COVID-19 & Mental Health

Reviewed by Diane Warns

While the COVID-19 pandemic has created dangers and risks for physical health, it has also impacted the mental health of people around the world. From grief to pandemic depression and anxiety, the effects of COVID-19 on mental health have been severe. With impacts to mental health services, COVID has also made it more difficult for people to seek help and get support for their mental health.

How Has COVID-19 Affected Mental Health?

COVID-19 has affected mental health in a variety of ways. Studies indicate that symptoms of depression rose in 2020 and 2021, with about 40% of people1 reporting some depression symptoms. Symptoms of anxiety2 also increased for many people throughout 2020 and into early 2021. In addition, overdoses, opioid-related deaths, and substance use all increased3 in the United States during 2020.

Pandemic Grief

One of the mental health challenges caused by the COVID-19 pandemic is pandemic grief. The grief experienced around the world was multifaceted. Not only have millions of people died from COVID globally, but people have also experienced grief over lost milestones and events. Such losses have been made more difficult by social distancing and COVID disinformation.

Loved Ones Lost to COVID

By October 2021, more than 700,0004 people had died in the United States from COVID-19. More than 140,000 children5 have lost at least one parent or caregiver. These numbers mean that many people have experienced the loss of a family member, friend, or coworker. 

One study in March 2021 suggested that one in five Americans6 had suffered the loss of someone close to them from COVID. In addition, people have died from causes other than COVID. The loss of a loved one for any reason is often difficult and may be traumatic, even during non-pandemic times.

Loss of Community Support

Due to the circumstances surrounding COVID-19, including social distancing and the disinformation surrounding COVID, grieving has been even harder during the pandemic than normal. Social distancing, lockdowns, and quarantines have impacted the ability of families to hold funerals and to grieve and receive support from their communities in normal ways. 

In addition, COVID disinformation affected people’s ability to empathize with those who lost loved ones or to accept the loss of their own loved ones to COVID. All of this has made the grieving process harder and may lead to more cases of prolonged grief disorder, an intense form of bereavement that can last six to 12 months or longer.

Long COVID

The COVID-19 pandemic didn’t only result in the loss of life. Individuals who experienced the effects of long COVID7, including difficulty breathing, fatigue, memory problems, and joint pain, may experience grief over the loss of their health. They may not be able to engage in activities such as work, exercise, hobbies, and daily tasks. 

Missed Milestones

Even for those who have not experienced COVID themselves, most people have experienced missed or altered milestones, including graduations, birthdays, weddings, and holidays. Missing these events and milestones can also create feelings of grief and loss for those who had been anticipating them.

Quarantine Depression: The Effect of Lockdowns

While lockdowns were necessary and important to protect physical health, reduce the number of deaths, and reduce the demands on health care systems, they also had unfortunate mental health effects. Some of these included:

  • Increased loneliness and isolation: With less face-to-face interaction during the lockdowns, many people experienced increased loneliness and isolation. The elderly, people with disabilities, and the immunocompromised have been especially at risk, with more limited opportunities for interactions.
  • Increased uncertainty: Lockdowns, reopenings, rising cases, and discussions about when or if people would be required to go back to the office all increased uncertainty. This led to more stress for many people as they tried to navigate rapidly changing situations for work, school, childcare, and other services.
  • Loss of community: Lockdowns meant that many community events were canceled during the pandemic. The loss of services also impacted people who used and depended on them. People accustomed to gathering regularly for religious purposes may have felt disconnected from communities that once brought them joy.
  • Increased anxiety over everyday tasks: With COVID-19, everyday activities came with increased risk of infection. Tasks like going to the grocery store could feel like a life-or-death decision. For many, this resulted in a state of increased anxiety and hypervigilance. It may have caused or exacerbated ritualistic cleaning behaviors associated with obsessive-compulsive disorder (OCD).
  • Reduced access to healthcare: On top of other effects, the lockdowns also reduced access to both mental healthcare and physical healthcare. Although telehealth services soared during the pandemic, not everyone’s healthcare needs could be met virtually. Many elective, nonemergency, and preventative procedures were put on hold due to hospital capacity issues.

All of these effects lead to an increase in anxiety and depression for people during the pandemic. A health poll in 20208 found that more than half of Americans felt that the pandemic was having a negative effect on their mental health. The number of people experiencing symptoms of depression and anxiety increased. Quarantine depression includes symptoms such as:

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

COVID-19 and Work

COVID-19’s effect on work also contributed to the rise in mental health challenges. Many frontline workers experienced long hours, increased stress, and challenging situations that led to trauma and burnout. Healthcare workers and first responders, in particular, suffered the trauma of treating COVID patients and being at a higher risk of catching COVID than others.

The pandemic also resulted in a number of changes to people’s work lives that often had negative impacts, including:

  • Job loss: Many people in the service industry, especially in hospitality and restaurants, lost their jobs at the beginning of the pandemic.
  • Working in an unsafe environment: Before vaccines were widely available, the politicization of masking meant that some people’s work environments may have felt unsafe due to anti-masking customers, coworkers, or bosses.
  • Loss of income: For those who lost a job or kept their job but lost valuable work or clients, the loss of income made it difficult for many families to make ends meet.
  • Change in abilities: Some people who contracted COVID-19 suffered long-term effects, such as long COVID, that may have prevented them from being able to work at the same level or capacity as they did before they fell ill.
  • Lack of work/life balance: Many people were able to transition from working in an office to working from home for much of the pandemic. Although working from home provided greater protection from COVID than working in an office, it also created problems of its own. Many struggled with work/life balance, contributing to higher rates of burnout. Others became increasingly isolated from never having to leave home, resulting in higher rates of depression.
  • Lack of childcare: Many parents, particularly women9, were forced out of the workforce due a lack of childcare services. With schools on unpredictable in-person and virtual schedules, as well as many daycares simply shut down, more than 2 million women in the U.S.10 were forced to give up their careers to provide care for their children.

COVID-19 and Children

COVID-19 affected children’s mental health in many of the same ways that it affected the mental health of adults. Many schools opted for online classes or Zoom school for safety reasons, which impacted some students’ academic learning and development. 

These precautions quickly accounted for a large percentage of young children’s lives. Today, children in second grade and younger. have only ever experienced pandemic schooling. 

Social distancing guidelines and cancelled events also led to a lack of socialization opportunities for children. Like adults, many children experienced an increase in symptoms of anxiety, depression, and stress due to COVID. Students were particularly affected by missed milestones, such as:

  • Virtual or cancelled graduations
  • Cancelled proms and school dances
  • Cancelled college campus tours
  • Delayed or deferred college plans
  • Cancelled sports seasons
  • Delayed driver’s education
  • Cancelled field trips and study abroad programs
  • Virtual, cancelled, or delayed internships
  • Delayed first employment experiences

COVID-19 Vaccines

The introduction of COVID-19 vaccines made many people feel hopeful that life would return to a more normal state. The World Health Organization (WHO)11 as well as the U.S. Centers for Disease Control and Prevention (CDC)12 have stated that the vaccine is both safe and effective according to several large, randomized controlled trials including people across all populations, age ranges, gender identities, ethnicities, and known medical conditions.

Findings from these clinical trials have shown that the vaccine is effective at preventing infection, serious illness that requires hospitalization, and even death from COVID-19—but it is not 100% effective. Fully vaccinated people can also still spread the virus to others. 

A fully vaccinated person who becomes infected by COVID-19 is referred to as a vaccine breakthrough infection13, however their risk developing severe symptoms—or any symptoms at all—is greatly reduced in comparison to unvaccinated people. They’re also more likely to recover faster and less likely to require hospitalization.

Despite these findings, disinformation about the vaccine caused confusion, disagreements, and strife between family, friends, and community members. Information intended to cause fear and outrage about vaccines contributed to increased levels of stress, anxiety, and fear.

Although vaccine hesitancy has not been unique to the COVID-19 pandemic and reasons for choosing to delay or refuse the vaccine are complex, the most common reason was that people had concerns about side effects.14 The Delta variant surge only added to the complexity behind vaccine hesitancy while also increasing challenges for both vaccinated and unvaccinated individuals. 

For the vaccinated, many felt anger and frustration over the number of people choosing not to be vaccinated, which contributed to the Delta surge.15 Both vaccinated and unvaccinated individuals continued to experience the grief of losing mostly unvaccinated loved ones.

Post-COVID Mental Health

Past pandemics and natural disasters suggest that mental health challenges will continue even after we enter post-pandemic life or a time when vaccines and treatments make COVID less of a risk. COVID-19 is a global trauma that will likely have generational consequences. Posttraumatic stress disorder (PTSD), OCD, anxiety, and depression may continue to be issues for many people. 

Generational trauma from COVID may have a lasting impact, such as:

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

Many people hoped they could address their mental health needs “after the pandemic.” However, “after” may never come—or, at the very least, it will not look like “before the pandemic.” 

The effects of COVID-19 will last long after the disease slows down or disappears entirely. If you are experiencing any struggles with your mental health during COVID, you are not alone. Reach out to a therapist today.