COVID-19 and Depression

Medically Reviewed by Michael W. Smith, MD on October 07, 2021
4 min read

Although your early COVID-19 symptoms have gone away, you still might not feel completely normal. You may deal with constant headaches, fatigue, nervousness, or an overall feeling of dread that makes it difficult to complete daily tasks. While experts still need to study the long-term effects of COVID-19 on the brain, over half of a U.S. COVID-19 survivor sample reported symptoms of depression months after recovery, those with more severe COVID symptoms being more likely to have depression.

In addition, researchers found that many survivors of COVID-19 reported cases of posttraumatic stress disorder (PTSD), anxiety, insomnia, and obsessive-compulsive (OC) symptoms. Other studies showed that the prescription of antidepressants, intimate partner violence, and suicidal thoughts have gone up since the start of the pandemic.

Those who’ve had COVID-19 appear to have a higher risk of a mental health disorder after recovery from the virus.

Experts believe that a COVID-19 infection can affect your mental health in two major ways:

  • Your body’s immune response to the virus itself
  • The psychological stress of a COVID-19 infection

When you get infected with the virus that causes COVID-19, your immune system produces cytokines, chemokines, and other things that promote inflammation. Experts found a specific kind of cytokine, called T-helper-2 cell-secreted cytokines, in people with COVID-19. Higher levels of these cytokines seemed to link to a more severe case of the virus. Experts found that if your body doesn’t properly control these cytokines, certain bad things can happen:

  • Nerve inflammation
  • Blood-brain-barrier disruption
  • Peripheral immune cell invasion into the central nervous system
  • Impaired nerve transmission
  • Hypothalamic-pituitary adrenal (HPA) axis dysfunction
  • Microglia activation and indoleamine 2,3-dioxygenase (IDO) induction

All of these represent the roots of psychiatric disorders, like depression. This suggests that the actual effects of the COVID-19 virus can lead to depression, even after a person recovers from the virus.

In a study, experts linked higher systemic immune-inflammation index levels (SII), which refer to your immune response and inflammation, to major depressive disorder. Inflammatory factors like SII were higher among males and people who stayed in a hospital during their COVID-19 illness.

Other psychological factors can cause COVID-19 survivors to get depression. People who had COVID-19 and didn’t have to stay in a hospital showed higher levels of anxiety and sleep disturbances after the start of COVID-19. Experts found that those who stayed in a hospital had higher levels of PTSD, depression, anxiety, and OC symptoms.

Studies show that these conditions came from emotional and mental stress, including:

  • Social isolation
  • The psychological impact of a severe and potentially fatal illness
  • Concerns about infecting other people
  • The stigma related to a COVID-19 infection

In these studies, researchers found that females and people with previous psychiatric diagnoses dealt with more severe mental health conditions after the start of COVID-19. Those who stayed in hospitals while infected with COVID-19 also had higher social isolation and loneliness, since they couldn’t interact with as many people. In addition, younger people with COVID-19 showed higher levels of sleep disturbances and depression. This further confirms past studies that reported younger people dealt with worse psychological impacts from COVID-19.

But experts still need to do more research to understand the link between COVID-19 survivors and the biomarkers of inflammation, mood disorders, and mental illness symptoms.

Whether you’ve had a case of COVID-19 or not, the pandemic has affected all of us in some way. Many things related to the pandemic can affect your mental health:

  • Trauma from a widespread disease
  • Fear of getting sick
  • Grief from losing a loved one, or from the loss of life in general
  • Physical distancing and the lack of socializing
  • Financial concerns (unemployment, housing security)
  • Loss of community
  • Less access to caregivers

After most traumatic events, depression tends to peak right after and then fall over time. But studies show that the rate of depression after the start of the COVID-19 pandemic actually went up. Those who were hit hardest with long-term mental health impacts include:

  • Families or people with a low household income
  • Unmarried people
  • Those who faced multiple pandemic-related stressors

In the U.S., 32.8% of adults had elevated depressive symptoms in 2021, compared to 27.8% of adults in the early months of 2020 and 8.5% before the pandemic.

This suggests that experts must continue to research the link between the pandemic and mental health, including how the COVID-19 virus directly affects mood disorders.

If you think you may be depressed or have noticed symptoms of other mental health disorders, talk to your doctor right away to get the help you deserve.