Mental Health & COVID

Mental health

The WHO has tracked mental illness globally since 1990 [using data synthesized from national surveys and epidemiological studies, compiled notably by the Global Burden of Disease (GBD) study] and typically 1 in 8 people (or roughly 13% of the global population) have reported some form of mental illness. That means you or someone you know likely suffers from some form of mental illness.

However, defining mental illnesses is complex. They are diagnosed based on people’s psychological symptoms and behavior rather than biomarkers, brain scans, or blood tests. This makes them more subjective – they are dependent on whether people share their symptoms and the way doctors diagnose them. For me as a neuroscientist without overt physical changes in the brain, I find it difficult to get a handle on them.

Since the 1990’s, the prevalence is increasing, likely due to better diagnosis, reduced stigma, aging populations in some regions, and increased awareness, but recently there was an abrupt jump.

Breakdown of disorders

Mental health disorder is a broad umbrella term for a range of conditions characterized by clinically significant disturbance in an individual’s cognition, emotional regulation, and/or behavior. Without a clear physical root—meaning the absence of definitive biomarkers, brain scans, or blood tests—diagnosis remains primarily reliant on subjective clinical interviews and behavioral observation. This fundamental challenge, coupled with the significant overlap of symptoms across different conditions, means current diagnostic manuals (ICD and DSM) often must ‘bin‘ patients into specific, rigid disorders. While this categorical system represents the best compromise for clinical communication and standardized research at the moment, it simplifies the clinical reality: most researchers and clinicians agree that mental illness exists on a spectrum or continuum rather than as a set of separate, strictly bounded conditions.

Regardless of where we place the specific boundaries, the data makes one trend clear: the recent surge in mental illness is not uniform. The steep increase reported globally following 2020 was disproportionately concentrated in just two specific categories.

Analyses confirm that this sharp increase was mainly due to a rise in Anxiety and Depressive Disorders.

Breakdown of COVID increase

To understand the roots of this COVID increase we need to increase the granularity of the data examining mental health at increased spatial and temporal resolution. For this, we can use for example the dataset from the Robert Koch Institute on ‘High frequency Mental Health Surveillance’ in germany. This calculates 3 month rolling estimates of indicators of depressive and anxiety symptoms from survey data. And the data is stratified according to sex, age and education level. Overlaid with the survey data indicating depression symtoms is the level of closure.

It is clear that depression increases during COVID and there are many reasons for this not least of which the general stress of a global pandemic and an unpredictable future. To me, there is no direct link between school closures/lockdowns and mental health reporting in this German data. However, this lack of visible correlation may reflect the heterogeneous nature of lockdown effects. Global studies consistently show that the most negative mental health outcomes were concentrated in specific high-risk groups (e.g., young people, low-income families, or those in small, inadequate housing) and depended heavily on the type and duration of the restrictions.¹, ² This suggests that the differences in how and the enviorment where lockdowns were implemented—especially concerning vulnerable populations, access to services, and environmental factors—are key to understanding the varying mental health effects.

Factors mitigating jump in mental health illness

There is a lot that can and should be done to help people suffering with a mental health condition, which is a leading cause of health burden world wide. ³ The global burden of mental illness is daunting, but I think there is a path forward. To mitigate this rising tide, we must move beyond rigid diagnostic ‘bins’ and embrace a multi-dimensional approach. This starts with smarter urban design—creating cities that act as external regulators for our nervous systems—and extends to precision psychiatry. By leveraging genomic and transcriptomic data, we can finally move past subjective observation to segment patients into the specific therapies they actually need. I am happy to connect and engage with people interested in preventing the mental health crisis from affecting more people.