For many of us the mental health effects of the pandemic may only be too clear – depression, anxiety, loneliness to name a few. We may have felt these feelings ourselves or know someone who has over the past 12 months. But for those who have had Covid-19 and are now in recovery, the physical effects of so-called Long Covid and its mental health effects are only just beginning to become clear and to be understood.
Research on how Long Covid may affect mental well-being is in its infancy and much more is required before healthcare professionals really understand its depth and breadth. However, it is thought that Covid-19 may have some lasting effects on the brain and as many as one in three patients recovering from Covid-19 may experience neurological or psychological effects from the illness. In addition to extreme, persistent physical fatigue, brain fog, confusion, dizziness, delirium, and other cognitive difficulties are commonly reported. It is thought that Long Covid can cause mental health conditions similar to those experienced as a result of the other acute respiratory coronaviruses such as SARS and MERS, including anxiety, depression, mania, and memory problems.
Initial research undertaken in the USA of 62,000 people who have had Covid-19 has shown that 18% developed a mental health condition such as depression, anxiety or dementia within three months of their Covid-19 diagnosis. What is not certain is whether the cause of the mental health condition was a direct result of the disease or if it was due to the stress of the pandemic and conditions such as isolation during the illness – or even a combination of the two.
Another smaller study undertaken in the UK and published in The Lancet Psychiatry highlighted stroke as one of the main neurological effects among those recovering from severe Covid-19 and found that some younger Covid-19 patients who had been hospitalised developed mental health conditions such as psychosis and catatonia. Those with a pre-existing mental health condition, such as ADHD, depression, schizophrenia and bipolar disorder were found to be 65% more likely to be diagnosed with Covid-19 than those without, even when accounting for other known risk factors.
Conversely, those who developed Covid-19 were twice as likely to develop a mood or anxiety disorder for the very first time. Older adults with Covid-19 were found to have a two to three times greater risk of developing dementia.
There are several theories as to the causes for these neurological changes. One theory is demyelination, a condition where the protective layer of nerve cells is attacked and weakened by the immune system which then causes inflammation in the brain. This can disrupt people’s cognitive abilities and for some people may cause psychosis and hallucinations. It can also affect physical mobility and stamina, which many sufferers of Long Covid also report.
There are other theories. Covid-19 causes significant strain on the body’s respiratory system and in extreme cases a reduction of oxygen to the brain and can cause damage to it. Increased anxiety causes levels of cortisol in the body to increase which can cause impairment to the body’s immune system and lower the body’s ability to fight off infections such as Covid-19.
There is clearly much more research to be done on the effects of Covid-19 on mental health and on how poor mental health may increase the risk of suffering from severe Covid-19 and/or Long Covid. These early studies however are important in highlighting the possibility of connections between this severe physical disease and mental illness.
Those suffering from Long Covid symptoms such as chronic fatigue, brain fog, anxiety, depression and stress can now access specialist help available at clinics located across England and provided by the NHS. Further details can be found on the NHS Covid Recovery website: https://www.yourcovidrecovery.nhs.uk/