By: Shea Dorsey, PharmD Candidate c/o 2021
COVID-19 has taken a major toll on the mental wellbeing of people around the world and continues to do so today, almost 7 months after the United States first announced quarantine. Many individuals previously diagnosed with an anxiety disorder, depressive disorder, trauma-and stressor-related disorder (TSRD) or expressed suicidal ideation before the COVID-19pandemic,report their condition worsening due to the burdens on lifestyle, family, health, and all-around fear of the pandemic. Individuals who were not previously diagnosed with a mental illness have also addressed their new symptoms of adverse mental and behavioral health conditions due to COVID-19 in a magnitude of mental health studies.¹
In August 2020, the Centers for Disease Control and Prevention (CDC) released a report to assess mental health and suicidal ideation among individuals in the US. The study was conducted from June 24-June 30, 2020 and consisted of 5,470 eligible patients. Participants who were eligible had to be a minimum of 18 years of age and had to be residing in the US. The patients completed online surveys that included questions about their feelings and understanding of COVID-19, demographics, and the social and behavioral health impacts of the COVID-19 pandemic. The four-item Patient Health Questionnaire (PHQ-4) was used to determine symptoms of anxiety or depression and the six-item Impact of Event Scale (IES-6) was used to determine COVID-19-related TSRD. Of the 5,470 participants, 40.9% reported an adverse mental or behavioral health condition. Of those who had a condition, 30.9% reported symptoms of anxiety or depressive disorders, 26.3% reported TSRD symptoms related to COVID-19, and 10.7% reported considering suicide within the past 30 days of completing the survey. Participant demographics were used to perform subgroup analyses among various groups of individuals. Overall, those aged 18-24 years old reported the most events of adverse mental or behavioral health conditions. Participants who reported already receiving treatment for diagnoses of anxiety, depression, or TSRD before the start of the survey reported worsening of symptoms. Unpaid caregivers for adults, defined as a person who self-reports that he or she provides unpaid care to anyone over the age of 18 by allowing them to help take care of themselves within the past 3 months, had a much greater incidence of adverse conditions compared to those who are not caregivers. Unpaid caregivers for adults had three times higher odds of reporting adverse conditions and suicidal ideation in June compared to before the start of the COVID-19 pandemic.¹
Many healthcare workers, especially those directly exposed to COVID-19 patients, have faced many different psychological burdens and stress including anxiety and depressive symptoms, emotional breakdowns, and sleep disturbances. In China, a national, cross-sectional online survey was conducted among healthcare professionals using the Patient Health Questionnaire (PHQ) to assess depressive symptoms and quality of life (QOL). If the patient’s score reflected depression, then the score was used to determine the depression severity. Out of the 1,103 emergency department nurses who completed the survey, 43.6% were classified as being depressed based on their survey score with 27.7% of those nurses reporting mild depression, 8.6% reporting moderate depression, 5.3% reporting moderate-to-severe depression, and 2.1% reporting severe depression. It was also noted that nurses suffering from depression had a much lower QOL than those nurses who did not report depression. ²
To address the current effects of COVID-19 on mental health, many approaches have been considered as to how to combat the issue and improve the mentality of the overall population. Telehealth, a means of providing health services remotely, has been heavily utilized during the pandemic to promote healthcare during quarantine and to allow people to receive health services from home. Telehealth is an effective way to deliver mental health treatment and many psychology and psychiatry programs addressing mental health have moved to a remote setting to promote patient access. ¹ The American Psychiatric Association has made a COVID-19 online resource page consisting of a collection of helpline numbers that are available to call 24 hours a day, 7 days a week to discuss mental health conditions based on individual need. The helplines include the Disaster Distress Helpline, National Suicide Prevention Lifeline, Physician Support Line, Crisis Textline, Veterans Crisis Line and many others. ³ Similarly, the CDC also has a list of helplines on their website that address issues such as suicidal ideation, crisis, and substance abuse. Guidelines addressing stress coping mechanisms, how to identify factors of depression or anxiety, and how to improve mental health during the pandemic are also provided. ⁴ Plans have been implemented to organize regular screening for depression and anxiety for workers in the healthcare setting. Screening will allow for treatment of psychological symptoms in depressed patients and allow healthcare facilities overall to continuously consider the mental wellbeing of their workers. ²
- Czeisler MÉ , Lane RI, Petrosky E, et al. Mental health, substance use, and suicidal ideation during the COVID-19 pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1049–1057. DOI: http://dx.doi.org/10.15585/mmwr.mm6932a1
- An Y, Yang Y, Wang A, et al. Prevalence of depression and its impact on quality of life among frontline nurses in emergency departments during the COVID-19 outbreak. J Affect Disord. 2020;276:312-315. DOI: http://dx.doi.org/10.1016/j.jad.2020.06.047
- APA Coronavirus Resources. COVID-19 / Coronavirus Resources. https://www.psychiatry.org/psychiatrists/covid-19-coronavirus. Accessed September 7, 2020.
- Coping with a Disaster or Traumatic Event. Centers for Disease Control and Prevention. https://emergency.cdc.gov/coping/selfcare.asp. Published September 13, 2019. Accessed September 7, 2020.