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  • People who have recovered from COVID-19 are at a higher risk of developing mental health disorders, such as anxiety and depression, according to a new study that included over 150,000 U.S. military veterans.
  • Researchers also found that after COVID-19 recovery, people are much more likely to develop substance use disorder and cognitive problems, including brain fog, confusion, and forgetfulness.
  • While it’s unclear what caused the mental health problems, experts say body and brain inflammation as well as physical and emotional factors related to pandemic measures may have played a role.

The COVID-19 pandemic has worsened problems such as social isolation, loss of loved ones, and financial worries, leading to increased rates of mental health issues, including anxiety and depression.

Now, a large new study published in the BMJ finds that surviving the disease could increase the risk of developing mental health issues, even when compared to non-COVID patients or even those who contracted the seasonal flu.

Researchers looked at more than 150,000 U.S. military veterans with an average age of 60 who were tracked for 1 year. They were compared with nearly 6 million veterans who had not contracted the virus.

The group included only patients with no preexisting mental health diagnoses or treatment for at least 2 years before contracting SARS-CoV-2.

This allowed researchers to isolate psychiatric issues and treatment associated with infection.

The study found about 15 more cases of depression per 1,000 people in the COVID-19 recovery group, and they were more likely to experience sleeping problems and higher rates of alcohol and drug misuse.

Those who recovered also showed a nearly 50 percent increase in suicidal thoughts compared to those who did not develop COVID-19.

“The disease is unique from a mental health standpoint because many of the recommendations that have been put in place to protect people from COVID-19 are, in fact, risk factors for mental illness,” Dr. Paul Poulakos, a board certified psychiatrist in Greenwich Village, New York, told Healthline.

Poulakos added that ordinarily, telling someone to socially or physically distance or quarantine would be counterintuitive for him to recommend.

“I typically encourage socialization to improve one’s mental health,” he said. “For example, social distancing – isolation and withdrawing from social interactions is one contributor and a possible symptom of depression.”

Maria Espinola, PsyD, assistant professor of clinical psychiatry & behavioral neuroscience at the University of Cincinnati College of Medicine, said she wasn’t surprised by the findings.

“Smaller studies have been showing a higher prevalence of certain mental health disorders among COVID patients,” she told Healthline.

Espinola explained that previous studies were limited by a maximum of 6 months of follow-up and a narrow selection of mental health outcomes.

“This study significantly increases our understanding of the problem,” she said.

This was an observational study, so it can’t determine what caused the mental health problems.

Researchers noted that previous studies of COVID-19, especially severe cases, found reduced blood flow to the brain and potentially injured neurons as an explanation for these results.

“It was also interesting to see that severity of COVID-19 illness alone could not explain the association between the virus and mental illness,” said Poulakos. “Since people with only mild infections were still at greater risk for mental illness following infection.”

“My belief is that inflammation can certainly occur in the body as well as the brain,” said Dr. Alex Dimitriu, double board certified in psychiatry and sleep medicine, and founder of Menlo Park Psychiatry & Sleep Medicine and Brainfood MD.

He explained that specific forms of mental illness, such as depression, have been associated with increased body and brain inflammation.

“One would think that any infection, especially a bodywide viral infection, would increase inflammation and lead to mental health issues,” Dimitriu said. “Surprisingly, from this study, influenza did not have this effect, while post-COVID-19 infection did.”

The study also found that COVID-19 patients were 80 percent more likely to develop cognitive problems, including:

They were also nearly 35 percent more likely to develop an opioid use disorder and 20 percent more likely to develop substance use disorders like alcohol use disorder.

“The findings add weight to the argument for integrated care, which refers to the integration of behavioral health services with general and/or specialty medical services,” said Espinola.

She added that a large body of research shows by treating patients’ mental and physical needs, “we can improve patient outcomes and satisfaction in a cost-effective way.”

Researchers found almost 20 percent were diagnosed with or prescribed medication for a neuropsychiatric issue in the following year.

That’s compared with fewer than 12 percent of the non-COVID group.

Dimitriu said the study was “interesting.”

“There may be something specific to COVID which has greater impacts on brain function than other virus infections we have seen,” he said.

Poulakos wondered whether a statistical error called “sample bias” might explain the findings.

“In other words, we know that access to mental health resources in the outpatient setting is very limited and can be expensive,” he said. “We know that the majority of people struggling with mental illness are, unfortunately, not connected with treatment.”

According to Poulakos, when a patient is hospitalized, they have access to a comprehensive staff of physicians crossing all specialties. This means psychiatrists are more easily consulted, and patients have greater access than if they were to try to find one in an outpatient setting.

“It is quite probable that hospitalized individuals had greater access to psychiatrists than the general population, hence resulting in an increase in catching/diagnosing psychiatric disorders,” Poulakos said.

New research finds that people who recover from COVID-19 experience a much higher incidence of mental health issues than people who didn’t contract the coronavirus.

Experts say this could be due to physical and emotional factors related to pandemic measures.

They also say that the study may have been influenced by a statistical error called sample bias due to hospitalized participants having easier access to health professionals.