In March 2020, when the media began to warn that the new coronavirus that had emerged in China was spreading around the world, one of the first reactions of many of us was unexpected; in a variety of countries, throngs of people rushed to shops to stock up on toilet paper. This was perhaps the first manifestation of how, beyond the effects of the virus itself, both the SARS-CoV-2 pandemic of COVID-19 and the measures laid down by the authorities have also had a significant psychological impact on a segment of the population. This is the other pandemic, that of those who have not fallen ill from the virus, but whose mental health has been affected in one way or another by an unprecedented crisis in their lives.
Even taking into account the 2009 H1N1 flu pandemic or the Ebola outbreak that shook the world in 2014, nothing has been able to disrupt the lives of the citizens of the planet like the current pandemic. For those who have fallen ill, for health workers exposed to serious risk or for people who have suffered other kinds of indirect consequences such as the loss of their jobs due to the shutdown of trade and industry, the psychological impact is obvious. But many of those who are not in any of the above situations, and are not even among the risk groups most vulnerable to COVID-19, are also experiencing negative effects on their mental health.
Toilet paper, a symbol of safety
According to the World Health Organization (WHO), which has been paying attention to this problem since the beginning of the pandemic, “in public mental health terms, the main psychological impact to date is elevated rates of stress or anxiety.” One of its earliest expressions was the stockpiling of certain consumer goods, especially toilet paper. Through an online survey of nearly 1,000 volunteers in 22 countries, a team of researchers from the universities of St. Gallen (Switzerland) and Münster (Germany) and the Max Planck Institute for Evolutionary Anthropology unravelled the profile of these people: a high perception of risk from the virus—more so as they get older—a predisposition towards being emotional, and a significant level of awareness or responsibility (conscientiousness), one of the five major personality traits.
According to the researchers, “toilet paper functions as a purely subjective symbol of safety.” But contrary to the idea that spread through social media at that time, the study showed that people who threw themselves into this compulsive stockpiling were not motivated by selfishness or a lack of solidarity towards others, so messages based on empathy do not hit the target. “These results emphasize the importance of clear communication by public authorities acknowledging anxiety and, at the same time, transmitting a sense of control,” the authors wrote.
Stress and anxiety are naturally linked to the threat of the pandemic, but the measures introduced by governments in many countries, such as confinements, school closures or quarantines, increase psychological pressure to such an extent that, according to the WHO, “levels of loneliness, depression, harmful alcohol and drug use, and self-harm or suicidal behaviour are also expected to rise.” Psychologist Elke Van Hoof of the Free University of Brussels wrote that the lockdown of 2.6 billion people by COVID-19 has been “the world’s biggest psychological experiment.” But Van Hoof warned: “We will pay the price.” Some experts have also pointed out that the psychological impact of the pandemic has been compounded by overexposure to the avalanche of information that has spread through the media, and even more so by the streams of misinformation and hoaxes that have circulated on social media.
Children, adolescents and parents with kids at home
A variety of studies have already confirmed the effects of the pandemic on the mental well-being of large segments of the population. A survey conducted in the US by researchers from Johns Hopkins University reveals that the number of adults with psychological distress has grown from 3.9% before this crisis to 13.6%. Another US survey, this one from the US Census Bureau in December 2020, found that more than 42% of respondents reported symptoms of anxiety or depression, up from 11% the previous year.
Contrary to what might be expected, in the John Hopkins survey the rise in psychological distress was more pronounced in the 18-29 age group, where these symptoms have increased eightfold, from 3.7% to 24%. According to study co-author Emma McGinty, “the distress experienced during COVID-19 may transfer to longer-term psychiatric disorders requiring clinical care.” Another study from San Diego and Florida state universities found a 28% risk of mental distress, up from 3.4% in 2018, and with a higher incidence among 18-44 year olds. According to study co-author Jean Twenge, 70% of those surveyed met the criteria for moderate or severe mental distress.
The reasons why younger people seem to suffer most from the psychological effects of the pandemic may be diverse. According to Twenge, fear of economic precariousness may be a relevant factor, along with the aggravation of increased social isolation in the Internet age. But there is a third factor: parents with children at home have emerged as one of the most affected groups, reversing the classic trend of parents having greater mental well-being than their childless peers.
Children and adolescents themselves are another group at risk of suffering the mental aftermath of the pandemic. In Spain, where one of the strictest lockdowns in Europe was put in place, between March and April adults were allowed to leave the home for essential tasks and even dogs were allowed to go out for their prescribed walks, but youngsters remained locked up inside for six weeks without the possibility of even stepping on the street. A study by the University Miguel Hernández, in collaboration with the University of Perugia (Italy), found that more than 85% of children in confinement had experienced emotional and behavioural changes, including difficulty concentrating, irritability, feelings of loneliness and uneasiness. In contrast, there was less of an impact on Italian children, who were able to walk outside near their homes.
More than a year and a half after the start of the pandemic, other studies have confirmed the marked mental impact on young children and adolescents. In August 2021, a global meta-analysis by the University of Calgary (Canada), which brought together 29 previous studies on a total population of almost 81,000 youths, found that one in four had suffered from clinical symptoms of depression, while 20% had experienced anxiety problems, with a higher incidence in older adolescents and girls. According to the authors, these figures are double the pre-pandemic figures, making children “the invisible casualties of this global crisis.” Among the measures mentioned by the researchers to mitigate this problem, in addition to the necessary support from families and institutions, is the return to the classroom in places where schools have been closed for prolonged periods of time.
More vivid dreams and poorer sleep quality
The study of the Spanish children also found that they slept more hours during the lockdown, a change that has not been limited just to youngsters. Some studies have shown that adults also took advantage of the lockdown and the shutdown of social events to prolong their nightly sleep by 13 to 30 minutes. However, this has not necessarily been accompanied by an improvement in sleep quality. According to the co-author of one of these studies, Christine Blume, at the University of Basel (Switzerland), “overall sleep quality decreased.” “However, this unprecedented situation also led to a significant increase in self-perceived burden, which was attendant to the decrease in sleep quality.” Some experts have reported disorders such as more vivid dreams, while others have warned of the health risks of poorer sleep quality.
Predictably, one of the sectors most affected by the psychological impact of the pandemic has been healthcare workers. In December 2020, a survey of more than 9,000 healthcare workers in Spain showed that one in seven experienced some disabling mental disorder during the first wave of the pandemic, while more than 45% suffered some form of psychological sequelae. In the UK, one fifth of healthcare workers surveyed showed moderate to severe symptoms of anxiety or depression.
Against this backdrop, specialists insist that the authorities must provide adequate coverage, both informational and healthcare, and perhaps prepare for an escalation in the number of cases in need of treatment as steep as that of the pandemic itself. Several large studies, including international collaborations, have been launched to continue to monitor a problem that experts predict will continue well beyond COVID-19. But they also suggest that, for our part, we can help ourselves: regular sleep, proper nutrition, avoiding toxic habits, maintaining social activity, getting some physical exercise, and spending time in nature can help ensure that, at least as far as our mental health is concerned, the new normal is as close as possible to the old one.