A pandemic is defined as “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people (1,2).” Given the novelty of SARS–CoV-2, the virus that causes COVID-19, and the subsequent coronavirus pandemic, little is known on the effects this pandemic is having in persons with pre-existing anxiety-based disorders and depressive disorders. The New York Times reported on a Census Bureau survey which found: A third of Americans are showing signs of clinical anxiety or depression, Census Bureau data shows, the most definitive and alarming sign yet of the psychological toll exacted by the coronavirus pandemic (3). This survey included a random sample of Americans with no appreciation for pre-existing depressive or anxiety disorders. Given that they saw an increase in anxiety and depression symptoms in a random population, it’s easy to surmise that those with pre-existing anxiety and depressive disorders will also show an increase in symptoms. The New England Journal of Medicine (4) wrote an article describing the mental health sequela of individuals from the coronavirus pandemic and subsequent isolation from quarantine. That some groups of individuals are more vulnerable to the psychosocial effects of pandemics (4). Particularly, “people who contract the disease, those at heightened risk for it (including the elderly, people with compromised immune function, and those living or receiving care in congregate settings), and people with preexisting medical, psychiatric, or substance use problems are at increased risk for adverse psychosocial outcomes (4).” They identified emotional sequela of the pandemic, including stress, depression, irritability, insomnia, fear, confusion, anger, frustration, boredom, and stigma associated with quarantine (4). The extent to which those with pre-existing anxiety and depressive disorders have an exacerbation of symptoms is unknown and unquantified. The article reports:
Even before the pandemic, mental health care in the country was severely underfunded and riddled with problems of access, disparities and insurance roadblocks. In the wake of the coronavirus pandemic, Congress appropriated trillions of dollars in emergency funds, but almost none of it has gone toward mental health programs and clinics.
- Bulletin of the World Health Organization 2011;89:540-541. doi: 10.2471/BLT.11.088815
- Last JM, editor. A dictionary of epidemiology, 4th edition. New York: Oxford University Press; 2001.
- Fowers, A., & Wan, W. A third of Americans now show signs of clinical anxiety or depression, Census Bureau finds amid coronavirus pandemic. New York Times. May 26, 2020 (
- Pfefferbaum, B., & North CS. (2020) Mental Health and the Covid-19 Pandemic. The New England Journal of Medicine. April 13, 2020. DOI: 10.1056/NEJMp2008017