Millions of Americans are searching for answers about the implications of long COVID, and now the Substance Abuse and Mental Health Services Administration (SAMHSA) has released an advisory that offers improved guidance to physicians on identifying mental health symptoms associated with the condition. These new guidelines were released in June as part of the Biden administration’s action plan for long COVID research. They provide a framework that can help physicians, patients, and providers better understand mental health symptoms such as anxiety, fatigue, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD) that may be connected to long COVID.
Dr. Serena S. Spudich, a professor of neurology at Yale School of Medicine, explains that these guidelines validate and categorize these conditions, as well as offer guidance on managing them. Molly Sanborn, a Public Health Analyst at SAMHSA, emphasizes the importance of prioritizing the identification and treatment of individuals with long COVID who are experiencing mental and behavioral health symptoms, as these symptoms can be highly debilitating.
A conversation between PBS NewsHour digital anchor Nicole Ellis, Molly Sanborn, and Dr. Serena S. Spudich delves into the impact of long COVID on mental health. Dr. Spudich states that the symptoms of long COVID can be categorized as either psychiatric or psychological, with some also having neurological elements. She points out that these conditions often overlap, such as depression and brain fog. A meta-analysis published in the Journal of the American Medical Association (JAMA) found that approximately one in three COVID-19 survivors were diagnosed with generalized anxiety disorders, and one in five were diagnosed with depression. Cognitive impairments, including difficulties with concentration, brain fog, and memory, were also observed in COVID-19 survivors.
Dr. Spudich explains that cognitive challenges can have significant implications for mental health. These challenges may be caused by abnormalities in brain function, such as impaired communication between brain nerves or changes in blood flow to the brain. SAMHSA’s new guidelines explicitly urge healthcare providers, particularly primary care physicians, to look for and document symptoms of long COVID in their patients. The guidance emphasizes the need for a multidisciplinary approach to managing long COVID, as it often affects multiple organ systems. SAMHSA also addresses the impact of social determinants of health on long COVID outcomes, noting that Black, Latino, and American Indian/Alaskan Native populations are more susceptible to higher levels of disease transmission due to long-standing structural, social, and health inequities. These populations are also more likely to experience long COVID compared to white individuals. The guidance highlights the need for accessible resources, including information on clinical trials and support groups, and acknowledges the increased demand for neuropsychologists, behavioral neurologists, and psychiatrists, resulting in appointment backlogs and extended wait times for patients.
Experts agree that while more answers are needed, an important first step is recognizing that long COVID can have an impact on mental health. Dr. Spudich emphasizes the significance of validating patients’ experiences and ensuring that these conditions are recognized and looked for, so that fewer individuals fall through the cracks.