The coronavirus pandemic may have a “profound” and “pervasive” impact on people’s mental health for some time to come, experts have warned.
Scientists from all over the world put together a survey to uncover how the outbreak is affecting our emotional wellbeing.
The thousands of participants reported feeling anxious, isolated and stressed as they adjust to the “lockdown”.
While no one knows for sure how the outbreak will play out, one viral epidemic was followed by a spike in suicides, with the scientists worrying social distancing could trigger everything from alcohol dependency to cyberbullying.
With the new coronavirus virtually unheard of at the start of 2020, there is still much experts do not know about its long-term effects on the body, including whether it alters the brain into a more depressive state.
Early research suggests the infection is mild in four out of five cases, however, it can trigger a respiratory disease called COVID-19.
Coronavirus: ‘Perfect storm to harm mental health’
Boris Johnson has introduced draconian measures that only allow Britons to leave their home for “very limited purposes”, like shopping for essentials.
Social contact must be restricted to the people we live with, with the public also being told to ditch non-essential travel and work from home, if they can.
Europe and the US, the epicentres of the pandemic, have similarly strict restrictions.
Latest coronavirus news, updates and advice
“Increased social isolation, loneliness, health anxiety, stress and an economic downturn are a perfect storm to harm people’s mental health and wellbeing,” said study author Professor Rory O’Connor from the University of Glasgow.
With the coronavirus pandemic being unprecedented, no one can say for sure how it will play out or the long-term impact it could have.
The scientists worry the UK’s lockdown may trigger everything from domestic abuse and online gambling to relationship breakdowns and feeling a burden – all risk factors for mental-health issues.
As well as potentially mourning the loss of a loved one, people may have to cope with unemployment as businesses shut up shop, unable to cope financially.
A lack of freedom, face-to-face support and sense of purpose may also take its toll.
The scientists also worry patients who survive the coronavirus could have an altered brain function as a result, making them more susceptible to mental-health issues.
“We know very little, almost nothing, about how this virus could affect the brain,” said study author Professor Ed Bullmore from the University of Cambridge.
“We know in China and Italy there have been reports that indicate a proportion of patients – typically the more severe – are experiencing symptoms, often quite minor, that imply the virus has somehow had an effect on the function of the brain”.
Professor Bullmore referenced the emerging symptom of a loss of taste or smell, which research suggests could be experienced by just under two-thirds of patients.
“Neurological symptoms like fatigue suggest the brain may be involved,” he added.
The new coronavirus is one of seven strains of a virus class that are known to infect humans.
It is genetically similar to fellow-strain severe acute respiratory syndrome (Sars), which killed 774 people during its 2002/3 outbreak.
Writing in The Lancet Psychiatry, the scientists described Sars as “clinically neurotoxic, causing mental health and neurological disorders”.
Although unclear, the new coronavirus could have “persistent direct neurotoxic effects and immune-mediated neurotoxic effects on the brain”.
While it may sound far-fetched, the Spanish flu pandemic of 1918/19 was linked to a spike in Parkinson’s disease after the virus triggered degeneration of nerve cells.
Coronavirus: ‘We can act now to protect as many people as possible’
Study author Professor Matthew Hotopf from King’s College London noted how widespread the emotional impact of the pandemic could be.
“It affects all of society - young people not at school, old people having to self-isolate, people with long-term conditions, the people looking after them, the people recovering from the infection,” he said.
“It’s quite unusual for a health story that it is so wide”.
Professor Hotopf worries the aftermath of the outbreak could widen the chasm between “the have and the have nots”.
“[The] experience of someone with a house and a garden in lockdown is very different to someone in crowded unstable housing with kids running around and a partner with anger problems”, he said.
The scientists have flagged who they consider to be particularly vulnerable to the mental-health consequences of the pandemic.
These include those with pre-existing mental-health conditions who may be missing out on support, front-line workers dealing with the stress of becoming infected and the already “socially-excluded”, like homeless people.
“[You] have the impact of immediate panic, the immediate displacement and the long-term economic impact,” said Professor Hotopf.
“We don’t anticipate this to be a temporary blip, we anticipate a slow burn with significant consequences longer term.”
The Sars epidemic was associated with a 30% increase in suicide in those aged 65 or over, while half (50%) of the recovered patients “remained anxious”.
The scientists worry this does not bode well for the ongoing pandemic, but stressed it does not have to be “inevitable”.
“In the past, the mental-health impact of epidemics has not been as actively investigated from the outset”, said Professor Bullmore.
“We have the opportunity to do things differently and better.”
Professor O’Connor added: “Looking at the last recession and different countries throughout Europe, there is evidence you can mitigate the risk.
“We can act now to protect as many people as possible.”
The scientists are calling for “moment-to-moment monitoring” of mental-health issues during the outbreak, as well as more evidence-led solutions.
They accept the lockdown is crucial to stem the spread of the coronavirus, but stress the mental-health implications should be seriously considered.
“The first thing we have to do is control the spread of the pandemic,” said Professor Bullmore.
“It’s always tricky prioritising these things [and we’re] not arguing we should relax social distancing for [the sake of] mental health in case the pandemic comes roaring back.
“[But] we should be cognitive that [the lockdown] will have a mental health impact.”
Study author Professor Emily Holmes from Uppsala University in Sweden agreed, adding mental and physical health are “two sides of the same coin”.
“We need people to be panicked enough to follow the hand washing advice, but not be unduly anxious,” she said.
In terms of protecting mental health, the survey participants cited the importance of staying connected with loved ones, exercising and keeping busy.
One mentioned they had joined a virtual choir and exercise class, while also ticking things off their to-do list.
“Being mostly confined indoors, I’ve used the extra time to attend to the many small but postponed jobs”, the participant said.
“I’ve even started giving my kitchen cupboards a thorough clean. Keep busy, but take time for reflection.”
Another mentioned how reading “settles them”, while one said talking to friends over the phone “keeps them sane”.
“The digital age, for all its problems, has bestowed a real gift: social media, the internet, video and phone meetings mean that social communication and research can continue in a way that would have been impossible even 20 years ago,” said study author Kate King, adviser to The Mental Health Act Review 2018.
What is the coronavirus?
Since the coronavirus outbreak was identified, more than two million cases have been confirmed worldwide, according to Johns Hopkins University.
Of these cases, over 501,000 are known to have “recovered”.
Globally, the death toll has exceeded 128,000.
The coronavirus mainly spreads face-to-face via infected droplets expelled in a cough or sneeze.
Most cases are mild, however, pneumonia can come about if the coronavirus spreads to the air sacs in the lungs.
This causes them to become inflamed and filled with fluid or pus.
The lungs then struggle to draw in air, resulting in reduced oxygen in the bloodstream and a build-up of carbon dioxide.
The coronavirus has no “set” treatment, with most patients naturally fighting off the infection.
Those requiring hospitalisation are given “supportive care”, like ventilation, while their immune system gets to work.
Officials urge people ward off the coronavirus by washing their hands regularly and maintaining social distancing.
For confidential emotional support at times of distress, contact The Samaritans at any time by calling 116 123 or emailing email@example.com.