Researchers around the world have learned much about the effects of the COVID-19 pandemic on mental health. The pandemic provided a natural research opportunity. Scientists observed and surveyed people as they coped with impacts from the pandemic. Some outcomes are predictable. Many people reported more symptoms of stress, depression, and anxiety. But other results have been somewhat surprising. We'll review how people coped with these conditions, the role of resilience, and what we could see down the road regarding mental health.
Research published in May of 2021 focused on the pandemic as it developed in early 2020. During the first several weeks, people experienced a surge of acute anxiety symptoms. They reported feeling overwhelmed, worrying, restless, and had trouble sleeping. After lockdowns began, people adjusted to staying at home. Reports of the acute anxiety symptoms lowered to more typical levels. People felt less anxious overall as they became accustomed to changes brought on by the pandemic. This study included mostly women and people younger than 30. So while it may not be accurate for everyone, it's a good snapshot of emotions during the early stage of the pandemic.
A survey by the US Census Bureau in December of 2019 showed that 11% of people experienced anxiety. In December of 2020, anxiety levels jumped to a whopping 42%, almost four times the usual rate. Overall, anxiety levels peaked and leveled again in the early stages. But it appears that anxiety affected a much larger number of people than ever before due to the pandemic.
The actual depression rate among adults worldwide is unclear. Depression is often underdiagnosed and underreported. But several studies showed that depression was on the rise as the pandemic progressed. Several different studies conducted before and during the pandemic showed this result.
The United States Census surveyed people in December of 2020. Results showed that 42% of respondents reported some symptoms of depression. At that time, vaccines were rolled out to limited groups of people. This was a positive development, but uncertainty and isolation during the winter months had taken their toll.
The University of Surrey in the United Kingdom conducted a study from the fall of 2019 through spring of 2020. Researchers reported that depression among college-age young adults had more than doubled. The pre-pandemic depression rate in 2019 was 14.9%, rising to 34.7% in May and June of 2020.
Symptoms were more widespread, not worse
Studies and surveys from various parts of the world found similar numbers. And like the pandemic's effect on acute anxiety symptoms, a higher number of people reported feeling depressed overall. However, symptoms themselves did not increase or worsen. As this study from the Journal of Affective Disorders states, this report could mean that people adjusted to their circumstances. So while more people felt depressed, their depression did not necessarily become more severe over time.
Reports of depression hit their highest levels nearly a year after the pandemic began. By comparison, anxiety appeared to peak early in the pandemic. These results may not represent everyone's experience. However, it does show the effects of prolonged exposure to stressful events. An initial reaction of anxiety can transition into sadness and loss of hope.
Sleep is a major contributing factor to emotional distress, which proved to be true in the pandemic. In a Chinese study from the early months of the pandemic, researchers surveyed over 5,000 adults. From this group, 20% reported symptoms of insomnia. The rates were even higher for healthcare workers and people living closer to the epicenter of the pandemic. This early study captured the immediate impact of the pandemic as it began to spread.
Sleep disruption makes it difficult to handle stress and cope with frustrations. It can make existing mental health issues worse. People with poor sleep often feel irritable and have a lower tolerance for stress. A study published in March of 2021 followed a group of young adults from a pre-pandemic period in 2019 through the pandemic surge of mid-2020. It showed a correlation between reported depression symptoms and poor quality sleep. This study also found a connection between increased anxiety and shifting bedtime to a later hour.
Each of these studies is a snapshot of a small section of the world's population. Many factors play a role, including gender, income, race, and local pandemic conditions. A single mother in an urban area would have a different experience than a retired adult in a small town. Remote education and changes with in-person school have impacted countless families this year. People with stable jobs that allowed for remote work did not face as much uncertainty. Some people were able to maintain their usual income, but others saw their jobs eliminated.
Families with lower incomes and less support are under high stress under normal circumstances. The pandemic only added to their emotional burden, especially when schools went remote. People with existing physical or mental health issues struggled as well. Anyone with a condition requiring ongoing treatment was vulnerable. Healthcare providers did what they could to provide vital services. But some people faced limited access and changes to their usual plan for several weeks.
The pandemic provided researchers and surveyors with a long-term natural experiment. But the effects on mental health are far from over. As people step out and resume normal activities, the adjustments will continue. As researchers gather data and learn how people have coped, they hope to understand more. They'll examine what could help for a future pandemic or a similar long-term stressor.
While some trends have emerged with mental health and the pandemic, the answers haven't always been clear. The pandemic has highlighted the divide between people with and without financial security. It has also forced society to change in ways we may fully realize until years down the road. Measures intended to increase safety also isolated people and disrupted daily life. The experiences and data from this pandemic will give researchers much to dig into for years to come.