Many long covid patients in US are reporting suicidal thoughts

Long COVID, a chronic condition that affects millions of Americans who’ve had COVID-19, often looks nothing like acute COVID-19.

Sufferers report more than 200 symptoms affecting nearly every part of the body, including the neurologic, cardiovascular, respiratory, and gastrointestinal systems.

The condition ranges in severity, but many so-called “long-haulers” are unable to work, go to school, or leave their homes with any sort of consistency.

The statistics around Long COVID and mental health are striking. A report published in eClinical Medicine last year found that about 88% of Long COVID patients experienced some form of mood or emotional issue during the first seven months of their illnesses.

Another study, published in BMC Psychiatry in April, found that people with post-COVID conditions were about twice as likely to develop mental health issues including depression, anxiety, or post-traumatic stress disorder as people without them.

COVID-19 survivors were also almost 50% more likely to experience suicidal ideation than people who hadn’t had the virus, according to a study published in February in the BMJ.

Exploring the body-brain connection of Long COVID

Understanding the link between Long COVID, suicide, and mental health issues is more complicated than it might seem. While some people do develop depression, anxiety, or other mental health issues after their diagnoses, others are suffering from physical symptoms that have psychological side effects or that are mistaken for mental health problems, experts say.

The virus that causes COVID-19 has well-documented effects on the brain, which can potentially result in psychiatric and neurologic symptoms, says Dr. Wes Ely, who treats Long COVID patients at Vanderbilt University Medical Center. “We’ve been collecting brains of some patients who didn’t survive Long COVID,” he says. “We’re seeing inflammation and ongoing cellular abnormalities in these brains.”

Those changes to the brain can have profound effects, possibly including suicidal thinking and behavior. “There is a high probability that symptoms of psychiatric, neurological and physical illnesses, as well as inflammatory damage to the brain in individuals with post-COVID syndrome, increase suicidal ideation and behavior in this patient population,” reads a January 2021 article in QJM: An International Journal of Medicine.

Research published as a preprint last year (meaning it had not been peer-reviewed) also found differences between “post-COVID depression” and typical depression, including higher rates of suicidal behavior—suggesting “a different disease process at least in a subset of individuals.”

Long COVID can also be incredibly painful, and research has linked chronic physical pain to an increased risk of suicide.

More than 40% of Long COVID patients experience moderate-to-severe sleep disturbances, according to recent research, and insomnia has been linked to suicidal thinking and behavior.

Part of the problem is that in the U.S., illnesses are typically considered either physical or mental, but not both, says Abigail Hardin, an assistant professor of psychiatry and behavioral sciences at Rush University who works with seriously ill patients, including those with Long COVID. “In reality, all of these things are actually very bidirectional,” she says. “Everything is integrated.”

In part because the medical system often fails to accommodate that complexity, many chronic-disease patients are misdiagnosed or assigned labels that don’t capture the full reality of their conditions.

Myalgic encephalomyelitis/chronic fatigue syndrome, a post-viral condition so similar to Long COVID that many long-haulers meet its diagnostic criteria, is one example.

Decades ago, doctors widely and incorrectly believed that patients’ symptoms—including crushing fatigue, often exacerbated by physical activity—were all in their heads.

002