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COVID-19 and Depression: Understanding the Connection

By April 8, 2024No Comments

Even after your other symptoms from COVID-19 have gone away, you might experience sadness, fatigue, and other signs of depression. Scientists are still studying how COVID can affect the brain in some people and why this may put them at greater risk of depression.1 

Depression is one of the most common issues some people experience after a COVID infection, as part of long COVID—sometimes referred to as PASC (post-acute sequelae of COVID-19). According to one analysis, roughly 10% to 30% of people may still experience depression symptoms three months later, which may be severe in 3% to 12% of people.2

This article explains more about the link between depression and COVID. It discusses how the virus that causes COVID directly affects the brain, other mental health effects of the pandemic, and tips on how to cope with depression after COVID.  

Is There a Link Between COVID-19 and Depression?

Although scientists were initially most concerned about COVID-19 symptoms such as shortness of breath from lung infection, the virus causing COVID-19 (SARS-CoV-2) can also affect other body systems, including your brain.1 

People who have COVID have a higher rate of depression than people in the general population. You might be more prone to getting depression even after your other symptoms from COVID, like sore throat, are gone, and you no longer have an active viral infection.3

People with severe COVID symptoms seem to have a greater risk of initial depressive symptoms. However, some studies have shown that people with mild COVID symptoms have a similar risk of post-COVID depression as people who had more severe infections that required hospitalization.2

What’s the Link Between Long COVID and Depression? 

Long COVID broadly refers to symptoms still present at least three months after a COVID-19 infection.4 

Not everyone with long COVID has the same symptoms. Some people have shortness of breath, dizziness, or pain without a clear cause. However, others have symptoms that are very common in clinical depression. Others might have mild depressive symptoms.

For example, many people with long COVID have fatigue, apathy (lack of interest), sleep problems (too much or too little), or decreased mental sharpness (brain fog). Many people also experience increased anxiety or sadness. In some cases, depression might be part of a long COVID syndrome, with or without additional symptoms.4 

What Causes Depression in People Who Have Had COVID-19?

Scientists are still learning about what causes depression in people who’ve had COVID-19. They do know that circumstances contribute to COVID-related depression. For example, if you’ve lost income or have to cancel plans due to a COVID infection, you may naturally feel some sadness.

However, the virus that causes COVID also seems to directly affect the brain in ways scientists don’t fully understand. Other infections may also trigger syndromes that can cause symptoms like depression, like the original SARS virus or Lyme disease.5

Scientists theorize that inflammation plays a role in the development of depression with COVID-19. The virus that causes COVID can trigger immune-signaling molecules that can enter the brain and affect your mood, sleep, sense of motivation, and enjoyment. Scientists think inflammation plays a role in depression, even in people who have never had COVID.1

However, the link between COVID and depression is complex. The virus that causes COVID binds to specific receptors in your brain, which might worsen depression. Some scientists speculate that low levels of the virus might be present in some people with long COVID, which could contribute to depression symptoms.6

Alterations in the normal immune response (autoimmune disease) may also play a role, but more research on the relationship between autoimmune disease, COVID, and depression is needed.7 

Risk Factors

Some people seem to be at greater risk of depression after COVID. For example, women have an increased risk compared to men—which is true for depression in general, as well. People with a history of depression or other mental health issues also have an increased risk.

Other Mental Health Effects of the Pandemic

The pandemic significantly increased rates of anxiety and depression overall, even in people who didn’t have the COVID-19. This was especially true early in the pandemic before vaccines and targeted treatments were available. Uncertainty about the virus was particularly stressful and profoundly affected people’s lives.3 

The pandemic also had broader effects, which varied based on individual circumstances. Some people were grieving from losing a loved one or managing the physical challenges of regaining their health, including from long COVID.

People were also dealing with the indirect impacts of the virus, such as job and income loss, social isolation, and burnout from increased responsibilities at home and/or work. Alcohol-related deaths and rates of suicide also increased.89 

Many of these trends improved as the impact of COVID lessened and disease outcomes became more predictable. Some scientists believe the overall effects on people’s mental health have been overestimated.10

However, some people are still struggling with mental health issues that might have been triggered or worsened by circumstances related to the pandemic. 

How to Cope With Depression After COVID-19

Depression after COVID-19 is relatively common, and symptoms decrease with time in most people.4 

If your depression is severely interfering with your life, reach out to a healthcare provider or mental health professional. It’s especially critical to do so if you are having thoughts of self-harm or suicide. They can help you determine how to best navigate this time.

If you’re experiencing suicidal thoughts, call or text 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor. If you or a loved one is in immediate danger, call 911. For more mental health resources, see the National Helpline Database.

Even if your symptoms are less severe, getting some input from a mental health provider is often helpful. Depending on your situation and personal preferences, you might consider drug treatments for depression or therapy such as cognitive behavioral therapy (CBT).3

Many people benefit from a holistic, multifaceted approach to depression treatment. Some considerations to help you cope include the following:411

  • Decrease stressors: Scale back responsibilities in a way that’s practical for you (when possible).
  • Lean on your personal support network: Find ways to connect with others, even if you mostly feel like withdrawing.
  • Exercise regularly: Try to exercise in ways you enjoy, but pace yourself and don’t overdo it. It can be beneficial to get out in nature. 
  • Pay attention to your diet: Make sure you are eating enough. Try to emphasize whole foods with protein, fiber, vitamins, and minerals over heavily processed foods with lots of sugar. 
  • Prioritize sleep: If you are sleeping too much, make small goals to help get you out of bed and engaged in a task.
  • Find time for your favorite activities: Even if you don’t feel like pursuing your hobbies, sometimes the enjoyment comes back once you get started. 
  • Try mind-body or stress-reduction techniques: Approaches like tai chi, yoga, meditation, massage, guided imagery, or prayer may help. Some people report improvement from alternative approaches like acupuncture.
  • Be kind to yourself: Practice self-compassion and remind yourself that it isn’t your fault you are having a tough time. 

A holistic approach may also work best if you have depression in the context of other symptoms from long COVID. You may want to connect with a long COVID clinic (facilities specializing in long COVID care), where they can provide additional expertise and treatment approaches.

Read the rest of the original article on Verywell Health.

If you are suffering from anxiety or depression due to long COVID, reach out for support and take the first steps toward healing with an effective combination of medication management and therapy for depression.

Barry J. Richman

Author Barry J. Richman

More posts by Barry J. Richman

Barry J. Richman MD Psychiatrist NY

Manhattan, NYC Psychiatrist
(212) 889-5463