What is PPSD?

Post-pandemic stress disorder (PPSD) is a term coined by Owen O’Kane, psychotherapist and the former UK National Health Service clinical lead for mental health. It refers specifically to the trauma experienced due to the ongoing COVID-19 pandemic.

How is it different from PTSD?

A more familiar term for most people than PPSD, post-traumatic stress disorder (PTSD) often follows a traumatic experience. These traumatic events are usually one big stressful or frightening event (e.g. war) that leaves a person with symptoms (e.g. nightmares, irritability, and guilt) that impact a person’s daily life.

Experts have conducted studies on the effects of COVID-19 on mental health. One such study published in PLOS ONE led to a conclusion of COVID-19 as a “traumatic stressor” that may bring about PTSD-like symptoms. Unlike PTSD, PPSD is not yet a formal medical term or diagnosis. But O’Kane coined the term PPSD as a more specific term linked to the series of smaller traumas experienced during the pandemic.

According to the authors of the PLOS ONE study, the traumatic stress related to PPSD is linked to “future events, such as worry about oneself or a family member contracting COVID-19, to direct contact with the virus, as well as indirect contact such as via the news and government lockdown — a non-life threatening event.” This is in contrast to PTSD, which is linked to a traumatic event that is already done and has already happened.

Why is it important to distinguish PPSD?

If you have food on your table and a roof over your head and all other basic necessities in the middle of this pandemic and lockdown, you might have thought at least once that you’re okay and fine and getting by. But according to O’Kane, that’s exactly what concerns him with PPSD.

“The issue is that the invisible nature of a pandemic may see trauma minimised, whereas an event like a war would normalise trauma,” O’Kane shares in an interview with Metro.co.uk. He further explains how there are two types of trauma: the “large T traumas” usually linked to PTSD and the “little t traumas” that produce symptoms of depression and anxiety. And what we’re experiencing right now in this pandemic is a lot of consecutive “little t traumas”.

It doesn’t seem as big or life-changing an event as other causes of PTSD (e.g. war), so people have a tendency to set it aside. But this pandemic is a life-changing trauma. Our lives have been turned upside down, and it is important to acknowledge that trauma. It’s important to recognize that this may not be a big distressing event, but it is a series of smaller distressing events that pile up together as a collective trauma.

What are the causes?

As mentioned, PPSD is caused by the series of little t traumas we experience daily due to the ongoing pandemic. This includes all sorts of things we’re going through right now, including loss (loss of loved ones, loss of jobs, loss of routine, loss of social interaction, etc.), illness, inability to say goodbye to loved ones, isolation, business and employment failures, and reading and hearing about the endless horrifying news from all over the world. But it also includes fear of the future, as found in the PLOS ONE study, or fearing things that haven’t happened yet, which means worrying about yourself, family and friends contracting the virus.

How can you recognize it? What are the symptoms?

While the term PPSD is not widely or officially used yet, many are acknowledging that they need help due to the pandemic trauma, according to therapist Sara Barry and counsellor Kathryn Taylor. Symptoms they have observed in patients include insomnia, mood swings, nightmares, OCD, ruminating, hypervigilance, and hopelessness.

According to Barry, some underlying trauma was brought to the surface and some existing and already recognized symptoms have been emphasized due to the pandemic trauma. “Trying to cope with these emotions, without access to supportive relationships, structures and agencies, has been incredibly challenging and at times detrimental to people’s mental and physical health,” she tells Huffington Post.

What are the effects of PPSD on a person?

Much like PTSD, PPSD may hamper one’s day-to-day life, where they may be unable to go through their usual routine or even do basic tasks like eating or taking a shower. However, since the pandemic has already disrupted that day-to-day life, the effects of PPSD may only become more apparent once lockdown has eased and people would attempt returning to the everyday routines of their pre-pandeic life. Barry explains to Huffington Post, “How someone reacts to trauma depends on many factors including the severity, level of support, levels of resilience and any previous traumatic experiences. There is an opportunity for us to respond to this crisis holistically and give everyone the best possible chance to recover.”

Is there a way to treat it?

At the moment, experts are treating PPSD much like  PTSD (the former was drawn from the latter after all). Making support accessible at all times is important. But if you’re not yet at a place where you can ask for help for the impact of the pandemic on you, O’Kane has shared tips on how to protect your mental health during this pandemic crisis.

First, you must acknowledge that you are going through a very difficult time, no matter how “big” or “small” you think you have been affected. You could talk to someone (better if a professional), but simply getting to talk about your experiences will help you process and accept what happened. Remember that it all happened and you have survived it.

Then set aside time for some self-care, where you simply spend time doing whatever you want and taking control of your day. Then re-engage with people and activities that you enjoy. This would allow you to gain a semblance of normalcy in an otherwise chaotic ever-changing world.

Something to remember

Just because it may seem like a little thing — a minor feeling, a little t trauma compared to others — doesn’t mean it’s any less valid than any other trauma. This pandemic has changed our lives, changed the whole world as we know it, and no one expected it. We are all going through a collective pandemic trauma due to this abrupt change, and it is crucial to acknowledge that. However large or little the trauma is, it’s important for your mental health to recognize this trauma and know that there is help available when you need it.

If you need someone to talk to, don’t be afraid to reach out. Call these hotlines if you need them.