COVID-19 lockdowns and young people's mental health

The rapid and extensive spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to the imposition of severe restrictions on social gatherings and interactions, business operations, educational institutions, travel across the country or international borders, as well as stringent shelter-in-place orders or lockdowns. A new preprint examines the extent of mental distress among young people in Denmark as a direct result of the lockdowns during this period.

Study: The Impact of The Initial And 2nd National COVID-19 Lockdown on Mental Health in Young People with And Without Pre-Existing Depressive Symptoms. Image Credit: engagestock / Shutterstock.com

Background

In the current study, the researchers looked at earlier papers for evidence of the impact of lockdowns on the mental health of the population. They found that overall, the impact appeared to be negative, with women, young people, and those who already had mental ill-health being the most affected.

Individuals who already had mental health problems appear to be the least studied from the perspective of comparing their mental health with pre-pandemic trends. This shows the need for research in this area, especially the longitudinal trends and long-term effects on mental health.

In Denmark, a lockdown was first imposed in March 2020, with all non-essential government workers asked to work from home, along with the closure of all other institutions. Private companies were also advised to adopt work-from-home policies.

While the lockdown was relaxed during the spring, it was reimposed in stages over fall 2020 as cases and deaths began to rise. The second complete lockdown began in the middle of December 2020 and remained in place until March 2021, which is when the restrictions began to ease.

Study findings

The study was planned to yield longitudinal data on the impact of the lockdown on the mental well-being of young people in Denmark without pre-existing mental issues. The scientists explored mental health, quality of life, and loneliness in particular, and also attempted to determine whether this was worse in women and in those who already had mental ill-health.

Over half of the participants in the study were between 18-20 years old during the first lockdown, and women outnumbered men (70% or more during the COVID-19 pandemic). More women were studying, living with their parents, and from educated families.

Apart from the first and the last waves of the coronavirus disease 2019 (COVID-19) pandemic, those participating in waves 2-7 were less likely to have pre-existing depression; were studying or from educated households; had no children, or had older mothers.

Prior to the lockdown, women and young people with a history of depressive symptoms were less healthy mentally than men and non-depressive young individuals. A decline in mental health, quality of life, and increase in loneliness occurred during the most stringent phase of the lockdown.

Women who had no mental health issues before COVID-19 began seemed to have a greater decline in the quality of life as compared to men, at -1.12 versus -0.85, respectively. Both groups reached their nadir around waves 2-5.

However, after a year, the quality of life and mental well-being remained somewhat lower than before the pandemic. In fact, these levels were comparable to the observations made during the first part of the initial lockdown in these previously normal young people.

People without depressive symptoms before the pandemic began were most prone to have deterioration in mental well-being and loneliness. These symptoms affected women and men equally in this group. The greatest change was during the early part of the lockdown.

After a year, the overall level of mental health was that observed during the first part of the lockdown. For loneliness, the decline was greatest in the phase of the first lockdown associated with the strictest restrictions and then improved so that, during the reopening of the last lockdown, it was only slightly raised.

Conversely, those youth who already had signs of depression did not have a worse outcome, with respect to their quality of life, mental health, and loneliness. Instead, they displayed a resilient outlook or signs of improved mental health.

Implications

In contrast to earlier research, the findings of the current study suggest that the lockdown did not cause any lasting adverse impact on mental health among young people, at least in Denmark. This shows the importance of using standardized methods to investigate mental health and the use of standardized databases.

The reason for the recovery following deteriorations in mental health and loneliness could be due to actions taken by the government to ease restrictions.

“It is likely, however untestable, that the participants in the DNBC-18 deliberately compensated, so their responses reflected their overall health and not solely their current lockdown situation.”

Earlier, many studies indicated that young people experienced a decline in mental health. Most of these are based on cross-sectional rather than longitudinal measurements and do not use a pre-pandemic baseline. The importance of this is obvious since depressed individuals are likely to have lower scores of quality of life, loneliness, and mental ill-health, even at baseline.

The resilience shown by young people who were already depressed could be due to the equalizing influence of the social isolation caused by the lockdown, bringing in a new way of life that was in tune with their normal life. With others, the fear caused by the unexpected crisis could have triggered the reduction in mental health seen here.

It is also possible that the residual impact seen at the end of one year would have disappeared if the measurement had been performed later during the reopening phase. However, it must be noted that depressed young people continued to enjoy a lower level of mental health than their non-depressed peers, even though the former did not deteriorate during the pandemic.

“More studies based on high-quality data used in different settings are needed to fully understand the impact of the lockdowns on young people’s mental health, including potential disproportional impact on vulnerable subgroups.”

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.