Depression and Anxiety Together Raise Long COVID Risk by 78% in Older Women

Older women battling both depression and anxiety face a 78% higher risk of developing long COVID after a SARS-CoV-2 infection, according to groundbreaking research from UC San Diego. The study, published in the journal Menopause, tracked women's health over 20 years and found that having both mental health conditions together creates the perfect storm for persistent COVID complications.

Why Does Having Both Conditions Matter So Much?

The combination of depression and anxiety signals something more serious than either condition alone. "Some people have only anxiety. Some have only depression. When these conditions occur together, they usually indicate more severe mental illness," said senior author Wael Al-Delaimy, MD, PhD, professor at the Herbert Wertheim School of Public Health and Human Longevity Science at UC San Diego.

What makes this finding particularly striking is that these women weren't getting infected with COVID at higher rates than others. Their infection rates remained the same, but their bodies struggled much more with recovery once infected.

What Specific Symptoms Were More Common?

The research revealed that higher anxiety scores specifically increased the likelihood of experiencing the most debilitating long COVID symptoms:

• Persistent Fatigue: Women with anxiety histories reported overwhelming tiredness that lasted months beyond their initial infection
• Brain Fog: Cognitive difficulties including memory problems and trouble concentrating became more prevalent in anxious participants
• Shortness of Breath: Respiratory symptoms persisted longer in women with elevated anxiety levels, even after the acute infection cleared

The study also found that elevated stress levels independently raised the odds of developing long COVID, suggesting that mental wellness plays a crucial role in how our bodies handle viral recovery.

How Did Mental Health Affect Safety Behaviors?

Perhaps most concerning, the research uncovered a troubling pattern in how mental health history affected pandemic safety habits. Women with long-term depression, or both depression and anxiety combined, were less likely to wear masks, wash their hands regularly, or maintain social distancing. Interestingly, women who felt anxious specifically during the early pandemic were slightly more likely to follow these protective guidelines.

This creates a dangerous cycle where those most vulnerable to severe outcomes were also least likely to protect themselves from infection in the first place. "People experiencing mental health illnesses are vulnerable to other diseases and may have trouble following public health guidelines," the researchers noted.

The study analyzed data from the Women's Health Initiative, a federally funded long-term national study that began in the early 1990s. The research included 414 participants who met the criteria for long COVID, with an average age of 83 years.

"We hope that by characterizing these mental health risk factors public health officials and policymakers can target preventative measures to those with the greatest need," said co-author William Bruno, MD, MPH, associate physician in the Department of Emergency Medicine at the UC San Diego School of Medicine.

The findings highlight the importance of considering mental health history when assessing COVID risk and recovery potential. As we continue to navigate ongoing viral threats, understanding these connections becomes crucial for protecting our most vulnerable community members.