The truth about the mental health impact of COVID-19
A year ago if you had muttered the words quarantine, lockdown or physical distancing, it probably would have been in reference to an apocalypse film where two of the last people on earth are fighting out against the end of the planet. We would have considered a global pandemic as something we would only experience through our screens. Yet, since March last year these words have, increasingly, become part of our rhetoric, to the point that they are beginning to feel mundane. The impact of these words and what they mean is undeniable, in particular there has been growing concern over the mental health impact of the current pandemic. Are the changes that aim to keep people safe from COVID-19 having an even more frightening effect on the mental stability of our population?
Last week, a study that had been analysing the changing mental health of those with and without mental health conditions, before and during the initial lockdown, was released. This study used ongoing data collection on a large number of participants within the Netherlands, on depression, anxiety and obsessive-compulsive disorder. The newly released study combined the previously collected data and new data from online questionnaires that had been sent to the same participants. This meant that the changes over a long period of time could be compared, allowing for a more accurate understanding of the mental health impact of the pandemic. The study focused on how severely the participants felt that the pandemic had affected their mental health and the changes in their symptoms associated with common psychiatric conditions.
Why is mental health a growing concern with the ongoing COVID-19 pandemic?
The report suggested several reasons why the current climate could lead to an increase in mental health problems. Specifically, the increased financial instability and smaller social networks; two common characteristics among people with mental health conditions. This isolation and economic decline have increased potential stressors and triggers for declining mental health for many individuals.
Another potential stressor for declining mental health is the changes to how healthcare services are provided, as the priority to prevent the spread of COVID-19 takes the forefront, and therefore decreased access to psychiatric care.
The current increased risks to our mental health highlighted an urgent need to quantitatively understand the impact of COVID-19 regarding the mental health of the population, and this study aimed to tackle this need.
What were the results of this study?
The new data collected for this specific study, compared with the previously collected data, showed that those with more severe or chronic mental health conditions reported "a greater impact on their mental health and less positive coping with the pandemic than those without". Additionally, the overall number of mental health symptoms related to depression, anxiety, worry and loneliness, remained significantly higher in those with chronic mental health conditions than those without.
However, although the number of symptoms remained higher, there was not an overall increase in symptom severity in those with chronic psychiatric conditions. In fact, a few analyses suggested an average significant decrease in symptom severity (1). By contrast, individuals without chronic mental health conditions showed a larger increase in symptoms related to depression, anxiety, worry and loneliness, suggesting that it was these group of individuals that had seen a greater change to their mental health at the beginning of the lockdown.
Of particular interest is that those with chronic psychiatric conditions may have experienced a decrease in symptoms severity, and those without chronic psychiatric conditions saw a greater increase in symptoms of declining mental health.
Suggested explanations for the decreased symptom severity in those with pre-existing mental health conditions
With lockdown strategies introduced to decrease virus transmission, individuals with severe mental health disorders might experience some sense of relief as their preferred habits become shared lifestyle features in all of society. Staying at home may help these individuals build a structured daily routine, providing a feeling of safety.
Additionally, the recovery of participants with mental health conditions over time may be reflected in the decline in symptom severity, therefore representing the natural evolution of these conditions over time.
In conclusion, the continued study of the long-term mental health consequences of the COVID-19 pandemic remains key in order to target the change in mental health support as the pandemic continues and the consequences unfold. Understanding the ongoing increased risks to our mental health throughout this pandemic will ensure sufficient improvements and changes within current mental health provisions.
This pandemic has proven to be, and continues to be, a massive challenge for the whole population, and while the Netherlands study did not focus on students, our lives as students have drastically changed. University life used to mean constant social interactions with many students, but now we have to remain isolated from the extensive student body. This remains a struggle for us all and many of us may have mental hurdles to overcome during this time. It is more important than ever to reach out to those close to you, or other professional bodies, if you are struggling in any way.
Samaritans is just one of the many charities that provide confidential support for those experiencing feelings of distress. They are a free 24-hour helpline. them Their contact number is 116 123. Do not hesitate to get in contact with them if you are struggling.
Link to full paper: https://www.thelancet.com/action/showPdf?pii=S2215-0366%2820%2930491-0
Reference 1-3: Correction to Lancet Psychiatry 2020; published online Nov 16. https://doi.org/10.1016/S2215-0366(20)30435-1. The Lancet Psychiatry. 2021;8(1).