As yet another variant COVID-19 threatens the world with renewed restrictions and canceled flights, it’s starting to seem like this pandemic ‘ain’t over til it’s over.’ And now, after almost 2 years of battling with the coronavirus, we’re slowly starting to learn of the many consequences a worldwide pandemic can really have on the physical and mental health of the population.
For one, we now know that at least one in five adults delayed or avoided seeking healthcare at the height of the pandemic, even when they had symptoms severe enough to warrant urgent medical attention. Among the most often ignored symptoms were chest pain, palpitations, and limb weakness, all potential signs of a heart attack.
According to the report, which was published in November in the journal PLOS Medicine, women and those with high levels of depression and anxiety were most likely to avoid seeking medical care. And what’s even more concerning: another study, also published in November of this year, has found that levels of depression and anxiety have risen sharply during the pandemic, leading to an increased risk for cardiovascular disease and other chronic health issues.
More anxiety, more problems
For the study, led by researchers at Intermountain Healthcare in Salt Lake City, investigators evaluated the health records of more than 4,500 patients who were asked to fill out a depression screening questionnaire as part of their routine primary care visits before and during the pandemic. For the purposes of the study, “before” was any time between March 1, 2019, and February 29, 2020, and “during” included the period from March 1, 2020, to April 20, 2020.
To analyze results, patients were first divided into two groups: those with depression or who were no longer depressed, and those who became or remained depressed. Then, the investigators looked at the patient’s electronic health records to determine if there were any instances of emergency department visits due to anxiety and chest pain.
Anxiety is one of the body’s normal reactions to stress — and small amounts of it are not necessarily a bad thing for you. In practical terms, a little stress can keep you motivated and engaged. It can also help you remain focused and energized. On the other hand, the absence of worry and engagement, which is sometimes referred to as emotional detachment, can lead to worsened symptoms of depression, substance abuse issues, and other forms of emotional distress.
The problem is when stress and anxiety become so overwhelming that you cannot function normally, translating into severe disruptions to your mental and physical health, and making you more susceptible to dangerous chronic conditions, especially if you are at risk of developing or have existing cardiovascular disease.
Heart disease and anxiety disorders share a complex connection that health experts are still trying to decipher. The association between anxiety and cardiovascular conditions hasn’t been as thoroughly studied as the relationship between heart disease and depression — depression is a known independent risk factor for heart attacks, even among people without heart disease — so there are still a lot of questions. However, experts believe that chronic anxiety could be just as damaging for the heart.
Studies show that some of the symptoms of anxiety could have negative, lasting consequences on the cardiovascular system. In fact, many anxiety symptoms, like chest pain and heart palpitations, mimic those of a heart attack.
Also, there are many lifestyle habits that people with severe, chronic anxiety seem to be more likely to engage in. For example, evidence suggests that people with anxiety are more likely to smoke than those without anxiety.
Chronic anxiety can also lead to poor diet choices, increasing your risk of developing heart disease. Social isolation and loneliness — which have skyrocketed during the pandemic — are also strongly associated with severe anxiety. And what’s more, isolation and loneliness have been shown to carry the same risk for heart disease as smoking.
Depression and Anxiety Associated with Increased ER Visits
The new study findings show that patients who were already depressed prior to the pandemic were even more depressed during lockdown. Additionally, the incidence of visiting the ER for anxiety-associated symptoms was also significantly greater among patients with depression.
According to Heidi May, the study’s principal investigator, the fact that so many patients were visiting the ER for anxiety probably means that their symptoms were “on the more severe side,” given that so many folks were delaying or avoiding medical attention during those stressful months.
Ultimately, studies like this speak to the importance of addressing mental health concerns during times of crisis. “These findings are significant. In looking at the first year of the pandemic, we are already seeing the mental health effects on our patients,” said Dr. May in a statement. She added that “We already know that depression raises a person’s risk for developing cardiovascular disease and other chronic health problems, so this is very concerning and highlights the importance of screening patients and providing the mental health resources that they need.”
