The coronavirus disease 2019 (COVID-19) pandemic itself is stressful for most of us. We are likely to experience fear and anxiety about what could happen to us if we contract the disease. These fears can be overwhelming and cause strong emotions in us.
At the same time, some public health actions, such as social distancing, can result in people feeling isolated and lonely and can increase stress and anxiety. Stress during an infectious disease outbreak can sometimes cause the following: fear and worry about your own health and the health of your loved ones, your financial situation or job, or loss of support services on which you rely. How you cope with your stress will determine how well you manage life in the pandemic.
There has been a recent study of the relationship between a diagnosis of COVID-19 and diagnosis of a psychiatric disorder. The study, titled “Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62,354 COVID-19 cases in the USA”, was published in Lancet Psychiatry. The authors include M. Taquet, S. Luciano, J.R. Geddes, and P.J. Harrison. The investigators found that people recovering from COVID-19 are more likely to be diagnosed with a psychiatric disorder such as anxiety, depression or insomnia within three months of their illness from the virus. "The incidence of any psychiatric diagnosis in the 14 to 90 days after COVID-19 diagnosis was 18.1%," the study found, including 5.8% that was a first diagnosis. Therefore, nearly 1 person in 5 diagnosed with COVID-19 is diagnosed with a psychiatric disorder like anxiety, depression or insomnia within three months.
The analysis was conducted by researchers at the University of Oxford, using electronic health records for 69.8 million patients in the U.S. — including more than 62,000 diagnosed with COVID-19. Compared with patients who had experienced certain other health events this year — such as influenza, kidney stones or a major bone fracture – those diagnosed with COVID-19 were more likely to have a subsequent psychiatric diagnosis in the following 14 to 90 days. To assess the psychiatric sequelae of COVID-19, the authors produced matched cohorts of patients who had been diagnosed with another health event. People recovering from COVID-19 were about twice as likely to be diagnosed with a mental health disorder as compared with someone who had the flu, according to Paul Harrison, professor of psychiatry at Oxford and one of the study's authors. The researchers were able to differentiate somewhat for severity of COVID-19 cases — for instance, they found that someone hospitalized for COVID-19 had a higher risk of getting a psychiatric diagnosis than someone who did not need hospitalization.
In yet another study, QuanQiu Wang and colleagues, in a study published in World Psychiatry, found that there was an increased risk of COVID‐19 infection and mortality in people with mental disorders following an analysis from electronic health records in the United States.
Wang and colleagues sought to determine the effects of a past-year diagnosis of a mental disorder, such as attention deficit disorder with hyperactivity (ADHD), bipolar disorder, depression and schizophrenia, on the risk for COVID-19 infections, as well as related rates of mortality and hospitalization. They analyzed electronic health record data of 61 million adults from 360 hospitals and 317,000 providers across the U.S. up to July 29, 2020.
Results showed a significantly increased risk for COVID-19 infection among those with a recent mental disorder diagnosis, with the effect strongest for depression and schizophrenia
You might say, “Aren’t most of us experiencing some level of anxiety right now, given the global pandemic?” As I noted earlier, the Oxford study is speaking to a level of anxiety far more severe than the normal anxieties and apprehensions many of us have at this time. As Dr. Harrison noted, "To get a diagnosis of an anxiety disorder, assuming the diagnostic tests were done correctly — this is more than simply the anxiety we're all feeling very, very reasonably because of the circumstances many people have lived through over the last few months."
In another article about the studies, Laurel Wamsley of NPR.org wrote about how “After COVID-19 Diagnosis, Nearly 1 In 5 Are Diagnosed With Mental Disorder”. From a different perspective, the author noted that Dr. Lauri Pasch from UCSF observed that many patients have a different experience, namely the presence of much gratitude. She stated that: "We're seeing a lot of gratefulness — that feeling that friends and family were there for them in a way that they didn't expect, and feeling really grateful for that. Feeling like celebrating life." Dr. Pasch also noted that some patients who had really difficult hospital stays say things like "I feel like I get a second chance at life" and "I'm going to make myself a better person," now that they have survived. She calls this "post-traumatic growth" – the inverse of post-traumatic stress and contends that the post-traumatic stress symptoms of COVID-19 symptoms will attenuate over the longer term. She and her colleagues are gathering data on that subject at UCSF.
So as in so many other areas of life, how we view stressors has much to do with whether we will have a more malignant or a more benign outcome. We discuss these issues in our book on stress management (I Can’t Take It Anymore: How to Manage Stress so It Doesn’t Manage You; Paul G. Longobardi, Ph.D., and Janice B. Longobardi, R.N., B.S.N., P.H.N.), available on Amazon at https://www.amazon.com/dp/1542458056. For more information about the book and authors, please visit our website at www.manageyourhealthandstress.com.
You indeed can influence your risk for a mental health disorder if you contract COVID-19. It is not inevitable. Reach out for assistance for yourself and/or loved ones. Practice good strategies such as proper diet, rest, exercise, physical relaxation/meditation, and engage yourself socially as fully as possible.
Good luck on your journey.
Dr. Paul Longobardi
For information on these and related topics, please visit my website at www.successandmindset.com