06/01/2022

Moving Beyond COVID: Psychological and Physical Considerations

By Jennifer Hopp, MD, Wentworth Health Partners Seacoast Orthopedics & Sports Medicine
Program Director, Women's Sports Medicine Program

The COVID-19 pandemic has had far reaching effects on so many aspects of society and the economy. Social distancing, team bubbles, pods, mask mandates are all terms that were foreign to us prior to March 2020. COVID numbers have been trending downward for some time. Mask mandates have broadly been lifted. Resuming life as normal is something that we have been hoping for since March 2020, when the lockdown first began. Regardless of whether you ever contracted COVID, the pandemic has left many of us changed, both physically and psychologically. 

As a nation, 39% of Americans gained weight during the pandemic. A study by Harvard Health notes that “approximately 27% gained 12.5 lbs or less, 10% gained more than 12.5lbs and 2% gained 27.5 lbs or more.” We ate more and became more sedentary as gyms shut down, playgrounds were closed, and working remote became the norm. The pandemic resulted in higher levels of stress among all ages. Stressors trigger changes to eating habits and often result in overindulgence. Highly satisfying foods appear to be the culprit; those that are higher in fat, salt and sugars. Weight gain is associated with health risks that include heart disease, hypertension and diabetes. Not only did Americans gain weight during the pandemic, but so did our pets. Forty percent of cats and 35% of dogs were diagnosed as being overweight in 2021, up 20% from a decade ago.

Recovering from COVID can also have physical effects that involve the heart, lungs and brain. The risk of developing myocarditis, inflammation of the heart muscle, and pericarditis, inflammation of the sack the heart sits in, are increased up to 16 times greater following a COVID infection. Myocarditis can have lasting effects on the heart’s rhythm and ability to pump blood to the body. The lungs can be scarred from COVID, regardless of whether a person was intubated or not. Persistent shortness of breath, asthma-like symptoms and long term need for supplemental oxygen can occur following recovery. The brain has also shown to be effected and is described as “long hauler syndrome” or Post-Acute Sequelae of COVID-19 (PASC). Persistent neurological symptoms include headache, fatigue, “brain fog” and dizziness. Most people who have had “uncomplicated” COVID generally note some deconditioning and fatigue that can last for up to six weeks as they return to sport and physical activities.

The pandemic was stressful and remains stressful for many today. The day-to-day worrying, the drastic life changes of lockdown and learning to live during the pandemic with adjustments to school/work/childcare has affected the nation’s mental health. We know from surveys and studies that the pandemic has impacted our collective behavioral health.  Mental health diagnoses have risen during the pandemic. These include grief reactions, substance use disorders, sleep disorders, depression, post-traumatic stress disorder (PTSD), anxiety and panic disorders. The rates for these diagnoses are higher among our more vulnerable populations including children, adolescents and the elderly. The World Health Organization (WHO) reports that globally, the prevalence of anxiety and depression are up 25%. At the same time as mental health diagnoses have risen, resources for behavioral health counseling and psychiatric services have been stretched beyond capacity. This has created a mental health crisis. 

As we begin to eke out of the pandemic and slowly attempt to resume life as normal, we need to be mindful of these national changes. Engaging in physical activity can help address both of these national trends. A large review of all randomized controlled trials from 1996-2016 that looked at treating depression and anxiety with exercise versus an antidepressant medication reveals that daily light-to-moderate cardiovascular exercise can be used as a stand-alone treatment for depression and anxiety. These studies point out the “exercise induces both acute and chronic responses, particularly in hormones, neurotrophines and inflammation biomarkers.” Essentially, exercise releases “feel good” hormones in the body and brain. Getting 45 minutes of this type of exercise, five days per week is similar to taking an anti-depressant and has the added benefit of weight loss and improved health. An example of light cardiovascular exercise is taking a long walk. Jogging at a pace where you can still hold a conversation would be considered moderate cardiovascular exercise. Exercise is not the only answer to the post-pandemic national trends, but it’s a step in the right direction to help improve mental and physical health.

Please remember, you are not in this alone. If you are struggling with any of the aspects mentioned in this article, reach out to your local health care providers and support networks. They are eager to assist you!

About Dr. Jennifer Hopp

Jennifer Hopp, MD, is a board-certified Primary Care Sports Medicine Physician. She is the Program Director for the Women’s Sports Medicine Program, specializing in multi-disciplinary care for active and athletic female patients. She cares for athletes of all ages and abilities, from the weekend warrior to the professional athlete. Prior to moving to New Hampshire in 2020, she was the team physician at several high schools and the University of Richmond.

She is a team physician at the University of New Hampshire and enjoys providing medical coverage for games and races. An avid runner and cyclist herself, she has experienced many injuries firsthand and understands that recovering from an injury is just as important as being an athlete.