Anxiety treatment before the COVID-19 pandemic protects against increased stress

The onset of the COVID-19 pandemic has led to unprecedented exposure to stressors driven by fears of a new and deadly disease, heightened uncertainty, and subsequent isolation measures, which in turn have led to increased anxiety for many. According to new research, however, people who were receiving treatment for anxiety before the pandemic began did not experience an increase in their symptoms throughout this extremely difficult time.

The new research suggests that cognitive-behavioral therapy (CBT) and dialectical behavioral therapy (DBT) provided tools to help people with anxiety manage their symptoms in the face of these intense stressors, according to the study authors. The study, led by psychologists at McLean Hospital, a member of Mass General Brigham and Touro University, was published March 13^u in PLoS One.

Our research shows that CBT and DBT can offer significant benefits in protecting the mental health of individuals in the midst of a major global disaster and period of turmoil. People who have been treated for anxiety know that fighting stress is not helpful and that there are tools to help accept the current reality of their situation,” he added. blessing.”

David H. Rosmarin, PhD, ABPP, lead author of the study, clinical psychologist at McLean Hospital and associate professor of psychology at Harvard Medical School

For the study, researchers compared the treatment paths of 764 people who participated in outpatient treatment and divided them into four groups based on when they started treatment: pre-pandemic (start date on or before 12/31/2019), start pandemic (from 01/01/2020 to 31/03/2020), during the pandemic (from 01/04/2020 to 31/12/2020) and after the pandemic as soon as vaccines become available (on or after 01/ 01/2021 ).

Anxiety was measured at intake and at each subsequent session using the GAD-7 questionnaire, which assesses anxiety symptoms. The researchers then analyzed the stress trajectories and compared the four groups. Treatment consisted of CBT and DBT.

Their findings revealed that overall, patients experienced moderate anxiety when they started treatment, which decreased rapidly within 25 days of starting treatment and gradually decreased to mild anxiety for the remainder of their sessions. When they compared the four groups of patients, the researchers found no significant differences between the groups, suggesting that the treatment effects were robust to environmental stressors associated with the pandemic. Furthermore, among patients who were in treatment at the beginning of the pandemic, the researchers did not find an increase in anxiety during the initial acute phase of COVID-19 (March 20, 2020 to July 1, 2020).

We were surprised. We thought that during the peak of the pandemic and before vaccines were available, patients would show increased anxiety and that the treatment would be less effective, but this was not the case.”

Steven Pirutinsky, PhD, study co-author, assistant professor in the Graduate School of Social Work at Touro University

Studies have shown that the COVID-19 pandemic has adversely affected mental health, with measurable increases in stress from the start of the pandemic in early 2020 to the first availability of vaccinations in early 2021. A report from the World Health Organization found a global prevalence of of anxiety and depression increased by 25% in the first year of the pandemic.

“There is a widespread misconception that stress is a risk factor for people breaking down and being unable to function,” says Rosmarin. “However, when people receive evidence-based psychotherapy and learn coping skills, they can become more resilient than those who have never had any stress.”

Limitations of the study include that the participant pool, although demographically and clinically diverse, consisted primarily of highly educated individuals geographically specific to the northeastern United States. The pandemic onset group was also smaller than the others, which may be attributable to the limited availability of treatment per person at that time. The study also did not look at other measures of mental health, including depression and substance use. More research is needed to gain insights into how these findings may translate to other regions of the country and conditions other than anxiety disorders.