Mental Health Effects of COVID-19 Infection

More than two years of pandemic-induced isolation was hard on the mental health of virtually everyone on the planet. Still, the millions of people who survived a COVID-19 infection are significantly more at risk for mental health-related issues. In addition, new research suggests the virus affects our brains in ways that can have negative psychological impacts.

COVID-19 Infections Associated with Diverse Mental Health Issues

Early in 2022, researchers at the Washington University School of Medicine in St. Louis published a study that hints at how widespread the problem is. The study found people who survived a COVID-19 infection were 60% more likely to have mental health problems than people not infected. But the most shocking findings lie in the significantly increased rates of specific mental health disorders.

To find out how prevalent the disorders were among people who survived COVID-19, the researchers compared the medical records of people who had been infected and survived COVID-19 between March 2020 and January 2021 to people who had not been infected. Two separate control groups consisted of people who had not tested positive for COVID-19 during the same time frame and people whose medical data came from 2018 and 2019 before the pandemic began.

The results appeared conclusive. People who had survived COVID-19 were significantly more likely to have several different psychological disorders than people in the control groups. The disorders that showed increased prevalence included:

• Anxiety disorders. COVID-19 survivors were 35% more likely to have these disorders.
• Depression and related mood disorders. These disorders were 40% more likely in COVID-19 survivors.
• Sleep disorders. These disorders showed 41% greater prevalence.
• Opioid use disorder was 34% more common in survivors.
• Abuse of alcohol or other drugs was 20% more common.
• Suicidal thoughts were experienced by COVID-19 survivors 46% more often.

This list of disorders is concerning, but it might not tell the whole story. For example, other studies suggest that COVID-19 infections could produce other mental disorders or worsen the symptoms of pre-existing conditions.

A 2021 study in JAMA Psychiatry found that among participants who had survived COVID-19, more than 30% showed symptoms of post-traumatic stress disorder (PTSD) after their recovery. That’s a rate several times higher than the expected rate of PTSD in the general population. In addition, participants who showed signs of PTSD were more likely to have long-lasting medical symptoms after they recovered from the COVID-19 infection. The participants most likely affected by PTSD were women, those with a pre-existing mental disorder, and those who experienced delirium or agitation while ill with COVID-19.

Other studies have suggested that COVID-19 infection could worsen the symptoms of pre-existing disorders. For example, symptoms of pre-existing anxiety or depression were likely to increase. Still, COVID-19 seems to have a compounding effect on the symptoms of many other disorders, ranging from eating disorders to schizophrenia.

Is COVID-19 the Cause?

Zeroing in on the reasons COVID-19 worsens mental health is a complicated task. Researchers are working to confirm the virus itself has an impact on mental health while at the same time trying to figure out what’s causing the effects.

One potentially confusing factor is that people hospitalized with severe COVID-19 illness were much more likely to have mental health issues than those with only mild illness. However, it’s well-known that the experience of being hospitalized with any severe illness can result in mental health issues, and that phenomenon could be at play with COVID-19.

However, the current research seems to make that possibility less likely. For example, the Washington University study compared the mental health of those hospitalized for COVID-19 to those hospitalized for other reasons. The COVID-19 patients were 86% more likely to have mental health issues. And while people with mild COVID-19 illness were less likely to have problems than people with severe illness, they were still at increased risk compared to the general population.

In addition, COVID-19 survivors were more at risk than people who survived other infections, such as the flu. The researchers also excluded people from the study diagnosed with a pre-existing mental health condition to confirm that COVID-19 produces new psychological impacts.

Overall, the data strongly suggests that having a COVID-19 infection increases your risk of mental health-related issues after you recover from the infection.

Looking for an Explanation

As it becomes clear that COVID-19 is detrimental to mental health, the next important question is why. Unfortunately, the answer might not be one-size-fits-all. The underlying cause likely varies from case to case, and researchers are pursuing many different possible risk factors, including:

• Changes to the brain caused by COVID-19. Research indicates that viral infection can produce structural and functional brain changes. These changes could underlie the mental health issues seen in COVID-19 survivors.
• Trauma associated with serious illness. For some people, the experience of being hospitalized with severe COVID-19 may be a critical factor in their mental health symptoms.
• Complications from physical symptoms. People who experience prolonged physical symptoms may be more at risk for developing disorders such as anxiety or depression as they struggle with recovery.
• Post-infection situations. COVID-19 survivors may face stressful situations after recovery (e.g., social isolation, fears of lingering effects or re-infection, and financial stress) that put them at risk of mental health problems.
• Pre-existing conditions. In some cases, people with an undiagnosed pre-existing mental disorder may be diagnosed when their symptoms are uncovered during COVID-19 treatment.
• Symptoms exacerbated by treatment. In some cases, medical treatments for COVID-19 could worsen the symptoms of some disorders, such as schizophrenia.

What Can We Do?

If COVID-19 infection puts our mental health at risk, the potential problem is gigantic. An estimated 77 million people have been infected with the virus in the United States alone. At the rates suggested by the Washington University study, this could mean the virus has contributed to almost 3 million new mental health diagnoses. So with that in mind, what can we do to bolster our mental health as we recover from the pandemic?  

• Actively pursue mental health care. During the pandemic, people were less likely to seek medical care of all kinds, which likely included mental health care. Since millions of us are now at risk of mental health issues, it’s more important than ever to be vigilant for the emergence of problems in ourselves and our loved ones and to get help when we need it.
• Be careful of isolation. Research has shown that isolation caused by COVID-19 has harmed mental health overall. Maintaining strong connections to other people is integral to staying mentally healthy.
• Support your physical health and nutrition. Dealing with medical problems can worsen mental health and vice versa. Doing what we can to stay physically healthy can also help us stay mentally healthy.
• Get plenty of exercise. Studies have shown that one of the most effective ways to ward off mental health issues associated with COVID-19 is to stay active.

Helpful Resources

When seeking additional resources regarding depression, anxiety, substance abuse, or other mental health-related topics, refer to the United Brain Association website. We share information about over 300 brain and mental health-related issues and disorders, including causes, diagnosis, treatment, and current research. In addition, our community members have shared stories about their experiences and those of their children, providing additional insight into health and well-being. 

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