Mar 26, 2026
Long COVID, also called post-COVID-19 condition, is a complex, chronic health condition that continues to affect a significant number of people in Canada and globally. In Canada, it is estimated to affect approximately 1 in 9 adults.
Clinically, Long COVID is defined as the persistence or development of symptoms three months after an initial COVID-19 infection, lasting for at least two months and not explained by another diagnosis. While Long COVID is often discussed in terms of physical symptoms, it is equally important to understand its cognitive and mental health impacts, which can be just as disruptive, and often less visible.
Long COVID is not a single condition, but rather a multi-system illness that can affect the brain, lungs, heart, and nervous system.
Symptoms can fluctuate over time, often described as coming in “waves,” and may include:
• Fatigue and reduced stamina
• Shortness of breath
• Pain and sleep disturbances
• Cognitive impairment (“brain fog”)
• Mood and emotional changes
Research suggests that a substantial proportion of individuals experience lingering symptoms months after infection, with fatigue, cognitive difficulties, and mood disturbances among the most common.
One of the most commonly reported, and misunderstood, features of Long COVID is cognitive dysfunction, often referred to as “brain fog.”
This can include:
• Difficulty concentrating
• Memory problems
• Slowed processing speed
• Word-finding challenges
• Feeling mentally “foggy” or disconnected
A large meta-analysis found that mental health conditions and cognitive symptoms occur in roughly 20% of people with Long COVID, with prevalence increasing over time. These symptoms are not simply stress-related, they are increasingly understood as part of the neurological impact of the illness itself.
Long COVID sits at the intersection of physical illness and mental health. People living with Long COVID commonly report:
• Anxiety
• Depression
• Irritability
• Emotional instability
• Grief and loss of identity
• Feeling “not like themselves”
These experiences arise through two overlapping pathways:
1. Biological effects: COVID-19 can affect the brain and nervous system directly, contributing to cognitive and emotional symptoms.
2. Psychological and social impact: Living with an unpredictable, chronic illness can disrupt identity, functioning, relationships, and daily life.
Importantly, Long COVID is sometimes misinterpreted as a primary mental health disorder, which can lead to invalidation or delayed care.
A more accurate understanding is that Long COVID is a chronic health condition with mental health consequences, not “just anxiety” or “just depression.”
A key challenge for many individuals is that common cultural advice: “push through,” “stay productive,” “keep going,” can actually worsen symptoms. One of the defining features of Long COVID is post-exertional malaise (PEM):
• A worsening of symptoms after physical, cognitive, or emotional exertion
• Often delayed by hours or days
Because of this, overexertion can lead to setbacks rather than recovery.
1) Pacing: Pacing is one of the most widely recommended strategies for managing Long COVID.
It involves:
• Balancing activity and rest
• Staying within personal energy limits
• Preventing symptom flare-ups
Rather than pushing through fatigue, pacing supports stabilization of the condition over time. For many people, this requires a significant shift in mindset- especially in cultures that prioritize productivity and endurance.
2) The Role of Psychotherapy: Psychological support plays an important role- but not in the way people often assume. Therapy is not about “fixing” Long COVID. Instead, it focuses on helping individuals:
• Make sense of their experience
• Adapt to changes in functioning and identity
• Manage anxiety, depression, and uncertainty
• Develop sustainable coping strategies
• Build self-compassion and reduce self-blame
Effective care recognizes that Long COVID is both a medical and psychological experience, requiring an integrated approach.
For individuals living with Long COVID, or supporting someone who is, care is most effective when it:
• Validates lived experience
• Recognizes the connection between body and mind
• Supports adaptation, not just recovery
• Prioritizes safety, sustainability, and quality of life
Long COVID challenges many of our assumptions about illness, recovery, and productivity. Psychological care is not about minimizing symptoms or reframing them as “just mental health.” It is about helping people live meaningfully and safely within a complex, ongoing condition; with dignity, understanding, and support.
If you’re living with Long COVID, you don’t have to navigate it alone. At Vox Mental Health, our therapists understand the complex overlap between chronic illness and mental health. We offer evidence-based, compassionate support to help you pace, adapt, and reconnect with what matters most. Book a consultation today to explore how therapy can support you in living more sustainably with Long COVID.
