We already know your emotional well-being can impact your body in many ways—from your heart health to your digestion. Now, new research suggests feelings like stress, depression, and even loneliness may increase your risk of developing a condition experts are just starting to learn more about: long COVID, which is estimated to affect between 20% and more than 50% of people who test positive for the virus.

For the study, which was recently published in JAMA Psychiatry, the researchers asked nearly 55,000 people—none of whom had previously tested positive for COVID and 38% of whom were health care workers—to complete self-reported questionnaires about their mental health between April 2020 and November 2021. Using these responses, the researchers measured levels of depression, anxiety, loneliness, perceived stress, and general worry about COVID. (Only people who were not active health care workers were asked about stress and loneliness.) They also tracked who tested positive for COVID, and of those who did, whether they experienced “post-COVID-19 conditions,” which the Centers for Disease Control and Prevention (CDC) describes as a “wide range of ongoing health problems” that can “last more than four weeks or even months after infection.”

During the study, 6% of the participants (3,752 people) reported testing positive for COVID and about 44% of them said they experienced long COVID symptoms, such as lingering fatigue, problems with their taste or smell, shortness of breath, brain fog, and memory issues. All of the emotional states listed above were associated with a greater risk of long COVID—between 32% to 46%—but people who had “high levels” of two or more types of psychological distress before their infection had a nearly 50% higher risk of long COVID compared to those who did not feel a significant dip in their mood.

“These results really reinforce the importance of mental health,” Erica Cotton, PsyD, a psychologist with the Northwestern Medicine Comprehensive COVID-19 Center who was not directly involved with the study, tells SELF. Having a greater awareness of this potential link may help doctors correctly diagnose people and appropriately treat them after symptoms develop, she adds.

The study’s researchers stressed that their findings do not suggest that mental health issues can directly cause long COVID. They also argue that their research does not support theories that say long COVID symptoms are simply psychosomatic.

Dr. Cotton says the study’s findings are actually pretty in-line with what experts know about how mental health can contribute to or exacerbate other physical health issues. Psychological distress, for example, has previously been linked to severe symptoms from various respiratory infections, including pneumonia, bronchitis, sinusitis, and the flu. The study authors also note that prior research has found that psychological distress may also be associated with long-term symptoms after a Lyme infection and in chronic conditions, like fibromyalgia, that can present with symptoms similar to long COVID.

Source: SELF

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