Patient name and other descriptors have been changed to protect privacy.

Sara is a 14-year-old patient of mine. I am a clinical psychologist, and I have been treating her for about 15 months. Sara has been struggling with trauma and associated psychiatric symptoms since the coronavirus ravaged her family.

This is the story of Sara’s treatment. Her plight and journey of recovery is what is so remarkable. And instructive. And worthy of sharing.

Sara is a bright, social young teenager who was cruising along in her everyday life. She had a happy, content family with her parents and three siblings. She was a good student, had many friends, and loved to ride horses. She was beginning to show an interest in dating. And she loved going to high school and college football games.

Then the coronavirus pandemic hit. Her world was turned upside down. It was a traumatic time for her because her father became infected with COVID-19. He was extremely sick, requiring hospitalization and ventilation. After 12 grueling days in the hospital, Sara’s father passed away.

Sara was shattered by her father’s death. It made no sense to her. She was riddled with powerful and unending questions: How could a virus kill her dad when we live in the greatest country on the planet? How could he not be saved? Did she do something wrong? How are we going to make it as a family? How can I help my mother?

Around the same time as the loss of her father, Sara’s school stopped in-person classes. She missed her friends and her favorite teachers. Staying at home was a constant reminder of her father’s absence. But she was able to keep a watchful eye on her mother and her siblings as they all grappled with their collective pain and sorrow.

Sara was becoming obviously depressed. She was sad. She cried. She was tense. She was constantly worrying. She was afraid. She had trouble sleeping at night. Her happy, joyful spirit was now snuffed out. She did not smile and laugh. She was preoccupied with negative and morbid thoughts. She was grouchy and snappy with her siblings. She stopped talking to her friends on the phone or via text messages. She lost 15 pounds without intending to.

Sara was brought to see me by her mother. Her mom was lost in sadness herself but could see that her daughter was struggling mightily. She worried that Sara was getting increasingly depressed and despondent. She feared she might be suicidal.

Much to her credit, Sara was eager for professional help. She and I connected immediately and our therapeutic alliance flourished. We both knew that she was profoundly depressed over the sudden death of her father and the unexpected daily consequences of this pandemic. I was concerned about Sara, but I also knew that her excellent premorbid mental health meant she had a very positive prognosis for recovery. But it would be a difficult road ahead.

I referred Sara to her pediatrician for an antidepressant medication, since her depression was so severe and it was affecting her sleep and appetite. She tolerated the medication well and it helped. She was thankful for it.

Psychotherapy with Sara progressed extremely well until she had to deal with another staggering trauma — her mother got sick with COVID-19.

Sara decompensated with the news of her mother’s illness. Her depression became florid again when her mother was hospitalized due to the severity of her illness. Sara and her siblings went to stay with her aunt and uncle and cousins while her mom was in the hospital. She thought it would be a short-term sleeping arrangement until her mother came home.

But it was not.

Sara’s mother died of COVID-19 in the same hospital where her father had passed. Sara was wrecked. She was consumed with fear. She felt lost and alone. She could not stop crying.

Luckily, Sara and her siblings were welcome to stay with her aunt and uncle. That stability was such a blessing for them. And Sara continued to see me in weekly therapy sessions. Her therapy had become a major anchor point for her. She knew that it was the place where all her feelings and fears could be verbalized, understood, and contained. By contained I mean she was able to experience her feelings and process them so that they did not overwhelm her in her daily life.

Sara became afraid that she would also lose me to the coronavirus. This was a “transference reaction” to the two deaths she had faced. Her fears about me opened a new door for exploration. Even as a young teenager, she was able to understand that her dependency on me was due to the unexpected deaths of her parents. It also affirmed that we indeed had a therapeutic alliance that allowed for honest and open communication about all of her feelings. This was psychotherapy at work.

Sara is struggling with a mixture of intense feelings: sadness, fear, loneliness, guilt, sense of responsibility, and many more. All of this is grist for the mill in her ongoing therapy.

Sara continues to see me weekly. She has weathered the storm of trauma and is recovering. She is still on medication, which helps to bolster her defenses and to allow her natural positivity and optimism to shine. She feels in control of her life. She has not become a victim of her trauma but rather a proactive, healthy master of her emotional life.

The pandemic has created havoc and indescribable anguish. It has been underestimated by so many. Its victims have experienced trauma that will change the course of their lives. Just ask Sara.

Sara’s recovery is a process but it is palpable. We can feel it and we can see it. Psychotherapy and medication — alone or in combination — can make a demonstrable difference.

It is the resilience and recovery of patients like Sara that keep me motivated to do my job every day in the face of this daunting pandemic. We must all endure.

Alan D. Blotcky, PhD, is a clinical psychologist in private practice in Birmingham, Alabama.