Having COVID-19 May Increase Your Risk of Depression

It can take weeks, months or even longer to physically recover from COVID-19. But if you still feel “not right” after the coughing, fever, congestion and other symptoms have gone away, there could be reason for it.

The virus may have affected your mental health.

“We know that viral infections like the flu can lead to post-viral depression,” says psychiatrist Jack Owens, MD. “It makes sense — and ongoing research is showing — that some people develop depression, anxiety or other mental health issues after they’ve had COVID-19.”

What exactly is the connection? Dr. Owens shares what we know.

Can COVID-19 cause depression?

In short, yes, COVID-19 can cause depression.

A study found that people with no prior history of a mental health disorder were up to 8% more likely to develop depression, anxiety or other mental health symptoms within two weeks to three months after a COVID-19 infection. The risk was twice as high in those who already had a mental health disorder.

Other research indicates that many people experience mental health issues six months after being ill:

• About 90% of people (9 in 10) who were hospitalized with COVID-19
• About 25% (1 in 4) in nonhospitalized adults

The risk of depression remains high for up to a year after a COVID-19 illness, regardless of your past mental health history.

“Even people who feel fine physically may find themselves struggling to sleep, concentrate or enjoy life the way they used to before they got COVID-19,” notes Dr. Owens.

5 ways COVID-19 causes depression

We know that stress and isolation during the pandemic negatively impacted mental health. But researchers are now examining the connection between COVID-19 and depression, beyond the effects of the pandemic.

Dr. Owens shares five factors that may be at play, as well as steps to take if you develop post-viral depression.

1. Inflammation

Inflammation may cause changes in your brain that trigger depression or anxiety.

Here’s how.

COVID-19 causes your immune system to flood your body with chemicals called cytokines. A “cytokine storm” can cause inflammation throughout your body, including your brain.

Studies suggest that people with high levels of cytokines are more likely to have a severe case of COVID-19, as well as develop a mental health disorder.

2. Damage to brain cells

The COVID-19 virus and the inflammation it causes may damage brain cells (neurons) and supportive cells (glial cells) that are crucial for brain activity and repair.

Researchers believe this damage may contribute to depression, anxiety and COVID-19 symptoms, like:

• Brain fog
• COVID-19 fatigue
• Memory loss

3. Lowered mood-boosting chemicals

One study found that people with long COVID had lower levels of serotonin — a natural mood booster that’s key to regulating emotions, memory and other brain functions.

People with long COVID have symptoms like headaches and difficulty thinking that last for three months or longer.

“You may get anxious and depressed if it’s months after your illness ‘should be’ over and you still feel unwell,” Dr. Owens says.

Depression and anxiety occur frequently in people with long COVID. So much so that many experts now consider them to be long COVID symptoms, rather than a result of having the illness.

4. Effects on blood sugar

Another study showed that COVID-19 affected the brain’s ability to use blood sugar (glucose).

Blood sugar is your brain’s primary source of energy. Study participants with lower-than-usual blood sugar levels had pain, insomnia, memory issues and other persistent symptoms up to three weeks after a COVID-19 diagnosis.

Altogether, these conditions can also play a role in developing mental health issues.

5. Impacts on your life

In addition to the biological effects of COVID-19, being sick can lead to financial worries due to missed work and medical bills. It can be isolating. And stressful. All of which can trigger mental health concerns.

“People who don’t have the financial means or social support to see them through an illness may have a higher risk for depression or anxiety after they recover,” Dr. Owens shares.

Signs of post-COVID depression

Depression after COVID-19 causes the same symptoms as depression without illness — with a few exceptions.

“Some people with post-virus depression may feel guilty or blame themselves for getting sick,” Dr. Owens points out.

Other common signs of depression include:

• Appetite changes that may lead to unintended weight loss or gain
• Changes to facial expressions, such as being slow to smile
• Difficulty concentrating, thinking or remembering (brain fog)
• Fatigue or low energy
• Feelings of hopelessness
• Loss of interest in activities that usually bring joy
• Poor sleep (insomnia)

In some instances, severe depression can lead to:

• Self-harm
• Substance misuse or abuse
• Suicidal ideation

Signs of post-COVID anxiety

The signs of anxiety and COVID-induced anxiety are also similar.

Dr. Owens notes that someone who develops anxiety after COVID-19 may worry about getting sick again or developing long COVID. If you were hospitalized, you may keep thinking about or reliving the hospital experience.

Other signs of anxiety include:

• Difficulty relaxing or enjoying oneself
• Feeling nervous, restless or on edge (irritable)
• Poor or unusual responses to stressful situations
• Slowed thinking.

Help for post-COVID depression

Get help if depression symptoms negatively impact your life or persist for two weeks. Your primary care provider can be a good first step and may help you find a therapist or psychiatrist.

Depending on the severity of your symptoms, you may benefit from therapy, such as psychotherapy (talk therapy), medications, like antidepressants and anti-anxiety drugs, or a combination of the two.

These steps can also help protect your mental health when you’re sick with COVID-19 or recovering:

• Eat nutritious foods that fight inflammation.
• Find healthy ways to relieve stress.
• Improve your sleep.
• Limit alcohol.
• Practice meditation, mindfulness or restorative yoga.
• Stop doomscrolling.

Get well soon(er)

The stress of being sick with COVID-19 can make you feel like you’re on an emotional rollercoaster. It’s common to feel worried, sad or tired when you’re not feeling well. Be kind to yourself and give your body and mind time to heal.

“Your physical and mental health greatly affect each other,” Dr. Owens reminds us. “Most people feel better mentally as COVID-induced inflammation and other physical symptoms subside. If that’s not true for you, talk to your provider so you can get the care you need.”