The early stages of the pandemic and the ensuing lockdowns were hard on all of us, in different ways. Isolation, joblessness, childcare, and many other challenges severely affected the mental well-being of many people around the world. Yet here we are, a year on. How are we coping?
The physical health effects of COVID-19 and the countless deaths the pandemic has claimed have been, and continue to be, devastating on a global scale.
However, the mental health of people across the globe also took a hit. Last year, dozens of Medical News Today readers spoke to us about the stress and anxiety that came with the first waves of lockdown.
People were worried about the emotional impact that the loss of loved ones would have on themselves and on their friends and neighbors. Many found it hard to cope with the grief and isolation, and others found it hard to deal with job loss and financial insecurity.
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Frontline healthcare workers and others in the caregiving industry faced similar emotional challenges.
The pandemic has forced some people to work and expose themselves to the virus, while others have benefited from working from home.
At the start of the pandemic, some people enjoyed more relaxed lockdown measures (depending on which country they were in), while others felt safer through strict self-isolation.
Still, overall, the mental effects of lockdown did not fail to appear: People reported feeling more agitated, more stressed, more restless, and more sleepless.
Studies confirmed this. A small but worrying survey from March 2020 revealed increased alcohol and cannabis use among people in the United States. They likely turned to these substances in an attempt to relieve their pandemic-induced anxiety and depression.
The same survey found that a whopping 38% of people were feeling tired or lacked energy, 36% were having sleep disturbances, and 25% were feeling down, depressed, or hopeless.
Around 24% of respondents also reported having difficulty concentrating, 43% felt nervous, anxious, or on edge, 36% reported not being able to stop worrying, and 35% said that they were finding it hard to relax.
In the United Kingdom, other studies with larger population samples found similar results. Of the participants, 25% said that their anxiety and depression during lockdown got significantly worse, and 37.5% met clinical criteria for generalized anxiety, depression, or health anxiety at the time (April 2020).
A year ago, however, there was also hope. Hope that, on a mental health level, the pandemic would allow us to slow down, be more mindful, and have more time to reflect.
MNT readers reported finding new working from home arrangements, for those lucky enough to have them, less stressful and more creativity-inducing. Working at a more “human pace,” said one reader, would hopefully enable them to work in more creative and environmentally friendly ways.
So, a year on, have any of these hopes materialized? Has the pandemic had any benefits for our well-being, or are we all worse off across the board? How have our mental health and well-being evolved and changed compared with this time last year?
To find out, we spoke to our readers and, as usual, examined some of the available research.
Scientists are using huge datasets to track the impact that pandemic control measures have had on people’s mental health. Although the full picture has yet to become clear, we can discern its early contours — and the overall first impression is looking rather bleak.
Scientists are starting to see a global “surge” in depression. According to a December 2020 survey by the U.S. Census Bureau, 42% of people in the country reported symptoms of anxiety or depression that month. This was a huge increase from the 11% they recorded in 2019.
The picture looks similar worldwide. One recently published Nature article notes an increase of 9% in depression rates in June 2020, compared with pre-pandemic times, among U.K. adults.
Another study that looked at residents in the U.S., U.K., Australia, and Canada found a 14% increase in anxiety as a result of the pandemic.
An important thing to note is that the pandemic seems to have affected older adults’ mental health less severely, compared with that of younger adults.
Here, the impact may have been buffered by the key element of resilience, though it is also worth mentioning that white older adults fared better than older adults from historically marginalized groups.
Many, though not all, MNT readers confirmed that, from a mental health perspective, things have indeed worsened rather than improved since the early days of the pandemic.
When explicitly asked if things had gotten better or worse, one MNT reader said: “At this stage, worse. While I’m hopeful about the vaccine bringing positive change, the way people have decided that the virus is no longer an issue is a cause of stress. Add in the other challenges that have arisen over the [past] year, and the stress is amplified.”
“Much worse,” said another reader. “I’d say my mental health has slowly declined over the past year.”
Yet another contributor categorically said, “I am feeling much worse a year on, hands down.”
Interestingly, some MNT readers pointed out that resilience is not necessarily protecting them from the adverse mental health effects of the pandemic. Even though they feel stronger, that does not make them feel emotionally better.
One reader said, “I feel I’ve become stronger mentally but have had to overcome stress and loneliness in a way I never would have imagined. [I feel] stronger, but certainly more weary! I’d say [my mental state is] worse overall.”
Another reader mentioned similar feelings, adding:
“The one positive that I can acknowledge 1 year on is that I have a newfound respect for myself and more confidence in my own abilities: I have made it on my own through a very isolating, difficult, anxiety-inducing time, and I remind myself of my own strength every day.”
Others reported feelings of emptiness and indifference at this stage. “I mostly feel sort of numb,” one reader said. “I feel like I go through each day on autopilot,” they added.
Another reader noted that they feel “removed” from other people.
Many MNT readers echo feelings that surveys documented at the start of the pandemic and report that these feelings have amplified. They note a lack of concentration, lack of energy, difficulty sleeping, and unhealthy eating habits.
“I’m exhausted all the time. It’s an emotional exhaustion. That being said, falling asleep is a challenge most nights because it’s the first time in the day when nobody is there, expecting things from me, and my brain begins focusing on every problem, question, or concern I pushed to the side in order to make it through a workday and parenting the children.”
“I have been having sleeping issues,” another reader noted. “I have some nights where I just lie awake, which I rarely had before. Other times, I wake after a long sleep but still feel exhausted, despite not doing much during the week.”
Many readers mentioned a lack of restorative sleep. “I don’t sleep less, but my sleep is of poorer quality, and I often don’t feel restored in the mornings,” said one reader.
Researchers have expressed worry that some of these adverse mental health effects may linger after we come out of the pandemic. “I don’t think this is going to go back to baseline anytime soon,” clinical psychologist Luana Marques — from Harvard Medical School in Boston, MA — told Nature.
Of course, for some people, the baseline was already quite low. This makes things more worrying for them.
“I have experienced exceedingly high levels of anxiety. Older concerns I used to have have come back and seem more overwhelming than ever,” one reader told MNT.
Another reader said:
“I’ve always been a relatively anxious kind of person, but that aspect of my personality has really come to the fore. I am constantly on edge. I no longer find joy in the things I used to love, and my go-to emotion is panic.”
This surge in depression and anxiety, while worrying, is not surprising given the numerous challenges the pandemic has posed to so many of us. People who reached out to MNT spoke about recurrent feelings of anxiety, depression, panic, loneliness, and isolation.
“I have retreated into myself over the past year and found myself reaching out less and less to friends, as if I’ve become used to living life alone,” one reader said.
Readers mentioned several reasons for their anxieties, including fear for one’s health and the health of a loved one, loss of income, being alone, and having too many parental responsibilities, to name only a few.
“As a single person who lives alone and did not have access to a support bubble, I have become increasingly isolated,” said one reader. “And since my family lives in a different country, the fact that I was unable to see them in person for an entire year, and that I was unable to support them effectively through times of illness and grief, have really left a mark and made the pandemic more difficult to cope with.”
Another reader said, “The lack of two incomes, the addition of other changes to work and health, and the spotty application of safety measures (at least here in Florida, [U.S.]) have taken a toll. I feel like I’ve hit my absolute limit, and the stress is weighing heavily on every day.”
Although many people are stressed because of a lack of work, many others feel overworked.
“My deepening sense of isolation has contributed to feelings of helplessness and anxiety,” said one reader. “The fact that I work from home means that I end up working longer hours. Work itself has become more stressful and intense, which makes me teeter on the edge of burnout almost constantly.”
Humans, in general — and those who are more scientifically minded, in particular — have a tendency to seek clearly understandable patterns, search for neat trends, and wrap up reality with a scientific bow.
However, reality is often messier than this. Much like the stages of grief that rarely occur in a neat order, a clear upward or downward trend in mental wellness throughout lockdown is also difficult to trace.
Many MNT readers said that the changes to their mental health have come in “waves” or “cycles.”
“The changes have come in waves,” said one reader. “At the beginning, the uncertainty and the worries about health were overwhelming, and it was a hit to my mental health.”
“Once changes were made, masks mandated, and our family found a new routine, it was actually a time of positive change. My family spent more time together, daily worries like getting places on time and rushed meals turned to relaxed time spent walking the neighborhood and playing board games after dinner.”
“[My mental state] fluctuated between an odd relaxed state at the beginning, to despondency at the state of the world, to a current state of awareness (yet again) of the need to do things now, while still making plans for the future,” said another reader.
Some researchers echo this sentiment, and some studies support this notion. For example, Richard Bentall — a professor of clinical psychology at the University of Sheffield in the U.K. — notes that while the effects of the lockdown may have appeared devastating in the short term and in the early stages of the pandemic, when we zoom out, “a different picture emerges.”
Prof. Bentall’s research suggests “an overall reduction in the number of people who report ‘above-threshold’ levels of psychiatric symptoms, and similar findings have been reported by other research groups.”
That is not to say that things are better overall, he notes. Instead, he points out that there are “different slopes for different folks,” meaning that different populations start out from different positions with regards to their mental health and that the emerging, overall narrative is likely to be multifaceted.
In fact, some people may even have benefited from the lockdown. Although this notion may seem inconceivable to those who are struggling the most, such positive effects do exist, and research has documented them.
The phenomenon bears the name of “post-traumatic growth.” A recent survey that MNT reported on found that 88.6% of respondents believe that certain positives have emerged from the physical distancing restrictions.
Around 48% of the participants, for example, said that they found a renewed appreciation for their family. Also, 22% of the respondents said that having their lives, albeit forcibly, slowed down made them mindfully reconsider what is important and what their personal values are.
Another study in a Spanish population found that, specifically, people who were more likely to experience post-traumatic growth as a result of the pandemic also shared a few psychological traits:
They were more likely to believe that the world was fundamentally a good place.
They were open to the future and had a higher tolerance to uncertainty.
They were more likely to identify with and empathize with humanity at large rather than be restricted to their own culture.
A significant number of MNT readers seem to find themselves in this camp, and some explicitly referred to their personal growth in their answers.
“I’d say my mental health is actually better during the pandemic,” one contributor said, “because I’ve been able to access meditation sessions and spiritual teachings online, instead of driving everywhere, so I am now able to work on my personal growth more often.”
These readers said that they feel downright better, mentally, as a result of the lockdown. They said that they work out more, drink less, sleep better.
“My mental health has actually improved slightly during the pandemic,” one contributor said. “Pre-pandemic, I was undergoing quite a prolonged period of anxiety, and I’ve noticed that I’m having a lot [fewer] symptoms now. I’m not 100% sure what has caused this, but it’s possible that the constraints of a lockdown have reduced exposure to the anxiety-triggering situations.”
“Also, it might be that the pandemic has forced me to readjust my thought patterns, and this has helped to reduce the ruminating thoughts I was frequently experiencing.”
Another reader, who has also experienced COVID-19, said that they are feeling “[b]etter mentally, emotionally. Also, unafraid of the disease now that [they] know more about it.”
Another person said, “I have been pretty upbeat throughout and would have enjoyed the slowdown had it not been for the knock-on effect of mental and physical health problems affecting other family members.”
This reader, who also contracted SARS-CoV-2, added that before having COVID-19, they were “happy” during the first lockdown, as they did not have to commute and could exercise more each day.
For many people, sleep has also improved. “I’d say my sleep […] has improved because the constraints of a lockdown has meant I have a more structured bed/wake-up time,” said one reader. They added:
“A silver lining of the situation we’ve been in is that I’ve been forced to slow down and reevaluate the priorities in my life. Over the [past] year, I’ve been exercising more, sleeping better, and actually spending time on my hobbies. Generally, I feel better than I’ve felt in years.”
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