COVID Long Haulers: Mental Health Effects

Courtesy of Chuying Huo

In 2020, the coronavirus disease of 2019 (COVID-19) virus swept the world off its feet and wreaked havoc on people around the globe. With more than 177.8 million reported cases and 3.8 million deaths reported, there is no doubt that this virus will have lasting impacts on society (New York Times, 2020). Although vaccines are being distributed and slowing down infection rates, there has been a lack of attention concerning the mental health impacts of COVID-19 on individuals. Today, we will explore the long-term mental health impacts of the COVID-19 virus on various groups of people with different social and economic circumstances. Specifically, the long-term effects on the general public, survivors, healthcare workers, and those with pre-existing mental health problems. By examining how racial, economic, and social disparities influence the long-term mental health effects, we can work towards creating effective long-term solutions.

Effects of Mass Quarantine on the General Public

Although some level of fear, confusion, and anxiety is felt by the general population during the pandemic, there is the challenge of isolating the direct long-term mental health effects of COVID-19 versus mass quarantine. Most of the potential long-term mental health effects of the pandemic such as an increase in social anxiety, depression, and Posttraumatic stress disorder are caused by mass quarantine (Newby, 2020). However, the economic instability directly caused by the virus plays an immense role in mental health decline during and after the pandemic. Employment, income levels, housing and food security in households are driving factors of uncertainty which adults transfer onto children. According to a study published by Kaiser Family Foundation (KFF), 53% of adults who experienced a job loss or lower incomes reported symptoms of mental illness versus 32% from financially stable households (Panchal, 2020). Social support, optimism, regular exercise, and mindfulness are ways to reduce the risk of long-term mental health effects for the general population.

Impacts on COVID-19 Survivors

Although the general population can implement simple strategies to increase resilience, those who have contracted the virus have higher risks of long-term mental health effects such as PTSD, depression, and a fear of hospitalization. According to Megan Hosey, a rehabilitation psychologist, prolonged time in the ICU can cause delirium and in some cases hallucinations of healthcare workers trying to harm them (Chung, 2021). The strange surroundings, mind-altering medication, and isolation can cause patients to have a recurring sensation of dread and terror. A study published in JAMA Psychiatry found that around one-third of COVID-19 survivors could experience PTSD (Janiri, 2021). COVID-19 patients can carry emotional scars from the virus in the form of nightmares, flashbacks, and agitation. Consequently, family members and close friends of survivors have a higher risk of long-term mental health issues by association.

Effects on Individuals with a History of Mental Health Problems

For individuals with a history of mental health problems, the long-term mental health effects of COVID-19 can be detrimental. Often, those with pre-existing mental health problems are also struggling with poverty, racial disparities, and substance abuse (Newby, 2020). An article from Business Insider stated that those struggling with substance abuse can worsen during a pandemic (Wilson, 2020). From past pandemics, we can see a rise in alcohol sales, suicide rates, depression, and PTSD (Kousoulis, 2020). One of the largest driving factors of this issue is the lack and unequal access to mental health support during the pandemic. An article from BBC reported that the pandemic can cause individuals with pre-existing Obsessive-compulsive disorder to regress (Savage, 2021). Combined with the uncertainty, fear, and anxiety of the pandemic, some individuals with OCD have developed severe germaphobia. During the 2003 SARS pandemic, there was a 30% increase in suicides in people over the age of 65 and a list of risks attached to quarantining individuals with pre-existing mental health issues including depression, insomnia, and PTSD (Panchal, 2021). Because the COVID-19 pandemic affected a greater population than SARS, the negative consequences are consequently amplified.

Impacts on Healthcare and Essential Workers

While society is shut down and the general public is at home, healthcare workers and essential workers are carrying the emotional brunt of the pandemic on their backs. Business Insider reported that healthcare work experiencing anxiety puts them at higher risk for depression, burnout, and PTSD (Wilson, 2020). Among healthcare workers, the stigma associated with contracting COVID-19 can cause stress, shame, and avoidance. There is also an increased risk of healthcare workers who contracted the virus leaving the industry after COVID-19 due to the shame of coming back. To cope with the high stress levels, healthcare workers have an increased risk of developing a substance addiction. Essential workers also reported significantly higher rates of poor mental health during the pandemic. According to a study conducted by KFF, compared to non-essential workers, essential workers reported a higher percentage of depression (42% vs. 30%), substance abuse (25% vs. 11%), and suicidal thoughts (22% vs. 8%) during the pandemic (Panchal, 2021). Aside from the risks mentioned for healthcare workers, they worry about affording necessities and economic disparities.

 

Racial Disparities and Mental Health Effects

Racial disparities which appeared before and due to the COVID-19 pandemic increase the risk of long-term mental health effects of minority populations. A study conducted by KFF found that the pandemic disproportionately affected people of color, with 48% of black adults reporting depressive disorder compared to 41% of white adults (Panchal, 2021). For Asian Americans, COVID-19 brought a surge of xenophobia and anti-Asian hate. An article published in Psychology Today stated that the media has played a large role in perpetuating negative Asian stereotypes and discrimination in COVID-19 (Aten, 2020). This same article found that perceived mental discrimination is correlated with a mental illness diagnosis, and can support inferences of the impact of discrimination through the media, continuing the cycle. Possible long-term effects of anti-Asian discrimination include post-traumatic stress disorder, generalized anxiety disorder, substance and alcohol abuse disorders (Aten, 2020).

Limitations

While conducting the research, the first and foremost challenge was the lack of established and concrete data surrounding the long-term effects of COVID-19 specifically. In regards to the general population, it was challenging to separate the mental health effects of quarantine from the direct effects of COVID-19 specifically. A large portion of the research available was the short-term mental health effects of COVID-19 or the potential long-term effects. Another portion of the research conducted used past pandemics such as SARS and influenza to predict the long-term effects of COVID-19. However, we tried to use a combination of reputable news sources such as the New York Times and BBC, combined with research from journals to provide an informative synopsis of the long-term mental health impacts of COVID-19.

Strategies and Solutions

Although there are potential long-term detriments to mental health afflicted by the COVID-19 virus, there are strategies and solutions to prevent, mitigate, and recover from its effects. An article from BBC found that some have even found the pandemic positive for their mental health, giving them a break from the chaos of the outside world (Savage, 2020). The Australian Black Dog Institute found that for those struggling with finances and small businesses, governments providing relief would remove a large portion of stress (Newby, 2020). The same study found that providing easily accessible reliable and high-quality information about the pandemic is key to minimizing panic and preventing long-term mental health impacts from the pandemic. Government officials putting more attention to the pros versus cons of mass quarantine and increasing transparency are ways to minimize long-term damage (Zhou, 2021). According to the Mary Ann Libert journal, establishing mental support systems for healthcare workers and survivors is a strategy for recovery in the long run (Zhou, 2021). Telehealth such as texting and video calls can be used to both monitor COVID-19 patient’s physical symptoms and mental health state to prevent long-term damage. In conclusion, although COVID-19 has afflicted long-term mental health impacts to global populations, together we can work together to mitigate the harm and fight the stigma of mental health in society.

About the Author

 

Chuying Huo is a Canadian high school student from London Central Secondary school. Outside of CVT, she enjoys journalism, policy research, and classic novels.

References

Aten, J., & Crowder, A. (2020). Long-Term COVID-19 Mental Health Effects for Asian Americans. Psychology Today. https://www.psychologytoday.com/us/blog/hope-resilience/202004/long-term-covid-19-mental-health-effects-asian-americans.

Chung, T. (2021). COVID ‘Long Haulers’: Long-Term Effects of COVID-19. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-anddiseases/coronavirus/covid-long-haulers-long-term-effects-of-covid19.

Favaro, A., Philip, E. S., & Jones, A. M. (2021, March 8). COVID-19 survivors struggle with nightmares, anxiety and other PTSD symptoms, research shows. Coronavirus. https://www.ctvnews.ca/health/coronavirus/covid-19 survivors-struggle-with-nightmares-anxiety-and-other-ptsd-symptoms research-shows-1.5337674.

Friedman, R. A. (2021, May 4). You Might Be Depressed Now, but Don’t Underestimate Your Resilience. The New York Times. https://www.nytimes.com/2021/05/04/opinion/covid-brain-mental-health.html.

Janiri, D. (2021). Posttraumatic Stress Disorder in Patients After Severe COVID-19 Infection. JAMA Network. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2776722.

Kousoulis, A., Bortel, T., Hernandez, P., & John, A. (2020, May 5). The long-term mental health impact of covid-19 must not be ignored. The BMJ. https://blogs.bmj.com/bmj/2020/05/05/the-long-term-mental-health-impact-of-covid-19-must-not-be-ignored/.

Newby , J. (2020). Mental health ramifications of COVID-19: the Australian context. Black Dog Institute. http://www.blackdoginstitute.org.au/wp-content/uploads/2020/04/20200319_covid19-evidence-and-reccomendations.pdf.

Panchal, N., Kamal, R., Cox, C., & Garfield, R. (2021). The Implications of COVID-19 for Mental Health and Substance Use. KFF. https://doi.org/https://www.kff.org/coronavirus-covid-19/issue-brief/theimplications-of-covid-19-for-mental-health-and-substance-use/

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