The Mental Health Implications of COVID-19

COVID-19 has impacted most of 2020—and the future is still unsure. Will we have a second wave? What are the long-term health implications? These questions feed into another that I have: what are the mental health implications of COVID-19?

Often we have examined more tangential issues such as the lack of PPE or the economic costs of COVID-19 and the lockdown. However, there is more to the impact of this pandemic than these concerns.

Healthcare providers are being overworked and carry the fear of being conduits for the virus. The rest of the American citizens in lockdown are feeling isolated, anxious, depressed, and stressed over the future. These things that we are feeling and thinking are going to have major implications in the future.

In this article, I will examine how COVID-19 is impacting our mental health and offering hope to ward away some of that doom and gloom.

The Impact of COVID-19 on Healthcare Workers

Healthcare workers face a unique challenge for being at the forefront of the COVID-19 Pandemic. Both nurses and physicians have a high probability of experiencing some sort of mental health deterioration because of COVID-19.

One early study shows that those caring directly for COVID-19 patients are more likely to experience symptoms like anxiety and depression. Often this means women and nurses, and of these groups, 10 to 20 percent are scored as experiencing moderate to severe symptoms. If we examine further, we can see that there were high rates of depression (50 percent) and distress (75 percent) amongst the 1257 participants.

Further research has found that healthcare workers are more susceptible than other groups for mental health issues. This is caused by factors like overwork and overstress, a lack of PPE, feeling insecure, and the hypervigilant news media. The existential dread of getting infected or spreading it to family and coworkers also plays a major role. There is a historical basis for mental health issues in healthcare workers during major crises as well. Studies done for the SARS outbreak showed very similar mental health effects, such as depression, anxiety, and trauma.

Trauma is a notable factor in the healthcare implications of COVID-19. The research is clear in suggesting that healthcare workers can experience symptoms like stress, anxiety, depression, and insomnia from the pandemic. These are all major contributors to post-traumatic stress disorder (PTSD)—and this has the potential to be a major concern in the future. While the causes are unique, these effects are more widespread outside of healthcare workers.

Let’s examine how others facing lockdown and job loss are fairing mentally.

The Impact of COVID-19 on Non-Healthcare Workers

Much like healthcare workers, those placed in quarantine or lockdown face many of the same mental health challenges. People will experience symptoms similar to PTSD, though it may not be diagnosed as such. This was also seen in the aftermath of the SARS outbreak. There’s a chance the COVID-19 pandemic will cause similar issues, and maybe even more so due to the scale of it.

“When we think about traumatic events, it’s not just what the event is; it’s really your interpretation and what the event causes for you,” says Luana Marques, a clinical psychologist and president of the Anxiety and Depression Association of America. For many, COVID-19 is one of the worst crises they’ve faced in their lives.

Those who are on the front lines, or who have experienced true loss from the pandemic are more susceptible to PTSD. This isn’t unique to those people though, as anyone can experience these symptoms because of this.

“Our society is definitely in a collective state of trauma,” says Jonathan Porteus, PhD, and overseer of the crisis and suicide hotline in Sacramento, CA. According to a Kaiser Family Foundation poll, 56 percent of participants said they experienced worsened mental health from stress or worry.

Mental health first responders have also noticed an uptick in calls or crisis cases. Sacramento noted a 40 percent uptick in calls from February to March, and many respondents have noticed COVID-19 being a primary focus in conversations.

Certainly, we are going to be facing long-term fallout from this pandemic. Before I look at this aspect though, it’s important to dive into a major component of immediate stress inducers: social isolation.

Rising Social Isolation

Lockdown and isolation are not new to a disease outbreak. In fact, it’s a very standard practice to mitigate the spread. Quarantine is a necessary tactic in fighting disease, but that does not mean it comes without its own problems. After all, this plays a unique role in the mental health impacts of everyone in the pandemic.

Social distancing practices will have major implications for our mental health in the future. A large body of research points to isolation and social distancing as causes for depression and substance abuse. Recent data has shown that 47 percent of those under shelter-in-place measures have reported negative mental health effects. Compare this to 37 percent who reported the same effects that are not under shelter-in-place orders. Those that regularly deal with depression and anxiety face a greater risk of worsening symptoms as well.

A few major mental health issues arise when one is under isolation for too long. One common effect seen is a rise in suicidal ideation. Isolation is well known to be a factor in suicidal ideation. Life expectancy and physical health can also deteriorate during isolation.

Beyond these side effects, depression, anxiety, stress, and low self-esteem can all arise from social distancing. All of these effects can lead to antisocial behaviors like substance abuse in the future.

Long-Term Effects of COVID-19

Now that we’ve covered some of the issues we face now, it’s important to think about how this impacts our future.

Unlike COVID-19, mental health issues can’t be vaccinated against, so we must consider how to handle the uptick America may face after all is said and done. There have been discussions on a looming mental health crisis in America. If this happens, it can realistically occur in other places as well. Like Italy, Brazil, China, and other nations hit hard by the virus.

After major catastrophes and traumatic events (e.g., 9/11, hurricanes, wildfires, etc), there is a noted uptick in depression and other mental health effects. Inside of America, the lack of a robust public healthcare system adds unneeded stress to the pandemic. Compounding this issue, before the pandemic, many Americans already lived paycheck to paycheck. With the sudden loss of approximately 40 million jobs, the mental health effects with all of these factors taken into account can be significant.

We must also consider some of the far-reaching effects of being in quarantine. Many family dynamics are tumultuous, with domestic and child abuse victims no longer being able to find respite. Peoples’ identities have taken a hit as well. Students that have grown up in grade school, or in their last years of higher education have had that taken from them. Tens of millions have lost their jobs, which many view as a vital part of their identity.

There will be many side effects from COVID-19, and we as healthcare professionals and mental health specialists must maintain vigilance to address these, both now and in the future.

Maintaining Hope: How Individuals Can Safeguard Their Psychological Health in Uncertain Times

The real impact of how this pandemic will affect our mental health is still too far out for us to be completely accurate. We can look back into history and see how SARS quarantines affected people, but I don’t think that and COVID-19 are truly comparable—not when we consider the scale of measures taken to mitigate the spread.

Here are some ways you can ward off these negative thoughts and hopefully prevent any mental health illness. One major way is, of course, self-care. I understand it can be difficult to maintain in times like these, but maintaining a healthy diet, a proper sleep schedule, and exercising regularly will do wonders for your mental health. It helps to unplug sometimes as well. When news comes out at a rapid rate, with some things being pure speculation and rumor, it only worsens the stress you may feel.

Telemedicine is also a great way to prevent, or treat, any mental illness. It has seen a steady increase in usage over the years. Of course, it was pushed to the forefront of medicine in the midst of the outbreak, and will most likely be a mainstay from now on.

Finally, we must remember that positive change can only happen from top to bottom. Not only can the individual work to better their mental health, but so can employers, businesses, and policymakers. Alleviating things like unemployment and increasing opportunities for education and structure in one’s lives can do wonders for mental health.

It is important to emphasize that we are not in a mental health crisis yet. A bleak future with the widespread ramifications of PTSD, depression, and anxiety does not have to happen. It will take effort from everyone, and in different ways, but there is always hope for a better future.

Melissa DeCapua, DNP

Melissa DeCapua, DNP

Writer
Dr. Melissa DeCapua is a nurse practitioner working at Microsoft on organizational behavior and culture change. She began her career in psychiatry and fine arts, and these skills fuel her passion for user experience (UX): building programs, conducting qualitative research, and designing services. By night, she continues to advocate for nurses through lobbying efforts, blogging, and volunteering. For more about Melissa, check out her website and follow her on LinkedIn and Twitter.

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