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Quoted in InStyle Magazine: The 'Covid Cloud' Is Real

covid longcovid Dec 07, 2020

The 'Covid Cloud' Is Real

Author: Jessi Gold

Remember the talking Golden Retriever, Dug, in the cartoon movie Up who finds himself doing one thing — and then suddenly thrown off course by the mere mention of a squirrel? This is my perpetual state of mind of living through a pandemic. It's the inability to focus on anything because there are so many things pulling your attention. Your kids. Your email. Your boss. The leaf blower. The world news. There is so much noise and so many changes to our work, home, social life, and day-to-day environments, that it's a wonder we can concentrate at all.

And frankly, most of us can't.

As a psychiatrist, I've noticed that my clinic is overrun with people who are coming in with "I can't concentrate," as their primary problem. Even my colleagues and fellow mental health professionals are experiencing it. It's clear to me as a mental health professional and resident Twitter psychiatrist that we are all suffering from this 'Covid cloud' to some extent right now – and that is completely normal. Whether it's grappling with grief from losing a loved one to coronavirus, or just struggling to find a semblance of work-life balance, there are many valid reasons we're all having trouble focusing — yet still we feel the urge to blame ourselves for not getting enough done.

Which is why the key to surviving right now is to be OK doing less right now — and being kinder to yourself about it. It might not be an easy thing to change (we are, after all, conditioned to measure our worth or success in accomplishments) but it's the only way to combat the Covid cloud we're all living in.

Here Are the Symptoms of ‘Covid Cloud’

When we think about trouble concentrating, it's not as simple as just being distracted. It permeates all avenues of people's lives. Here are some ways it can manifest.

You can’t sit still or sustain attention for very long at once.

Our distracted thoughts make us physically (and mentally) antsy, which makes it much harder to do work for long periods of time at once. (Which is why some are even referring to this covid-induced inability to concentrate as 'pandemic ADD'.) Hassan, a 23-year-old medical student at a Sudanese college, explains that he used to be able to sit and study for over an hour, but now can only manage 30 minutes at a time. After reading about the coronavirus, these episodes of trouble concentrating are more frequent and last longer, he adds.

You “zone out” during tasks.

Our worries can also make us lose track of time. "I find myself just kind of zoning out [for a minute] and then realize 20 minutes have gone by," says therapist Brit Barkholtz, M.S.W., L.I.C.S.W. In Attention Deficit Hyperactivity Disorder (ADHD), this is referred to as time blindness, or the inability to estimate how much time has actually gone by — and it can occur even in those without ADHD.

Tasks take longer to complete.

As a result of the difficulty sustaining attention, zoning out, and often making careless mistakes along the way, tasks that used to be easily completed take us much longer. "Typically when I am creating presentations for workshops, I finish them well in advance," explains Dr. Melissa Geraghty, a clinical health psychologist explains. Lately though, she's been procrastinating starting, then working for days right until the day of the workshop, due to a lack of concentration. "I struggle with wording, the flow, and at times I don't even know if what I wrote made sense." This is extremely frustrating as we cannot at all accomplish as much as we used to in the same allotted time frame and begin to question if something is, then, wrong with us.

You can’t focus when you read or watch TV.

Others are able to focus on work, but as soon as they try to relax or do something for their own self-care, their concentration goes out the window. Blythe McDonald, a manager and mom whose husband is an essential worker, explains she has felt distracted, anxious, irritable, and had trouble sleeping — and all of that has made it so she is less able to do the things she wants to do. "My usual ability to spend hours on things I enjoy is frayed. It's not that I can't rustle up my attention with intentional effort, but it's driving nails with a rock instead of a hammer. I'm getting my work done from home, but the energy for creative and fun stuff just isn't there like I want it to be," she explains.

You feel a pull to multitask.

With the way our work from home, kids at home, scenarios have played out, as well as the countless hours we all now spend on Zoom, there is a substantial pull to multitask, which makes our concentration that much more difficult. Irene Goo, a 23-year-old medical student, explains that she feels the need to do more things at once than she did before COVID-19 started. "When I need to study or do work, it's definitely harder with a loss of work-life balance. I'm studying in the same room as my bed and I find my mind darting between my schoolwork, my notifications on my phone, thoughts about errands I need to run, the laundry I need to do/fold, etc.," she says. "My mind feels like there are too many reminders closeby of my life responsibilities that it's difficult to focus specifically on my work."

You're forgetful.

Another common and quite distressing symptom for people, especially when they are too young to be experiencing it: forgetfulness. Dawn Friedman, a therapist in Columbus, Ohio, has noticed her patients are forgetting where they put things, forgetting about tasks they need to complete, and even forgetting words (also known as lethologica).

"I'm usually the person that remembers exactly where my keys are, if there's an extra tube of toothpaste in the box of supplies or not, and can mentally map out upcoming items on my calendar," explains Cecilia G., a 29-year-old communications associate. "Starting a few months ago, I've noticed that I can't pull up all those details as needed. Either I have to really think about it or I end up going through coat pockets and bags looking for my keys. It's unnerving."

Though distressing when it happens, it makes sense that our short-term memory is suffering. We can't consolidate thoughts when our mind is pulled in 100 directions or never focused on the one task at hand. When we are regularly worrying about the future or spiraling about compounded uncertainties, it becomes easy to forget why we walked into the kitchen in the first place.

While the specific cluster of symptoms each person is experiencing is unique, and this list is far from complete, it is important that we realize we are all dealing with, in some capacity, this change in our abilities. Look around: Not concentrating is the new normal.

Why Our Concentration Problems Aren’t Easy to Fix

When we can't concentrate and cross items off our to-do lists, we blame ourselves and call ourselves lazy or useless. Instead of spending hours in therapy talking about that thought process, or showing ourselves some compassion (more on that later) often people show up in my clinic and ask me to "fix it." Unfortunately, doing that is far from a simple task, particularly during a pandemic when, as we established, baseline concentration is abnormal.

That's because literally everything in your day to day life can affect concentration. Your sleep affects concentration — too little or too much. Eating affects concentration. Substance use affects concentration, too. While alcohol and marijuana make it worse, caffeine might make it better, at least temporarily.

And coronavirus itself can absolutely worsen your concentration. A few people, including Dr. Geraghty, described difficulty concentrating since having coronavirus and experiencing long-haul Covid. Emily, 24, a community mental health professional, explained that since her COVID-19 diagnosis this year, the Covid fog has lingered. "I can be in the middle of a conversation and all of a sudden have no idea what they just said to me because my mind went to something else...I've been having to rewatch lectures since I can't focus on it for more than 5 minutes, or reread the same paragraph. I've noticed I'm always really antsy and have trouble sitting still as well." Certain mental health conditions like depression and anxiety can also worsen concentration and then, of course, Attention deficit hyperactivity disorder (ADHD) does as well. (For what it's worth though, while there are many self-reported claims of ADHD right now, unless you had symptoms before age 12, it's unlikely that the pandemic is the trigger for them.)

Ultimately, it's extremely hard to tease out which one of these things causes the disrupted concentration when all of them compound each other, overlap with each other, and are even experienced in the same person. If you think the root of your issue is depression, anxiety, or undiagnosed ADHD, a mental health professional can help you figure out medication solutions that make sense for you.

For most of us though, our 'off" concentration does not need a label or a diagnosis. Much of it is simply a normal reaction to the abnormal world we are in — and that itself — needs to be normalized. Here's where to start.

How to Combat Covid Cloud

Normalize doing less.

Normalizing doing less feels uncomfortable, vulnerable, and might even make us feel like a failure. This is because we often measure our success by our productivity. But we are not attempting our usual productivity in a world any of us have experienced before. There is no typical concentration in a pandemic so we need to accept that we are simply at a different baseline. We need to be able to forgive ourselves for not doing as much and simply say, "This is a different year, I will not and cannot do as much, and that is OK."

Of course, I realize that this needs to be accepted by employers, too, or it will feel like a constant uphill climb for the rest of us, but acknowledging out loud that the world is different right now is key. Doing so validates our inner experience and normalizes what that means for our own productivity. If we feel like we are equal to others, and all of us are in the same boat (worse off than before, but together), we won't feel like this is "just us" or a "weakness," but instead, simply concentration in 2020.

Work on self-care and sleep hygiene.

While expectations at work may feel out of our control, self-care and sleep hygiene isn't. I can seriously feel you all eye-rolling at me as I write this, but we need to think about taking care of ourselves as actually being productive. If we don't prioritize ourselves, or put ourselves on our to-do list, we can't possibly get the rest of it done.

While getting more sleep is often easier said than done, limiting screen use before bed and creating a bedtime ritual you look forward to can help. Figuring out coping skills that help you personally de-stress can also go hand-in-hand with sleep, i.e. just because everyone else thinks mindfulness is cool and trendy, if you hate it, try something else. Other simple self-care tips that actually work? Incorporating exercise into your daily routine, remembering to drink water, and limiting the post-work happy hours as your only social activity.

Separate work and play.

Speaking of a ritual, routines, in general, can be helpful for concentration, including actually going to a specific room to "work" and leaving that at the end of the day. Ultimately, taking time for yourself and valuing yourself in the equation — and even blocking off a bit of time each week for "fun" even if it seems like you have zero hours to spare – will actually make the time you spend doing work more efficient because you will feel better and more present during that time.

Make sure your to-do list is actually do-able.

The next step is working on self-efficacy. That means making a to-do list that is actually do-able and in chunks that you can actually get done. Often when people tell me they didn't do anything and they never finish their work, their to-do list is made up of all huge tasks like "write a paper." That is wonderful and great, but writing a paper is a to-do list item that could take weeks, not days. That makes a to-do list feel unaccomplishable and sometimes even hard to start. Rachael Rosen, a Ph.D. student, explains, "At times, I feel paralyzed by my 'To-Do' list and ignoring it altogether seems to be the easiest option. It takes a herculean effort to begin a task."

Instead, break your list up into smaller sub-tasks. Yes, it makes your list longer (sorry!), but it also lets you check things off of it. Checking things off your list helps you feel like you accomplished something, and accomplishing something makes you feel more effective and better about yourself overall. This helps with resiliency, which is desperately needed right now.

Have self-compassion.

Here is something we are not good at: Being nice to ourselves for having feelings or not doing what we expect of ourselves. Productivity is one of those things. To be able to feel better, and survive this pandemic in which we accept we can't get as much done, we need to learn to be kinder to ourselves.

Dr. Brené Brown, a research professor, best-selling author, and the person we all love to quote on Instagram, often says to talk to yourself like you would to a friend. This is a helpful way of thinking as you would never tell your friend they are a failure for not getting something done. You tend to be kinder, more validating, and much more aware of the environment that they are existing in ("hey, it's a pandemic, you are doing your best"). This mindset can help you better survive the fact that this will be a different time right now and you need to be kinder to yourself through it.

Spend more time on things you want to spend time on.

If we can acknowledge we are not going to get as much done right now and we are OK with that, it might also help us feel better to find things we like to do and are happy to have accomplished. This might mean first prioritizing things you enjoy or putting those tasks in-between ones you don't.

We can also (if we are lucky) try to spend more of our time on things we find meaningful, which helps prevent burnout. I've encouraged my college student patients, who tend to say 'yes' all of the time and overcommit often, to use this time during the pandemic to think about what they actually want to be doing, and then spend more time doing it. Honestly, that might make this time and lack of productivity a blessing.

Dr. Veronica Ridpath, a psychiatry resident, noted that she has had the opportunity to take on more meaningful work, and though she sometimes works longer, she now works on things she enjoys and can say no to things she does not want to spend her energy on. "The one benefit I realized is that attention is absolutely a finite resource and I wasn't rationing it well before coronvirus hit. With more burdens I've had to guard my energy more closely," she says.

2020 has been a lot of things to us and most of the emotional words are negative. But, what if it could also become the year we learned to work less, and enjoy it more? Now, that is a cultural reframing of productivity in this country that I could get behind.

Jessi Gold, M.D., M.S. is an assistant professor in the Department of Psychiatry at Washington University in St. Louis

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