The resurging coronavirus leaves behind a trail of economic and public health wreckage. But its toll on mental well-being could be even more devastating.

In the past months, the COVID-19 pandemic’s inevitable effects on public health systems and the economy of virtually every country have become the world’s lingua franca. In its October rendition of the World Economic Outlook, the International Monetary Fund predicted a 4.4% drop in world GDP in the wake of the crisis. Intensive care units on all continents are quickly filling up as sick patients flock to hospitals already stretched to their limits.

Yet there’s another, more close-to-home aspect of the crisis that has flown largely under the radar. The exceptionally stressful nature of a pandemic, strict lockdowns and blanket uncertainty have left a blistering mark on our psychological health. PTSD, self-doubt, anxiety and depression are all on the rise in the face of an invisible foe.

Mental pandemic

A European Commision study co-authored by the University of Amsterdam and the WageIndicator Foundation, an online labor market library, exposed how “the rising numbers of COVID-19 cases and deaths, prolonged lockdowns, substantial restrictions on public life and an economic downturn negatively affect personal well-being.”

Millions of Europeans have first-hand experience with this mental strain thanks to COVID-19. Many lost their jobs or suffered income reductions. This led to more dissatisfaction and anxiety, according to researchers. States of emergency imposed from above increased anxiety, and dissatisfaction spiraled after a wave of movement restrictions.

A scientific paper published in the esteemed Lancet magazine draws another revealing conclusion. “The psychological impact of quarantine is wide-ranging, substantial, and can be long lasting,” the authors wrote, including “post-traumatic stress symptoms, confusion, and anger.”

Divided we stand, together we fall

Spain and Slovakia have tread different paths throughout the course of the pandemic.

Spain was still reeling from its plethora of economic woes when the virus hit early this year. On 30 October, the total number of infected in Spain since the beginning of the pandemic had reached 1,185,678 cases.

Slovakia’s effective response to the pandemic’s first wave was a global cause célèbre. Still, Slovaks lost trust in their leaders. Close to 60,000 people had caught the virus in Slovakia by the final days of October.

The fates of Spanish and Slovak citizens serve as case studies of the psychological burdens highlighted by the scientific community. These are their stories:

SPAIN: Too young to feel bad

Silvia Nortes

In Spain, the coronavirus crisis is psychologically affecting the younger generations.

“It’s as if I was hitting a wall that blocks my way forward.” Manuel, 32, holds three degrees and two master’s degrees, but he does not have enough savings to become independent.

Spain was badly hit during the financial crisis of 2008. And young people suffered especially. In 2014, youth unemployment rates were 3.5 times higher than the OECD average. Between 2007 and 2015, the unemployment rate for 16- to 24-year-olds increased by more than 30 percentage points. Among those aged 25 to 34, it increased by more than 18 percentage points.

The crisis frustrated their expectations, and many left the country running away from precarious jobs. A decade later, when they are thinking of moving, having kids, buying a home… the Coronavirus crisis has made their plans collapse again. 53% of those fired during March 2020 in Spain were under 35 years old. The temporary employment rate stood at 25.2% on average, compared to 13.9% in the European Union, according to the Bank of Spain’s Annual Report.

When María Ruiz, 29, lost her job back in March, she was on probation and was not entitled to any compensation. “It’s frustrating never to achieve stability.” Since she was 19, María has been chaining temporary jobs. “The longest has been one year and two months.”

And this is having psychological effects. The Universidad Complutense de Madrid studied the consequences of the Coronavirus on the psychological health of Spanish society. The one developed by researcher Carmen Valiente’s team shows that youngsters aged between 18 and 39 showed the most anxiety (34.6%) and depression (42.9%) symptoms during the lockdown, doubling the general figures.

Laura Fernández, 32, works for a Spanish hotel chain in Los Cabos, Mexico. She spent the lockdown in her hometown in Spain, and felt “anxiety, nerves, uncertainty… I cried a lot because Gonzalo (her three-year-old son) will grow up in a totally different world.”

According to UCM, 43% of young people present symptoms of depression, while among those over 65 it is only 9.3%. Dr. Valiente explains that young people are especially “punished” because the pandemic is “a rupture and a threat” to their vital projects. In addition, they perceive that their economic circumstances place them in a more disadvantaged situation.

“Young people are entering the labor market, forming families… and COVID has partially broken those vital projects,” says Iván Blanco, a researcher at UCM. His research group, Psychopathology of Affective and Psychotic Disorders, launched an app to evaluate psychological processes and disorders. Through a game consisting of ordering words, they monitored the mood of the users for 14 days. 50% had depressive symptoms and 40% anxious symptoms, tripling normal figures.

Laura Fernández and her husband had to postpone their return to Spain. “Going back now is suicide. The economic crisis will be worse than the health one. It no longer makes sense to make plans.”

And here comes another key aspect: uncertainty. “One of the risk factors for both anxiety and depression,” says Blanco. “This is not only about the present crisis, but about the future it will bring.”

After spending some time finding a job, María Rodríguez, 29, started working at her partner’s nightclub. “After months working tirelessly, we managed to make it work.” But just when the club had taken off, the lockdown came and they had to close. But expenses are still there. “Since March we have not stopped paying the rent, taxes, social security for workers….”

What can we expect from the future if young people feel lost and frustrated? According to Dr. Valiente’s study, young people are among those most vulnerable to post-traumatic stress.

But there is always a good side. Iván Blanco’s study showed high resilience capacities in young people. As Blanco says, being a punished generation helps us to be resilient and adapt to uncertainty.

María Ruiz hopes to find work as a journalist. Laura and her husband see the bright side. “We are healthy, that’s the most important thing”.

“I got myself off the hook once,” says Manuel. “I will do it again.”

SLOVAKIA: From hero to zero

Edward Szekeres

Lack of communication and chaotic management corroded trust in authorities while putting the public’s mental health at hazard.

First, they were anxious. With time, they grew weary. By the end, they just didn’t care anymore.

In late-May and early-June, Slovak students David Belosic and Oliver Karolyi spent two weeks of isolation in “smart quarantine” under the constant surveillance of a smartphone app known as “e-Quarantine”. The software would constantly check upon their whereabouts and ask them to take selfies for 14 days, up to eight times a day, to prove that they were staying put.

“At first I didn’t sleep well, because I was nervous about missing the required selfie check in the morning,” Karolyi says. His app started crashing, and sometimes the checks wouldn’t come in at all, or they’d appear unnoticed and he would miss them. “But nothing ever happened after I didn’t check in, so I stopped worrying,” he adds.

Belosic’s app, in turn, kept warning him that he left his designated place of isolation, though he never ventured beyond the garden of the secluded house he was staying in with Karolyi. He too would soon stop brooding over the faulty app.

Frustration, confusion, anxiety and eventual apathy follow an all-too-familiar line of emotions that people experience in quarantine, as transnational studies have observed. But there’s an even graver danger lurking beneath this disgruntled state of mind – the underestimation of risks involved and eventual non-compliance with the rules.

Fast and effective communication of information is key, wrote a group of scientists in the esteemed Lancet magazine with regards to obeying quarantines. But Karolyi and Belosic were left in the dark, not knowing why their app was malfunctioning and what consequences that might have for them.

Though the student duo dutifully completed their isolation, their trust in the rules has eroded. And it didn’t take long for the country as a whole to lose faith.

Fading star

Throughout the spring and early summer, Slovakia was hailed as Europe’s Coronavirus-conquering poster child. Media outlets across the world lauded the landlocked country of roughly 5.5 million people for its swift and sweeping response to the pandemic. Thanks to strict state mandated quarantines and the widespread adoption of face mask wearing in public places, reports from April claimed, Slovakia had the lowest per capita COVID-19 death rate on the continent.

By May, it had effectively flattened the curve, recording no new registered cases on some days. Polls at the time testified of more than half of the population being satisfied with the government’s response to the virus outbreak. The future looked bright for Slovakia.

Fast-forward to autumn, and the small central European country is on its last legs while being embroiled in a struggle to contain the rampant spread of COVID-19. It has slipped down the death per capita rankings, registering 219 deaths as of 31 October. The country is now in its second nationwide lockdown.

Slovakia is no longer the famed Coronavirus-slayer it once was. Its star has fallen, despite the recently executed trailblazing project where most of the country’s population was tested for Coronavirus with antigen tests of dubious reliability. The brainchild of populist Prime Minister Igor Matovic, the wholesale testing was “voluntary” according to state authorities, but was nevertheless carried out under a threat of unspecified future sanctions for those who didn’t show up at one of the 5000 testing stations around the country. No test also meant severe curbs on free movement and the ability to work.

Another kind of pandemic

The pressure to partake only added to the psychological strain already endemic among Slovaks, experts suggest. The Slovak Academy of Sciences (SAS) says half of young Slovaks have already suffered from depression-like feelings and anxiety throughout the pandemic.

Since the beginning of the Coronavirus crisis, the demand for emergency psychologic aid has ballooned fivefold amid the younger population, psychologist Marek Madro said in a statement. “We now get around 280 requests every day,” he added.

On the public trust front, the government is nowhere near its popularity from half a year ago. Less than 30% of Slovaks are happy with how PM Matovic and his ragtag four-party coalition are handling the crisis and its second wave, latest polls show. 

“The big drop in trust is a natural occurrence in the current situation – major crises in general increase trust and reliance on public institutions and leading representatives of the state,” said sociologist Miloslav Bahna in an SAS explainer.

People’s trust in their government sinks when crises recede. But it should, according to Bana’s reasoning, skyrocket when trouble abounds. And yet in Slovakia, it is apathy rather than confidence that has taken a foothold as the pandemic rages on and mental health problems soar.

In it for the long-term

A glance back at the e-Quarantine app reveals hints as to where it all went wrong. The software was downloaded by close to 6000 users, but swathes of them voiced similar sounding complaints in a Facebook group dedicated to quarantined Slovaks.

The app was faulty, users claimed, not knowing whether they would have to bear the brunt of its technological mishaps. Many of the questions went unanswered, and the smart quarantine’s lifespan was eventually cut short, largely due to its apparent shortcomings. After a mere two weeks of stutter and stumble, the app was shut down on 10 June.

Those in smart quarantine were free to go. But the app somehow forgot to send out the memo. The likes of Belosic and Karolyi had to find out from the news. Their confidence in their government’s ability to help them navigate through the perils of a pandemic was tainted for good.

“Decision-makers walk on thin ice when managing fundamental choices they’re making for society as a whole,” psychologist Hana Sevcikova says. People must see and feel that care so that they “respect the rules and take them seriously,” she adds.

But Slovaks lost public trust from sight and the Coronavirus is wreaking havoc across a country once largely spared from its deadly toll.

And the frustration, anxiety and depression are likely to stay, thinks Lubomira Izakova from the Slovak Psychiatric Society. “The impact of this crisis on mental health will be felt in the long-term,” she said in a statement.

This article was supported by funding from Hostwriter. Edward J. Szekeres contributed to this article.