The spread of the Coronavirus has had worldwide repercussions, causing an economic and health crisis, including in reference to mental health. In fact, many scientific studies document the relationship between the Covid-19 pandemic and the growth of manifest psychological problems such as: anxiety, depression, and post-traumatic stress disorder (PTSD).
A fertile ground for the development of depressive disorders, in particular, is:
- fear of infection, death of loved ones and self;
- socialisolation;
- the change of life habits ;
- the distress related to the bereavement of one’s family members;
- the distress related to the increasing unemployment induced by the pandemic.
In this article we will focus on the relationship between covid and depression and ways to deal with this issue.
Depression and Covid-19: some studies
We review some studies that explore the relationship between Covid-19 and depression. A well-known study fromIRCC San Raffaele Hospital in Milan, carried out in March 2021 and conducted on 226 patientstaken care of by the post COVID-19 follow-up outpatient clinic, observed that at 3 monthsafter discharge, about one-third of patients hospitalized for severe forms of Covid-19 manifested:
- post hospitalization depression;
- anxiety;
- insomnia;
- post-traumatic stress syndrome.
Post covid depression, in particular, persists the most, and its severity isclosely related to the intensity of the systemic state that follows severe forms of Covid-19, even for months after recovery.
In fact, in comparison with the other disorders such as anxiety, PTSD, and insomnia that showed significant improvement over the three-month follow-up period, post-Covid-19 depression was found to be much more long-lasting and in directcorrelation with the index of systemic inflammation, which can remain elevated even for months after recovery from acute infection.
Beyond Covid-19, in the scientific landscape, several scholars have long argued that infections such as influenza or viral pneumonia can precede episodes of major depression.
Covid-19: the consequences for children and adolescents
Yet another study focuses on the condition of children and adolescents, assessing the short-term effects of social distancing measures planned for relatively limited periods.
A worsening of psychological conditions was shown, especially among adolescents, with an increase in depression and anxiety. We witness a profound change in our living habits, new forms of living and working together that can be experienced with feelings of anger, fear and frustration.
Emotions that, if not thought about, recognized and accompanied, can result in a problematic symptom picture.
Pandemic as a social phenomenon: the psychological implications
For a long period of time, each of us has been exposed to a profound emotional disorientation related to the major changes that the pandemic has entailed and, to some extent, still entails.
We are talking about a collective emotional disorientation, which has made the pandemic a phenomenon to be considered not only from a medical, but a social perspective. The defenses adopted have been:
- the vaccine;
- social distancing;
- shutting oneself in the home.
The portrayal of the risk of contagion of the virus made us all, potentially “enemies” of each other. The vaccine campaign also brought with it uncertainty, fear, distrust, unrest in the public and private sphere of our homes, conflict, dissidence.
Researchers and virologists have followed with dissenting opinions, and the analysis of epidemiological data has been a daily appointment, not always reassuring. Every emotional habit with which we connote reality has been challenged, and control and planning seem to have failed.
Social reality has become new and potentially dangerous. Lockdown has meant the disruption of our habits, the compulsion to domestic life without the space of work, school, meeting and leisure opportunities.
The home, in the period before and after the lockdown, assumed a central role in our lives: for some it was experienced as a safe place, for others as a prison. Home may have been associated with loneliness, with forced relationships, with bored repetitiveness, with claustrophobic reactions.
Depression and pandemic
Emotions such as anger, frustration, and deep sadness, when they remain confined to our inner world, can result in disorders of the psychological sphere. Indeed, covid depression and covid anxiety have developed.
Today we experience a different condition, one of living with the virus and reopening activities, but the unease related to this experience continues to pervade society. There remains the fear of not being able to reorganize one’s life, recognizing and integrating into everyday life the changes that the pandemic has brought. There is the fear of the future, of what will follow this time:
- How much longer will we have to live with the virus?
- What about the economic crisis and rising unemployment?
Our habits are changing and collide with a profoundly changed context, so we are called to assume different patterns of living than in the past. A picture marked by uncertainty in every sphere.
In addition, today there is talk of the “cabin syndrome,” according to which some people continued to experience leaving home after lockdown with fear.
The signs of depression from Covid-19
Some people have used the pandemic-induced slowdown to place a reflection on their existence and chart new goals and ways, while others experience a mournful experience compared to pre-pandemic life and cannot accept the changes and upheavals.
In this condition of protracted emergence, it is possible to develop fatigue, anxiety, frustration, anger, and reactive depression (the type of depression that arises as a response to a specific, particularly stressful situation).
This situation, which affects the physical and psychological spheres, has been termed pandemic fatigue or pandemic stress by WHO as an individual and collective phenomenon.
Can we assume that a specific form of Covid-19 depression is developing? Scientific studies place attention on both organic factors such as the link to Covid-19 infection and socialstressors experienced by all of us for more than two years.
The symptomatic features of the depressive picture are diverse and manifest on multiple levels: emotional, physical, behavioral, and cognitive. The most common symptoms include:
- a decline in mood
- a reduction in interests and engagement in pleasurable activities due to anhedonia
- changes in the content of thinking
- asthenia
- alterations in cognition
- vegetative issues, such as alterations in sleep and appetite
- hopelessness and apathy throughout the day
- difficulties with attention
- negative thoughts about oneself, one’s future, and the social environment.
Post covid depression: does it really exist?
So does a specific “Covid-19 depression” really exist? Has a specific form of depression developed or certain symptoms exacerbated?
A recent study published in The Lancet Public Health showed that long Covid affects not only physical health but also mental health, with symptoms of depression and sleep disturbances that can last as long as 16 months after diagnosis.
That publication showed symptoms of depression, anxiety, stress, and sleep disorders in 247,249 people (who had participated in seven studies in Denmark, Estonia, Iceland, Norway, Sweden, and the United Kingdom) with or without Covid-19 and followed up to 16 months. It was found that:
- 20.2 percent of patients with Covid-19 experienced symptoms of depression, compared with 11.3 percent of people who had not contracted the virus;
- likewise, patients with Covid-19 were more likely to develop sleep disorders (29.4 percent vs. 18 percent of the group without Covid-19).
Those most at risk for mental disorders were those who had had Covid-19 in a severe form and had been bedridden for seven days or more. We can think that the higher incidence of post hospitalization depression and anxiety among patients with Covid-19 who spent seven days or more in bed could be associated with multiple factors, such as:
- the state of constant worry and anxiety about the health condition;
- the persistence of symptoms caused by Covid-19 over a long period of time;
- the limitations and changes in social relationships.
In addition, previously reported studies observe that among patients with severe manifestation of Covid-19 symptomatology, the inflammatory response may contribute to the depressive state and other problems in the emotional sphere.
How to deal with depression following Covid-19?
What to do in case of signs of depression or depressive disorders caused by Covid-19? We have seen that some studies show a direct relationship between the inflammatory state induced by the virus and the depressive response.
However, there are also many people who experience depressive disorders even if they have not contracted Covid-19, as a result of the difficulties associated with the pandemic-induced changes:
- the state of uncertainty orbiting the present and future
- the anxiety and fear
- the sense of helplessness
- disorientation.
There are, then, people with pre-existing psychological distress who have exacerbated the manifestation of depressive symptomatology with the contraction of the virus and the social and emotional consequences of the pandemic. If we notice that someone around us (or even ourselves) manifests such signs, let us try to listen and not judge our own and others’ emotions and behaviors.
First of all, it is important to recognize the symptoms that relate to the depressive picture and not to be alone with our own experiences. In certain cases, for example, it may be helpful to do an initial screening by completing a depression test together with a mental health professional.
The possibility of finding a relationship where one can share one’s emotions can help the person listen to himself and get in touch with his inner self. In these casesstartinga therapeutic journey (in-person or with an online psychologist) is helpful in making sense of those emotions, thinking about them, trying to contextualize that symptomatology in the network of relationships in which the person is immersed.
It is necessary to understand how the person interprets and experiences the pandemic change and to use this as a pretext to learn more about themselves, and then to look to the future by developing useful resources to relate to the uncertainty of the change we are experiencing.