Symptoms of COVID-19 typically clear up within a couple of days or weeks. However, as many as 2 out of 10 people experience ongoing health problems as a result of this condition. Long COVID, also called post-COVID conditions or post-acute COVID-19 syndrome, is the name for ongoing symptoms that occur after your initial infection with SARS-CoV-2, the virus that causes COVID-19.

During the COVID-19 pandemic, experts have developed varying definitions of what counts as long COVID. According to the World Health Organization (WHO), long COVID usually develops within three months of experiencing COVID-19 and leads to symptoms that last at least two months. However, the Centers for Disease Control and Prevention (CDC) defines this condition as health problems that occur four or more weeks after infection and cannot be explained by any other illness.

Long COVID can affect your mental health as well as your physical health. Several members of myCOVIDteam have discussed their struggles. One member wrote, “I’m having shortness of breath today, feeling very weak, and having chest pains and anxiety.” Another commented, “I wake up some days and just start crying.”

The Mental Health Symptoms of Long COVID

The most common mental health issues in people with long COVID include mood disorders, like anxiety or depression, and “brain fog” (problems with concentrating or thinking). These conditions can have overlapping symptoms, and they frequently exist together.

Additionally, long COVID can lead to sleep problems. Lack of sleep can worsen mental health issues. Having a mental health condition can, in turn, make it harder to get a good night’s rest.

Anxiety

One study found that, several months after being hospitalized for COVID-19, nearly 1 out of 4 people still experienced anxiety or depression. Anxiety includes feelings of worry, fear, or dread. While some anxiety is normal in stressful circumstances, anxiety disorders occur when your fear doesn’t go away during everyday situations or when it gets worse over time.

Symptoms of anxiety include:

• Feeling nervous or restless
• Feeling like something bad is about to happen
• Thinking you are in danger
• Having fears or concerns that feel outside of your control
• Avoiding situations that make you feel more worried
• Feeling tired or weak
• Having trouble focusing
• Breathing more quickly than usual
• Having a racing heartbeat
• Sweating
• Shaking
• Feeling dizzy
• Experiencing digestive changes, such as heartburn or diarrhea
• Sleeping less or more poorly than usual

There are several types of anxiety disorders. General anxiety disorder leads to ongoing worries about health, social interactions, and everyday activities. Social anxiety occurs when you feel extremely nervous in social situations. You may have panic disorder if you frequently experience panic attacks (episodes where you feel intensely afraid and have physical symptoms such as a fast heartbeat, trembling, and trouble breathing).

Many members of myCOVIDteam have talked about experiencing anxiety. “I was feeling fine, but the next minute I felt strange,” said one member. “It may be anxiety. My hands were shaking, and I just did not feel right.”

Another member commented, “My anxiety got way worse after recovery. I don’t even feel like going anywhere.”

Depression

One study found that people who’d had COVID-19 were 18 percent more likely to have depression several months later. Depression is a condition that often leads to feelings of sadness or hopelessness. Alternatively, it may make you feel empty. Depression typically makes it harder to follow through with your normal daily activities.

Members of myCOVIDteam have discussed dealing with depression. One member wrote, “I still don’t have my energy back, and I quit my job because I was in a depressive state.”

Depression symptoms may be mild or severe. To qualify as depression, symptoms must be present for at least two weeks. Signs of depression include:

• Feeling sad, hopeless, or worthless
• Feeling empty or like nothing matters
• Getting suddenly angry or frustrated over something small
• Being irritable
• Feeling anxious or restless
• Feeling a lot of guilt that you can’t seem to control
• Losing interest in things you used to enjoy
• Having trouble remembering things or focusing
• Feeling like your brain is working more slowly than it should
• Craving food more than usual, or not feeling as hungry as you usually do
• Noticing weight changes
• Feeling very tired or not having energy to do small tasks
• Experiencing headaches or back pain
• Having trouble sleeping or sleeping too much
• Thinking about death or suicide

If you’re thinking about trying to hurt yourself, reach out to someone right away. Call a friend, family member, doctor, or spiritual leader. Alternatively, you can call a suicide hotline number. If you live in the U.S., call 800-273-8255 to reach the National Suicide Prevention Lifeline.

Brain Fog

Brain fog is a common name for cognitive dysfunction, or thinking problems. In one survey, researchers found that brain fog was one of the most common symptoms among people who had ongoing health issues six months after a COVID-19 infection.

People experiencing brain fog are most likely to have symptoms like:

• Taking a long time to process information or make a decision
• Having trouble remembering things
• Experiencing problems with executive function (a set of skills that help you plan and follow through on getting things done)
• Needing a longer time than usual to come up with the right words
• Having trouble paying attention

Cognitive issues may especially be a problem for people who were severely sick with COVID-19. People who needed to spend time in an intensive care unit (ICU) may experience a condition called post-intensive care syndrome (PICS). PICS often leads to brain fog. It may also lead to other mental health problems, such as post-traumatic stress disorder (PTSD).

Sleep Disturbances

According to some research, 1 in 4 people who were hospitalized for COVID-19 have trouble sleeping several months after being discharged. However, other studies have estimated that sleeping problems occur for more than half of people with long COVID.

Insomnia is a condition that occurs when you don’t get enough sleep or get poor-quality sleep. It can lead to symptoms like:

• Lying awake for a long time before falling asleep
• Waking up in the middle of the night and having trouble getting back to sleep
• Feeling like you can only sleep for short bursts
• Waking up too early
• Feeling tired or not well-rested during the day
• Having trouble concentrating
• Feeling depressed or cranky
• Experiencing worry about being unable to sleep

These sleep problems can lead to physical and mental health problems and affect your quality of life.

Long COVID and Existing Mental Health Conditions

Some research suggests that if you have already been diagnosed with a mental health condition, your symptoms could worsen if you develop COVID-19. Having mental health conditions like depression may also make you more likely to experience severe COVID-19 symptoms. If you struggle with your mental health, you may want to make a plan with your health care provider for what to do if your symptoms worsen with COVID-19.

Why Does Long COVID Affect Mental Health?

Experts don’t yet understand why long COVID can cause mental health changes (also called psychiatric symptoms). One possible reason is that the coronavirus itself may directly cause changes in the brain.

Another possibility is that dealing with long-term effects on health could lead to fear or despair. Some people may worry that the symptoms will never go away. Several myCOVIDteam members have expressed these fears. “I still have fatigue and anxiety,” commented one member. “I think it’s more of fearing the unknown. It’s a slow recovery.”

Poor mental health may also arise as a result of feeling like no one understands. Long COVID is a new condition, unfamiliar to many people. Someone with long COVID may feel their family, friends, coworkers, and even doctors don’t grasp what they’re going through. “Depression for me is really bad,” wrote one myCOVIDteam member. “Sometimes people don’t believe your symptoms. I feel alone.”

Managing Mental Health After a COVID-19 Diagnosis

If you’re a COVID-19 survivor and you’re noticing some of these mental health issues, contact your health care team and ask your doctor about being evaluated for long COVID. Diagnosis of this condition can be complicated, but your doctor can perform a physical exam and order lab tests that can help identify long COVID symptoms or rule out other potential health problems. Your doctor can also help diagnose and treat any new or worsening mental health conditions or refer you to a mental health provider, such as a therapist or psychiatrist, for diagnosis and treatment.

Treatments for Mental Health Conditions

The mental health treatment that works best for you depends on which condition you have and the severity of your symptoms. You may be able to improve your stress levels and boost your mental health with some of these suggestions from the CDC:

• Stay away from news and social media for a little while.
• Meditate regularly with the help of a book, smartphone app, or online video.
• Learn some breathing exercises that can help you relax.
• Work on a hobby or activity you enjoy.
• Improve your sleep by going to bed a little earlier, avoiding caffeine in the afternoons and evenings, and making sure your bedroom is dark, cool, and quiet.
• Limit or avoid drinking alcohol and using drugs.
• Try your best to eat a balanced diet containing lots of different foods.
• Get more physical activity by taking a walk around the block or trying an online fitness class with a friend.
• Reach out to loved ones or to a support group like myCOVIDteam.

If you need additional support, one treatment option is therapy or counseling. Therapy can help you figure out how to manage difficulties in your life, and assist you in changing behaviors or thought patterns that aren’t working for you. There are many different types of therapy. If your first therapist doesn’t feel like a good fit, switching to someone else may help.

Another treatment option is medication, which your health care team may recommend based on your condition. Often, therapy and medication are used together to provide the most benefit.

If you’re experiencing symptoms of anxiety or depression, or if you notice other changes in your mental health, follow up with your doctor.

Talk With Others Who Understand

On myCOVIDteam, the social network for people recovering from COVID-19, more than 4,000 members come together to ask questions, give advice, and share their stories with others who understand life with long COVID.

Are you dealing with stress, anxiety, or depression due to ongoing effects of COVID-19? Have you tried any strategies to support your mental health? Share your experience in the comments below, or start a conversation by posting on your Activities page.