Many people have persistent symptoms after recovering from COVID, a condition termed "long COVID". The UK's Office for National Statistics estimates 1.8 million people in the UK have long COVID symptoms at least 12 weeks after their initial infection.
Long COVID symptoms can include extreme fatigue, headaches, problems with concentration and memory (known as "brain fog"), disturbed sleep, palpitations and organ impairment. Some people fail to improve after having COVID, whereas others get better but then decline.
There are also a variety of mental health concerns associated with long COVID, with symptoms of anxiety, depression and post-traumatic stress disorder raised in those who continue to face symptoms after their initial infection.
While a lot of research has investigated the mental health effects of the pandemic, lockdowns, and even COVID infection, research looking at the mental health effects of long COVID has been limited.
Long COVID and mental health
Sometimes long COVID symptoms can completely alter a person's life, making it difficult for them to work, socialise and even complete everyday tasks. Long COVID can also be unpredictable. People will often feel better for a period but then have a relapse.
It's not altogether surprising that people's inability to rebound physically from COVID can affect them emotionally and mentally. Research has shown people with long COVID have a poorer quality of life compared to those without the condition.
In addition to the physical symptoms, people with long COVID may struggle with feelings of disbelief and shock at their diagnosis, and difficulties accessing adequate healthcare. Many long COVID patients face stigma and discrimination in relation to their condition. All these factors could compound the mental health effects of long COVID.
Read more: Long COVID stigma may encourage people to hide the condition
It's also possible that the mental health symptoms associated with long COVID could be related to the inflammatory reaction that COVID sets off throughout the body, including in the brain. This could contribute to cognitive issues associated with long COVID, and may play a role in mental health symptoms. But researchers are still working to understand the effects of COVID on the brain.
Also, some evidence suggests people with psychiatric disorders might be at greater risk of developing long COVID.
Calculating the effect of long COVID on mental health
For this article, we have taken data from a large long-running survey in the UK (called Understanding Society) to estimate the effect of long COVID on mental health.
As part of the COVID-19 dataset of Understanding Society, people were surveyed between April 2020 and September 2021. The sample we analysed comprises around 123,000 people. Some 9% reported having had COVID symptoms, of which 92% recovered fully, whereas 8% still had symptoms (long COVID).
Measures of mental health in this survey were based on a general health questionnaire used by GPs to screen patients for mental health problems. Scores range from 0 to 36, where 0 is the best mental health and 36 is the worst.
The average mental health score of a respondent with long COVID was 16.4, which is higher than the score of a person who had recently had COVID symptoms, 13.3. The average mental health score of a respondent in the survey who had never experienced any COVID symptoms was 12.1.
It's important to note this is not peer-reviewed research, but these calculations should give some sense of the mental health consequences of long COVID and the value of continued research into this issue.
Read more: Supporting a child with long COVID - tips from parents of children living with the condition
If you're struggling, try to seek support early on to reduce the risk of longer-term mental health issues. Cognitive behavioural therapy and breathing exercises have been shown to reduce symptoms of anxiety and depression in patients with COVID.
The use of apps and support groups may also offer benefits. Having a community of people who are going through similar experiences can be very helpful.
Authors: Muhammad Waqas - Assistant Professor in Economics, Faculty of Management, Law and Social Sciences, University of Bradford | Syka Iqbal - Lecturer in Psychology, University of Bradford