How long covid takes a toll on relationships and intimacy

Now Kenny brings the outside world to her bedside: flowers from their garden, freshly cut grass to smell, or foraged acorns and chestnuts to hold.

“You have to reframe your thinking a little bit,” Kenny said. “We can’t really do much together anymore. You adapt, and you find new ways to find joy.”

How chronic illness affects relationships

Haddock and Kenny aren’t alone in their struggles to adjust to a relationship that includes long covid. While much has been written about the physical toll of long covid, less is known about how the condition affects relationships.

Common symptoms such as fatigue, brain fog and dizziness can make it difficult for someone with long covid to help with household chores, go out on dates or be physically intimate. As a result, experts say many long-covid patients struggle with strained relationships.

Some have even started bringing their partners to doctor’s appointments, said Alba Azola, an assistant professor of physical medicine and rehabilitation at Johns Hopkins University. “At times, I’m asked to be a mediator for some of the issues that they’re having,” she said.

Many of the challenges couples face when one partner has long covid are similar to the challenges of any relationship, such as communication, sexual intimacy and navigating career and home priorities. But when one partner has long covid, how couples approach these issues often requires extra planning, compassion and compromise.

Whether long covid also carries a higher risk of divorce or breakups isn’t known, but other research suggests that chronic illness can take a significant toll on relationships and can present additional financial challenges for couples. Experts say caregivers may report stress or feeling burdened. And sick or disabled partners may feel misunderstood or isolated.

Long covid is also uniquely challenging for couples because of how much uncertainty it brings into relationships, said John S. Rolland, an adjunct professor of psychiatry at Northwestern University’s Feinberg School of Medicine and author of “Helping Couples and Families Navigate Illness and Disability.”

Because scientists are still learning about the condition and how to treat it, couples don’t know what to expect or whether their partners will recover.

“It becomes a question of ‘When do we start to plan our lives as if this is not going to go away?’” Rolland said. “If every hope is put on a cure, what happens if the illness doesn’t go away?”

With long covid, he said, people may focus so much on trying to cure the illness that they forget to maintain a healthy connection with their partner.

When long covid delays your plans

Haddock met Kenny in 2008 in college, where they were both studying veterinary science, but they didn’t begin dating until 2012. Later they both began veterinary careers, moved in together and got a black cat named Salem. On their 10-year anniversary, Haddock proposed.

But because of long covid, their plans to get married are on hold.

While Kenny tries not to mourn what they used to be able to do together, he said it can be difficult to see friends getting married or having children — milestones that feel out of reach.

“We feel like we’re just treading water,” Kenny said.

To navigate her illness, the two of them approach everything as a team, sometimes joking that Kenny is like the body, cooking or doing chores while looking after Haddock’s physical health, and Haddock is like the brain, providing a positive attitude and checking on Kenny’s mental health. On good days, when she is feeling better, they cuddle in bed together and watch movies. On bad days, he holds her hand, or simply sits by her side.

“Our connection has never really faltered,” Haddock said. “If anything, going through this has probably made us stronger, even though it’s a challenge every day.”

How long covid adds unpredictability to a relationship

Another challenge of long covid is that many who are sick may not look sick, said Elisabeth Nickels, a rehabilitation psychologist at Johns Hopkins Hospital.

Because of this, some long-covid patients say they sometimes feel like their partners don’t believe them, or they feel pressured to “power through” their symptoms and suffer consequences later.

Hinda Stockstill said her partner sometimes struggles to understand how sick she still is. The 37-year-old from Cincinnati got covid in December 2020 and never fully recovered. At her worst, symptoms such as crushing fatigue, body aches, and brain fog got so bad that she struggled to speak and get out of bed, and she had to take months away from her job as an office manager.

Her symptoms have slowly gotten better over time, allowing her to sometimes make dinner for her partner, go out on dates or run errands. She has also started working remotely again. (Her partner asked not to be named for privacy reasons.)

But her partial recovery created new complications. She still has setbacks, and her symptoms can worsen for weeks at a time. This whiplash confuses her partner, who has sometimes questioned why she can’t do something that she was able to do before.

“I had to sit down and really explain to him that when I say I don’t feel well, I really can’t do those errands for you,” she said. “I try to see things from his point of view. He has never had covid and does not know what it feels like to be that sick. He only understands what I tell him.”

Before long covid, Stockstill said she was an energetic person who played multiple sports, went to church every Sunday and volunteered for Big Brothers Big Sisters of America. She had dated her partner for only five months before getting sick.

He’s “not hoping and waiting for me to go back to the person I was,” Stockstill said. “But my partner doesn’t fully know the person I was before I got sick, which makes me a little sad.”

When she first got sick, Stockstill assumed that her partner would just break up with her. But instead, he arrived every Sunday to watch movies, cook for her and pick up medications. “He stayed with me through the most difficult part of my life,” Stockstill said.

The loyalty and care he showed made her fall in love with him, she said.

A third ‘person’ in the relationship

Stockstill and her partner try to have days where they don’t talk about long covid. Otherwise, she said, it starts to feel like the disease has become a “third person” in their relationship. They do arts and crafts, watch movies and cook together.

Rolland said these types of bonding activities help couples avoid forming a solely caregiver-patient relationship, which can make it more difficult to have romance and intimacy. He suggests that couples should limit the time they focus on the illness, and try to create separate rooms for caretaking vs. intimacy if feasible.

For Stockstill, long-covid symptoms have also made it harder for her to get in the mood or feel sexy. Small acts of self-care, such as taking a hot bath, can help. She said intimacy often requires creativity to get around some of her physical limitations.

“You have to find intimacy in other ways. If you can’t physically have sex for 30 minutes in a certain position, you might need to change positions, get sex toys or try something else more comfortable,” she explained.

When her symptoms are worse, she and her partner focus on other acts of intimacy — giving each other compliments, cuddling or having him rub her joints with massage oils.

Getting comfortable with intimacy can take time, because it requires the partner with long covid to relearn their body, said Bianca I. Laureano, a disabled sex educator.

In addition to addressing emotional vulnerability or body confidence, long-covid patients also often report sexual libido, function or climax problems, Azola said. Studies also have shown an association between long covid and erectile dysfunction.

Couples struggling with intimacy can look for a disabled sex therapist or find advice from other disabled people on websites like disabledparts.com.

A ‘whole new relationship’ after long covid

The initial shock of a sudden health change is often the most stressful period to navigate, Azola said. Over time, experts say, couples in which one partner has a chronic health issue can adjust and still have a healthy, satisfying relationship.

After he developed long covid in September 2020, Sam Williams felt an immediate shift in his relationship with his wife of nearly 20 years. Crushing fatigue, dizziness and spasms meant that Williams, 51, of Okehampton, England, could no longer go camping, take long walks or do long bike rides with his wife and teenage daughter.

“My wife found it incredibly hard to accept that my life was different, and I couldn’t do all the things that I used to do,” Williams said. “It’s like a whole new relationship.”

Initially, Williams tried to push through his symptoms, but that just made them worse. With Williams unable to work, his wife found a higher-paying job to cover the bills and cost of their daughter’s education. She’s also taken on chores that Sam can no longer do, such as mowing the lawn or grocery shopping. (Williams’s wife asked not to be named for privacy reasons.)

Williams helps when he can, he said, but still feels guilty and sometimes has struggled with depression or suicidal thoughts. “I sometimes sense my wife and daughter pitying me,” he said. “They know how little I can manage, and I see it changing the way they behave toward me.”

He believes this shift in how he and his partner view each other has also impacted their sex life. They have been physically intimate only a few times since his illness, and the thought of intimacy prompts worries about worsening his symptoms.

“It’s not necessarily about overcoming the physical barriers, it’s about overcoming the psychological ones,” he said.

Just like any married couple, Williams and his wife have arguments. But long covid seems to exacerbate their issues. She often feels unappreciated, he said, while he feels misunderstood.

Williams sees a therapist twice a month and chats online regularly with other long-covid patients, which he said helps him feel less isolated.

Over time, he said, some aspects of his relationship with his wife have improved. They’ve gotten better at listening to each other, and Williams has learned to pace himself so he can go out for lunch or take short walks with his wife. They have also found joy in watching movies together with their two small terriers curled up on the sofa beside them.

And just as his symptoms fluctuate, he said he has good days and bad days in his relationship.

“The strongest feelings that I have are grief for the life I lost,” Williams said. “I’m not the same person.”