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Experts say guilt and shame can lead to “double the suffering” for many people diagnosed with COVID-19. d3sign/Getty Images
  • COVID-19 has been highly stigmatized since the beginning of the pandemic.
  • Feelings of guilt and shame following a COVID-19 diagnosis are common, especially as Omicron is leading to more breakthrough infections in fully vaccinated people.
  • These feelings can exacerbate stress and lead people to further isolate from loved ones.

A COVID-19 infection is stressful enough, but many people experience an added layer of emotional torment: feelings of guilt and shame after contracting a virus that has been highly stigmatized for the past 2 years.

This is especially true now as the highly transmissible Omicron variant continues to sweep across the United States, passed on to people who have been vaccinated, boosted, and taken every reasonable step to protect themselves.

But experts emphasize that contracting SARS-CoV-2 doesn’t mean you did something “wrong,” and feelings of guilt and shame only add to the suffering.

“Initially, at the start of the pandemic, the motto was ‘stay at home,’” said Hillary Ammon, PsyD, an assistant professor of Clinical Psychiatry in the Perelman School of Medicine at the University of Pennsylvania.

“We were being told to mitigate risk as much as possible by decreasing contact with those not in your household. Therefore, when people saw other individuals still traveling or attending concerts, opinions were being formed, like ‘they aren’t being careful’ and ‘they are contributing to the spread of the virus.’”

This thought pattern has persisted even as the nature of the pandemic has evolved over the past 2 years with the introduction of vaccines and the emergence of variants that can evade those vaccines.

While scientists are still working to better understand how Omicron spreads and how well available vaccines and medications work against it, what is known is that cases among fully vaccinated people are becoming more common. The Centers for Disease Control and Prevention (CDC) says these breakthrough infections are “likely.”

“It is automatically assumed that someone was being reckless and violating COVID protocols or CDC guidelines,” said Thea Gallagher, PsyD, clinical assistant professor in the Department of Psychiatry at NYU Langone Health. “This may have been true for some but not all.”

Additionally, these guidelines continue to change and can be difficult to keep up with, so “someone could be doing everything ‘right’ and still get COVID,” Gallagher said.

Mental health experts say feelings of guilt and shame are perpetuated by societal stigma related to a COVID-19 diagnosis.

“First, it is important to understand the difference between these two feelings,” Ammon said. “Guilt is believing that you did something wrong. Shame is experienced when you are concerned others are judging or rejecting you due to your actions.”

When someone contracts a SARS-CoV-2 infection, they may experience feelings of guilt related to their choices.

“They may ask themselves, ‘Why did I visit with others in their home?’ or ‘Why did I say I was comfortable with everyone not wearing masks?’” Ammon said. “Furthermore, they may experience feelings of guilt related to possibly infecting others, whether it be loved ones, co-workers, or strangers.”

People may also worry if others will judge them for not being cautious enough, leading to feelings of shame.

Guilt and shame after a COVID-19 diagnosis exacerbate the pain and stress a person is already going through from the illness.

“It’s truly like insult on injury,” Gallagher said. “You may feel physically ill and, on top of it, emotionally burdened. It’s double the suffering.”

While having COVID-19 means you have to physically isolate from others, these difficult feelings may also lead people to isolate themselves further socially and not talk with others about their diagnosis.

“Loneliness and lack of socialization are obvious concerns related to isolation,” Ammon said. “We know that both of these factors can negatively impact mental health.

“Furthermore, if they are not discussing their diagnosis or well-being with anyone,” she continued, “they may lean further into their thoughts of guilt and shame, ‘I was careless,’ or ‘I’m a bad person for putting others at risk.’”

Hiding a COVID-19 diagnosis from loved ones can also be dangerous to an individual’s physical health.

“It’s important that people remain in contact with others while sick, particularly if they start to notice their symptoms worsen,” Ammon said.

Finally, guilt or shame should never hinder you from disclosing a COVID-19 diagnosis to your close contacts for possible exposure.

“By being open and honest about one’s diagnosis, you can help slow down the spread,” Ammon said.

Gallagher and Ammon work with their patients to get through the difficult feelings of guilt and shame following a COVID-19 diagnosis.

“I like to tell clients that I am working with that they made the best decision they could with the information they had at that present time,” Ammon said. “Additionally, reminding them that their risk and safety calculations are personal and unique to their life circumstances.”

Gallagher emphasizes self-compassion.

“Even if you did something that you regret, face it, apologize if you need to, and work toward forgiving yourself, and remember we all make mistakes, and it doesn’t make us ‘bad people,’” she said.

“Talk to yourself the way you would talk to someone you love, and give yourself that advice,” she continued. “We are much kinder toward others than ourselves.”

Finally, Ammon works with her patients to assess what’s factual versus a thought.

“Because of the Omicron variant, COVID-19 is highly transmittable right now,” she said. “Sometimes it can be helpful to actually review the data with clients so they do not feel so much shame about their diagnosis or their choices.”