Quick Answer
Anxiety and long COVID often occur together. Lingering symptoms like fatigue, breathlessness, brain fog, palpitations and poor sleep can be frightening and unpredictable, and uncertainty about recovery adds worry. Anxiety doesn't mean symptoms aren't real. Pacing, medical care, therapy and careful medication choices can help people cope.
Understanding anxiety and Long COVID
Long COVID refers to symptoms that continue or develop weeks to months after a COVID-19 infection. Common symptoms include fatigue, breathlessness, brain fog, palpitations, dizziness, sleep problems and symptoms that worsen after physical or mental effort. Recovery timelines vary widely, and uncertainty is one of the hardest parts. Many people also feel dismissed or disbelieved, which adds frustration and isolation. Anxiety is a natural response to all of this. It can show up as constant worry about health and the future, fear of activity, health-focused vigilance or panic. Anxiety doesn’t make long COVID symptoms less real. This guide is part of the NY anxiety resource center.
The NYC Health Department‘s 2024 report described how the COVID-19 pandemic intensified anxiety and stress for many New Yorkers, and how its effects continue. For people with long COVID, those effects are personal and ongoing. Addressing anxiety is part of comprehensive care, alongside medical evaluation and treatment of physical symptoms. Some hospitals offer post-COVID clinics that coordinate care across specialties. Psychiatric care can work alongside these services. Our guide on POTS vs anxiety covers a condition that can develop after COVID.
New York was hit early and hard by COVID-19, and many New Yorkers are still living with its lingering effects. The same NYC Health Department report found that about 945,000 adult New Yorkers, or 14%, had an unmet need for mental health treatment in the past year. Secure video visits anywhere in New York can make it easier to start care without a commute or a long search.
Lingering symptoms and worry, fatigue and pacing, and overlap with POTS and breathlessness are the three topics this guide covers.
Feeling dismissed
Many people with long COVID have been told their symptoms are just stress or anxiety, which can feel invalidating. It’s reasonable to seek clinicians who take your symptoms seriously. At the same time, anxiety can develop because of long COVID, and treating it can improve quality of life. Both things can be true. A good care team addresses physical symptoms and emotional wellbeing together, without dismissing either. You deserve to be heard.
Brain fog and worry
Brain fog, including trouble concentrating, memory lapses and slowed thinking, is common in long COVID. It can make work and daily tasks harder and raise worry about lasting damage. Fatigue, poor sleep and anxiety can all worsen brain fog. Pacing mental effort, using lists and reminders, and protecting sleep help. If cognitive symptoms are significant, an evaluation can clarify what’s contributing. Treating anxiety and sleep problems often improves thinking. Many people see gradual improvement over time.
Key Takeaways
- Long COVID can cause fatigue, breathlessness, brain fog, palpitations and sleep problems.
- Uncertainty about recovery and feeling dismissed can fuel anxiety.
- Anxiety treatment helps coping but doesn't mean symptoms are psychological.
- Pacing activity helps many people avoid symptom crashes.
Anxiety and Long COVID at a glance
| Symptom | Why evaluation matters |
|---|---|
| Palpitations | Can reflect POTS or heart issues |
| Breathlessness | Can reflect lung or heart changes |
| Brain fog | Can come from fatigue, sleep loss or anxiety |
| Fatigue and crashes | May worsen after exertion |
| Poor sleep | Feeds both anxiety and fatigue |
Overlap with POTS and breathlessness
Some people develop POTS or other autonomic problems after COVID, causing a racing heart on standing, dizziness and fatigue. Breathlessness can reflect changes in the lungs, heart or breathing patterns. These symptoms overlap with anxiety, which can make it hard to know what’s causing what. That’s why medical evaluation comes first. Once other causes are addressed, anxiety treatment can help with fear and avoidance. Coordinated care between your medical and psychiatric clinicians works well. Treating anxiety doesn’t replace treatment for physical conditions.
Fatigue and pacing
Many people with long COVID find that pushing through activity leads to a crash of worsened symptoms a day or two later, sometimes called post-exertional malaise. Pacing means planning activity in manageable amounts, resting before exhaustion and gradually adjusting based on how your body responds. It’s different from the push-through approach many people are used to. Anxiety can make pacing harder, either by driving overactivity to prove recovery or by causing fear of any activity. Your care team can help you find a sustainable balance. Pacing helps many people stabilize. Our guides on anxiety with COPD and asthma and POTS vs anxiety cover related topics.
Long COVID anxiety care for New York patients
Video visits save energy on low-energy days, with no travel or waiting rooms. Visits run by secure video anywhere in New York, while you’re physically in the state. The practice is in-network with Aetna and Cigna; confirm your New York plan with the office, and see self-pay fees on the Good Faith Estimate page.
Medication considerations
Medication choices in long COVID need care, since people may be sensitive to side effects and may have POTS, sleep problems or fatigue. SSRIs are commonly used for anxiety and are sometimes used for other long COVID symptoms, though responses vary. Some medications affect heart rate or blood pressure, which matters with autonomic symptoms. Sedating medications can worsen fatigue. Your prescriber will start low, adjust slowly and coordinate with your other clinicians. Therapy has no physical side effects and helps many people cope.
When to seek help
Seek urgent care for chest pain, severe breathlessness, fainting or sudden new symptoms. Consider an anxiety evaluation if worry is constant, you’re having panic attacks, fear is limiting activities beyond what your body needs, sleep is poor or mood is low. Long COVID can lead to depression, especially when recovery is slow. Thoughts of suicide need immediate help through 988, available around the clock. Anxiety with long COVID is treatable, and support can make recovery easier.
The Bottom Line
Anxiety and Long COVID is common and treatable, and careful care can make daily life feel more manageable.
Frequently Asked Questions
Is anxiety common with long COVID?
Yes, anxiety is common in people with long COVID. Lingering symptoms like fatigue, breathlessness, brain fog and palpitations can be frightening and unpredictable. Uncertainty about recovery and feeling dismissed add to worry. Anxiety is a natural response and doesn't make symptoms less real. It's treatable alongside physical care.
Is long COVID just anxiety?
No, long COVID involves real physical symptoms, and anxiety doesn't explain them away. Some people develop anxiety because of long COVID, and some develop conditions like POTS after infection. Medical evaluation should come first for new or persistent symptoms. Treating anxiety helps coping and quality of life. Both physical and emotional care matter.
What is pacing in long COVID?
Pacing means planning activity in manageable amounts and resting before exhaustion. It helps many people avoid crashes of worsened symptoms after exertion. Activity is adjusted gradually based on how your body responds. Anxiety can make pacing harder in either direction. Your care team can help you find a sustainable balance.
Can long COVID cause POTS?
Some people develop POTS or other autonomic problems after COVID. Symptoms include a racing heart on standing, dizziness and fatigue. These overlap with anxiety, which can make diagnosis confusing. A medical evaluation helps sort out the cause. Anxiety treatment can work alongside POTS care. Coordinated care helps people cope while the body recovers.
What anxiety treatment helps with long COVID?
Therapy helps with worry, uncertainty, fear of activity and adjusting to limits. SSRIs are commonly used for anxiety, started at low doses. Medications that affect heart rate or cause sedation are chosen with care. Your prescriber will coordinate with your other clinicians. Pacing and sleep support are also part of the plan.
Can I get anxiety care for long COVID by video in New York?
Yes, evaluations and follow-ups happen by secure video anywhere in New York, saving energy on low-energy days. You need to be physically in New York during each visit. Your clinician can coordinate with post-COVID clinics or your other doctors. The practice is in-network with Aetna and Cigna; confirm your New York plan with the office. Prescriptions go electronically to your pharmacy.
Where to go from here
- Right now, if you're not safe
- Call or text 988, or call 911.
- If you'd like an evaluation
- See how scheduling and telehealth work on the new patient page.
- If you want to keep reading
- Return to our anxiety care hub for New York adults for more guides. For more help preparing and finding care, see NIMH’s tips for talking with your health care provider and FindTreatment.gov.
How We Reviewed This Page
Written by Steven Lockhart of Health Marketing Group and clinically reviewed by Gabriella I. Farkas, MD PhD, a board-certified psychiatrist. Clinical information comes from the sources listed below, and the page is reviewed every 180 days or when guidance changes.
What’s new: September 29, 2026. Page published.
References
- NYC Health Department. The State of Mental Health of New Yorkers (2024). https://www.nyc.gov/assets/doh/downloads/pdf/mh/state-of-mental-health-new-yorkers.pdf
- National Institute of Mental Health. Anxiety Disorders. https://www.nimh.nih.gov/health/topics/anxiety-disorders
- 988 Suicide & Crisis Lifeline. https://988lifeline.org/
- Tips for talking with your health care provider. https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider
- FindTreatment.gov. https://findtreatment.gov/