The Covid depression is real. Here’s what you need to know

The World Health Organization noted this year that anxiety and depression increased by 25% worldwide in just the first year of the Covid-19 pandemic. And researchers have continued to find more evidence that the coronavirus has wreaked havoc on our mental health: In a 2021 study, more than half of American adults reported symptoms of serious depressive disorder following coronavirus infection. The risk of developing these symptoms — as well as other mental health disorders — remains high for up to a year after recovery.

It’s not surprising that the pandemic has had such a huge impact. “It’s a seismic event,” said Dr. Ziyad Al-Aly, a clinical epidemiologist at Washington University in St. Louis and head of research and development for the St. Louis.

Health concerns, grieving the loss of loved ones, social isolation and disruption to everyday activities were a recipe for distress, especially at the start of the pandemic. But compared to those who managed to avoid infection (but also dealt with the difficult impacts of the pandemic), people who contract Covid-19 appear to be much more vulnerable to a range of mental health issues.

“There’s something about the coronavirus that really affects the brain,” said Dr Al-Aly. “Some people experience depression, while others may have strokes, anxiety, memory disorders and sensory disturbances.” Still others don’t have any neurological or psychiatric conditions, he said.

Why do some people get depressed when they have Covid?

Scientists are still learning exactly how the coronavirus alters the brain, but research is starting to highlight some possible explanations. Some studies, for example, have shown that the immune system kicks into high gear when certain people get sick. They can wipe out inflammation throughout your body and even your brain. There is also some evidence that the endothelial cells that line blood vessels in the brain are disrupted during a Covid-19 outbreak, which can inadvertently allow harmful substances to pass through, affecting mental function. And cells called microglia, which normally act as the brain’s gatekeepers, can go rogue in some patients, attacking neurons and damaging synapses, Dr. Al-Aly said.

It is possible that Covid-19 even compromises the diversity of bacteria and microbes in the gut. Since microbes in the gut have been shown to produce neurotransmitters such as serotonin and dopamine, which regulate mood, this change may be at the root of some neuropsychiatric problems.

Who is most at risk?

One of the biggest risk factors for developing depression after Covid-19 – or after any serious illness – is having a mental health disorder diagnosed before becoming ill. People who had severe Covid-19 symptoms and had to be hospitalized during their illness were also more likely to experience depression, said Megan Hosey, a rehabilitation psychologist who works with ICU patients at Johns Hopkins Hospital.

According to World Health Organization estimates, young people are at a disproportionate risk of suicidal behavior and self-harm after Covid. Women are more likely than men to report mental health effects after Covid. And people with preexisting physical health conditions, such as asthma, cancer and heart disease, are more likely to develop symptoms of mental disorders after illness.

Additionally, people who experience extensive sleep disruption, social isolation, or a significant change in other behaviors, such as the amount of alcohol they consume or the type of prescription medications they take, may be more likely to experience depression after physical symptoms subside. of Covid-19 disappear. “We know that having additional stressors can predict later depressive symptoms,” said Dr Hosey. Some studies suggest that people who experience these stressors may be more vulnerable to developing long-term Covid in general.

When do Covid blues become clinical depression? What are the early signs?

While you’re in the midst of fighting the viral infection, it’s normal to feel tired and have a headache. “When you feel physically awful, it can interfere with your mood,” Hosey said. “I would never diagnose someone with clinical depression in the acute stages of a Covid infection.”

But if the exhaustion and feeling of being overwhelmed persists for two to six weeks after the Covid infection and begins to interfere with day-to-day activities or negatively affect your relationships with other people, it could be a sign of depression, explains the doctor. Hosey.

Some people with depression may also experience persistent sadness, crying, irritability, changes in appetite or weight, difficulty thinking or concentrating, or intense feelings of guilt, worthlessness, or hopelessness. Those with severe depression may frequently think about death and develop suicidal thoughts, warns Hosey.

What can you do to treat post-Covid depression?

If you are concerned that you or a loved one may have symptoms of depression after being infected with Covid, it is important to speak with a doctor or mental health professional. “Not everyone needs to see a psychiatrist to be evaluated for depression,” said Dr. Al-Aly. People can share what they’re going through with their primary care physician for help too, he said. “The most important thing is to seek help. And as soon as possible.”

Depression is not something you usually get over on your own, said Dr. Hosey. It can be tempting to turn to online resources and self-diagnosis tools and order supplements that promise to calm Covid-related inflammation or repair your gut health. But many of these interventions are not reliable or supported by evidence.

It’s a good idea to take stock of your diet, sleep, and drug and alcohol use. Consuming more nutritious food and establishing a good sleep routine, for example, can have a small positive impact on your mental health. Research suggests that exercise and meditation can also help heal the mind in some cases. But if behavioral changes don’t work, a professional may recommend therapy or medication, depending on your needs.

During the pandemic, access to telemedicine and mental health services has expanded, said Dr Hosey. Several US states now allow licensed psychologists to provide care to patients in other states that are part of the Interjurisdictional Psychology Covenant. That means you can more easily search for a mental health provider in person or online, even if there’s a shortage of specialist care in your area, Hosey said.

It’s still unclear how long it takes to get over symptoms of post-Covid depression. “Recovery from depression is a very individualized process,” explains the doctor. Many people recover after a short period of treatment. Some experience relapses, as their symptoms get better and worse, and may need to try a different treatment, she said. Sometimes depression goes away without treatment, although this is more likely to happen in people with mild cases.

“After a Covid infection, you have to take time out and be patient,” said Dr Hosey. “An infection can be difficult to treat.”

Translated by Luiz Roberto M. Gonçalves