Blog Post 90: Long COVID and Type C
“Long COVID,” meaning a continuation of some symptoms for an extended period after an acute infection, has become a significant health issue for many people. Chronic fatigue in particular is common to COVID. This New York Times article has some interesting insights we want to discuss, given many Type C people struggle with medically unexplained fatigue.
From a scientific perspective, one hypothesis for the chronic fatigue associated with long COVID is a disruption in the mitochondria of cells. Mitochondria are known as the cell’s powerhouse and produce the energy necessary for the cell’s survival and functioning. As the article notes, mitochondrial dysfunction can lead to many processes becoming more slow in the body. A second hypothesis includes the virus lingering in the body, leading to an attempt to conserve energy, while a third suggests a reduction in cortisol levels in the morning - cortisol is known as the “get up” hormone, and if it’s low, one feels very tired.
These insights are helpful to Type C people experiencing fatigue. It might be helpful to consider fatigue may be happening on a cellular level and our bodies need to be treated accordingly. One very important strategy is called pacing. Often, if someone struggles with fatigue or pain, they do as much as possible on days when they feel better. However, this can lead to a relapse in symptoms on following days. Pacing means you do less on the days you feel better so that you don’t overdo it, and allow yourself to maintain energy (or reduced pain) levels longer. When one does less overall in a day, it can lead to doing more in a more consistent way in the long run.
Setting new baselines, as the article discusses, is also an important strategy. I (Anna) have struggled with chronic fatigue for about 20 years, and it has been difficult to accept that my former energy levels might not return. Making peace with this, accepting that I have to work with my new energy levels instead of against them, has been helpful. Doing the things that bring me more energy is a daily battle - I tend to revert to poor self care easily instead of sticking to the things that work! For me, these are intermittent fasting, a nutrient-dense keto diet, sunshine, emotional expression through journaling, engaging in creative projects, talking with friends and family.
When I revert to poor self care, it’s usually because I am putting other people’s needs first. I feel stressed by the notion of disappointing or confronting someone and I fall off the wagon. This is so typical of Type C - we focus constantly on the never-ending home and work to-do lists in order to keep others happy. We do not give ourselves enough breaks because they cause us worry and guilt - someone might need us, we can’t indulge ourselves in doing something restorative.
A final strategy that can help here is noticing the costs of not taking breaks. If we overdo it, or we revert to bad habits, what happens? Our energy levels are even lower longer-term. If we notice the costs, it can motivate us to take a break from a screen, to do a little less. We can sit for a minute, drinking a cup of tea or eating a healthy snack, without any other distractions. We can go for a walk, call a friend, put down the to-do list.