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Is It Just the COVID-19 Blues or Is It Depression?

The answer depends on whether "down" feelings come and go or come and don't go.

Photo by cottonbro from Pexels
Source: Photo by cottonbro from Pexels

“Don’t wish it away. Don’t look at it like it’s forever. Between you and me, I could honestly say that things can only get better.”

These words from Elton John’s song "I Guess That’s Why They Call It the Blues" may be good advice for many of us who have become a bit stir crazy after being cooped up at home for months, compliments of the unrelenting COVID-19 viral pandemic. But what exactly are “the blues?” Do they constitute a mental health disease – like anxiety disorder or clinical depression — requiring professional therapy? Or do those feelings of sadness, loneliness, anxiousness, pessimism, and melancholy ascribed to “the blues” represent simply a transitory “psychological state of mind,” in this case, one effected by the confinement, social isolation, and repetitive daily sameness wrought by the virus?

They Just ‘Come and Go’

Psychiatry and psychology professionals view “the blues” as a type of “situational depression” – a temporary problem that usually dissipates as quickly as it develops once the issues causing a person’s “down” feelings have resolved. Indeed, “the blues” are not even listed as a psychiatric condition in the Diagnostic and Statistical Manual of Mental Disorders.

Although seemingly similar to those of clinical depression, blues symptoms tend to be shorter-term and milder, do not significantly interfere with day-to-day functioning, are more readily managed with social support and changes in personal lifestyle, and affect just about everyone at some point or another in their lives.

The “COVID blues” may be putting people in a funk that affects sleep; promotes fatigue; and leads to boredom, disinterest, and a lack of energy. But most sufferers will enjoy a return of optimism and blue skies following widespread vaccination and resumption of normal socialization habits and family visits, restaurant dining, concerts, theatre performances, and sports venues, sans masks.

As one clinical psychologist is quoted saying in a 2020 article published by the American Association of Retired Persons, “the blues come and go” and “do not last for…weeks.”

But What If They Come and Don’t Go?

But what if “the blues” do last for weeks and seem to worsen with passage of time?

That may be a sign of true clinical depression. Persistency and severity of symptoms are hallmarks of the disorder. According to the National Institute of Mental Health, clinical depression is characterized by ongoing pessimism, anxiousness, and hopelessness; self-isolation and loneliness; difficulties sleeping and concentrating; loss of interest in once-enjoyed activities and hobbies; even suicidal ideation – symptoms that transcend any one problem, situation, or event in a person’s life.

It's important to realize that depression has both genetic and environmental causes. Indeed, many studies looking at the heritability of depression have shown that it is about a 50/50 balance between nature and nurture — so both our genetics and environment play equal roles. This is an important fact to consider because some people may be prone to depression based on genetics alone. In these instances, we often hear of family histories of siblings, parents, grandparents and even children who had depression, or some other unusual characteristic ranging from short tempers, to alcoholism, anxiety, as well as depression. Historically many people were never formally diagnosed, so I always make it a point to ask about "eccentric behaviors, or characters," among family members. Most people with mental illness in the past, would also self-medicate with alcohol, so alcoholism is always a marker of something significant. Genetics are important because they demonstrate that some people may be inclined to become depressed. In these instances, the blues can continue longer, and with more intensity and become depression. Another key distinguishing feature between the blues and depression is the degree of impairment. If someone cannot sleep, eat, work, or enjoy their free time, it may be worth seeking professional help. Loss of interest in pleasure, and low mood on most days in a two-week time span, are also cardinal symptoms of depression, and should be addressed with a professional.

Can ‘State of Mind’ Lead to True Disease?

Meanwhile, a raft of surveys and studies concerning the impact of COVID-19 on mental health has been published during the past eight or nine months. The Centers for Disease Control reports “considerably elevated adverse mental health conditions” in 2020 and indicates that symptoms of anxiety and depressive disorders are on the increase, spurred in large part by the pandemic. Some mental health professionals fear that this documented uptick in psychiatric disorders may be due to prolongment of the pandemic, putting “susceptible individuals” at risk of moving beyond “the blues” to real clinical depression.

A study in Psychiatry Review, December 2020, suggests that fears of COVID-19 are exacerbating depressive symptoms among pregnant and postpartum women. In a 2020 edition of the American Journal of Geriatric Psychiatry, scientists indicate that the self-isolation and loneliness forced by the pandemic is elevating the presence and severity of psychiatric disorders and problems within older populations. And Stanford University psychologists, writing in an August 2020 edition of the journal Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, indicate some adolescents are more likely than others to internalize “stressful social contexts, such as a prolonged period of isolation [ongoing school closures, social distancing] and uncertainty during COVID-19.”

Human beings are social animals. Indeed, scientists have shown that. Research just reported (November 2020) by the Massachusetts Institute of Technology in Nature Neuroscience indicates that absence from social interaction is neurologically similar to hunger. The same region of the brain is activated. If prolonged, hunger-induced states affect the psyche, causing strong negative emotions, such as anger, irritability, and bad temper, then why cannot social isolation do the same? In fact, it does, which, of course, suggests the possibility that long-term social isolation will lead to mental disorders in some individuals.

How to Maximize Mental Health

COVID-19 is expected to continue impacting the way we live for at least the first half of 2021. Yet all of us can take actions to remain positive – and sane – while confined at home:

  • Stay connected to family and friends – even though that must still be done remotely.
  • Be an achiever. We all have pre-pandemic projects that we just never took the time to complete – or even start. Life got in the way. Now, is the time to set goals and get these tasks done – and feel better for it.
  • Get creative. Find new activities and hobbies in which to become involved. While routine is important, also consider mixing it up sometimes and do something different or new; take a class, learn an instrument, connect with a new or old friend, or read a book.
  • Sleep – regularly and sufficiently. Authors of a 2020 study in Behavioral Brain Research report finding that poor sleep habits increase mental strain on adolescents and aggravate psychiatric symptoms. Such symptoms can later promote onset of depression and other mood disorders in adulthood.
  • Exercise – even if it just involves daily walks, stretching, and other fitness routines. Indeed, a paper published in a 2017 issue of the American Journal of Psychiatry indicates that as little as an hour of physical activity a week – at any intensity level – reduces risk of depression.
  • Seek solace in nature. Research has demonstrated that a walk – or jog – in the woods, parks or amidst other natural surroundings lowers levels of cortisol, a stress chemical, in the body.
  • Do a few things that make you happy. Enjoy a movie day at home. Order out dinner one or two times a week. Sip an occasional glass of wine and be a bit extravagant. If money permits, buy yourself that catalog item you have been considering for a long time.
  • Mix up your media viewing. Stop stressing over the latest COVID numbers and positivity rates featured on TV and sent as alerts to mobile phones. Ignore “real life” on occasion and switch your media devices from stressful news shows to some comedies and dramas.

Finally, make every effort to ensure your routine is not the “same thing every day.” And if you have tried just about everything and still feel mired hopelessly in negativity, lack of motivation, and sleepless anxiety – even to the point of considering taking drastic measures, such as suicide, contact a mental health professional -- immediately.

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