The Centers for Disease Control and Prevention (CDC) provides detailed guidelines, which are regularly reviewed and revised. Recently, the CDC added certain “mental health conditions” to the high-risk COVID-19 list, which means people with a diagnosis of a mental health condition like depression or schizophrenia will qualify for the booster shot.
An Important Step Forward
Amy Morin, LCSW, psychotherapist, author, and editor-in-chief of Verywell Mind, thinks it’s somewhat surprising that mental health issues are being recognized as serious conditions that can put people at higher risk for severe COVID-19 illness. However, she believes the addition of mental illness to the CDC list may help people feel legitimized. “You can’t see mental health issues, so people often don’t recognize that their friends or family members have mood disorders or they question whether those mental health issues are valid,” Morin says. “There isn’t a lab test for anxiety or a scan for depression, so people who experience mental health issues are often told their conditions aren’t real or aren’t that serious.” Board-certified cytopathologist Celina Nadelman, MD, agrees that mood disorders have a huge impact on overall well-being. “From access to healthcare (e.g. inability to get to healthcare centers) to homelessness, many mental health disorders such as depression and schizophrenia can have an impact on physical health,” she says. There’s plenty of evidence to back up that close connection. A research letter published in JAMA Network Open analyzed data from 1,685 people who were hospitalized with COVID-19 between February 15 and April 25, 2020. Of those, 473 (28%) had received a psychiatric diagnosis before being hospitalized. Patients who had a psychiatric diagnosis were also more likely to have underlying medical comorbidities like cancer, congestive heart failure, diabetes, liver disease, kidney disease, or HIV. Altogether, 318 patients (19%) died from COVID-19. Those who had a psychiatric diagnosis were more likely to die of the virus than those who didn’t have a previous psychiatric diagnosis—specifically 35.7% (compared to 14.7%) after two weeks and 44.8% (compared to 31.5%) after four weeks. A study published in the journal JAMA Psychiatry found that people with schizophrenia are almost three times more likely to die from COVID-19 than those without the illness. Taking into account all the available data, people with schizophrenia are the second likeliest group to die of COVID-19, after the over-65s. “After controlling for demographic characteristics, other medical comorbidities, and hospital location, the risk of death remained significantly greater among patients with a psychiatric disorder,” the researchers wrote. “It’s important to recognize that there is a clear link between physical health and mental health, and the fact that someone’s mental health condition may affect their immune system or even their ability to keep themselves safe,” Morin says. She points out that the severity of a condition like schizophrenia can vary greatly—some people are able to manage their symptoms well with medication and other treatment while others may experience ongoing symptoms.
Managing a Mental Illness in Pandemic Times
The updated CDC guidelines include brief explanations on why people with other health conditions on the list are at a higher risk for severe COVID-19, but don’t offer any more specific advice beyond links to information on mood disorders, depression, and coping with COVID-19. According to the National Alliance on Mental Illness (NAMI), one in five US adults experience some form of mental illness every year, and one in 20 experience a serious form of mental illness—meaning a lot of people are potentially impacted by this. “The new guidelines will allow healthcare providers and those with mental health disorders to have an easier time getting the actual booster and protecting themselves,” says Dr. Nadelman. Also, many people with mental health disorders may be experiencing exacerbated psychological symptoms as a direct result of the COVID-19 pandemic, such as increased anxiety and agoraphobia. These further isolate this population and interfere with daily life. “Those who choose to receive an additional booster may experience reduced anxiety for contracting COVID-19 and thus feel relief from some of their symptoms,” says Dr. Nadelman. “In addition, it may alleviate anxiety that may be exacerbating other mood disorders.” The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page. When making any health decisions, it’s important to understand the CDC’s recommendations. Those who recognize their risk levels, their health conditions, and the latest recommendations can make more informed decisions about what is best for them. If you don’t understand anything in the current guidelines, ask your doctor for advice.
