Coronavirus: The possible long-term mental health impacts

Researchers are also gathering empirical data which they hope will provide a better grasp of the long-term mental health side effects of this unique crisis, and therefore how to manage it. Major UK studies are looking specifically at the mental health of patients hospitalised with Covid-19 and nurses working on the front line. In Sweden, researchers at the Centre for Psychiatric Research in Stockholm are conducting a year-long project involving more than 3,000 people with pre-existing mental health conditions, including depression, anxiety and OCD. An Australian nationwide survey by the Matilda Centre for Research in Mental Health in Sydney is measuring the impact of the pandemic on the ongoing mental health and wellbeing of the general population. 

“There is concern that mental-health problems may rise or are rising, but this needs to be better understood,” says Nitya Jayaram-Lindström, operations manager for the Stockholm project. She says the Swedish research will focus on how much Covid-19 may have exacerbated existing mental health inequalities, how patients’ symptoms develop or change over the next year and which groups are worst affected. “We also want to understand factors that contribute to resilience, which is as important to understand as the risk factors.” 

At the Centre for the Study of Traumatic Stress in Maryland, Joshua C Morganstein argues that these sorts of projects will be an essential resource for both healthcare providers and governments. “Health surveillance of various populations to better understand these aspects of risk is essential for us to provide interventions and plan for subsequent pandemic waves as well as future public health emergencies,” he says. “Stress is like a toxin, such as lead or radon. In order to understand it and how it is affecting a society, we need to know who is exposed, when, how much and what effects were caused by the exposure.” Although there is little data so far, Morganstein predicts that long-term studies are likely to further expose the wellbeing disparities across race, gender and income which have already been highlighted during the pandemic, and need to be taken into deeper consideration when developing future responses. 

Resilience and hope 

Despite ongoing concerns about the long ‘tail’ of mental health challenges caused by the impact of Covid-19, psychiatrists say it’s important to recognise there are some positive takeaways, too. 

Taylor argues that while a significant minority may struggle long-term, the pandemic has highlighted high levels of resilience to stress in the wider population, alongside humans’ capacity to “bounce back” after catastrophic events. For instance, in Wuhan, where the pandemic first started and cases were brought under control after a strict 76-day lockdown and mass testing, the city staged a massive water-park music festival in August. Thousands of people crowded together shoulder to shoulder, with no masks and zero social distancing. Large gigs also returned in New Zealand after community transmission of the virus was curbed. These kind of events have taken place, Taylor reflects, despite a fatalistic mood at the start of 2020, when “many people doubted that life would return to normal, and some speculated about a grimly Dickensian post-pandemic world”. He believes that “similar events will likely occur elsewhere in the world when the pandemic is over”. 

Psychotherapist Nippoda points out that for some people, the adverse circumstances of the pandemic have actually had a “remarkably positive impact” on their mental health, which may also be long lasting. The experience of lockdown, she argues, helped reduce anxiety levels or stop panic attacks among some who had high levels of stress in the outside world before the pandemic. This is because they felt a greater sense of freedom and safety by spending more hours at home. Although there is a risk of social isolation and loneliness for those who retreat too much, she says that this enforced time indoors has encouraged some to strive for a better work-life balance in the future or to “take their own pace in life” when it comes to socialising – by finding “their own comfort zone within the boundaries between indoors and outdoors”. 

Others have used the era of social-distancing to declutter their homes, and “the new space within the home has been reflected positively within their mind, almost as if they were able to tidy up the complications in their head”, says Nippoda. Increased time for hobbies, especially making and doing things from scratch, is also thought to have provided a sense of satisfaction, fulfilment and stress-relief for many. 

But these sorts of experiences ring hollow for people like germaphobe Susan Kemp in Stockholm who are still struggling to visualise an end to their more acute mental health challenges connected to the pandemic. “Clearly there needs to be some balance between being careful and being an absolute hermit that I’m not able to achieve,” she laments. “But I irrationally can’t get over my fear. It’s very hard these days to decide when I’m being rational and when I am not.” 

“I find it really, really difficult to rebalance myself,” agrees American PTSD sufferer Lindsey Higgins, who says she’s unsure her symptoms will improve even if scientists develop a vaccine. “It is going to take time to distribute, and even longer to convince people they should even take the vaccine. Honestly, I’m not sure I’ll ever really feel secure again.”