In March 2022, a scientific briefing released by the World Health Organization showed that in the first year of the COVID-19 pandemic, the prevalence of anxiety and depression increased by 25% globally, with young people being particularly affected.
People who are not infected, those who have been infected, and people who have recovered from infection can all be affected by this and develop mental health problems. Many people are nervous, anxious, insomnia, and even depressed, unable to return to normal life.
In response to the mental and psychological problems caused by the epidemic, as early as the early stage of the outbreak, that is, in February 2020, the National Health and Health Commission issued a series of policy documents on psychological emergency rescue and psychological counseling, and adopted relevant measures, such as the establishment of In response to the epidemic, the psychological assistance hotline has issued a series of guidance documents such as the “Psychological Counseling Work Plan for the New Coronary Pneumonia Epidemic”, “Guidelines for the Work of the Psychological Assistance Hotline During the Prevention and Control of the Novel Coronavirus Pneumonia Epidemic”, and more than 600 psychological assistance hotlines have been set up in public hospitals across the country .
But the work being done now is far from enough. Objectively speaking, the attention and energy of the entire society are focused on how to prevent the spread of the epidemic and how to cure and save the infected. The mental health problems caused by the new crown epidemic are like “invisible scars”.
After the outbreak of the epidemic in 2020, Lu Lin, academician of the Chinese Academy of Sciences and president of Peking University Sixth Hospital, and the research team conducted an online survey across the country to understand the psychological impact of the new crown epidemic on people. After that year, the research team conducted another Follow-up, found some unexpected conclusions.
How does the epidemic affect people’s mental health? How should we deal with the psychological impact of the epidemic? Regarding these issues, Nanfengchuang interviewed Academician Lu Lin and asked him to talk about people’s mental health problems after the epidemic.
A state of uncertainty can lead to depression
Nanfengchuang: What research have we done on the impact of the new crown epidemic on people’s mental health? What are the main manifestations of the overall impact of the new crown epidemic on people’s mental health? What is the scope and extent?
Lu Lin: Since the outbreak of the new crown epidemic, our research group has done a lot of work to study the psychological impact of the new crown epidemic. In 2020, we conducted an online survey of more than 50,000 people, and carried out research in Wuhan on the mental health status and related influencing factors of different groups including the general population, children and adolescents, Wuhan university students, front-line medical staff, and people infected with the new crown. Research. We also conducted a longitudinal study on the long-term impact of the epidemic on the public’s mental health, exploring the public’s Internet addiction and substance use behavior during the epidemic, psychological stress related to the COVID-19 vaccine, and more.
The 2020 study found that during the outbreak of the new crown pneumonia epidemic, nearly half of the respondents experienced symptoms of depression, anxiety, insomnia or acute stress. A year later, we conducted a follow-up interview. It is intriguing that 12 months after the outbreak, anxiety and insomnia showed a significant trend of relief, but depression showed a slight worsening trend, and the Internet addiction behavior of the public, especially teenagers, also changed significantly. too much.
We also thought it was strange at the time, but the reasons for this problem are more complicated, and we can only make some inferences based on the investigation results. At the beginning of the epidemic, everyone didn’t understand the virus, and they were nervous, panicked, and worried, all of which were signs of anxiety. And one year later, everyone began to understand the virus and was less panicked. However, due to other factors in the whole society, such as a decrease in income, or even an increase in the number of unemployed or more people who have been quarantined for a long time, people become depressed. This is a sample of our investigation, it can only be used as a reference, not necessarily universal.
Nanfengchuang: How does the new crown epidemic affect people’s mental health, and what is its mechanism of action?
Lu Lin: For COVID-19 patients and recovered patients, in addition to respiratory symptoms, neuropsychiatric symptoms are also more common. Neuroimaging and neurobiochemical evidence show that patients with severe COVID-19 pneumonia, especially those with neuropsychiatric symptoms, may be accompanied by Neuroimmune dysfunction and brain injury. As early as the early stage of the new crown epidemic, studies have found that new crown infection can directly invade the central nervous system, affect the body’s innate and adaptive immune systems, and cause neuroinflammatory responses. The destruction of immune function and neuroinflammation by the new coronavirus will eventually lead to brain damage, showing severe neuropsychiatric symptoms.
More importantly, for the general public, the COVID-19 epidemic is a serious stressful event, which may cause various physiological and psychological stress reactions such as depression, anxiety, fear, and insomnia.
When people face uncertain situations, they may become nervous and anxious. The more uncertain things, the more anxiety and insomnia will occur, and mental health problems will occur. For some of them, the longer the period of uncertainty, the more likely it is to turn into depression.
The new crown epidemic was an uncertain event at the beginning, but it was basically confirmed after half a year, and corresponding treatment methods were available. At this time, the prevention and control measures in the place where I live have become uncertain events, such as where I will be taken to quarantine or whether my residence will be sealed off, whether my job will be lost, etc. New uncertainties keep people in a constant state of uncertainty. a state of stress.
This year, repeated outbreaks across the country have left many people isolated at home, uncertain about work and income, and reduced social activities. These factors may also cause psychological or mental problems in some sensitive groups.
The new crown epidemic was an uncertain event at the beginning, but it is basically certain after half a year. At this time, the prevention and control measures in the place where I live have become uncertain events, such as where I will be taken to quarantine or whether my residence will be sealed off, whether my job will be lost, etc. New uncertainties keep people in a constant state of uncertainty. a state of stress.
Adolescents, women, frontline workers are disproportionately affected
Nanfengchuang: What are the differences between different groups, different age groups and different genders in terms of mental health problems caused by the new crown epidemic?
Lu Lin: Judging from our research results, front-line workers (medical staff, grass-roots workers) and their families, people infected with COVID-19 and their families, close contacts of infected people, quarantined people, and unemployed people due to the epidemic are the main causes of the epidemic. Susceptible populations with related mental and psychological problems. The World Health Organization reports that in 2020, the first year of the pandemic, the global prevalence of anxiety and depression increased by 25%, with adolescents disproportionately affected.
Adults have more experience and know how to seek help, so they have a stronger psychological tolerance. Teenagers have experienced little psychological stimulation before, and their psychological flexibility is not yet mature. When encountering the stressful event of the epidemic, the reaction is even greater.
In addition, during the epidemic period, due to long-term online classes, teenagers cannot go out to communicate with their peers, lack sufficient physical exercise, and are addicted to games and mobile phones. The proportion of Internet addiction has increased significantly. Strict supervision by parents has significantly increased the incidence of depression and anxiety in children and adolescents. Moreover, the long-term online teaching and the use of electronic equipment have reduced the willingness of children and adolescents to go to offline classrooms.
Additionally, studies have shown that women are more severely affected than men and that people with underlying medical conditions are more likely to develop mental health problems. In the face of all disasters, women are more affected, because women are a vulnerable group compared with men.
During the epidemic at home, women have to take on more tasks. Moreover, studies in other countries have found that domestic violence has increased a lot during the COVID-19 pandemic, with women suffering the most. One is because of the epidemic at home, the two spend more time together. Usually, there may be no chance of domestic violence because of work, and there are more opportunities for such opportunities during the stay at home. The second is that due to the increased economic and social pressure affected by the epidemic, people’s emotions have become irritable and irritable. Another reason why women’s mental health is more affected is that many caregivers (doctors, nurses) are predominantly women. This industry determines that women are more affected.
During the outbreak of the epidemic in 2020, we surveyed more than 16,000 medical staff, among whom 45% were depressed, 34% were anxious, 22% were insomnia, 34% were stress symptoms, and many had somatic symptoms.
For COVID-19 patients and recoverers, in addition to the mental and psychological symptoms caused by the virus and disease, they also face the problem of stigma in daily life. Because of the fear of the virus, people infected with and recovered from COVID-19 are often discriminated against. Many people hide at home and dare not go out for fear of being discriminated against, which brings them great psychological pressure.
The epidemic also has a great impact on the elderly. Because the elderly cannot go out to communicate with their peers, they will feel social isolation and loneliness, which may lead to psychological problems in the long run.
Nanfengchuang: After recovering from the COVID-19 patients, will there still be psychological problems?
Lu Lin: This is possible. According to a survey, 19.7% of patients who were cured of the new crown still reported at least one psychiatric symptom after recovery, including depression, anxiety, insomnia, headache, autonomic disturbance, cognitive impairment, Post-traumatic stress disorder and so on, we need to give them more understanding and care, not blame. Anyone can get this infectious disease, and discrimination and prejudice will seriously increase the psychological burden on patients.
We should have a scientific understanding of the new coronary pneumonia. After the patient is completely cured, theoretically it will no longer be contagious. But many of us have misunderstood whether a person is still contagious after the infection. So the popularization of scientific knowledge is very important.
Nanfengchuang: You did relevant research in 2020. Compared with that time, are there any changes and characteristics of the psychological problems caused by the current epidemic situation compared to that time?
Lu Lin: Even after the epidemic has passed, the long-term psychological impact of the epidemic still exists. According to the epidemiological data of several major infectious disease periods since the beginning of the 21st century, the prevalence of post-traumatic stress disorder (PTSD) among medical staff and infected persons after the pandemic of infectious diseases is higher than 20%, and the prevalence of PTSD among the general public The prevalence rate of PTSD is also close to 20%, and there is no significant difference in the prevalence of PTSD 6 months after the outbreak compared with that within 6 months. Especially for patients with COVID-19 and those who have recovered, some people may still live in depression and anxiety even after their bodies recover.
A long-term study by our research group found that in the early stage of the outbreak of the new crown pneumonia epidemic, the detection rates of depression symptoms, anxiety symptoms and insomnia symptoms were 27.9%, 31.6% and 29.2% respectively, and the detection rates of acute stress symptoms were 24.4%, and the detection rate of any kind of mental and psychological problems was 47.1%. Anxiety and insomnia showed a trend of remission within 12 months after the outbreak, but depression showed a slight worsening trend.
Nanfengchuang: Some extreme events have recently occurred in some closed areas, which have also caused an impact on people’s mental health. Which is more harmful, this impact or the psychological impact of the new crown epidemic itself?
Lu Lin: The harm brought by the two cannot be said to be good or bad. For an individual, it is not a good thing to catch up with either one. Our various supporting measures must be in place. At the beginning of the epidemic in Wuhan, our suggestion to the government was to implement a shift system, and the frontline personnel must not be overtired, and the ration materials should be abundant.
During the outbreak, we surveyed more than 16,000 medical staff, among whom 45% were depressed, 34% were anxious, 22% were insomnia, 34% were stress symptoms, and many had somatic symptoms.
We suggested at that time that people who go to the shelter hospital should eat better than those at home, and can get better protection, so as not to cause psychological shock to them. In addition, it needs to be humanized and give everyone a sense of security. While making the epidemic information transparent, it also needs to give everyone sufficient channels and opportunities for explanation and communication.
Take mental health as seriously as you take care of your body
Nanfengchuang: How can we maintain our mental health?
Lu Lin: Generally speaking, mental health is a kind of personal state of mind that is positive, self-recognized, consistent with words and deeds, and has the ability to adapt to society. A mentally healthy adult should first be in a happy or peaceful state most of the time, without persistent psychological conflicts; secondly, he should be self-reliant and have the ability to survive in society on his own.
To maintain good living habits. Regular work and rest, regular diet, adequate sleep, moderate exercise, and moderate relaxation are the foundations of physical and mental health. Avoid going to bed too early before going to bed, don’t overeat three meals a day, especially don’t overeat at dinner; do moderate physical exercise to strengthen your body; develop hobbies, increase life fun, and improve overall life satisfaction.
Relieve negative emotions in time. You can find good friends, classmates, relatives and friends, etc. to talk about your depressed mood, and get emotional understanding and support from them. If the depressed mood still cannot be relieved, you can seek the help of a professional psychiatrist. Avoid venting emotions in bad ways, such as smoking, drinking, drug abuse, etc., which will only further endanger physical and mental health, and even cause serious consequences.
Stay socially connected. Interpersonal communication is an important way to maintain mental health. As a member of society, people must live in social groups. Through social activities, you can feel a sufficient sense of social security, trust, and motivation, greatly enhance your confidence and strength in life and study, and reduce the occurrence of psychological problems. At the same time, when interacting with others, you should pay attention to identifying whether it has a positive impact on yourself. Bad behaviors such as gathering people to drink and gamble will not only damage personal and physical health, but also have a negative impact on the social environment.
Another is to reduce the time spent watching online videos and using electronic platforms. At the same time, it is recommended to browse epidemic-related information for less than one hour and pay attention to reliable information.
Nanfengchuang: Have we taken any measures and established any plans for mental health and psychosocial support under the epidemic situation? What aspects still need to be improved?
Lu Lin: As far as my country’s mental health is concerned, I suggest improving the construction of my country’s public psychological crisis intervention system. This requires promoting a normalized and standardized grading diagnosis and treatment model of mental psychology, building a social psychological crisis early warning system; improving the mental and mental health service capabilities of the entire society, strengthening the management capabilities of grassroots mental and mental health institutions, and improving the utilization efficiency of mental health resources; Increase the popularity of mental health knowledge among Chinese citizens and eliminate the stigma of mental illness.