The year 2020 will go down in history as one of the most devastating in history. Hundreds of thousands have died and millions have been hospitalized due to the novel coronavirus pandemic. COVID-19 has changed the lives of so many.
No matter where you live, dealing with the effects of economic and physical lockdowns in a community leads to multiple mental health challenges. After months of living with the coronavirus, many people are getting tired, burned out, and more and more frustrated.
In America, we face a particular challenge. Our federal government has chosen to take a backseat during the pandemic. Instead of leading the charge in fighting it, they have let the individual states choose their own path. This has led to continuing large numbers of Americans exposed to and infected by the coronavirus.
The Pandemic’s Mental Health Toll on Families
In a new survey published in the journal, Pediatrics (Patrick et al., 2020), we learn from a study of 1,011 parents just how much of a toll the pandemic has taken on the mental health of families. Over a quarter of people agreed that their mental health has gotten worse. And it’s no wonder — nearly half of people said they had lost access to childcare, a cornerstone of so many family’s stability.
Large numbers of people — nearly 40% of those responding to the survey — said they are forgoing children’s doctor’s visits out of fear of the coronavirus. The survey, called the Vanderbilt Child Health COVID-19 Poll, was distributed during the first week of June 2020.
The researchers noted:
Loss of childcare, delays in health care visits, and worsened food security were common among families experiencing worse mental and behavioral health.
Disruption in routines can be detrimental for children, especially those already with behavioral health diagnoses. For some children, this is complicated by challenges accessing traditional office-based services and the loss of mental health services that students may receive at school.
This is why so many school officials have been trying to weigh the public health benefits of keeping schools closed with the mental health needs of children. There are no easy answers.
Mental Health-Related Deaths May Rise
We learn from Elisabeth Brier’s reporting that these continuing challenges to our mental health may result in an increase in mental health-related deaths:
In May, the nonprofit Well Being Trust, in conjunction with the D.C.-based Robert Graham Center for Policy Studies in Family Medicine and Primary Care, published research that suggests conditions stemming directly from Covid-19—including widespread unemployment, social isolation, dread and a murky future—could lead to an estimated additional 75,000 deaths on top of those caused by physical illness. Fatalities from drug overdoses, alcohol abuse and suicide (otherwise known as “deaths of despair”) is what those on the front lines of mental health are working to combat.
And the mental health challenges and anxiety appear to be even worse in minority communities, which mirrors the disproportionate toll the coronavirus pandemic has taken against these communities:
Dr. Hairston, who also serves as the president of the American Psychiatric Association of Black Psychiatrists, echoes this experience; she’s noted an uptick in patients who are suffering from more severe mental health issues.
“There’s certainly been a surge of patients in crisis,” Hairston explains. “Particularly working with those from underserved communities, there’s added distress about housing, the fear of getting evicted and unstable unemployment stemming from the virus. All of the uncertainty definitely makes a lot of these cases more challenging. It can be difficult to reassure patients.”
Mental Health Consequences of Contracting COVID-19
Additional recently-published research suggests that COVID-19 may come with longer-term mental health consequences. Mazza et al. (2020) looked at the psychiatric health of 402 adults who had survived a COVID-19 infection a month after being discharged from the hospital.
The results were not encouraging. From both a clinical interview and a number of self-report measures, the researchers found that many of the recovered patients suffered from significant psychiatric symptoms:
28% for PTSD, 31% for depression, 42% for anxiety, 20% for [obsessive-compulsive] symptoms, and 40% for insomnia.
Overall, 56% scored in the pathological range in at least one clinical dimension.
In short, it appears from this early research that if you get seriously ill from COVID-19 and require hospitalization, you’d be in the minority to come away from the hospitalization without having significant psychiatric symptoms a month later. To be fair, some have called some of the study’s findings into question.
We’re only starting to understand what the long-term ramifications of a COVID-19 infection are. And while many are focused on potential chronic health problems associated with the disease, this is one of the first studies to look at the possible long-term mental health problems. As quoted in the above article, Dr. Dara Kass at Columbia University Medical Center notes:
“Just because you don’t die, it doesn’t mean that your life isn’t completely affected, and/or you don’t have new chronic disease. We are looking now at lung disease and heart disease and we also need to look at brain disease, and remember these are new chronic diseases that are accumulating as a result of the virus spraying. unrelenting, affecting people who are young and have lives ahead of them.”
It’s important that we acknowledge the toll the pandemic is taking on our mental health, whether or not we ever get COVID-19. Dealing with the constant unknown of what tomorrow may bring, school reopenings, economic insecurity, and not engaging in everyday social activities has an ongoing negative impact in most people’s lives. We’ve moved from an immediate reaction to the pandemic (“Let’s stock up on toilet paper!”) to a more chronic phase, one where the new normal is to get used to not quite knowing what tomorrow will bring.
Mazza, M.G. et al. (2020). Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain Behav Immun. doi: 10.1016/j.bbi.2020.07.037
Patrick, S.W. et al. (2020). Well-being of Parents and Children During the COVID-19 Pandemic: A National Survey. Pediatrics. DOI: https://doi.org/10.1542/peds.2020-016824