How to Cope with COVID-19 Survivor’s Guilt

Experts say there are common symptoms of survivor’s guilt and a variety of ways to cope with this condition. Shape Charge/Getty Images

Experts say survivor’s guilt is becoming an issue for people during the COVID-19 pandemic.They…

Experts say there are common symptoms of survivor’s guilt and a variety of ways to cope with this condition. Shape Charge/Getty Images
  • Experts say survivor's guilt is becoming an issue for people during the COVID-19 pandemic.
  • They say the most vulnerable people are those who know someone who has died from the disease or had a serious illness from it.
  • They say symptoms of survivor's guilt include obsessive thoughts, sleep difficulties, and a loss of motivation.
  • Among the ways to cope with this guilt are socializing, expressing gratitude, and helping others.

Recovering from COVID-19 can lead to complex feelings of grief, better known as survivor’s guilt.

And experts are saying this is a growing issue as the pandemic hits its 1-year mark in the United States.

“Survivor’s guilt occurs when an individual survives a harrowing or traumatic experience, but concludes that they were somehow undeserving of survival or that someone else would have been more deserving,” Arianna Galligher, LISW-S, associate director of STAR Trauma Recovery Center at The Ohio State University Wexner Medical Center, told Healthline.

Prior to the pandemic, survivor’s guilt was associated with people who have survived life threatening situations such as war, the Holocaust, the September 11th terrorist attacks, and organ transplants.

The condition is common in groups such as veterans and first responders.

However, experts say the ongoing COVID-19 pandemic is showing us that this common symptom of post-traumatic stress disorder (PTSD) doesn’t discriminate. 

“It can be really challenging to have a positive or better outcome post-trauma when you know that others have not been afforded a similar opportunity,” Akua K. Boateng, PhD, LPC, a licensed psychotherapist, told Healthline.   

Who is at risk?

Experts say no one is immune to COVID-19 survivor’s guilt because we’re all experiencing collective trauma.

However, people who have developed the illness and recovered are more susceptible. 

“Survivor’s guilt tells you that you have done something wrong for merely surviving something tragic,” said Boateng. 

“Since the symptoms and long-term effects of COVID-19 vary widely from person to person, it can lead some who contracted the illness and recovered to wonder, ‘Why did I make it when others didn’t?’” said Galligher.

She says the following situations further increase the likelihood of experiencing survivor's guilt:

  • knowing someone who lost their life to COVID-19
  • knowing someone who has experienced more severe long-term consequences from COVID-related complications
  • believing you put yourself in a risky situation that led to contracting the virus
  • having pre-existing mental health conditions that affect your ability to cope with grief related to survival

Boateng adds that people can experience complex grief related to COVID-19, even if they haven’t developed and recovered from the illness. 

“A similar phenomenon of survivor’s guilt could be manifesting for those that have experienced more ideal outcomes during the pandemic,” said Boateng.

“The more ideal outcome could be less loss, better economic status, and now even having access to the vaccine, where others are still looking for this access,” she added.

Signs and symptoms

Psychiatric effects such as depression, anxiety, and mood changes are long-term effects of recovering from COVID-19, according to the Centers for Disease Control and Prevention (CDC)

However, Boateng adds that feeling remorse or regret can also occur along with anger.

“Anger that has been internalized because you’ve had more mobility, economic support, access, and decreased loss in total,” she said.

While it’s expected to feel a range of emotions when surviving an ongoing pandemic, there are signs and symptoms to watch for to prevent further psychiatric distress and longer-term mental health issues related to survivor’s guilt.

Galligher says the following are signs and symptoms of COVID-19 survivor's guilt:

  • obsessive thoughts related to the course of illness and recovery
  • obsessive thoughts related to someone else’s inability to recover
  • irritability and anger
  • feelings of helplessness
  • feelings of grief and sadness
  • problems sleeping
  • decreased motivation
  • social withdrawal or isolation
  • experiencing the impulse to overcompensate in an effort to prove oneself more “deserving of survival”
  • thoughts of suicide

These thoughts, feelings, and behavior changes can be debilitating and disabling. Talk with your doctor as soon as possible to discuss available options. 

If you're experiencing suicidal thoughts, you can connect with a network of more than 150 crisis centers offering free and confidential emotional support around the clock at the National Suicide Prevention Lifeline:

Coping strategies

Along with reaching out for support from your family doctor or a mental health professional, there are other ways you can begin to manage complex feelings of grief associated with surviving COVID-19.

Galligher offers the following advice:

  • Give yourself permission to feel and express your emotions.
  • Challenge the impulse to isolate. Access support from others.
  • Instead of asking “Why me?” try “Why not me?”
  • Explore ways to express gratitude or do something good for others.   
  • Practice being kind to yourself.
  • Use compassionate self-talk.
  • Prioritize self-care.
  • Seek support from a mental health professional if you start to experience suicidal thoughts.

Special considerations for children may also be necessary. 

“Children experiencing survivor’s guilt may need support from a caring adult to be able to understand and express their feelings,” said Galligher. 

“Children experiencing survivor’s guilt may also need help engaging with others,” she added.

Boateng echoes that helping others in need can be a positive way of coping with pandemic grief. 

“Seek to support those that you feel are in need and or could benefit from your help and forgive yourself for being on the other side of the circumstances that are outside of your control,” she said.

“Have compassion, for you are doing your level best to deal with the ruins of post-traumatic experience,” she added.