Behavioral therapy helps prevent severe fatigue after Covid-19

People who remain severely stressed long after Covid-19 may benefit from cognitive behavioral therapy. Dutch research shows that about 60 percent of patients who followed the treatment were visibly less tired after 17 weeks of treatment. They can focus better, and other physical complaints have decreased. This effect was still measurable six months later. The study appeared Monday in the scientific journal Clinical infectious diseases.

“The findings are consistent with what we see in other diseases in which severe and persistent fatigue occurs, such as post-breast cancer, multiple sclerosis (MS) and type 1 diabetes,” says study leader Hans Knopp, professor of medical psychology at UMC Amsterdam. “Cognitive behavioral therapy also has a positive effect on these disorders in some people with burnout.”

The study involved 114 people who continued to experience severe fatigue 3 to 12 months after they were exposed to Covid-19. Almost all of them became ill before vaccination. Half received cognitive behavioral therapy, while the other half received the usual care: supervision by a general practitioner or specialist, physiotherapy and, when necessary, occupational therapy.

Strange sensation

One of the participants is Wendy van Iperen (52), a sober Zeelander and owner of a clothing store in Kapelle. “I’ve had Covid-19 for three weeks and it’s not getting better. After two hours of working in my shop my legs are flabby and the lights go out, then I had to lie down and go to sleep. Weird feeling, I’m self-employed, I’m never sick. When I saw an ad on Facebook for these Study, I called right away and asked first about cognitive behavioral therapy. Because it wasn’t really in my mind.” Van Iperen decided to get involved. “I wanted to be able to run my shop again and take care of my horses.”

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Participant treatment consisted of a combination of online modules and an average of twelve contacts with a psychologist, as needed by email, telephone, video call, or face-to-face.

Cognitive behavioral therapy didn’t work for everyone, but it did for the majority: 60 percent of the participants were no longer seriously tired afterward. In the control group, this was only the case in 27 percent of the patients. Patients who received the treatment were able to focus better, work and seeing friends improved, and shortness of breath and sleep problems decreased more than in the control group.

give up

Follow-up studies should show whether these findings also apply more broadly – they mainly include people infected after coronavirus who were not hospitalized for Covid-19, and who self-medicate.

Van Eyperen also recovered. “I had to get in and out of bed at set times, and I was allowed to rest during the day, but never fell asleep again. That was very difficult. I had always learned to listen to your body, but that wasn’t the case now. In my weekly contact with my psychiatrist, For example, it was about how your environment reacted to your complaint.

She also learned to release her energy. “At first I had to walk five minutes a day, and whenever I could, I was allowed to build up to five minutes. Now, after seven months of treatment, I’m back at work full time, and can look after my horse and still work in the garden in the evenings. What I still had shortness of breath from time to time, but I made a full recovery. I never thought that cognitive behavioral therapy could also help with these types of complaints.”

If you think something is permanently broken, it has an effect

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This study does not provide an explanation for the positive effect. But Knoop has an idea: “We think that a disease, like Covid-19 in this study, causes fatigue, and that sometimes it is maintained in part by certain situations or habits. Distribution of activities throughout the day.

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How a person feels about fatigue and pain can also play a role, Knopp says. “For example, if you think something is permanently broken by infection and that you will never recover, that will have an effect.”

Knopp is happy to clear up a widespread misunderstanding. “The fact that cognitive behavioral therapy can help with post-coronavirus stress does not mean that the cause is psychological, nor that there is no physical cause. It is important that we continue to search for the biological cause.”

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