Lockdown and Depression The mental health damage caused by the pandemic
Bonn · Bonn studies have revealed an increase in depression and anxiety disorders during the Coronavirus pandemic. Women, children and adolescents are particularly affected. Are the lockdowns to blame? A conversation with experts.
Leonie has been living with depression for years. To "function," she needs a fixed daily routine. "I need to know: I get up now, I get dressed, I go to university," says the 19-year-old. The Coronavirus pandemic has to a large extent eroded these structures, and this has had a negative impact on her illness.
Leonie moved to Bonn in October to study German and Hispanic studies. She has found friends, a support group and now, finally, a therapist, despite learning primarily online. "I had a list of 80 therapists in the area, and yet it took months," she says. "One therapist was able to offer me a first appointment in March; I couldn't wait that long."
She has often been unwell during the pandemic, which started when she was in the midst of high school graduation preparations. "It's not just because of the pandemic, but it definitely had an impact on me," the student says. "I feel better when I can hang out with friends, but that, of course, hasn’t been possible as much."
Signs of depression rose in first lockdown
It's no secret that the Coronavirus pandemic is affecting many people's moods. The topics of mental distress and illness have been on the minds of many psychologists, other experts and politicians since the pandemic began. According to data from health insurance provider Kaufmännische Krankenkasse (KKH), the number of people being treated for depression is on the rise. And a startling study by the German Federal Institute for Population Research (BiB) recently found that the number of young people showing signs of depression increased significantly in the first Coronavirus Lockdown in 2020. According to the study, before the pandemic, ten percent of young people between the ages of 16 and 19 had symptoms of depression; after the first lockdown, the figure was 25 percent.
So many people were not happy with statement made at the beginning of January by German Health Minister Karl Lauterbach (SPD). Appearing in the chat show "Hart aber fair," he rejected the idea that Germany's comparatively strict Coronavirus measures were responsible for an increase in mental health issues. "You have to be careful saying things like that. As I see it, that’s not what the studies say,” he said. But what do the studies indicate - and what do other experts say?
Bonn-based paediatrician Axel Gerschlauer disagrees with the health minister, at least as far as the effect on children and adolescents is concerned. "Mr Lauterbach is demonstrating a lack of specialist knowledge and of practical experience,” he said Gerschlauer is chairman of the Professional Association of Paediatricians (BVKJ) for Bonn and the Rhine-Sieg region and spokesman for the BVKJ North Rhine. He says that his own observations as well as talks with colleagues clearly show: "When the schools closed, psychological problems among children and adolescents became more serious. When they opened again, mental health issues have often subsided, at least in part."
He believes that much of the negative effect on young people – psychological distress, as well as psychiatric illness, increased sleeping and eating disorders – is a direct result of isolation and a lack of regular daily routines due to school closures. He also says, "My colleagues and I have never before seen such an increase in mental health issues."
But it's not just children and young people. Women in particular also seem to be suffering more in the pandemic. "Women are generally more prone to anxiety and depression," explains Franziska Geiser, director of the Clinic for Psychosomatic Medicine and Psychotherapy at Bonn University Hospital (UKB). In addition, they more often work in jobs that are directly threatened by the pandemic, such as in the catering industry. "On top of that, in families it is often the mothers alone who take on home schooling and family work," says Geiser, "another psychological burden."
When there is conflict between couples, which can easily increase during a lockdown, women are more likely to be victims of domestic violence, she adds. However, Geiser also points out that her own patient volume is not sufficient to draw conclusions about an increased incidence of mental health problems. "We had long waiting lists even before the pandemic." She said there are studies that have a broader data base for this question. What's more, those studies show there is a correlation. "Yes," Geiser says, "Since the beginning of the pandemic there has been an increase in the number of people who are under such psychological strain that they could be described as having a mental illness.” But, "You can't pinpoint the reason.” Most studies don’t look into whether these problems are because of the pandemic itself, as Lauterbach suggests, or because of lockdowns and contact restrictions.
Daniel Huys, head physician of the Department of General Psychiatry and Psychotherapy 3 at the LVR Clinic in Bonn, also reports that patients often complain about the duration of pandemic-related stress, such as a lack of social contacts. However, "causal relationships are not easy to establish."
Neuroscientist Tania Singer is head of the Max Planck Society's Social Neuroscience Research Group in Berlin and is overseeing a study of the psychological effect on Berlin residents that will run for several month. She says: "Our data clearly show a so-called lockdown shock effect during the first lockdown and a lockdown fatigue effect during the second lockdown, which includes symptoms such as depressiveness, anxiety, loneliness and stress." During the second lockdown, from October 2020 to March/April 2021, Berliners' mental health progressively worsened with each passing month. Singer also says, "Younger people from 18 to 25 and also women suffered more from the restrictions."
Help is available from therapists and in self-help groups
International comparative studies also show this trend, for example in the October 2021 medical journal The Lancet. Scientists at the University of Queensland (Australia) compared the effects of the pandemic on anxiety disorders and depression in the population in different countries. To do this, they analysed movement data from smartphones to check the connection between restricted mobility and mental illness. The result: restricted mobility due to lockdowns and rising Covid-19 infection figures correlated with rising numbers of mental health problems; also, mainly women and young people were affected.
Anyone suffering from mental health problems can find help from therapists - and in self-help groups. Like student Leonie, Sonja has already attended a group for depression in Bonn. The 37-year-old works in a hospital and has struggled with depression since her youth. She is doubly affected by Corona: In the first year of the pandemic, she was infected with the virus and then developed Long Covid - which caused her to miss several months at work. "I was never really afraid of Coronavirus, even though it affected me myself," Sonja says. "What's worse for me is the isolation and the lack of things to do." And she's noticed something else: "I feel like a lot of people are distancing themselves emotionally, too." She also found it difficult to find a therapist but was eventually successful. And even though more and more mental health problems are being reported, especially in the wake of the pandemic, it remains difficult for those affected to admit to it. "My colleagues at work don't know anything," Sonja says. She hopes that she will feel better in the spring - "Winter is very bad for me even without the pandemic."
Franziska Geiser from the UKB takes a differentiated view of the intensity and increase in mental health problems. "Whatever happens, we need to take measures to combat the pandemic,” she says. Lockdowns have their price, but the goal in the pandemic must be to save as many lives as possible. "Of course, a middle ground must be found here in terms of how people are burdened as little as possible," Geiser says. "It’s important that this is discussed by politicians and by society in general.”
Help for those affected is available from the Bonn self-help contact point of Der Paritätische NRW, among others. In December, a new depression self-help group was founded due to high demand. A group on the subject of loneliness for people aged 60 and over is currently being set up, as is a self-help group for young people up to the age of 26 suffering from depression. Info at www.selbsthilfe-bonn.de.
(Originaltext: Johanna Lübke; Translation: Jean Lennox)