Measuring The Pandemic's Toll On Mental Health
A new study finds a rise in depressive symptoms due to the Covid-19 pandemic.
By Mark Travers, Ph.D. | January 4, 2022
A new article published in the academic journal Psychology and Aging reports that depressive symptoms have increased in Germany as a result of the Covid-19 pandemic. But it is unclear how much the pandemic has influenced psychological well-being as a whole.
I recently spoke with Dr. Markus Wettstein, a psychologist at Heidelberg University in Germany and the lead author of the paper, to discuss this research in more detail. Here is a summary of our conversation.
What inspired you to investigate the topic of psychological well-being during Covid-19 and what did you find?
We know that, although well-being is to some extent stable and might reflect an enduring personality trait individuals have, there are also life events and life circumstances that might trigger short-term or long-term changes in well-being. The pandemic could be such a life event.
It is quite plausible that the onset of the pandemic had (or still has) an impact on individuals' well-being because so many life circumstances were suddenly and profoundly altered when the pandemic set in. Individuals were forced to reduce their face-to-face social contacts, which might increase feelings of loneliness and decrease well-being. Certain leisure opportunities, such as going to concerts or cultural events, or traveling, were no longer available or restricted. The situation of a spreading and potentially dangerous virus might in itself be perceived as threatening by many individuals, thereby eliciting fears and compromising well-being. Finally, there were various other everyday challenges during the pandemic and during lockdown phases, such as closed schools and childcare facilities so that parents had to re-organize childcare, or the necessity to work from home. Others even lost their jobs as a consequence of the pandemic.
This is why we investigated, based on data from the German Aging Survey, to what extent well-being changed after the onset of the pandemic in Germany.
In our sample of middle-aged and older persons, life satisfaction slightly increased both between 2014 and 2017, which was the "pre-pandemic" time interval we included for comparative purposes, but also between 2017 and June/July 2020, which was when Germany was still facing the first COVID-19 infection wave. There was thus no general trend of lower life satisfaction due to the pandemic.
However, when we investigated depressive symptoms as an alternative indicator of well-being, we found that there was an average increase in depressive symptoms between 2017 and 2020, whereas depressive symptoms had remained stable between 2014 and 2017. One of our conclusions is therefore that it might depend on the specific well-being indicator whether we find a "COVID-19 effect" on well-being or not.
It seems that depressive symptoms are more susceptible to such a COVID-19 effect, whereas life satisfaction might be more resilient against the negative impact of the pandemic.
Can you describe a few of the ways researchers tend to measure psychological well-being?
Well-being is indeed a multidimensional construct and comprises multiple domains. Hedonic well-being refers to maximizing pleasure and minimizing pain. It is usually assessed by affective components (positive and negative emotions) as well as by cognitive-evaluative components (such as life satisfaction). Eudaimonic well-being differs from well-being as it focuses on aspects such as meaning (or purpose in life) and self-realization.
What are the practical takeaways from your research for someone struggling to find balance during the Covid-19 pandemic?
We found that certain individuals have a higher risk of lower well-being during the pandemic, such as individuals with poorer self-rated health and those perceiving the pandemic as particularly threatening. Individuals with poorer health might reveal lower well-being as they indeed have higher COVID-19 health risks. Providing the best protection for these individuals, and also for those who feel very threatened by the pandemic, might help them to prevent a decline in well-being.
This could be achieved via vaccinations or by providing opportunities to work from home, but also by ensuring ongoing optimal medical treatment during this pandemic for those with health restrictions and chronic diseases.
Did you find any gender differences or other demographic differences?
We found that middle-aged women had a higher risk of lower life satisfaction during the pandemic, whereas older women and middle-aged as well as older men did not have such a higher risk. Similar findings have been reported by other researchers. Middle-aged women thus seem to be particularly challenged during the pandemic, which is probably also due to factors such as the temporary closure of schools and childcare facilities, because particularly mothers were forced to take over additional childcare responsibilities.
Are there any personality traits, or behaviors, that have been shown to predict resilience in the face of the global health crisis?
Findings from other studies suggest that those who had mental health problems already prior to the pandemic are at a higher risk of lower well-being in times of the pandemic, whereas high pre-pandemic levels of resilience, self-efficacy, and sense of coherence are protective factors.
But there seem to be other factors as well. For instance, those with negative self-perceptions of aging report higher levels of psychological distress during the pandemic. Others found that feeling younger might to some extent help adjust to the pandemic situation. Feeling informed about the pandemic is, according to some findings. helpful for well-being, whereas excessive exposure to COVID-19 news can have detrimental effects. Finally, physical activity seems to be a behavior that is associated with greater well-being in general, but also during the pandemic.
After conducting your research, are you more likely to view the Covid-19 pandemic as a crisis of mental health as much as a crisis of physical health?
Several researchers have pointed out that this pandemic has important psychological and mental-health-related dimensions, and I fully agree with such statements. Of course, the physical health implications of COVID-19 should not be neglected, and individuals have to be protected from the virus. However, at the same time, we need to be aware that the pandemic is also a considerable challenge for individuals' mental health.
How might your research inform clinical efforts to improve psychological well-being during this difficult time?
At first glance, it is good news that we did not find a general decline in life satisfaction in German middle-aged and older adults during the pandemic. However, we identified individuals who are at risk of COVID-19-related well-being declines, such as those who perceive themselves as less healthy and as highly threatened by the pandemic. These individuals might also benefit from psychosocial support, coaching, or therapy formats which help them to find ways and strategies to adjust to the pandemic situations.
Do you have plans for follow-up research?
Yes, definitely. The pandemic is not over, and maintaining well-being might be harder the longer the pandemic lasts as psychosocial resources might get increasingly depleted. Some individuals might get increasingly exhausted from the pandemic and in consequence reveal declines in well-being.
What we found with regard to well-being in summer 2020 might thus not apply to all phases of this pandemic, with all its unpredictable dynamics, infection waves, virus mutations, and temporary increases and decreases in infection rates. What we need is a long-term monitoring of individuals' well-being in times of the pandemic. Effects of the pandemic might come with some delay, so what we report and conclude now is to some extent preliminary.
We also still need to learn more about strategies, resources, and characteristics that help to psychosocially adjust to this challenging pandemic situation as well as about risk factors for mental health problems during the pandemic so that we can develop strategies and interventions to prevent mental health problems due to COVID-19 for a substantial part of the population.