The Hidden Toll of COVID-19


How has COVID-19 affected your patients of all ages? One psychiatrist weighs in.




This article is a response to the article “The Last 4 Years of the COVID Pandemic” by H. Steven Moffic, MD.

Thankfully, the acute fear and isolation of the COVID-19 years have dissipated, but for many the long-term emotional consequences and behavioral changes have not. Leaving aside the physical sequela of long COVID-19, the ebbing of purpose, confidence, and vibrancy in my patients’ lives have had such significance that I started to consistently ask the question, “In what way has the COVID pandemic changed your life?” For psychiatrists attuned to the aftereffects of trauma and fear, it is natural that we should be curious about the subtle repercussions of such a traumatic event.

As such, I appreciated H. Steven Moffic, MD’s question, “What has the post COVID years been for you and your patients?”1

Although grateful that they came through unscathed without long-term physical consequences, many of my older patients are more isolated, avoidant of crowds and large family gatherings. Grocery shopping has gone the way of home delivery despite the exercise and enjoyment they experienced prior to the pandemic. Being confined to home for 2 years has lessened confidence in driving ability. One of my patients who had regularly driven on a highway to babysit her grandchildren now only drives locally; another who enjoyed playing in local gigs with his band of many years, after a 2-year layoff without practice, has started to question his ability as a musician. “I don’t think I sound as good as I did prior to the pandemic.” Two years of absence from any endeavor takes its toll but especially on older individuals.

My young adult patients also carry the long-term sequela of the forced isolation during their school years. Virtual college limited opportunities to make new friends beyond high school years. Many students still grieve important milestones missed in their young lives. I have given my own name “failure to maturate post COVID” to young adults who continue to struggle with the critical transition from remote learning with minimal standards to the high expectations of the workplace environment. One of my patients who went from remote college to a remote internship to 2 years of remote work had no real understanding of the patience, hard work, or teamwork required to jumpstart a career. It would not be helpful to him if I were a virtual psychiatrist.

My role with my patients has taken on nuances that were not present prior to COVID-19. Supportive and behavioral interventions have become as important as medication management to

help my patients reclaim their confidence, direction, and purpose post-COVID.

Dr Varas is a psychiatrist in Westwood, New Jersey.


1. Moffic HS. The last 4 years of the COVID pandemic. Psychiatric Times. March 15, 2024.

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