Acceleration of Anxiety, Depression, and Suicide: Secondary Effects of Economic Disruption Related to COVID-19

Abstract

The SARS-CoV-2 (COVID-19) pandemic has contributed to increasing levels of anxiety, depression and other symptoms of stress around the globe. Reasons for this increase are understandable in the context of individual level factors such as self-isolation, lockdown, grief, survivor guilt, and other factors but also broader social and economic factors such as unemployment, insecure employment and resulting poverty, especially as the impacts of 2008 recession are still being felt in many countries further accompanied by social isolation. For those who are actively employed a fear of job and income loss and those who have actually become ill and recovered or those who have lost family and friends to illness, it is not surprising that they are stressed and feeling the psychological impact. Furthermore, multiple uncertainties contribute to this sense of anxiety. These fears and losses are major immediate stresses and undoubtedly can have long-term implications on mental health. Economic uncertainty combined with a sense of feeling trapped and resulting lack of control can contribute to helplessness and hopelessness where people may see suicide as a way out. Taking a macro view, we present a statistical model of the impact of unemployment, and national income declines, on suicide, separately for males and females over the life cycle in developed countries. This impact may reflect a potent combination of social changes and economic factors resulting in anomie. The governments and policymakers have a moral and ethical obligation to ensure the physical health and well-being of their populations. While setting in place preventive measures to avoid infections and then subsequent mortality, the focus on economic and social recovery is crucial. A global pandemic requires a global response with a clear inter-linked strategy for health as well as economic solutions. The models we have constructed represent predictions of suicide rates among the 38 highly industrialized OECD countries over a period of 18 years (2000-2017). Unemployment has a major effect on increasing suicide, especially in middle-aged groups. However, the impact of economic decline through losses of national income (GDP per capita) are substantially greater than those of unemployment and influence suicide throughout the life course, especially at the oldest ages.

Keywords: COVID-19; Great Recession; depression; economy; national income loss; recession; suicide; unemployment.

Figure 1

Impact of GDP pc on age-specific male intentional self-harm (ICD-10 X60-X84) death rate (pooled cross-sectional time series regression, 38 OECD states, years 2000–2017). Estimated coefficients with 95% confidence intervals. Adjustment variables: unemployment rate, mental, and behavioral disorders due to psychoactive substance use (ICD-10 F10-F19) death rate, road injuries (ICD-10 V01-V89) death rate, exposure to fire, heat, and hot substances (ICD-10 X00-X19) death rate, accidental poisoning by and exposure to noxious substances (ICD-10 X40-X49) death rate, regional dummies.

Figure 2

Impact of GDP pc on age-specific female intentional self-harm (ICD-10 X60-X84) death rate (pooled cross-sectional time series regression, 38 OECD states, years 2000–2017). Estimated coefficients with 95% confidence intervals. Adjustment variables: unemployment rate, mental, and behavioral disorders due to psychoactive substance use (ICD-10 F10-F19), adverse effects of medical treatment death rate (ICD-10 T36-T50, T80-T88), regional dummies.

Figure 3

Impact of unemployment rate on age-specific male intentional self-harm (ICD-10 X60-X84) death rate (pooled cross-sectional time series regression, 38 OECD states, years 2000–2017). Estimated coefficients with 95% confidence intervals. Adjustment variables: GDP pc, mental, and behavioral disorders due to psychoactive substance use (ICD-10 F10-F19) death rate, road injuries (ICD-10 V01-V89) death rate, exposure to fire, heat, and hot substances (ICD-10 X00-X19) death rate, accidental poisoning by and exposure to noxious substances (ICD-10 X40-X49) death rate, regional dummies.

Figure 4

Impact of unemployment rate on age-specific female intentional self-harm (ICD-10 X60-X84) death rate (pooled cross-sectional time series regression, 38 OECD states, years 2000–2017). Estimated coefficients with 95% confidence intervals. Adjustment variables: GDP pc, mental, and behavioral disorders due to psychoactive substance use (ICD-10 F10-F19), adverse effects of medical treatment death rate (ICD-10 T36-T50, T80-T88), regional dummies. ICD-10 causes of death: (1) intentional self-harm (ICD-10 X60-X84); (2) mental and behavioral disorders due to psychoactive substance use (ICD-10 F10-F19); (3) road injuries (ICD-10 V01-V89); (4) exposure to fire, heat, and hot substances (ICD-10 X00-X19); (5) accidental poisoning by and exposure to noxious substances (ICD-10 X40-X49); (6) adverse effects of medical treatment (ICD-10 T36-T50, T80-T88).