Self-care is critical with long COVID. Since my second COVID infection in January 2021, I’ve had a persistent feeling that my body is trying to force me into a state of dormancy or semi-hibernation until it has finished recuperating. Most people who have long COVID and/or myalgic encephalomyelitis/chronic fatigue (ME/CFS) have an experiential understanding of post-exertional malaise (PEM). If you’ve never heard of it or don’t know what it is, the simplest tasks can and often do cause debilitating and protracted fatigue, usually with severe pain on board. I can’t imagine how people maintain jobs with this. I don’t think of this as “malaise.” It gives new meaning to “run over by a freight train.” I can usually recognize my limits and stop ahead of them, but the crash sometimes hits without warning. Other times — usually after feeling great for the first time in weeks — I ignorantly push through my limits because I cling tightly to the idea that I’m “able” again. Able to complete an insignificant task like chopping an onion, loading the dishwasher, or walking to the mailbox without having to rest on the sidewalk before returning home.
I can’t hibernate. Human bodies aren’t built for hibernation, and modern societies certainly don’t support such notions. I can and do prioritize my health, physical, mental, emotional, and spiritual health. This illness takes a lot of care and attention. Here are some practical ways I care for myself.
I’m fortunate that I started meditating early in my long COVID journey. In fact, I wasn’t yet aware I had long COVID when I started. I’m also quite fortunate that I learned it easily, but I think long COVID played a big role in my abbreviated learning curve. If I hadn’t been so desperate for relief, in the grips of despair, I probably wouldn’t have fallen into flow as quickly as I did. Most meditation methods use breathing as a point of focus, at least in the early stages of learning, which I learned by reading books and watching videos on YouTube. In retrospect, I would recommend a teacher, but with the caution to be as diligent in your search as you would be in seeking out a therapist or spiritual adviser. Trust is imperative! If you can’t swing a teacher for whatever reason (usually money), there are hundreds of books on the topic.
I’ve been practicing meditation daily since September 2020. It’s the first thing I do every morning and the last thing I do before I go to sleep at night. I now consider regular twice-daily meditation an essential part of living, as necessary as water and perhaps even a little more necessary than food with this COVID-plagued body. Please bear in mind that I’m conveying my own personal experience of this illness and my meditation experience, which both differ greatly from one person to another.
I’ve tried many different breathing techniques: belly breathing, box breathing, pranayama breathing. I learned most of these methods by watching YouTube videos. One of the earliest things I learned: I cannot observe my breathing without also changing it. I’ve practiced this hundreds of hours by now, and I’m not yet convinced that it’s possible to observe without changing it. Once I’ve attained a meditative (trance-like) state of mind, then I can hand the breathing back to the breathing master, my body. It’s not my job to direct my breathing, yet when I want to watch it, I jump into the control-freak role and take over. Relaxing is key. If you can relax your body and simply observe, without usurping control from your body, then your breathing can help you to deepen the relaxed state.
Long COVID makes relaxing difficult. I started my journey with a long history of trauma, depression, and anxiety. I’ve been in and out of therapy since my early twenties, more than forty years. My body was (is) riddles with lasting imprints of my traumas that started in early childhood. Long COVID has shined a bright light in every hidden cranny of stored-up somatic memories of those many years of trauma: psychological, emotional, spiritual, and, yes, also physical. It’s almost as though my immune system, in survival mode since COVID, is attempting to cleanse my body of the scars and toxins it has accumulated. My son first suggested this to me, and I believe he’s onto something here. Evidence: I had severe menstrual cramps that felt exactly like what plagued my teen years. I have no uterus and no ovaries. Those “cramps” had to be scar tissue. There’s no other explanation.
Psychological and emotional traumas, rather than scarring, appear as micro-tensions in my musculature all over my body. I’ve had terrible posture since before my second birthday. In photographs from my youth, my head hangs low, shoulders squeezed forward, back hunched. I look in those photographs much like I feel: like I’m shrinking myself, trying to disappear from this world. Do you know how tense you are? I sure didn’t! Learning how to relax is simple but not easy. I recommend guided meditations, and you can find many online.
A strong caution about meditating if you have a history of trauma: Meditation can evoke involuntary movements that terrified me the first time I experienced this. I later learned it’s common enough that it seems to have inspired a new specialty in (concierge) mental health. It’s painful. It’s incredibly frightening. And the first two times it happened, my body got stuck in a contorted position for half a minute or so. Bizarre. I believe the correct terminology for this is myoclonic jerk. It’s neurological in origin. Know that it’s a possibility and remind yourself before practicing. Then if it happens, maybe it won’t terrify you the way it terrified me the first couple of times it happened.
PEM makes movement difficult. When I got my second COVID infection, I was walking every morning at least an hour. Brisk walk, not some leisurely stroll. Now I can barely get to my mailbox without feeling like I’ll faint. I tried so many different ways of moving to see if there’s anything I can tolerate. I tried yoga, tai chi, qi gong, and belly dancing. The problem with all those methods, for me, is the tension in my body.
Then one day, I got myself stuck in one of those myoclonic jerks, the worst one yet. Incredibly painful, horribly distorted — a pose I couldn’t voluntarily replicate if I tried. I felt a panic coming. “Don’t, Pam,” I said aloud to myself. “If you panic in this stature, you can seriously injure yourself. Don’t do it. Breathe.”
Then, as spontaneously as the myoclonic jerk had started, my body went into fluid movement. Dance, even. Don’t ask me what kind of dance. My body was choreographer and dancer. I was merely observer. This became my preferred method of meditation, until I learned to relax enough to sit in cross-legged position, then half lotus, and now working up to full lotus.
All those words to say, basically, that dance is the best form of movement I’ve found. I’ve since added yoga into my daily practices. If I miss a day of movement, I suffer for having neglected my health.
Please remember, all of the above is what I’ve found to be of help to me. These aren’t cures, by any means, but these things help me in small ways that add up to moments of feeling human again. I even had one full day earlier this year, my first full pain-free day in more than two years. Your situation won’t be the same as mine. I hope you find something useful here that can help to lighten the burdens of living with long COVID.