More than two-and-a-half-years into the COVID-19 pandemic, we’re still wrestling with understanding the extent of its impact. One important area to consider is the lasting effects of the pandemic on mental health, including whether it has catalyzed an increase in post-traumatic stress disorder (PTSD).
PTSD is a mental disorder triggered by experiencing or witnessing a traumatic or stressful event. It is marked by the following symptoms:
- A re-experiencing symptom, such as experiencing flashbacks of the traumatic event.
- An avoidance symptom, such as avoiding the location of the event.
- Reactivity symptoms, such as being easily startled.
- Cognition or mood symptoms, such as trouble remembering key features of the event.
In order to be considered PTSD, symptoms must last more than a month and be severe enough to interfere with relationships or daily life; symptoms that last less than a month may be considered acute stress disorder.
According to the Mayo Clinic, some of the most common events that lead to the development of PTSD include being threatened with a weapon, sexual violence, combat exposure, an accident, physical assault, and child physical abuse. However, there are many traumatic events, including witnessing something traumatic happening to someone else, that can lead to the development of PTSD regardless of how minor the event may appear on the surface. Further, PTSD does not only impact war veterans and sexual assault survivors; it can impact anyone at any age, with women more likely to develop it compared to men.
Outbreaks and PTSD
Most people have experienced one or more pandemic-related stressors, such as job loss/financial stability, sudden illness or disability, prolonged social isolation, or witnessing a loved one pass away. Given these stressors, it should not be surprising that the pandemic has triggered a 25% increase in anxiety and depression worldwide.
It is too early to have a full picture of the relationship between COVID-19 and the development of PTSD. However, if history repeats itself, the outlook is concerning. Both the 2015 Middle East Respiratory Syndrome (MERS) and 2003 severe adult respiratory syndrome (SARS) outbreaks were associated with an increased prevalence of PTSD that, for many, continued for more than a decade.
Initial evidence is pointing to a similar pattern among COVID-19 patients. One study found a PTSD prevalence of 30.2% among hospitalized survivors of one of the initial waves of COVID-19. These rates map nearly perfectly to the rates of PSTD observed following MERS and SARS outbreaks. Of highest risk are COVID-19 patients who experienced the sensation of not being able to breathe, with up to one-third of these patients ultimately developing PTSD.
Like in previous outbreaks, health care workers and other first responders who work directly with COVID-19 patients also have a particularly high risk of developing PTSD. One study found that over 10% of health care workers developed PTSD from the first wave of the COVID-19 pandemic; a number that increased dramatically to over 20% following the second wave, suggesting that exposure to repeated waves of COVID-19 was particularly harmful to health care workers.
Another striking trauma – the death of a parent or caregiver – is particularly apparent in the wake of the COVID-19 pandemic. Notably, more than 140,000 children have lost a parent or caregiver to COVID-19, and the number of children seeking emergency psychiatric care has accordingly increased. The trauma of losing a parent at a young age will undoubtedly impact these children for years or decades to come.
Three Ways to Act
Crucial actions must be taken in both research and health care settings to understand and mitigate the mental health impacts of COVID-19, including its effects on the prevalence of PTSD:
- Research is needed to better understand the impact of other pandemic-related stressors, including constant exposure to negative news, on mental health.
- We must grow the mental health workforce to accommodate the growing demand for psychiatric services in the wake of COVID-19.
- PTSD is linked to several physical ailments, including cardiovascular disease; it is imperative that our health care system is equipped to tackle increased rates of these diseases.
- Check out this Alliance Discussion on equity in mental health care featuring Patroski J. Lawson, Chief Executive Officer of The KPM Group DC, and Katie Landes, Senior Director of Strategy and Execution at The KPM Group DC.