The Link Between Mental Illness and COVID-19

01.22.2021 | 3 min read

Dr. William Beecroft, MD, DLFAPA, is the Medical Director Blue Cross and Blue Shield of Michigan Behavioral Health and Behavioral Health strategy and planning. Dr. Beecroft received his M.D. from Michigan State University. He is board certified in general psychiatry with added qualifications in geriatrics and Consultation-Liaison Psychiatry. He will serve as the Michigan Psychiatric Society President in 2025.

It appears that even after people have recovered from COVID-19, they face an increased risk for a new challenge: mental health issues. A study published in The Lancet found that for people with no previous psychiatric history, nearly 20% of COVID-19 patients developed conditions such as depression, anxiety, insomnia and dementia within 90 days following diagnosis. That rate was twice as high when compared to other patients with different illnesses during the same period. The same study suggests that people diagnosed with a psychiatric condition in the year prior to testing positive for COVID-19 had a 65% greater risk of getting the disease.

Bi-directional links between chronic illness and depression well established

It’s not surprising that a major medical diagnosis could lead to mental health concerns. Experts have long known that depression is common after diagnoses such as cancer, stroke, heart disease and other chronic conditions. Adjusting to life with a medical condition comes with a level of loss and grief and depression is sometimes the result of working through a new reality. People with depression also tend to be at greater risk for developing illnesses like diabetes and Alzheimer’s disease, among other conditions. Sometimes, mental illness makes it hard for people to focus on their physical health. Habits such as regular exercise, eating healthy foods and taking medication can be neglected when mental illness isn’t managed. Oftentimes, people with mental health challenges also face co-occurring socioeconomic factors that make accessing health care more difficult.

Factors specific to COVID-19 that could raise risks for mental illness

Although the study authors didn’t pinpoint the exact reasons why COVID-19 appears to be tied to an increased risk for mental illness, there are factors that could be contributing:

Isolation and loneliness. People diagnosed with COVID-19 are urged to self-isolate, avoiding contact with others to keep them safe. When patients are hospitalized, they often aren’t allowed to have visitors due to strict safety precautions. A deep sense of loneliness caused by isolation can lead to depression.
Long-term symptoms. For some people with COVID-19, symptoms persist long after the virus is detected in the body. While severe symptoms such as fever and breathlessness might have passed, feelings of fatigue and “brain fog” have been noted for weeks and months in so-called “long haulers.” Feelings of uncertainty related to when they’ll get back to normal could contribute to some COVID-19 patients developing anxiety or depression.
Neurological effects. In many cases of severe COVID-19, the virus appears to affect the brain, causing neurological and cognitive symptoms such as delirium and confusion. Inflammation caused by the virus could also target the brain. This type of stress on the brain has been associated with depression and anxiety.
Novelty of the disease. Much is still unknown about COVID-19 and its long-term effects. Being one of the first people to contract the disease could certainly lead to feelings of anxiety about the potential for death or serious complications.

This early research about the mental health after-effects of COVID-19 highlights the importance of mental health care after patients have recovered from the worst of their symptoms. It’s important that patients and their loved ones check in with how they’re feeling. If symptoms of depression or anxiety are persistent, or even if something just feels off, it’s important to talk to a primary care physician or mental health professional to learn more about treatment options. About the author: Dr. William Beecroft is medical director of behavioral health for Blue Cross Blue Shield of Michigan. Related:

Photo credit: digital skillet