The Latest Symptom Covid-19 Long Haulers Are Facing: Immune-Mediated Depression

Leah Campbell

Depressed little boy sitting by the window, wearing surgical mask.

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As we’ve learned over the last year, one of the hardest things about tackling a novel virus is dealing with the unknowns. COVID-19 spread in what felt like an instant across the globe, and here we are a year later, still learning about what the fallout of all those infections may be.

Because it’s not just death those infected with COVID-19 have to worry about. It’s also the long-term health impacts far too many are currently facing—to include adolescents.

One such impact, it seems, may be an increased risk of immune-mediated depression.

What is immune-mediated depression?

Immune mediated depression refers to the relationship between the immune system and depression, specifically inflammation,” licensed clinical psychologist Jenna Palladino, PsyD, recently explained.

Researchers have looked into this potential link and have discovered that malfunctions with the immune system can, in fact, contribute to increased rates of depression. This seems to be especially true in individuals with autoimmune diseases.

Neuropsychiatrist Adam Kaplin, M.D., Ph.D., explained that, “In the case of autoimmune diseases and infections, the level of inflammation is much greater, leading to pronounced rates of depression that is often treatment resistant by conventional antidepressants in the face of such pronounced levels of immune overactivation.”

He went on to say that the rate of clinical depression seen in patients impacted by Covid-19 have been “staggeringly high.” A fact families of those infected by Covid-19 need to be paying attention to.

What We Know So Far

Doctors and scientists are obviously having to learn as they go when it comes to the long-term impacts of Covid-19, but Palladino theorized that the prolonged inflammation that occurs as a result of Covid-19, alongside the effects on the immune system that can persist after exposure, may be to blame for the heightened risk of depression doctors are noticing in patients post-Covid infection.

“At this point, long haulers are defined as those who have symptoms for weeks after having COVID-19, which casts a wide net,” Kaplin said. “While there’s still research being conducted on the impact of the illness on long-haulers, the evidence of immune system persistent activation and its relation to depression have made a compelling case.”

He pointed to a recent study from research at Harvard, which found that 52.4 percent of COVID-19 met criteria for moderate or greater symptoms of major depression four months after their initial infection. And he said it’s important to note that COVID-19 cases are almost invariably accompanied by excessive host immune response.

Those two pieces of information, he explained, make for a compelling argument that what COVID-19 patients are experiencing is truly immune-mediated depression.

Of course, there are other possibilities to consider as well.

“Pandemic related stress, such as an increase in sedentary lifestyle, psychological stress, social isolation, and less healthful food intake can also impact the immune system’s functioning,” Palladino said. “The combination of pandemic related stress and the direct impact of COVID-19 on the immune system can exacerbate the likelihood of depression in long haulers.”

Either way, those infected with COVID-19—and especially the “long haulers” who are still symptomatic weeks down the line—have an undeniable increase in risk for depression.

Combatting Immune-Mediated Depression

With vaccinations now open to kids 12 and older, one of the best ways to prevent this symptom in those who have not yet contracted Covid-19 is to vaccinate your family.

But Palladino said it is also important to remember that depression can impact anyone. If you or anyone in your family is dealing with symptoms of depression, regardless of the cause, she suggested these coping skills to help work through it:

Exercise: Finding ways to move our bodies through walking, running, dancing, biking, hiking, yard work, or whatever works for you can help us manage stress and improve wellbeing.
Healthy choices: Taking care of our physical health by eating healthy and limiting alcohol or other substance use is important. Trying out a healthy new recipe is a great way to nourish our bodies and try something new.
Sleep: Continuing to practice helpful sleep practices, such as limiting time in bed and avoiding napping, can help us get more restful sleep at night and feel better throughout the day.
Structure: Maintaining structure and routine helps provide certainty and stability.
Connect: Finding ways to stay connected with loved ones in social distant ways, such as small group gatherings, going for a walk with a friend, calling a family member, or joining a local video support group, book club, dinner party, etc.
Disconnect: Although it is important to stay aware of current events, limiting time on social media and news outlets can help improve wellbeing and minimize stress.
Breathe: Participating in Meditation, deep breathing, or a brief yoga practice can help manage stress and increase calmness.
Get outside: Having fun by spending time in nature, spending time with pets, fostering creativity, trying out a new hobby, or spending some time reconnecting with an old hobby can also help improve our moods and bring some joy into daily life.

“The public should understand that if they’ve had or had a loved one who is exhibiting depressive symptoms, it is because of the impact of inflammation from the infection upon the mood regulating functions of their brain,” Kaplin said. “In essence, it is a just another effect of COVID-19, and not due to a personal weakness or character flaw. And just like other consequences of COVID-19, depression must be evaluated by a trained health professional and treated.”

As parents, especially, it’s important to pay attention to changes in mood and behavior your children may be exhibiting post-infection. Don’t wait it out if you, your partner, or your child is experiencing depressive symptoms. Help is available, and everyone deserves to utilize that help as soon as possible.

So pick up the phone and call a doctor. The sooner you do, the sooner your family can get back to a healthy place again.


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