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Coping with Depression after COVID-19
Adrian Drew
For many people around the world, the coronavirus pandemic has created mental health problems or exacerbated issues that previously existed. With tremendous amounts of stress and uncertainty surrounding our current situation, 2020 saw a significant rise in mental illness—particularly depression and anxiety—among people of all ages. With much of the United States vaccinated, you might be wondering why people are still struggling with depression even after the worst of the COVID-19 pandemic seems to be over. Let’s take a look at the strong link between COVID-19 and depression, and why people are struggling.
How COVID-19 Led to an Increase in Mental Health Issues
The exact causes of this trend have yet to be determined definitively, but there are many potential contributing factors.
Social Isolation
Social distancing and self-isolation left many people feeling more lonely. Being stuck indoors and away from others could magnify preexisting conditions, such as anxiety and depression. Survey data shows that this risk was elevated in young people between the ages of 18 and 24. In the time since lockdowns began in April 2020, participants in this age range were far more likely to experience loneliness than other control groups, suggesting a connection between inactivity due to COVID-19 restrictions and loneliness, which can contribute to depression.
This might be the case because, under normal circumstances, younger people tend to be more engaged in an array of social activities than people in other age ranges. With the closure of schools and universities, adolescents and young adults in particular were forced to miss out on key developmental milestones in their lives, losing valuable social and educational experiences. This could result in fear of missing out and anxiety about the future, as well as loneliness and depression.
Feelings of loneliness aren't limited to younger populations, however. Thirty-nine percent of people who were married or in a civil partnership reported high levels of anxiety when surveyed, compared to 19 percent before the pandemic began. As more data emerges, it's becoming clear that symptoms of anxiety and depression in the COVID-19 setting aren't limited to any specific subgroup, but can affect us all in different ways.
Fear and Uncertainty
With official guidance on preventing COVID-19 infection evolving continuously over the course of spring 2020, it was difficult to gauge the level of risk involved in typically harmless activities like seeing friends and family, going to the grocery store, and taking public transportation. That uncertainty has only been compounded by variations in guidelines across the country and the world, as well as the often politicized nature of the debate around the virus.
In addition to being afraid of contracting COVID-19 themselves, many people are concerned about the health and well-being of their aging parents or relatives, the possibility of being laid off at work, and having to help their children continue learning remotely. These factors could be contributing to the development of depression for many people and making existing depression more difficult to address for others.
The Virus Itself
While the general stress and loneliness instigated by the pandemic are likely causing increases in anxiety and depression for many, emerging studies show that there may also be a direct connection between COVID-19 diagnoses and the rise of depression during the pandemic. In other words, it could be that the infection itself plays a role in the onset of mental health issues.
Research published in The Lancet shows that a striking 18 percent of COVID-19 patients developed mental health issues, including depression, anxiety, and even dementia, within three months of diagnosis. Such studies support the notion that COVID-19 may be responsible not just for physical symptoms, but for mental side effects too.
Managing Depression After COVID-19
Thankfully, there are a number of steps you can take to mitigate symptoms of loneliness and depression and improve your mental health if you’re struggling with depression even after the factors above have resolved.
Helping Others to Help Ourselves
Taking care of your friends and family can be a tremendous stress reliever. Studies have shown that simply being kind and compassionate toward others is directly linked to feelings of happiness and positivity for people of all ages. Moreover, strengthening connections with others can remind us that, despite how we might feel, we are not alone.
Seeking Professional Support
In addition to interpersonal support, we should also seek professional support when necessary. Both mental and physical support options are available to most people and can boost mental health and alleviate symptoms of depression, anxiety, and other mental health conditions. Because stress has been known to weaken the immune system, seeking support to reduce stress levels could also help bolster your defenses against future infections.
There are many depression treatment options to choose from. Understanding what options are available can enable you to select the best course of action for your unique situation. Reaching out to a licensed therapist is one option, as is seeking treatment in the form of transcranial magnetic stimulation (TMS). TMS therapy involves the use of non-invasive, FDA-cleared devices to stimulate areas of the brain connected to mood regulation. When other treatment options have failed to have a positive impact on alleviating depressive symptoms, TMS may boost a patient's mental health, and the treatment has proven to be a strong contender in the fight against depression.
Hope for the Future
There is hope on the horizon for the end of the COVID-19 pandemic, but the symptoms of depression amid COVID-19 are becoming increasingly prominent. Fortunately, we can all take proactive steps now to boost our mental health and navigate the current climate.
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. Should you be left with a metallic taste by the spray, the Care Team will offer suckers to help make the flavor dissipate. After your dose, you’ll be encouraged to lie back in your comfortable recliner. While most patients enjoy a quiet setting, Greenbrook is prepared to accommodate patients with a more animated reaction to the medication. You may feel sleepy, dizzy, mildly dissociated, and/or nauseated during treatment. Greenbrook's Care Team is readily available if you need assistance. How to Prepare for after your Nasal Esketamine Treatment Most side effects begin to wane in the second hour of observation, but if you’re wondering, “Is it safe to drive immediately after nasal esketamine treatment?” the answer is a resounding no. In addition to the mandatory ride home, you will need to block off time to rest and let side effects fully dissipate. This extended rest period is especially important in the first weeks of treatment when you’ll have treatment twice a week. Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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