The Impact of COVID-19 on Depression

As the world attempts to resume to (some sense of) normality, it is a perfect time to reflect on how the COVID-19 pandemic affected us. In an emergency situation, like the COVID-19 pandemic, people with pre-existing conditions are deemed ‘vulnerable’. However, this vulnerability does not specifically relate to physical conditions, it also includes mental health conditions and substance use disorders. This is classed as a vulnerability because mental health conditions can affect a person’s thinking, feeling, mood or behaviour in a way that influences their ability to relate to others and function each day (CDC, 2020).

In this blog post, we will specifically be writing about depression and COVID-19. The reason for this is because across our social media, we have decided that every month we will raise awareness to different mental health conditions, and we are starting with depression. You might ask, ‘why depression?’… well read the facts below and you might consider it a pandemic of its own.

4 facts you may not have known about depression (World Health Organisation, 2020)

1. Globally, more than 264 million people of all ages suffer from depression.
2. Depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease.
3. More women are affected by depression than men.
4. Between 76% and 85% of people in low- and middle-income countries receive no treatment for their disorder.

What happened to depression levels during COVID-19?

Well, the numbers are not entirely clear but there have been a few studies measuring this. The one that we have been following is the COVID-19 Social Study run by University College London. They release a weekly survey and have over 70,000 people in the UK take part, so we view this as pretty representative of the population. Additionally, this study measures a lot more than depression (for example compliance with guidelines, confidence in the UK Government, anxiety, stress, self-harm, well-being…and the list goes on).

Participants were asked to complete the Patient Health Questionnaire (PHQ-9), a standard instrument for diagnosing depression in primary care and we have summarised the (significant) weekly results below.

• 8^thApril release (data collected from 21^st March): They found an increase in levels of depression, however, relatively constant since lockdown. Levels were highest in younger adults, those living alone, those with lower household income, and those with an existing mental health diagnosis. As one might expect, people with an existing mental health diagnosis had levels above the threshold indicative of clinical depression.
• 16^thApril release: Depression levels seemed relatively constant since lockdown (and the previous report). The same groups mentioned above were still reporting the highest levels.
• 28^thApril release: Depression levels have shown a slight decrease since lockdown came in, however, the levels overall are higher than usually reported averages (2.7-3.7 for depression). The same groups mentioned above were still reporting the highest levels.
• 6^thMay release: Depression levels increased from the previous week and overall levels were still higher than usually reported values. Other than the usual groups reported, depression levels were also higher in women compared to men, those living in urban areas and those living with children compared to those living with just adults.
• 20^thMay release: At this point lockdown easing had begun and there was no change in depression levels. Depression levels were highest and showed least improvements in over-crowded households.
• 3^rdJune release: Some decrease in depression levels, especially amongst adults under the age of 60. Groups mentioned previously were still reported the highest levels.
• 9^thJune release: Depression levels lower than the previous week, until the weekend, when levels increased, especially in younger adults.
• 17^thJune release: Depression levels stopped decreasing and plateau. Groups mentioned previously still reported the highest levels.
• 25^thJune release: Depression levels remained stable.
• 1^stJuly release: Depression levels showed some improvements but still highest in groups reported previously. However, there were some ethnicity differences reported. People from BAME (Black, Asian and minority ethnic) backgrounds had higher levels of depression across the pandemic.

This may seem like a repetitive summary, but it is interesting to see how depression levels were affected (or not) on a weekly basis and could have coincided with certain events, although not explicitly linked in the results (e.g. good weather, protests, lockdown easing etc). Overall, I think these results suggest that levels of depression most definitely increased throughout the pandemic but may be now starting to decrease. The highest levels of depression were consistently reported in certain groups and, as expected, this included the ‘vulnerable’ group with pre-existing mental health conditions.

To continue following this study and look at the other findings, here is the link: https://www.covidsocialstudy.org/results

Why did levels of depression increase during the COVID-19 pandemic and what are some coping strategies?

Simply, the COVID-19 outbreak resulted in people experiencing uncertainty about the future and a dramatic change to the life they casually lived, which can be very difficult to cope with. More specifically, some factors related to COVID-19 that contributed to the increase include:

• Trauma from widespread disease
• Grief over loss of life
• Fears of getting sick
• Unprecedented physical distancing and separation from family and friends
• Financial concerns, especially in those whose lost their jobs or housing
• Loss of ‘sense of community’
• Reduced access to caregivers or people that usually help during day-to-day life

For those struggling with symptoms of depression, here are some tips to support you:

• Stick to a daily routine– keeping a good structure is hard when your everyday normal does not happen, so try to plan you day out and stick to it (this includes what time you will wake up, sleep, eat, have some ‘you’ time and goals for the day). Keep this achievable, do not overwhelm yourself with things to do and become disappointed when you do not do it.
• Have some ‘you’ time– you may be in an over-crowded household or struggle to be alone, but you need to give yourself (and others) some space to relieve some tension and avoid arguments.
• Limit media use– we may be on the other side of the pandemic but the news, at times, can still be overwhelming and induce negative thoughts, so avoid it when you can. We understand that is not always possible so only use trusted sites for your updates and set a maximum time you will spend reading.
• Stay in contact– not just using social media platforms but there are different forums and online support groups where you can connect with strangers who are going through the same things as you.
• Get help if needed– if you feel unable to cope, you should consult a professional. Most clinicians and therapists continued to work throughout the pandemic, but switched to remote sessions, and this will continue to be an option. However, if you put this off during the pandemic because you prefer face-to-face sessions, get in contact once again and see if they have opened and make sure you are comfortable with their new social distancing and hygiene procedures.

Throughout the pandemic, Phoenix Mental Health Services remained open and most clinicians and therapists moved to remote appointments. They are still taking on new patients and some are offering face-to-face appointments. Please see our website to see what services we offer and view our team to select who you would like to see.