Large Study Shows 60% Increase in Anxiety, Depression after COVID-19

From Bezzy’s sister site, PsychCentral

• A study of more than 11 million people shows a 60% increase for mental health disorders up to 1 year after having COVID-19.
• The risks for mental health diagnoses and prescriptions were higher among those hospitalized with the virus but also occurred in people with mild cases.
• The findings highlight the need to prioritize mental health care among survivors of COVID-19 and the importance of vaccinations for prevention.

Most people who test positive for COVID-19 feel better within a couple of weeks. For others, post-COVID conditions — known as long COVID — may persist for months or more.

And now, a February 2022 study comprising more than 11 million people suggests that mental health conditions could be among the growing list of symptoms associated with long COVID.

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Can long COVID affect your mental health?

The large-scale research shows a 60% increase in a broad range of mental health conditions for up to 1 year after developing COVID-19.

The risk for mental health diagnoses and prescriptions was greater among those who were hospitalized from COVID-19 but was present among those with a mild infection, too.

Possible mental health outcomes following a COVID-19 diagnosis included:

• anxiety
• depression
• substance use disorders
• neurocognitive decline
• sleep disorders

Using data from the U.S. Department of Veterans Affairs national healthcare databases, the researchers examined the risks of mental health outcomes among individuals who survived at least 30 days following a positive COVID-19 test between March 2020 and January 2021 (before the arrival of the COVID-19 vaccine).

Data for 153,848 subjects was compared with two control groups without COVID-19:

• 5,637,840 pandemic-era controls
• 5,859,251 pre-pandemic controls

Participants were largely white men in their early 60s, though women and minority groups were also included.

Results suggest that, compared to mental health disorders typically seen after influenza, a SARS-CoV-2 infection (the virus that causes COVID-19) exacerbated the risk of onset among the 150,000+ people observed.

Possible causes

Study co-author Ziyad Al-Aly, MD, chief of research and development at Veterans Affairs St. Louis Health Care System and a clinical epidemiologist, said the “neuropsychiatric manifestations” associated with long COVID could offer a possible explanation for the increased risk for mental illness following infection.

“We see higher risk in COVID versus flu. We also see higher risk in people hospitalized for COVID versus those hospitalized for any cause,” Al-Aly told Psych Central.

“All of this tells us that there’s something about the SARS-CoV-2 virus itself that may lead to the increased risk of mental health disorders. This may be related to changes in brain chemistry, neuronal connections, and brain architecture that may affect centers in the brain that are related to mood.”

Causation vs. correlation

A causal relationship seems to exist between COVID-19 and mental health.

A growing body of evidence shows that pandemic-related stressors have caused severe mental health and psychosocial problems worldwide.

In the United States, a growing youth mental health crisis has been exacerbated by the pandemic, with Youth of Color and other marginalized groups disproportionately affected.

And in September 2021, the Centers for Disease Control and Prevention (CDC) added mental health conditions to its risk list for severe illness from COVID-19.

Al-Aly said he and his team of researchers designed their study with a possible causal relationship in mind.

That’s why they looked at the risk of mental health outcomes in those who did not have underlying mental health conditions before infection, noting increased risks in onset among those individuals.

“The mayhem that COVID can cause does not surprise me anymore,” Al-Aly said. “It’s not the stress of having an infection or the stress of being sick or hospitalized. It’s more likely there are biological drivers of this — the virus may be doing something in the brain that’s resulting in all of this.”

Monica Gandhi, MD, MPH, an infectious diseases specialist with the University of California, San Francisco, offered another possible explanation.

“Anxiety, broken-heart syndrome, and fear of the unknown have been on the rise over the past 2 years, especially for those who contract COVID-19,” Gandhi told Psych Central.

According to Gandhi, anxieties and fears synonymous with the pandemic — mortality, morbidity, and ongoing symptoms — are common among those with COVID-19 and are compounded with conflicting reports in the scientific literature about long-term effects.

“The medical establishment owes it to society to convey factual information without hyperbole or increasing fear about the effects of COVID-19,” Gandhi said.

Limitations and future research

While the new study is composed of more than 11 million people, only about 150,000 individuals were examined closely, the majority of whom were older white men.

Still, the study was large in size. Data from other populations included:

• 10% female participants (more than 1 million)
• 20% Black participants (more than 2 million)

“I think we need to know more about the mechanisms of mental health disorders in people with COVID-19 and if there’s a way to reduce that risk in people who get COVID-19,” Al-Aly said.

“We will continue to delve deeper into this and follow people for a longer period of time. Our data was only for 1 year, and we would want to know what happens after 18 months and after 24 months. This is very important.”

Since the study data was collected, millions of people have been vaccinated, and researchers are making progress with various treatments for COVID-19. As treatment and prevention methods improve, the onset of mental health outcomes following COVID-19 may change.

Takeaway

Though COVID-19 may soon become endemic, the risk of infection may remain indefinitely. If you or a loved one have recently contracted the virus, you may wish to reach out to a mental health professional for support.

If you’re concerned about the long-term symptoms associated with the virus, which may include an increased risk for mental illness, a recent large-scale study on long-haul COVID speaks to the importance of vaccinations.

According to the results, those who received 2 vaccine doses were less likely to report long-haul symptoms than unvaccinated individuals. Vaccinated subjects reported no more frequent symptoms than those who had never contracted the coronavirus.

“We as a medical community should work hard on mental health concerns following COVID-19 diagnoses, tout the effectiveness of the vaccines, their ability to control longer-term symptoms, and convey the vast amount of conflicting information being put out about COVID-19 with compassion, humility, and reassurance,” Gandhi said.