had some symptoms of post-COVID syndrome, including exercise intolerance and difficulty breathing. 

Christopher Power, professor of medicine in the Division of Neurology, shared a rolling list of neurological infections he has been tracking since 1984, with COVID-19 as the latest addition. He flagged the human ability to travel so quickly across the globe as a huge determinant of emerging infections.

Power outlined a few of the next steps being taken by researchers, including defining all the neurological signs and symptoms that arise (since there are so many, and people experience the infection differently), and trying to determine whether there are any biomarkers associated with the presence of long-term neurological symptoms, which could be extremely helpful for patient care.

Katherine Aitchison, associate director of mental health for the NMHI, highlighted that while COVID undeniably has a physiological impact on the brain, there is also a need for mental health interventions, particularly for those most vulnerable.

According to Aitchison, certain demographics—including young people, women and those who have lost their jobs—are more likely to experience depression and anxiety as a result of the pandemic. She discussed a few of the readily available resources, including the Text4Mood program developed by fellow NMHI member Vincent Agyapong, and other resources available through Alberta Health Services. Aitchison examined several studies documenting rates of pre-pandemic cases of PTSD, anxiety and mood disorders such as depression, as well as studies looking at rates during the pandemic. She found rates rose significantly across the board, with the upper limit of individuals experiencing these conditions nearing 50 per cent of the population.

"It's like throwing a dice—you may or may not have it [a condition such as anxiety, depression, etc.]. Anybody with one of these conditions needs to realize that they're not alone in their struggles, and there really is no reason for stigma," said Aitchison.

She also stresses that those who are not sure if they need help should complete the self-assessment available on the Wellness Together Canada website. Options for those who know they are suffering from mental health issues and require help include virtual health-care delivery, novel approaches such as virtual reality therapy by NMHI member Suzette Bremault-Phillips and repetitive transcranial magnetic stimulation (rTMS). 

Peter Silverstone, professor and interim chair of the Department of Psychiatry, finished the evening with a talk on resilience. He emphasized that the infection isn’t happening in a vacuum and that the mental health impact of the economic crisis occurring in parallel with the coronavirus must be considered. He echoed the other presenters in stressing the importance of focusing both research and dollars on long haulers as we move forward, helping to address the long-term impact on those who have recovered but still aren’t the same as they were prior to the infection.

Silverstone also provided five easy, actionable tips that can help us continue to deal with the effects of the coronavirus in 2021.

• Exercise 

— Aim for between 15 and 30 minutes of sweat-inducing activity per day, and focus on daily exercise rather than intermittent bursts to keep a steady stream of endorphins releasing in the brain.

• One positive thing

— Every day, ask yourself to think of one positive thing that you’ve experienced or enjoyed that day.

• Practise mindfulness

— Many researchers have spoken about the impact of mindfulness on mental health, and Silverstone emphasizes that even 15 to 30 seconds at a time of meditation or mindfulness can be beneficial.

• Explore cognitive behavioral therapy  

— While not everyone may have access to or even need in-person therapy, there is an abundance of free online tools and books that can help your overall well-being. 

• Set SMART goals every night 

— Every night, set one or two SMART (specific, measurable, achievable, realistic, timely) goals. They could include something as simple as going for a 15-minute walk or scheduling a call with a friend.

A version of the public lecture is available to watch online. If you’d like to be kept in the loop about public lectures from the NMHI, subscribe to the institute’s community newsletter