Yes, it is. People can also have symptoms of anxiety and other mood symptoms after COVID too.
This can also happen after other infections like the flu or even Epstein Barr Virus [(EBV), the one that often causes mononucleosis]. Between 20-30% of people can develop mental health symptoms* up to 6 months after COVID or another infection (1). More studies and attention on long COVID have helped us learn more about why this might happen, who might have this, and what we can do about it.
Read on to find out what you should know about mental health symptoms after COVID
Why does this happen?
We are not 100% sure, but there is research that tells us more about why this happens, not only in COVID, but also in other infections. One possible cause is that COVID increases inflammation in the brain. Another idea is that the damage caused to blood vessels by COVID can change how much blood and oxygen get to the brain and therefore impair its important functions. Finally, a third idea is that viral infection can change the balance in the gut (the “microbiome” for fellow nerdies out there!). This matters because the gut itself is sometimes called the little brain. It is full of pathways that send signals to the brain! So if the gut is not intact, this could also lead to changes in the brain’s functions (2).
One important thing to know is that this isn’t just because of COVID related stressors in work or life. It is because of many reasons, including changes in the immune system response as well as individual factors such as other illnesses and/or psychological stress.
Who might have this?
Estimates vary but studies tell us that between 1 in 5 and 1 in 3 people who have long COVID will have depressive and/or other symptoms. This is important because it can also worsen other symptoms of long COVID (3). There are many risk factors for having mental health symptoms after COVID. Some of the symptoms are not always going to be mental health diagnoses but they can still be very difficult to live with in the long run. For example, some people have severe sleep disruptions after having COVID and may sleep for only short periods of time (less than 60 minutes at a time). Others might have crushing fatigue, which makes it difficult for them to work or take care of themselves. Symptoms like these can be a part of long COVID, but they can also make mental health symptoms worse and/or mental health diagnoses can make them worse.
This is a little different from having mental health symptoms alone after having COVID. For most people who have mental health symptoms alone, these start within 2-3 months of the infection. People may report unusual anxiety or depression that is out of character for them. They often state that symptoms came “out of the blue.” A smaller group of people may have had a mental health diagnosis before COVID. This group of people is at even higher risk of either having new mental health symptoms or worsening of symptoms that were previously stable.
In either case, it is important to know that many studies have shown associations with inflammation, immune changes, and cortisol dysregulation, which can contribute to depression and other mood issues. They are not only caused by psychological or social stressors (4).
What can we do about it?
It is very important that we acknowledge that these symptoms can happen after having COVID. By talking about them and including them in our definitions of long COVID, it may encourage people to seek help if they recognize the symptoms. Some people will only have mental health symptoms after having COVID. For this group of people, it is important to know that the symptoms are not likely just due to stress, but that they can be related to COVID.
The good news is that mental health symptoms of long COVID are treatable. If someone is not sure if they have depression or anxiety or another mental health symptom, they are not alone. We have talked before about depression and anxiety (links below); these posts may help you understand a little more about what you or others are experiencing. There is a lot of overlap in symptoms between long COVID and mental health diagnoses. That is why it is so important to talk to your primary care clinician, mental health clinician, or other specialist to figure out the right treatment for you.
The bottom line: Depression (and other mental health diagnoses) are common after COVID infection. There are reasonable explanations for why this happens with or without long COVID. Some people are more at risk than others, such as people with prior mental health diagnoses. By recognizing the symptoms, talking about them, and seeking help, people can get better.
Stay safe. Stay well.
Those Nerdy Girls
*In this post, we talk generally around mental health symptoms because a variety have been reported after COVID. Depression and anxiety are the most common.
Please note: If you or a loved one need additional resources, Mental Health America (MHA) (https://bit.ly/3c1pRX7 ) offers a great way to search for resources. And if you are in need of immediate assistance, please contact the National Suicide Prevention Lifeline at 988 OR 1-800-273-8255 (Español: 1-888-628-9454; Hearing Support: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.
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Sources:
1. Post viral mental health sequelae (ZĂĽrcher et al., 2022)
2. Plain language discussion on depression and COVID-19
3. Post-COVID Depressive Symptoms
4. Fallout from the COVID-19 pandemic (Lyons et al., 2020)
Depression and Anxiety Links from Those Nerdy Girls:
Additional Study:
1. Study on association of mental health conditions with long COVID-19 (Wang et al., 2020)
