Now that the pandemic has passed and we’ve returned to our usual way of life, we are learning more and more about the long-term effects of COVID-19. One phenomenon that has caught the attention of both researchers and the general public is long COVID. Long  COVID refers to long-term effects after a person becomes infected. These effects include several health problems, some of which can last for years. Long COVID may also be called long haul COVID or post-COVID conditions. Researchers are learning about the different health problems that can arise with long COVID, and some have taken an interest in the link between long COVID and depression.

Long COVID and Depression: What the Research Says 

The Centers for Disease Control and Prevention (CDC) lists several general symptoms of long-COVID. Among these symptoms are depression and anxiety, as well as a host of other symptoms that might indicate depression. For instance, long COVID may cause problems with thinking and concentration, sleep disturbances, and fatigue, all of which are also symptoms of depression. 

So, are these symptoms indicators of depression, or are they just associated with immune system dysfunction after the infection? Research suggests that long-haul COVID can actually lead to the development of depression. One recent study that included patients across the globe found that 4.32% of COVID survivors experienced prolonged depression. 

Additional research has shown an even higher prevalence of depression in people diagnosed with COVID. Some recent findings include the following:

• A study of patients discharged from the hospital in China following treatment for COVID found that 23% had anxiety or depression.
• A study of US adults found that 52.4% developed major depression after infection with COVID-19.
• A third study found that 13.8% of patients discharged from the hospital after COVID treatment screened positive for depression.

A research report in the professional journal CNS Drugs reviewed a multitude of studies concerned with the link between long-COVID and depression. Results revealed the following:

• 21% to 45% of COVID survivors demonstrate clinical levels of depression.
• Women are more likely than men are to develop symptoms of depression post-COVID, with 46% to 50% of women showing depression symptoms, compared to 32% to 39% of men.
• Among COVID-19 survivors participating in a follow-up psychiatric assessment, 21% to 33.7% have symptoms of depression.

Why The Link to Depression?

A considerably large body of research suggests that people who have had COVID are at risk of developing depression over the long term as a symptom of long-haul COVID. This leads people to wonder why COVID is linked to the development of depression symptoms. Scientists believe that the COVID-19 infection causes damage to the nervous system via changes to the immune system, which can increase the risk of depression. 

The COVID-19 infection is also associated with systemic inflammation, which can affect the brain and lead to inflammation in the brain cells. Inflammation can cause a host of other issues, including hormonal disruptions and problems with communication between cells in the brain. These factors can all lead to depressive symptoms. 

Beyond the physiological effects of the COVID-19 infection, stressors surrounding becoming infected can also increase the risk for depression. For instance, the process of quarantining others while ill can lead to social isolation, thereby increasing the risk of a mood disorder. Furthermore, anxiety surrounding the illness, fear about the future, and survivor’s guilt can all lead to deteriorating mental health. These stressors can also cause alterations in the nervous system and the hormonal system, which can contribute to depressive symptoms. 

Treating Depression From Long COVID

Given the link between long COVID and depression, it’s essential to be knowledgeable about treatment options. Because of inflammation and damage to the nervous system, symptoms of depression may appear, even months after a person recovers from the acute effects of the COVID-19 virus. 

While depression symptoms can be attributed to long-haul COVID, this doesn’t mean that a person is destined to suffer. In fact, there is a range of quality treatment options available:

• Antidepressant Medications: Research suggests that antidepressant medications are effective for treating depression symptoms that arise after someone recovers from COVID-19 infection. A class of drugs called SSRIs, typically used as a first line of treatment for depression, are particularly effective for treating post-COVID symptoms, as SSRIs have anti-inflammatory effects, and they enhance the transmission of a brain chemical called serotonin, which plays a role in mood. 
• Psychotherapy: Participating in psychotherapy, or talk therapy, can be beneficial for overcoming post-COVID depression. A therapist can help patients overcome distorted or negative thinking patterns that are making depression symptoms worse. Therapy can also help patients to develop healthy coping skills. Interestingly, consulting with a therapist virtually using teleconferencing software has been found to be beneficial for patients experiencing psychological complications from COVID.  There are numerous virtual treatment options available; some may involve consulting with a therapist via email or chat, whereas others involve live counseling sessions using video conferencing programs. These services may be referred to as “teletherapy” or “telemedicine.” 

Managing Treatment-Resistant Depression

There are effective depression treatment options, and while many people benefit from medication and/or therapy, some may not experience adequate relief with these traditional treatment modalities. When people do not respond to antidepressant medications, they are said to have treatment-resistant depression.

Some patients coping with depression from long COVID may find that medication and therapy don’t relieve their symptoms. In this case, they may benefit from transcranial magnetic stimulation (TMS), which has been found to be effective for depression cases that don’t respond to usual treatment methods. This non-invasive treatment option uses a device placed against the forehead to stimulate mood-related brain areas. 

Pulse TMS provides services to the Southern California community, conveniently located in Los Angeles. Contact us today to learn more or to determine if you’re a candidate for TMS.