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The COVID-19 pandemic and mental health

Reviewed by Robert Bogenberger

A woman wearing a face mask.

Alongside its physical health risks, the COVID-19 pandemic has impacted our mental health in significant ways.

Between 2020 and 2021, the US Centers for Disease Control and Prevention (CDC) saw serious increases in symptoms of anxiety and depressive disorders among adults.1 A 2020 poll found that more than half of Americans felt the pandemic was harming them psychologically.2 Also in 2020, overdose deaths rose substantially in the United States.3

From grief to depression to anxiety, the effects of the pandemic have been severe—and COVID has also strained mental health care services, making it more difficult to get support.

Pandemic grief

Grief is a major mental health challenge of the COVID-19 era. Millions have died from COVID globally, and millions more have grieved lost loved ones, community, health, and experiences. Social distancing and pandemic stress, meanwhile, have made those losses harder to bear.

Lost loved ones

By September 2022, more than a million people had died from COVID-19 in the United States.4 Between April 2020 and June 2021 alone, approximately 140,000 children lost at least one parent or caregiver.5 A 2021 poll found that one in five Americans had lost a relative or close friend to COVID.6 Throughout the pandemic, people also lost family and friends to other causes.

Loss of community support

Grieving has been harder than usual during the pandemic: Social distancing, lockdowns, and quarantines made it challenging to hold funerals, gather, and receive support from our communities. In addition, COVID disinformation left some people less able to empathize with others who’d lost loved ones, or even unable to accept the loss of their own friends and family to COVID.

Long COVID

People affected by post-COVID conditions, or “long COVID,” have endured symptoms like fatigue, memory problems, difficulty breathing, and joint pain.7 Some have lost the ability to work, exercise, enjoy their hobbies, and take care of daily tasks.

Missed milestones

Whether or not they got sick themselves, most people missed or had major changes to milestones like graduations, birthdays, weddings, and holidays. Missing important events like these can also cause feelings of grief and loss.

Coping with grief

We all experience grief—but we don’t all experience it in the same way. Your grieving process may look different than someone else’s, even if you’re both grieving the same loss. There’s no “right” way to grieve, and there’s no “normal” grieving timeline. The best thing you can do in times of grief is acknowledge your feelings without judgment and rely on the support of friends, family, and a professional therapist, if necessary.

The effect of lockdowns

While lockdowns and quarantines have protected people’s physical health, reduced deaths, and lowered demands on health care systems, they’ve also had negative mental health effects, such as:

  • Increased loneliness and isolation: With less face-to-face interaction, many of us became lonely and isolated. Community events and services were often canceled, affecting everyone who depended on them for support and connection. Elders, people with disabilities, and immunocompromised people have been especially at risk, with more limited opportunities to socialize.
  • Inability to escape dysfunctional homes: Quarantining and shutdowns forced some to spend more time in stressful or abusive living situations.
  • Increased uncertainty: Lockdowns, reopenings, rising cases, and our evolving understanding of COVID have caused uncertainty and confusion. Navigating rapidly changing circumstances around work, school, childcare, and other services has been stressful.
  • Increased anxiety over day-to-day tasks: When everyday activities come with greater risk of COVID-19 infection, a trip to the grocery store can feel like a life-or-death decision. This has caused widespread anxiety and hypervigilance. For some, it may have caused or worsened symptoms of obsessive-compulsive disorder (OCD).
  • Reduced access to health care: Both mental and physical health care were harder to access during the first year of the pandemic in particular. Telehealth services soared, but not everyone’s care needs could be met virtually. In addition, hospital capacity issues put many nonemergency and preventative procedures on hold.

Discrimination and the pandemic

Throughout the US, the pandemic has often been much worse for people who already experience discrimination. Longstanding inequities in health care, living environments, workplaces, and communities were worsened by the stresses of COVID.

Indigenous, Latinx, and Black people faced higher risks of getting infected, being hospitalized, or dying from COVID-19.8, 9 A 2020 study showed that non-White nurses, and Black nurses in particular, dealt with workplace racism, racial microaggressions, and high levels of distress about COVID.10 LGBTQIA+ people, especially those of color, were likelier to lose their jobs or have their work hours cut.11 And due to caregiving requirements, traditional gender expectations, lack of paid leave, and health disparities, women—particularly women of color and low-income women—saw disproportionate stress and economic strain.12

Along with these and other major stresses, there have been increases in racial scapegoating and a spike in violence against Asian and Black communities (as well as other communities of color) during the pandemic, with hate crimes and incidents rising to a 12-year high in 2020.13, 14

COVID-19 and work

For frontline workers, long hours, increased stress, and challenging situations have led to trauma and burnout. Health care workers and first responders have suffered the trauma of treating COVID patients while being at higher risk of catching COVID.

Other pandemic work challenges include:

  • Job loss: Many service industry workers, especially in hospitality and restaurants, lost jobs at the beginning of the pandemic. Across the entire labor force, job losses were higher among women: Between February 2020 and January 2021, more than 2.3 million US women left the workforce, compared to 1.8 million men.15 Women with disabilities, Hispanic or Latina women, and Black women faced significantly higher pandemic unemployment rates than women and men overall.16
  • Unsafe work environments: Before vaccines were widely available, the politicization of masking made some workplaces riskier due to anti-masking customers, coworkers, or bosses.
  • Loss of income: Workers who lost jobs (or kept their jobs but lost valuable work or clients) struggled to make ends meet.
  • Change in abilities: Post-COVID conditions prevented some people from working at their pre-illness capacities.
  • Lack of work-life balance: Many non-frontline workers were able to work from home during the pandemic. This offered more protection from COVID, but it also created problems: For some, lack of work-life balance led to burnout, while others felt increased isolation and depression.
  • Lack of childcare: With schools on unpredictable in-person and virtual schedules and many daycares shut down, many parents, especially women, were forced out of work because they couldn’t access childcare.17

COVID-19 and children

As schooling moved online for safety reasons, students lost important developmental opportunities to socialize. Some struggled to learn without in-person support, resources, and structure.

Challenging pandemic precautions at school quickly accounted for a large percentage of younger children’s lives. Older students, meanwhile, missed milestones like graduation ceremonies, first jobs, school dances, sports events, driver’s ed, and going to college.

Like adults, kids of all ages have endured the isolation of social distancing and canceled events. And like adults, many have experienced more symptoms of anxiety, depression, and stress.

Vaccines and disinformation

The introduction of COVID-19 vaccines brought hope that life would return to a more normal state. The World Health Organization (WHO) and the CDC both confirmed the vaccines’ safety and effectiveness using reliable, inclusive data.18, 19

For most, COVID vaccines have significantly lowered the risk of infection, serious illness, and death. Fully vaccinated and boosted people can still get the virus and be contagious, but vaccines have reduced their risk of severe symptoms and made them likelier to avoid hospitalization.20

Despite these findings, vaccine disinformation has caused confusion and conflict between family, friends, and community members. Disinformation-fueled fear and outrage about vaccines have also increased people’s stress and anxiety.

Vaccine hesitancy hasn’t been unique to the COVID-19 pandemic, and people’s reasons for choosing to delay or refuse the vaccine are complex. Many vaccinated people have felt anger and frustration about people who choose not to be vaccinated—and both vaccinated and unvaccinated people continue to experience grief over losing loved ones.

Depression and anxiety

The pandemic’s array of stresses have caused or worsened symptoms of depression and anxiety for large numbers of people, affecting their work, relationships, energy, and ability to function.

Symptoms of depression include:

  • Feelings of sadness or hopelessness
  • Lack of interest in activities
  • Thoughts of suicide or self-harm
  • Anger or irritability
  • Restlessness

Symptoms of anxiety include:

  • Uncontrollable worry
  • Feelings of dread or doom
  • Difficulty concentrating
  • Irritability
  • Avoidance of people, places, things, or situations that worsen your symptoms

Anxiety and depression can make daily life difficult and less fulfilling, especially when they happen at the same time. If you have symptoms of either condition, there are many ways to find support. Browse our directory to find a specialist—or learn how to choose a therapist who’s right for you.

Post-COVID mental health

COVID-19 is a global trauma that will likely have future generational consequences. Past pandemics and disasters suggest that long after the COVID pandemic winds down, mental health challenges like posttraumatic stress disorder (PTSD), OCD, anxiety, and depression will continue for many survivors.

Generational trauma from COVID may have lasting effects such as:

  • Greater feelings of vulnerability
  • Hypervigilance against threats
  • Increased collective and individual fear
  • Changed attitudes and beliefs

Get help now

If you or a loved one are struggling with your mental health as a result of the pandemic, therapy can help. Visit our directory to find a provider near you.

The CDC’s COVID-19 mental health resource site, How Right Now/Qué Hacer Ahora, offers resources and information designed to improve the well-being of those most affected by pandemic-related stress, grief, and loss.

If you’re in crisis, help is available now. For free, confidential 24/7 support, please call the 988 Lifeline at 988 or 1-800-273-TALK (8255) or text “HOME” to 741741.

Sources

About the author

The editorial team at therapist.com works with the world’s leading clinical experts to bring you accessible, insightful information about mental health topics and trends.

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