Six years in, mental health care providers are still uninformed on Long COVID. And it’s making the crisis worse.

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February 24, 2026

The American Psychological Association headquarters in Washington, D.C., Harrison Keely / CC By 4.0

Key points you should know:

Since 2020, many people living with Long COVID have experienced new and worsening mental health conditions — most commonly depression, anxiety, and post-traumatic stress disorder.
It can be difficult for people living with Long COVID to access the mental health therapy they need because many providers don’t understand the condition.
There is a lack of Long COVID guidance from professional organizations like the American Psychological Association, American Psychiatric Association, and American Medical Association.
A therapist’s toxic positivity can be a source of stress.
Working with the right therapist can make all the difference, and there are resources available to help people with Long COVID find one.

After only a few months of working together, Mars’s therapist dropped them as a client, claiming that their cognitive issues resulting from Long COVID made talk therapy “not helpful.”

The therapist expressed difficulty understanding Mars and what they needed, and she said she would mentally check out while they were talking. “I felt completely unheard,” Mars said. “Before starting with her, I had triple-checked that she was chronically ill informed — it was her specialty. She came highly recommended.”

Mars, 28, who, along with other people with Long COVID interviewed for this story, asked to omit their last name for privacy reasons, isn’t alone in their frustration. Six years into the ongoing COVID-19 pandemic, many people living with Long COVID still aren’t getting the mental health support they need. This is the case for physical treatment, too, as there’s no dedicated therapy or cure. But when it comes to mental health, more options are available — at least in theory.

People living with Long COVID are twice as likely to develop anxiety and depression compared to those who recovered from a SARS-CoV-2 infection, according to a 2025 population-based study published in the journal Discover Mental Health. And a 2023 study published in BMJ Open found that people with Long COVID can experience worse quality of life than those with other diseases.

Unlike for Long COVID itself, there are a range of treatments for anxiety and depression that should be made available and could potentially provide relief. Unfortunately, they’re not always accessible to people living with Long COVID.

So what’s causing this disconnect? What barrier prevents people living with Long COVID from getting the mental health care they need? At this point, it still comes down to unempathetic, uninformed mental health providers and a lack of guidance from major mental health organizations — including the American Psychological Association (APA). To better understand this problem, The Sick Times spoke with psychologists and people living with Long COVID about these challenges, and where we go from here.

Uninformed and unprepared

Since 2020, many people living with Long COVID have experienced new and worsening mental health conditions — most commonly depression, anxiety, and post-traumatic stress disorder (PTSD). Long COVID’s neurological symptoms go far beyond these mental health conditions: evidence suggests SARS-CoV-2 infection impacts the brain. Additionally, people can experience PTSD from negative encounters with the medical system.

But when people seek professional help for managing these challenges, practitioners aren’t always up to the task.

Some people are fortunate enough to work with a therapist who understands Long COVID and other chronic illnesses, believes them when they say they’re sick, and offers the support they need. Not everyone is so lucky. In fact, some mental health professionals are so unprepared to deal with someone living with Long COVID that they can actively make things worse.

Take Steph Fowler, a psychotherapist living with Long COVID since early 2020, for example. After seeing no improvement in her symptoms, she switched to a new mental health practitioner in 2022, but it wasn’t a good fit.

“The therapist kept using microaggressions, clearly didn’t understand disability, and could not see that living with Long COVID in a world that was denying, ignoring, and burying COVID was its own trauma,” Fowler said. “It wasn’t until I was fortunate enough to find a therapist who also has Long COVID that I had all of my experiences validated, and I truly experienced what a difference this made.”

It wasn’t until I was fortunate enough to find a therapist who also has Long COVID that I had all of my experiences validated, and I truly experienced what a difference this made.
Steph Fowler, Misfit Mental Health

Fowler — whose practice, Misfit Mental Health, focuses on serving clients who are neurodivergent, chronically ill, or living with invisible or dynamic disabilities — gathered from others in the chronic illness community that their experiences in therapy were at best neutral or unhelpful, and often actually hurtful.

“I’d heard from people that they were being told things like they ‘identified too much with their illness,’ which is one of the most invalidating and dismissive things I could imagine,” she said.

According to Fowler, people with Long COVID often feel as though they don’t control their own bodies. This is especially true when multiple medical professionals conclude someone is “fine,” even when they know something is wrong. “It’s a very special kind of hell to have your body going haywire,” Fowler said.

A lack of guidance

How can therapists be so uninformed about Long COVID? In short, because professional guidance for treating people living with Long COVID doesn’t exist.

“Because the literature on Long COVID is new and still evolving, there is no established protocol for the psychological treatment of people living with it,” said Marisa Menchola, a board-certified clinical neuropsychologist and associate professor of clinical psychology at Midwestern University–Glendale. “We have effective evidence-based psychological treatments backed by decades of research, but we are still learning how these approaches might work for patients with Long COVID.”

While the American Psychological Association (APA) has acknowledged the challenges of Long COVID in articles, a webinar, and a podcast episode, according to a spokesperson for the organization, the APA “does not have a clinical practice guideline currently or planned on Long COVID right now.”

The Sick Times also reached out to the American Psychiatric Association and American Medical Association to ask if they had any Long COVID guidance or policies, but neither responded to the request for comment.

There are a set of Long COVID guidelines out of Canada, but they recommend cognitive behavioral therapy (CBT) as a treatment for the disease, a move that experts and patient advocates have critiqued.

Support independent Long COVID journalism

This lack of guidance contributes to some therapists not taking Long COVID seriously or educating themselves on the disease and other chronic illnesses. Often, therapists write it off as psychosomatic, even though extensive scientific papers have demonstrated otherwise.

“Most therapists with this knowledge have learned by spending their own time doing research, getting consultation from another professional, from their work with clients, or from personal experience.”

It took Emily, 40, four attempts to find a therapist who took Long COVID and myalgic encephalomyelitis (ME) seriously.

“The pandemic is an ongoing mass disabling event that’s disproportionately hurting already vulnerable groups,” including women, children, BIPOC, and LGBTQ+ people, she said. “[It’s] causing a slew of chronic illnesses that have historically been inappropriately psychologized and treated with harmful methods. The field of psychology desperately needs to get up to speed.”

According to Emily, therapists need training in infection-associated chronic conditions and in the history of medical misogyny and medical gaslighting. “It shouldn’t be left to severely ill patients in an imbalanced power dynamic to try to educate them,” she said.

It shouldn’t be left to severely ill patients in an imbalanced power dynamic to try to educate them.
Emily, person with Long COVID

Additional challenges

Some therapists also overlook the impact that cognitive symptoms — like attention lapses, slow processing speed, so-called “executive” deficits (difficulty planning, organizing, multitasking, and staying on task), and memory problems — can have on someone living with Long COVID, Menchola said.

“People who experience significant cognitive symptoms often fear they have sustained brain damage and worry they will never come back to their previous level of functioning,” she explained. “It can all become a self-perpetuating cycle, where cognitive lapses create more stress and anxiety, which in turn worsens our cognitive lapses.”

At this point, multiple studies have, in fact, found that Long COVID can cause brain damage.

A therapist’s toxic positivity can also be a source of stress.

Though it’s not considered an official recommendation or directive, the APA published an article discussing Long COVID in Monitor on Psychology in November 2024 encouraging mental health practitioners to tell clients with Long COVID to be optimistic.

“Instilling optimism is really key,” Michael Basso, a clinical neuropsychologist and professor of psychiatry and psychology at the Mayo Clinic, told the APA. “Give patients the expectation that they can and will get better, and we will provide services to help them achieve that outcome.”

But it’s a fine line between healthy optimism based in reality and empty platitudes, or telling someone to look on the “bright side.” Research suggests full recovery from Long COVID is rare, with only 6–9% of people recovering in two to three years.

Because Long COVID continues to be downplayed and dismissed, increasing numbers of people of all ages are joining Long COVID support groups distraught and in disbelief that they’re now chronically ill, Fowler said. Many people thought that they wouldn’t get long-term symptoms because they were vaccinated, or had felt fine after earlier infections.

“I think therapists need to acknowledge this and sit in that uncertainty and grief with clients, and find ways to cultivate optimism within that space instead of trying to bypass it,” she said.

For Misty, 41, the toxic positivity was too much. It was “straining” to talk to a therapist “who tried to make me see the positive in everything rather than letting me express myself or sit with the negative feelings and learn how to deal with them,” she said.

I think therapists need to … sit in that uncertainty and grief with clients, and find ways to cultivate optimism within that space instead of trying to bypass it.
Steph Fowler, Misfit MEntal Health

Finding the right therapist

Working with the right therapist can make all the difference, though that person can be “tough to find,” Fowler said.

If you’re not sure where to begin, Fowler suggests starting with the resources below. However, she cautioned that most of these directories aren’t vetted, and providers are often self-reporting their expertise and/or identities.

The COVID-Conscious Therapist Directory: Lists therapists who at least have some understanding of why people might continue to avoid infections. This probably includes some awareness of Long COVID, but it’s not guaranteed they know a lot about the unique challenges of living with the condition, and they may have varying degrees of risk mitigation.
The Inclusive Therapists directory allows people to search for numerous helpful criteria:
- Options for “Advocacy Focus” include “COVID Conscious”
- Options for “Specialty” include “Chronic Illness”
- Options for “Provider Identity” include “Disabled or Chronic Pain/Illness”
The Chronic Illness Therapists Directory: Therapists can list which conditions they have knowledge about. All should have at least a broad understanding of/compassion for the realities of complex medical conditions.
Long Hauler Approved Practitioner List: The folks behind the A Friend for the Long Haul podcast started a crowdsourced directory.

It can also be helpful to ask other people living with Long COVID if they have any recommendations for therapists.

In addition, or while waiting to find a therapist, it could be helpful to try a Long COVID support group. “These meetings may have less location limitations than one-to-one therapists or group therapy, and the leaders could have connections to mental health providers,” Fowler said.

Though finding the right therapist may be a challenge, Fowler stresses that you’re not the problem. “Everyone deserves to have support from someone well equipped to help them,” she said. “But if your search involves some dead ends and [it] takes some time to find a good fit, please know it’s not your fault if you encounter these shortcomings of the mental health field.”

Elizabeth Yuko, PhD, is an award-winning journalist and bioethicist. She has been living with Long COVID since April 2020.

All articles by The Sick Times are available for other outlets to republish free of charge. We request that you credit us and link back to our website.