It’s been over a year since the start of the COVID-19 pandemic. Vaccination rates are rising and we’re starting to trend back to normalcy in the U.S. There’s light at the end of the tunnel for the COVID-19 pandemic but there may be a mental health pandemic on the horizon.
Recent research has discovered that COVID-19 often has secondary effects on neurological and mental health. In an article published in the Lancet Psychiatry, researchers found that 1 in 3 COVD-19 survivors experienced neurological or mental health problems six months after recovering. For 12% of survivors, this was their first time experiencing a neurological or mental health problem. It’s unclear if mental health outcomes are the caused by COVID-19 (e.g., the result of neuroinflammation) or secondary to consequences associated with being infected (e.g., social isolation). However, the rates of mental health diagnoses observed among COVID-19 cases are significantly higher than the rates observed among those with the flu or other respiratory illnesses. This is especially troublesome since those with a mental health conditions are more likely to get COVD-19. Thus, there’s a vicious, bi-directional relationship between mental health conditions (ADHD, anxiety, depression) and COVID-19 infection—those infected with COVID-19 are more likely to develop a mental health condition and those with a mental health condition are more likely to be infected by COVID-19.
Of note, none of these studies account for the increase in mental health conditions due to the secondary stressors related to COVID-19, such as social isolation and economic uncertainty. The CDC observed a spike in anxiety and depression in the U.S. over the last year—especially among young adults and college students. If you are feeling anxious and depressed, you are not alone!
This all translates into a rising demand for mental health care services. While rates of infection are much lower in children relative to adults, there are still millions of children who have been infected with COVID-19 and little is known about their outcomes after recovery. At the international meeting of the Society for Research in Child Development, Dr. Jim Swanson warned that we may see an increase in ADHD in the coming years. He noted that, similar to how the neuroinflammation seen during the 1918 influenza pandemic corresponded to a rise in hyperkinesis (ADHD) cases, the neuroinflammation seen with COVID-19 may also correspond to a rise in ADHD. Although COVID-19 affects children far less than adults, millions of children have already been infected.
At the time of this post, there have been 169 million documented COVID-19 cases and over 3.5 million deaths. While this is almost certainly an under-representation of the actual number of cases and deaths, this means that there are at least 130 million COVID-19 survivors worldwide (and counting). If 12% of them develop their first mental health condition, that works out to 15.6 million new mental health patients around the globe. In the U.S., we’ve had over 33 million cases so far, suggesting we can expect approximately 4 million first-time mental health patients. According to the American Academy of Pediatrics, “as of May 20th, over 3.94 million children have tested positive for COVID-19” in the U.S. Although we don’t know the rate of mental health diagnoses in children who had COVID-19, even if it’s half the rate of what we’ve observed in adults, that would correspond to well over 200,000 kids getting a first-time mental health diagnosis. These numbers underscore the implications of a significant mental health crisis on our already over-stressed mental health system.
Children and adults with ADHD are known to be sensitive to changes and environmental changes and may experience greater difficulty adjusting during those times. While there’s light at the end of the tunnel, COVID-19 makes those who get infected at risk for mental health problems and places particular risk in front of individuals with pre-existing mental health conditions, such as ADHD, depression, and anxiety.
But what can we do? On an individual and personal level, pay attention to your self-care. Acknowledge the isolation and economic stressors. You are not alone. While economic indicators and vaccination rates have been improving, COVID-related stressors remain very high. Be kind to yourself, your loved ones, and strangers. For those with existing mental health conditions—including ADHD, depression, and anxiety—stay vigilant to your mental and physical health needs.
I have also highlighted free, reputable resources to help those with ADHD or other mental health concerns cope with the pandemic and social isolation in a separate blog post.
The Science:
Rogers, J. P., & David, A. S. (2021). A longer look at COVID-19 and neuropsychiatric outcomes. The Lancet. Psychiatry, 8(5), 351–352. https://doi.org/10.1016/S2215-0366(21)00120-6
Swanson, J. (2021). What is the history of the evolving concept of ADHD? In the symposium, Conceptual and methodological challenges in ADHD research: Understanding risk factors and optimizing outcomes (Chair, J Cotton). Presented at the biennial meetings of the Society for Research in Child Development, April 8.
Taquet, M., Geddes, J. R., Husain, M., Luciano, S., & Harrison, P. J. (2021). 6-month neurological and psychiatric outcomes in 236379 survivors of COVID-19: A retrospective cohort study using electronic health records. The Lancet Psychiatry, 8(5), 416–427. https://doi.org/10.1016/S2215-0366(21)00084-5
Taquet, M., Luciano, S., Geddes, J. R., & Harrison, P. J. (2021). Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA. The Lancet Psychiatry, 8(2), 130–140. https://doi.org/10.1016/S2215-0366(20)30462-4
Walter, K. (2021, March 24). CDC Report Highlights Mental Health Issues During COVID-19. Retrieved May 28, 2021, from https://www.hcplive.com/view/cdc-mental-health-covid-19
Wang, Q., Xu, R., & Volkow, N. D. (2021). Increased risk of COVID-19 infection and mortality in people with mental disorders: analysis from electronic health records in the United States. World Psychiatry, 20(1), 124–130. https://doi.org/10.1002/wps.20806