Caroline Ravello
Most of the writings I have done on mental health and the pandemic have dealt with the general well-being of the entire population. Using research and anecdotes from my experience, I have tried to keep the conversation going about self-care, especially the care of the mind, to encourage us to take control of our mental health and emotional well-being.
Mental health mending must not be considered an automatic reflex. While there are those who will heal quickly or easily after an infraction, for many of us, the severity of the issues with which we have dealt–isolation and quarantine, fear of infection, infection, death, lockdowns and stay-at-home orders–are sufficiently severe to have caused lasting injury.
“Social isolation, loneliness, stress and anxiety, domestic abuse, bereavement, financial difficulties, unemployment and severe COVID-19 infection are all factors that might have caused people’s mental health to deteriorate,” says the president of England’s Royal College of Psychiatry (Medical News Today).
Studies in the general population have shown increased prevalence of depression, anxiety, stress, and PTSD, to name a few. Studies among first responders are also showing similar characteristics.
Early studies in 2020 found various levels of psychological/mental health distress. Many suffered vicarious traumatisation–trauma derived from witnessing other people’s trauma or traumatic events–and this was found to be not only among healthcare workers but in the public, among people with pre-existing psychiatric conditions, and among those quarantined.
There is, however, another group of great concern with increased prevalence of mental illnesses according to researchers. As early as 2020 there began measurements of people’s coping ability and changes in mental health status among those who had been infected and those who were hospitalised with COVID-19.
One 2020 study in China looking at neuropsychiatric outcomes of patients who were isolated in hospital wards with COVID-19 infection found those patients reported a higher psychological impact. They were found to have higher levels of depression, anxiety, and stress compared to people with pre-existing psychiatric conditions, and healthy individuals.
Several issues compounded people’s level of psychological resilience. This particular study said that added to the perceived threat, people’s susceptibility due to pre-existing conditions, their levels of physical discomfort and the severity of infection plus other stressors, patients who were hospitalised and isolated experienced “anger, fear, hysteria, depression, anxiety, and other psychological issues.”
In 2022, the Washington University School of Medicine published their findings from a large study of mental health outcomes in those with COVID-19 infections. They reported that people who were infected were at significantly higher risk of mental health problems.
The report said that mental health disorders “arose within a year after recovery from the virus in people who had serious as well as mild infections” compared with those who were not infected. And, among the former, disorders included “anxiety, depression and suicide ideation, as well as opioid use disorder, illicit drug and alcohol use disorders, and disturbances in sleep and cognition.”
Researchers found, in post-infection people in the US compared with those without infections, pe3ople were 35 per cent more likely to suffer from anxiety disorders and almost 40 per cent more likely to experience depression or stress-related disorders. They also reported simultaneous higher use of antidepressants (55 per cent increase) and anxiety treatment/drugs (65 per cent).
Those who recovered from COVID-19 were also found to be 41 per cent more likely to have sleep disorders. And, among them, neurocognitive decline, which includes forgetfulness, confusion, brain fog and lack of focus, was as high as 80 per cent.
The study also pointed to an alarming increase in opioid disorders and non-opioid substance use disorders (alcohol and illegal substances) in that US sample and that group was 46 per cent more likely to have suicidal thoughts.
Of course, none of these studies can offer precise measurements of psychological distress and mental disorders, especially where many people would not disclose their feelings, symptoms or illnesses due to stigma–perceived and real, systemic and self-stigma–and the fear of being discriminated against.
What we have from these estimations is a sense of the magnitude of the issue and how it is distributed among all levels of the population–healthy, COVID-19 infected, infected and hospitalised–requiring national or population interventions which we hope are forthcoming. But knowing what we do, it is important that we each take stock of our circumstances.
All of us have been affected and all of these issues have major health impacts on behaviour and emotions, so it is important for each of us to find pathways to better health and well-being. More importantly, if you had a COVID-19 infection, you would do well to have an evaluation of your mental health and emotional well-being.