Mental distress didn’t end with lockdowns; it left a long shadow we must measure honestly and treat decisively.

By Rafael R. Castillo, MD

In recent years, mental health has emerged from the shadows of public health discourse to become a pressing global concern. Far from being a peripheral issue, mental disorders now affect hundreds of millions of people worldwide—and the onset of the COVID-19 pandemic appears to have magnified the problem. Understanding how widespread mental health problems are, what drives them, how the pandemic factored in, and what we can do is critical for individuals, communities, and governments alike.

How prevalent are mental health problems?

Globally, mental disorders are a major burden. According to the World Health Organization (WHO), in 2021 approximately 1.1 billion people (roughly 1 in 7) were living with a mental disorder.
During the first year of the pandemic, WHO reported a 25% increase in the prevalence of anxiety and depression worldwide. In the U.S., data from the Centers for Disease Control and Prevention showed the percentage of adults reporting symptoms of an anxiety or depressive disorder increased from 36.4% in August-31 August 2020, to 41.5% in February 2021.

In younger age groups, the burden has been heavier: in one study of U.S. adults aged 18-29, psychological distress was reported at around 58% during the pandemic. A large meta-review found high rates of symptoms in the general population during the pandemic: anxiety ranged from 6.3% to 50.9%, depression from 14.6% to 48.3%. From a longer-term perspective, studies with long-term follow-up up indicate sustained effects of the pandemic on anxiety, depression, trauma and sleep-disturbance. In short: mental health problems are both common and rising, with significant increases observed during and after the pandemic across populations and age groups.

What are the causes?

The rise in mental-health burden is multi-factorial, reflecting the interplay of biological, psychological, social and systemic factors. Some of the key drivers include:

• Social isolation and disruption: Lockdowns, school and workplace closures, restricted movement, and reduced contact with friends/family all severed normal support networks. Studies show that social distancing and isolation were strongly associated with worse mental health outcomes.
• Economic stress and job loss: The pandemic caused major economic disruption—job insecurity, unemployment, reduced income—all of which elevate risk of anxiety, depression and substance-use disorders. Economic distress was found to account for large proportions of pandemic-related mental distress.
• Fear of infection, illness, bereavement: Living through a global infectious-disease crisis generated fear of contracting the virus, losing loved ones, long-COVID, and being cut off from health services. Research shows people who contracted COVID-19 had elevated risks of anxiety (35% higher) and depression (nearly 40% higher) compared with uninfected controls.
• Disruption of mental-health services: Many mental‐health services were interrupted or diverted during the pandemic, reducing access to care just when demand surged.
• Vulnerable populations: Young people, women, individuals with pre-existing mental conditions or chronic illness, and those with less education or lower incomes were disproportionately affected. For example, children and adolescents experienced higher rates of anxiety and depression compared with pre-pandemic.
• Digital overload, media stress and lifestyle changes: The pandemic accelerated remote work and digital learning, increased screen time, disrupted sleep and exercise patterns—all of which can adversely affect mental well-being. (Although less well quantified, these factors are widely cited in reviews.)

In sum: while mental-health problems existed well before COVID-19, the pandemic triggered and amplified many of the upstream drivers.

Was the COVID-19 pandemic a factor?

Yes — and the evidence is substantial though complex. The pandemic did not occur in a vacuum, but it accelerated many risk factors and placed unique psychological burdens on individuals and societies.

The WHO’s finding of a 25% global increase in anxiety/depression in the first year of the pandemic shows a clear temporal signal. Meta-analyses show consistent but variable worsening of mental health during lockdowns and social-restrictions. Longitudinal studies suggest that people who contracted COVID-19 have elevated risks of neuropsychiatric disorders long afterwards. Furthermore, models using U.S. Household Pulse Survey data estimated that job loss and housing insecurity driven by COVID-19 policy responses were strongly associated with increased depression/anxiety (path coefficients around 55-60%).
However, it’s also true that mental health trends varied by country, region, and demographic group. A UK study found that most adults (roughly 77 %) remained resilient or returned to pre-pandemic levels, though a minority experienced persistent deterioration.

Thus, while COVID-19 was not the sole cause of the global mental‐health burden, it acted as a catalyst and accelerant—exposing vulnerabilities, disrupting protective systems, and generating novel stressors.
As one expert put it: “COVID-19 was a stress-test for minds—and for systems.”

What can be done?

Addressing this mental-health crisis requires a multi-layered strategy: population-wide prevention, targeted interventions, service delivery innovations, and policy/system reforms. Key priorities include:

1.    Integrate mental health into primary care and universal health coverage
Embedding screening, counselling, and referral services into primary-health settings helps reach more people and reduce stigma. The WHO’s mhGAP (Mental Health Gap Action Program) is one model for low- and middle-income settings.

2.    Scale community-based and youth-focused interventions
Early detection and intervention among young people are vital; school-based mental-health programs, peer-support networks, and digital apps can play a role. A review found physical exercise, entertainment access, and positive family relationships helped buffer children/adolescents during the pandemic.

3.    Address social determinants and reduce economic stress
Policies to support income security, employment, housing stability and social protection will indirectly protect mental health. Structural supports reduce the burden of economic and housing insecurity—strong predictors of distress.

4.    Expand access to care, including tele-mental-health
The pandemic accelerated telehealth adoption, which should be sustained beyond the emergency. Expanding crisis lines, mobile counselling, and digital mental-health platforms improves reach, especially in underserved areas.

5.    Promote resilience, self-care, and community supports
Encouraging good sleep, regular physical activity, limiting doom-scrolling/social-media overload, maintaining social contacts, and building coping skills help individuals. Awareness campaigns can reduce stigma and encourage help-seeking.

6.    Focus on high-risk groups
Tailored approaches are needed for adolescents, young adults, women, people with chronic illness, persons who had COVID-19, and socio-economically disadvantaged groups—these have elevated risks.

7.    Strengthen data, monitoring and research
Better surveillance of mental-health trends, service-utilization gaps, and long-term outcomes—including post-COVID neuropsychiatric sequelae—will guide policy and practice.

Conclusion

Mental health is no longer the “silent” health crisis—it has become a global priority. The post-pandemic world shows both the fragility and the resilience of minds: widespread increases in anxiety, depression and distress reflect enormous systemic shock, yet many individuals have bounced back. For the user whose ambition is to live strong, happy, healthy, and spiritually grounded, this means recognizing mental-wellbeing as essential — not optional. At the societal level, it means transforming health systems, economies and communities to support mental health as much as physical health. The pandemic showed what happens when we neglect this; our challenge now is to build systems and habits that safeguard it for all.

“COVID-19 was a stress test for minds—and for systems. Scaling care is now non-negotiable.”

References

1. WHO. Mental health and COVID-19: early evidence of the pandemic’s impact. 2022.
2. WHO. COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. News release, 2 Mar 2022.
3. CDC. Symptoms of Anxiety or Depressive Disorder and Use of Mental Health–Care Services — United States, August 2020–February 2021. MMWR. 2021.
4. KFF. The Implications of COVID-19 for Mental Health and Substance Use. 2022.
5. Meta-review: Frontiers. Mental Health in COVID-19 Pandemic: Meta-review of meta-analyses. 2021.
6. Nature Medicine. How COVID-19 shaped mental health: from infection to pandemic. 2022.
7. PMC. Long-term effects of COVID-19 on mental health: A systematic review. 2023.