On March 13, 2020, everyone’s lives were suddenly put on pause. One day we were grabbing morning coffee, speed–walking out the door, and gearing our sleep–deprived minds to focus; the next, we were sullenly placed in front of a computer screen attempting to replace authentic interaction. Though everyone had different experiences during the height of the pandemic, we can all relate to the general fogginess of days that seemed to melt into one another.
Fast–forward to Oct. 14, 2021—the Centers for Disease Control and Prevention (CDC) announced that they officially added “mental health conditions” to a list of risk factors for severe COVID–19. This decision was based on long–established scientific research about the dependent relationship between mental health and physical health—meaning that individuals affected by mental illness are less physically equipped to fight a COVID–19 infection.
This announcement is mired in a grim context. In addition to the COVID–19 pandemic, the world is also experiencing a mental health pandemic resulting from social distancing guidelines and an economic recession.
Humans are one of the most social species of modern animals, which is why the pandemic’s series of lockdowns and regulations has had severe mental health effects on millions. During the pandemic, about four in ten adults in the U.S. have reported symptoms of anxiety or depression. This is a 400% increase from 2019, when only one in ten adults reported these symptoms.
Young adults have been especially affected by pandemic restrictions, particularly the closing of high schools, universities, and recreational centers. In a new CDC survey, 62.9% of 18–to–24–year–olds reported experiencing symptoms of anxiety and or depression. Notably, a quarter of participants said that they had seriously considered suicide.
Among all ages, rates of anxiety and depression were particularly exacerbated by the pandemic. Worldwide, about 76 million people reported anxiety problems associated with the pandemic—a 26% increase from 2019. Similarly, the pandemic was associated with 53 million new cases of depression—a 28% increase from 2019.
This demonstrates what is already known about the damaging effects of long–term loneliness, which is as damaging to one’s health as smoking 15 cigarettes a day. Both chronic loneliness and smoking have the same physical effects: depression, heart and vascular diseases, and higher mortality rates.
In addition to the general sense of isolation, the pandemic caused an economic recession that led to higher rates of job loss. This economic insecurity and loss of income increased widespread depression, anxiety, and low self–esteem. About 53% of adults in households with job loss reported symptoms of mental illness.
Similar to chronic loneliness, stress and anxiety also damage physical health. Humans have not evolved to cope with the long–term activation of the stress response system, which is only geared for quick fight–or–flight responses. This means that long–term overexposure to the stress hormone cortisol disrupts the body’s natural functions and alters the immune system.
On a smaller scale, this causes digestive issues, weight gain, severe headaches, and memory impairment. But on a more serious level, this results in muscle pain, high blood pressure, insomnia, and increased risks of heart attacks and stroke.
But with a disease as deadly as COVID–19, individuals affected by mental illness are especially vulnerable.
A new study by the Department of Psychiatry found that people with schizophrenia are three times more likely to die of a COVID–19 infection. This makes schizophrenia the second–highest risk factor for COVID–19–related death. Another study found that individuals with severe mental illnesses—schizophrenia, depression, and bipolar disorder (BPD)—were at significantly higher risk for COVID–19 hospitalization and/or death.
The reasons for this remain unclear. Some scientists suggest that schizophrenia, BPD, and depression impair the immune system and resulting responses. Other scientists think that the effects of antipsychotic drugs suppress the immune system by getting into individuals' bone marrow, which is where most of the immune cells are born and developed. People affected by mental illness are also more likely to be predisposed to chronic diseases (obesity, cardiovascular disease, stroke) and substance abuse, which weakens their immune system.
But the CDC’s decision to include mood disorders was not just a necessary scientific measure—it was also a fight against the stigmatization of mental illness.
Around 60% of adults with a mental illness do not receive care because of social stigma surrounding mood disorders. A recent study published by the CDC found that only 25% of adults affected by mental illness felt that society was caring towards them.
People affected by mental illness, stereotyped to be “violent” or “burdensome,” are shunned from society—which is why they are more prone to living in homeless shelters, being incarcerated, or having limited healthcare access. Society’s treatment of people affected by mental illness is a perpetual cycle, as mental health will only worsen when they are neglected and impoverished.
This stigma also intersects with race and biological sex. People of color experience healthcare discrimination, lower rates of health insurance, a lack of diversity among mental healthcare providers, and diminished access to high–quality treatment. Those that do manage to obtain a quality doctor are often stereotyped to have a higher pain tolerance. This is why Black people, Hispanic or Latinx people, and Asian Americans receive treatment at a rate 50%–70% lower than non–Hispanic whites.
Similarly, women are stereotyped to be “hysterical” or “emotional,” which makes them more likely to be prescribed antipsychotic drugs that could damage their immune system.
The pandemic exacerbated these existing inequalities in mental health access. The mental health of women and people of color suffered from the recession, as people of color and women are more likely to work in low–wage essential jobs that are more prone to pandemic–era layoffs.
The mental health of working mothers was also severely affected by school closures: The duties of childcare mainly fell on women, especially mothers of low–income households that cannot afford childcare. A new report found that school closures are responsible for about half of the decline in mental health experienced by mothers, whereas school closures did not affect the average father’s mental health.
The mental health of women was also affected by a spike in gender–based violence, which is a historic pattern in times of stress. But, because of nationwide lockdowns and social distancing measures, survivors of violence had extremely limited access to informal support networks (friends and relatives), psychological support, or even the basic ability to leave home.
The gendered and racial disparities in mental illness treatment mean that the CDC’s decision is not only destigmatizing, but also equitable. By listing mood disorders as a risk factor for COVID–19, the CDC gives tens of thousands of people access to the booster vaccine—many of whom will be women and people of color. And even in a post–pandemic future, the CDC’s decision presents a clear message: Our priority as a global society is, first and foremost, to care for one another.