One of the main aspects that has been affected by the pandemic is people’s mental health. Mental health is sensitive to stressful events and to the social and economic impacts that these events can bring. Measures to contain the virus, such as working from home, lockdowns, social distancing, and home-schooling have more than just direct effects on people, as does a high degree of uncertainty and other increasingly common factors, such as temporary unemployment.
In the second round of the Life with Corona survey we are particularly interested in understanding the psychological effects that the pandemic and the preventive measures to contain it have had on people. Since these impacts may not be evenly distributed across the population, we have investigated who has been most affected.
Our data reveals that a considerable share of the population show at least mild symptoms of depression. Close to 50% of the respondents in Argentina, Indonesia, Portugal, the United Kingdom and the United States, and close to 40% in Germany1, score more than the threshold for mild depression in the depression severity score2.
Exposure to large-scale traumatic events, such as the COVID-19 crisis, are associated with increased Incidence of mental illness in the general population (Xiong et al. 2020; Ettman et al. 2020; Pierce et al. 2020). The high prevalence of at least mild levels of depression in our sample potentially indicates an increase of the overall incidence during the pandemic.
Moreover, we find that having symptoms of COVID-19 could trigger ill mental health. In the Life with Corona survey, we ask participants the degree to which they have recently experienced a series of COVID and non-COVID symptoms. The data shows a positive and a significant relationship between a symptomatic scale and the depression severity score in all the six countries analysed3. This suggests that fear of being ill with COVID might be causing higher levels of stress.
Interestingly, the corona pandemic has come with a higher cost to younger people in terms of mental health. In all of the six countries analysed, younger people are more likely to present higher levels of depression compared to older people. This is in contrast with normal times when the young and old tend to be happiest and the middle-age glummest . Mental health concerns are typically associated with older adults, especially those living in isolation. However, our survey exposes the additional burden that younger generations are experiencing from the pandemic.
Another aspect of our lives that has been severely disrupted by the pandemic and that affects people’s mental health is changes in income. In the survey we asked participants How much has your monthly net income changed since the start of the COVID-19 crisis? We grouped our respondents based on the type of change they experienced: Income decreased, income did not change, and income increased.
Our survey finds that in most countries, those that have seen their income decrease during the pandemic are more likely to show higher levels of depression. This outcome is expected but it still has particular relevance given the longstanding duration of this crisis. This suggests that these stressors will be further exacerbated as the crisis continues.
Moreover, our data shows that in all of these countries, those that are having difficulties paying bills are more likely to show higher levels of depression. The disruption caused by the pandemic has increased unemployment and decreased income, making it harder to keep up with financial obligations.Levels of psychological distress derived from financial hardship can have a profound impact on family well-being or household behaviour, impacting the quality of the relationships (Prime et al. 2020). This result suggests that experiencing the pandemic and being financially vulnerable may reinforce each other, leading to disproportionately large adverse mental health consequences for already at-risk individuals, heightening societal inequalities.
1 Countries with n = > 150 included in the analysis.
2 We measured the severity of depressive symptoms using the depression module of the Patient Health Questionnaire (PHQ-9; Kroenke & Spitzer, 2002). The nine-item questionnaire is scored from 0 (not at all) to 3 (nearly every day) according to the presence of the symptom in the previous two weeks. A sum score was calculated to indicate depression severity (max 27) and scores of 5, 10, 15, and 20 represent cut off points for mild, moderate, moderately severe, and severe depression (Kroenke et al., 2001).
3The COVID-19 symptomatic scale does not fully explain the relationship but it does explain an important proportion of it (the R-squared for all countries is between 0.2-0.3).