Post-COVID depression

This term has appeared just recently because we have known COVID-19 for less than two years. However, now we can confidently say that post-COVID depression is a very common phenomenon.

COVID-19 comes in various forms. The notion of the post-COVID syndrome includes complaints and symptoms that develop during or after COVID-19 and last for more than 12 weeks. It is also called Long COVID.

Long COVID has a fairly large set of symptoms that are observed even when the virus itself has already been defeated and is absent in the body, which is confirmed by tests. Research in this area is still ongoing and there is not too much information on the nature of symptoms and their severity, as well as the effect on the human condition. However, some facts are already known.

It has been confirmed that the coronavirus negatively affects the psycho-emotional health of people. Post-COVID syndrome may include depressive mood, despondency, depression, and melancholy. In some cases, a depressed mood can lead to suicidal thoughts.

An unstable emotional state is manifested by sudden mood swings, low self-control of behavior, and panic attacks.

The Lancet journal published an article by scientists from the British University of Oxford, in which they analyzed 69 million medical records of US residents, more than 62 thousand of whom had had coronavirus. The study found that one in five subjects was diagnosed with a mental disorder within three months of recovery, leading to anxiety, depression, and insomnia. This may be due to a combination of psychological stressors and physical consequences of the disease.

Recently, WHO has introduced “post COVID condition” into the International Classification of Diseases.

Italian scientists have examined more than 400 patients who had recovered from COVID-19. One month after recovery, over 55% of them had at least one psychiatric symptom.

A team of specialists at the National Hospital of Neurology and Neurosurgery in London noted that “coronavirus infection is associated with a wide range of neurological syndromes affecting the entire nervous system, including the vasculature of the brain.” 

Russian doctors also note the negative consequences of COVID-19 for the psyche of patients, but there is still no consensus on what exactly leads to depression. Some experts posit that the reason lies in thrombovasculitis, inflammation, autoimmune reactions to coronavirus, and damage to nervous tissue. The psychological background is self-isolation, loss of loved ones, job loss, and the flood of negative information coming from the media.

Doctors note that post-COVID depression has its specific features. They consist of the particularities of the course of the disease and the patient’s experiences, and in how, at the biochemical level, the body responds to drugs. A psychotherapist or psychiatrist should diagnose a depressive state.

An online survey of people with suspected and confirmed COVID-19 was conducted. It was distributed through support groups and social media. The responses from 3,762 COVID-19 participants from 56 countries with illnesses lasting more than 28 days were collected and analyzed.

For more than 91% of respondents, recovery took over 35 weeks. The most common symptoms after 6 months were fatigue, post-exercise tiredness, and cognitive dysfunction. Cognitive dysfunction or memory problems in all age groups were noted by 88% of the subjects.

On July 22, 2021, British researchers published a report in the journal EClinicalMedicine indicating that COVID-19 is causing an irreversible decline in intellectual ability. The authors saw a drop in the average IQ values ​​for the group of patients who had recovered. And the more severe was the illness the bigger the drop was.

Scientists have not had the opportunity to test the IQ of their respondents before the disease. This is a serious flaw in the study. However, the cognitive impairments that affect problem-solving on IQ tests are undoubtedly a consequence of “long COVID”. Participants in all studies of the syndrome complain about them: such disorders are typical for other post-viral syndromes. Long-term studies of patients who have experienced acute respiratory distress syndrome (a condition that severe COVID leads to) show that full recovery from a previous illness is possible, but for many, the consequences persist even five years after the illness. For survivors of severe illness who had to be admitted to intensive care units, cognitive impairment can also persist for quite some time.

These conditions are difficult to distinguish from common anxiety and depressive disorders. Usually, people themselves note that after the coronavirus, they find certain changes in the body that were not previously there.

The post-COVID condition begins with asthenia, which does not go away after the illness. During post-COVID anxiety disorder, a person experiences fear of suffocation, death, worries about relatives and friends, anxiety, panic attacks, sleep disturbances, anemia, tingling sensations in various parts of the body, changes in appetite, and hypochondria.

During post-COVID depression, in addition to the standard symptoms, suicidal thoughts of a specific nature may appear. As a rule, these are occasional fleeting thoughts that frighten people. It is important to monitor the prevalence of thoughts and behaviors aimed at harming yourself. A large study of adults aged 18 and over found that 26.1% of respondents reported thoughts of self-harming and 7.9% reported self-harming behaviors at least once between March 2020 and May 2021. If you are experiencing suicidal thoughts, you must seek help.

An associated symptom is memory impairment – more pronounced than with normal depression.

American researchers have shown that people who have had COVID-19 are twice as likely to experience anxiety and depressive disorders as those who have had the flu or other infections.

Therapy for any depression is specific to an individual. After COVID-19, the body’s work is disrupted – and you need to understand that this is normal. Nerve endings are restored by 1 mm per day. Even with a common cold, we feel unwell for a long time after the illness, and here we are talking about a serious virus.

It is impossible to say how long the symptomatology will last and how it will manifest itself – some do not have it at all, and some suffer from post-COVID conditions for up to a year. A lot depends on how severe the illness was and whether the body has physical and psychological resources.

If you suspect you have depression after COVID-19, you can assess your psychological state using the Beck depression inventory. Also, be sure to contact a therapist to rule out the likelihood of other diseases.

How to help yourself if you are experiencing the symptoms of depression?

• Try not to withdraw from people – if possible, communicate with your friends and family. If you are isolated, communication via video conferencing, telephone, and instant messengers will help.

• Share what is happening to you, with someone you can trust, who can listen and support, without judging or criticizing.

• Maintain your body: you need at least minimal exercise, proper nutrition, and healthy sleep.

• Practice relaxation techniques. Jacobson relaxation, meditation, breathing, yoga – all will be beneficial.

• You can join a Facebook group for “Atypical Coronavirus”. In these communities, post-COVID survivors share their experiences, and doctors advise on what tests can be done. However, if you are an anxious person and tend to “try on” other people’s symptoms, it is better not to do this, so as not to “get infected”.

• See a specialist if you feel like you’re not able to cope.

Regardless of how the situation unfolds, we want to remind you that experiencing a wide range of complex emotions is a normal reaction to a potentially life-changing situation. This does not mean that you are weak, going crazy, or unable to deal with emotional problems – not at all. You just need to help yourself in a difficult moment. And we are trying to help you.