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When you hear “post-COVID depression,” you probably think of extreme stress and mental health. After all, we know these are the side effects of simply living through a pandemic. That’s not all. As it turns out, coronavirus isn’t just a respiratory virus. Its unique microbial structure and symptoms seem to worsen underlying mental health disorders. Researchers are looking into whether COVID-19 causes them as well.
Whether you’ve been infected with the virus or not, there are real implications of the pandemic on our health. Read on about how the social and physical symptoms of the COVID-19 pandemic affect your brain, your mental health, and how to seek help to treat both.
How does COVID-19 affect the brain?
COVID-19 quickly gained a reputation as a respiratory illness, and for good reason. In the early days of the pandemic, when little was known about the virus, ventilators were in scarce supply. The number one symptom to watch out for was shortness of breath (along with loss of taste and smell). It would make sense, given the stress and fear prevalent at the time. However, this caused us to generally dismiss anxiety and depression as being COVID-related. Pandemic and crisis-induced, sure — but not a diagnosable by-product of the virus itself.
Estimates vary of how many patients experience neurological symptoms (as well as other physical symptoms of the virus). Regardless, it seems clear that COVID has a marked impact on both cognitive functioning and emotional health. And because the brain is the control center of the body, neurological symptoms vary widely. Individuals experience everything from brain fog to sleep disruption to symptoms resembling dementia.
Reports of the 1918 flu epidemic showed similar trends. People cited similar symptoms, like cognitive impairment and sleep disturbances. Additionally, about 15-20% of recovered SARS (2002) and MERS (2012) patients showed signs of depression, anxiety, exhaustion, and memory issues. Historically, it seems likely that COVID-19 has a similar impact.
That’s not to say that coronavirus directly infects the brain. According to researchers at Johns Hopkins, there seem to be four ways that COVID can potentially affect the brain. This includes severe infection, an immune system in overdrive, chaos in the body, and blood-clotting abnormalities.
1. Severe infection
In a study of patients who died from COVID-19, researchers found changes in the brain tissue. But there was something unusual: there was no evidence that the virus was present in the brain. These tissues did reveal “signatures of inflammation, abnormal nerve cell communication, and chronic neurodegeneration.” These symptoms are similar to those of patients with cognitive impairments and disorders (like schizophrenia and Alzheimer’s).
2. Hyperactive immune system
Johns Hopkins hypothesizes that the immune system may produce an overly-strong response to try to fight severe COVID-19 infections. This makes sense in light of the above research on inflammation, which is usually the immune system’s second line of defense. An extreme response, however, could damage organs and tissues, similar to an autoimmune disease.
3. Chaos in the body
Given the severity of COVID-19 symptoms, it seems likely that the body (and brain) could respond with both mental and emotional distress. After all, we know that our physical and mental well-being are linked. Stress on the body has an impact on cognitive function and mental health. When added stress impacts critical functions like respiration and movement, it can cause chaos.
4. Blood-clotting abnormalities
The final theory is that the infection disrupts the normal healing and clotting process in the body. COVID patients are much more likely to develop blood clots. That also might explain the increased tendency for COVID patients to experience strokes. Those patients who experience strokes often experience long-term neurological symptoms.
7 symptoms of post-COVID depression
Researchers have started to look at the occurrence of depression in recovering COVID patients. Scientists found that over 50% of patients were likely to display symptoms — with nearly a quarter of those being considered clinically significant. Researchers used self-reporting questionnaires to assess COVID depression, which shares symptoms with major depressive disorder. Here are several signs and symptoms of depression in COVID-19 patients:
- Feeling sad, listless, or hopeless
- Not seeing the point in trying to recover
- Little or no reaction to others being infected with or dying from COVID
- Uninterested in trying to resume daily activities or hobbies
- Withdrawal from social interactions and relationships with loved ones
- Reluctant to make plans for the future
- Fearful of catching COVID — or conversely, lax about precautions because “there’s no point”
Mental health consequences of COVID-19
Although related, the mental and cognitive effects of COVID-19 go beyond depressive symptoms. Patients have reported long-term cognitive disruption, including:
- Brain fog, forgetfulness, and decreased performance on cognitive tasks
- Distraction, poor focus, and concentration
- Sleep disturbances, including insomnia
- Symptoms of anxiety and COVID PTSD
- Frequent headaches
- Increased or problematic substance use
- Compassion and empathy fatigue
- Symptoms of burnout
- Increased risk of developing a mood disorder, or dementia in older adults
Beware of pandemic fatigue
Even if you were never diagnosed with COVID-19, the pandemic has likely had an impact on your mental health. Life has changed for everyone since the first lockdowns started in early 2020, and if anything, life is even more uncertain as we enter the third year.
The depression related to COVID isn’t just a symptom of the disease itself, but also a mental and emotional consequence of the global crisis. Most people and health care providers report increased symptoms of anxiety and stress since COVID started. Social distancing has put emotional strain on relationships and logistical strain on workplaces. Caregivers of small children, aging parents, and sick family members are under even more strain. Many say that they’re hitting a breaking point.
The human brain is designed to look for patterns, and for that reason, routines are very comforting. We feel more secure when we know what to expect. But the very nature of a once-in-a-lifetime, novel coronavirus outbreak is that no one quite knows what to expect. There’s no timeline for a return to normalcy, no real idea what normalcy will look like, and our routines are constantly being made and remade. This is a major disruption to our daily patterns in response to new cases, new variants, and new social distancing and health regulations.
There’s a bi-directional relationship between some mental health conditions and COVID infection. We need to determine what we can do and identify which actions can make us feel more secure about protecting our mental and physical health.
How can I cope with post-COVID depression?
Whether you were diagnosed with COVID or are mourning the loss of normalcy, it’s important to be proactive about treating your post-COVID depression. Here are some ideas for how you can cope:
1. Create new routines
It’s hard to keep your rhythm going when you don’t know what the next day, week, or year will look like. Think about what you can control that’s COVID-independent. Can you start doing virtual workouts, work from home, or take up a new hobby? Try to wake up and go to sleep at the same time every day, and get dressed (something that you didn’t sleep in) even if you’re not going anywhere.
2. Maintain social connection
Make time to talk to friends and family. Even if you can’t meet in person, give them a call or connect over social media. Look for new ways to bond, like reading a book together, starting a new favorite series, or “meeting up” for an online yoga class.
3. Manage physical symptoms
If COVID, anxiety, or depression is leaving you feeling fatigued, do what you can to manage your physical well-being. Make sure that you’re getting enough sleep, moving your body, eating nourishing food, and drinking enough water. Illness and depression can both affect your ability to care for yourself.
4. Take precautions
As the pandemic stretches on, it’s easy to want to let go of the precautions that we all adhered to at the beginning of the crisis. You can only maintain a state of constant vigilance for so long before you begin to adapt to your new circumstances. Maintaining practices like social distancing, masking, and disinfection can help you retain a sense of control over your well-being. Letting these habits go could do more than harm your health. It could make you feel like you’re giving up.
Know when to seek help
Researchers have never been sure whether depression is circumstantial, biological, or genetic. In today's world, the answer has the potential to be all of the above. But with COVID-19, we have a perfect storm of stressors and risk factors that make depression, anxiety, and other mood disorders more likely.
For some, you might start to feel it in your body before your mind recognizes that anything is off. You might have a friend or family member draw attention to changes they’ve observed. Or you might notice your friend or loved one seems to be struggling — and you want to help.
Regardless of the reason for your depression (or a loved one), if you recognize yourself in any of these symptoms, it’s important to be proactive. Don’t hesitate to seek the services of a mental health professional. If you need to speak with someone immediately, please call 800-273-TALK (8255). They answer every call, and they’re available 24/7.
BetterUp Staff Writer