COVID depression is real.  Here's what you need to know.

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 the first year alone of the Covid-19 pandemic. (Jon Han/The New York Times)

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 major depressive disorder after coronavirus infection. The risk of developing these symptoms – along with other mental health conditions – remains high for up to a year after your recovery.

It’s no surprise that the pandemic has had such a huge impact. “It’s a seismic event,” said Dr. Ziyad Al-Aly, clinical epidemiologist at Washington University in St. Louis and chief of research and development at Veterans Affairs St. Louis Health Care System.

Health problems, grief over the loss of loved ones, social isolation and disruption of daily activities were sources of distress, especially at the start of the pandemic. But compared to those who managed to avoid infection (but who also faced the difficult impacts of living through a pandemic), people who fell ill with COVID-19 appear to be much more vulnerable to a variety of health problems. Mental Health.

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“There’s something about the coronavirus that really affects the brain,” Al-Aly said. “Some people have depression, while others may have strokes, anxiety, memory problems, and sensory disturbances.” Still others have no neurological or psychiatric conditions, he said.

Why do some people get depressed when they have COVID?

Scientists are still learning exactly how the coronavirus changes the brain, but research is beginning to point to some possible explanations. A few studies, for example, have shown that the immune system goes into overdrive when some people get sick. They can end up with inflammation throughout the body and even in the brain. There is also evidence that endothelial cells lining blood vessels in the brain are disrupted during an episode of COVID-19, which can inadvertently let in harmful substances, affecting mental function. And cells called microglia, which normally act as the housekeepers of the brain, can go rogue in some patients, attacking neurons and damaging synapses, Al-Aly said.

It is possible that COVID-19 even compromises the diversity of bacteria and microbes in the gut. Since gut microbes have been shown to produce neurotransmitters like serotonin and dopamine, which regulate mood, this change could be 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 you got sick. People who had severe symptoms of COVID-19 and had to stay in hospital during their illness also have an increased risk of depression, said Megan Hosey, a rehabilitation psychologist who works with intensive care patients at the Johns Hopkins Hospital.

According to WHO estimates, young people are disproportionately at risk for suicidal behaviors and self-harm post-COVID. Women are more likely than men to report post-COVID mental health effects. And people with pre-existing physical health conditions, such as asthma, cancer and heart disease, are more likely to develop symptoms of mental disorders post-COVID.

Additionally, people who experience significant sleep disturbances, social isolation, or a significant change in other behaviors, such as the amount of alcohol they drink or the type of prescription medications they take , may be more likely to face depression after physical symptoms of COVID-19 fade. “We know that having additional stressors on your plate can predict depressive symptoms later,” Hosey said. Some studies suggest that people who experience these stressors may be more vulnerable to developing long COVIDs in general.

When covid the blues become a clinical depression? What are the first signs?

While you’re in the thick of the action, battling a viral infection, it’s normal to feel tired and have a headache. “When you feel physiologically terrible, it can interfere with your mood,” Hosey said. “I would never diagnose someone with clinical depression in the acute phases of a COVID infection.”

But if your exhaustion and feeling of being overwhelmed persists for two to six weeks after your COVID infection and begins to interfere with daily activities or negatively affect your relationships with others, it could be a sign of depression, said Hosey.

Some people with depression may also experience persistent sadness, tearfulness, irritability, changes in appetite or weight, problems thinking or concentrating, or feelings of overwhelming guilt, worthlessness, or helplessness. despair. People with severe depression may think about death frequently and develop suicidal thoughts, Hosey said.

What can you do to treat post-COVID depression?

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

Depression isn’t something you can usually get rid of on your own, Hosey said. It can be tempting to use online resources and self-diagnostic screening 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 foods 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 behavior changes don’t work, a professional can recommend therapy or medication, depending on your needs.

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

It’s not yet known how long it takes to get past symptoms of depression after COVID. “Recovery from depression is a very individualized process,” Hosey said. Many people recover after brief treatment. Some people experience relapses, where their symptoms get better and worse and they may need to try a different treatment, she said. Sometimes depression resolves without treatment, although this may be more likely to occur in people with mild cases.

“Following a COVID infection, you should give yourself a little break and be patient,” Hosey said. “An infection can be difficult to manage.”

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