Having COVID-19 greatly increases the likelihood of developing new mental illnesses, potentially exacerbating existing suicide and overdose crises, according to a new study that looks at millions of US medical records over the course of a year.
As The Guardian writes, the long-term effects of having COVID are still being detected, including an increased chance of diagnosing mental disorders. These include depression, anxiety, stress and an increased risk of substance use disorders, cognitive decline and sleep problems — a notable difference from other people who have also experienced the stress of the pandemic but have not been diagnosed with the coronavirus.
“Essentially, this tells us that millions and millions of people in the US who are infected with COVID are developing mental health problems,” said Ziyad Al-Ali, head of research and development at the Virginia Health System in St. Louis and senior author of the article. “That makes us a nation in distress.”
Of particular concern, he said, is a higher risk of mental disorders, including suicidal ideation and opioid use.
“It’s really a near-perfect storm that’s brewing before our eyes — another opioid epidemic in two to three years, another suicidal crisis in two to three years,” Ziyad Al-Ali added.
These unfolding crises are “quite a concern,” says James Jackson, director of behavioral health at Vanderbilt University’s Intensive Care Recovery Center, who was not involved in the study. It also accepts patients whose previous conditions, including anxiety, depression and substance use disorder, have worsened during the pandemic.
Studies like these show a clear need to follow up patients for weeks and months even after a mild COVID diagnosis and seek prompt treatment for any emerging illnesses, experts say. “If we pay attention to this now and nip it in the bud, we can literally save lives,” warns Ziyad Al-Ali.
More than 18% of COVID patients developed mental health problems, compared with 12% of those who did not have COVID, according to a study released this week.
The study took more than 153,000 patients who tested positive for coronavirus in the Veterans Affairs Health System between March 2020 and January 2021 and compared them to other medical records: the 5.8 million people who did not test positive at the time, but experienced the same stresses of the pandemic and with the 5.6 million patients seen before the pandemic.
Among all patients who developed new mental health problems during the pandemic, patients with COVID were significantly more likely to develop cognitive problems (80%), sleep disorders (41%), depression (39%), stress (38%), anxiety (35%) and opioid use disorder (34%) compared to those who did not have COVID.
The study only looked at patients who had not had a mental health diagnosis in the past two years. It compares those hospitalized for COVID with other illnesses and compares the results to thousands of flu cases. The study also took into account factors such as demographics, other health conditions, and other factors.
All the results were unequivocal: COVID has a noticeable impact on mental health. Those with more severe cases of COVID, especially those requiring hospitalization, tend to be at higher risk. But even those with mild or asymptomatic cases were more likely to receive diagnoses of mental health disorders.
“People who were hospitalized had it worse, but the risk to non-hospitalized patients is significant and not at all trivial – and this represents the majority of people in the US and the world,” says Ziyad Al-Ali.
The study had some limitations: most of those analyzed were older white men. But adjusting for race, sex, and age showed no change in risk.
Other studies have shown that coronavirus can be found in the brain. “In fact, we can see the virus in the amygdala, in the hippocampus, the very centers that are responsible for regulating our mood, regulating our emotions,” Al-Ali said.
The study complements other studies showing that “mental health issues are a huge concern” in the wake of COVID, says James Jackson. And the results match what he sees among patients.
“We will see that COVID can be even more problematic and more serious than we thought,” Jackson said.
Early treatment for patients facing new or additional post-COVID mental health issues could be critical, experts say.
“The idea here is to identify patient data at an early stage so that hopefully it doesn’t become a much bigger problem in the future,” says Al-Ali. “If the disease is left unattended, it will only get worse.”
But the longer the virus continues to circulate, the more long-term problems it can create, further increasing the strain on health systems.
“A wave of people with mental disorders will hit clinics in the next year, two or three due to COVID and as a result of the pandemic,” warns Ziyad Al-Ali.
And many practicing psychiatrists do not accept insurance, creating a big stumbling block for patients, while others have long waiting lists.
“It’s a huge problem and I’m not entirely sure what we’re going to do about it,” admits James Jackson. “The needs far outstrip the resources.”
Jackson has created peer support groups to counsel patients suffering from “long-term COVID” (brain fog, cognitive impairment, memory problems, feelings of inferiority). The groups are meeting on Zoom, so patients from all over the country can join.
“We need to pay attention to the long-term effects of COVID,” says Ziyad Al-Ali. “If we only focus on the short-term effects, the first 30 days or the first 90 days, we are really missing the bigger picture. The pandemic itself has left the US unprepared, and we will again find ourselves unprepared for a prolonged COVID. The reality is that COVID has long-term consequences and we can’t just want to get rid of it, sweep it under the rug, or not deal with it.”