The Mind Matters: How Stress and Mental Disruption Open the Door for COVID-19

Background: The emergence of the global coronavirus disease 2019 (COVID-19) pandemic brought with it unforeseen and unprecedented conditions for millions. Conspicuous disorders of the respiratory, gastrointestinal, and neurological systems have taken center stage, but an important category must be brought to the forefront: the psychological and emotional effects of this pandemic. Mandatory nationwide lockdowns, self-quarantining, and understandable anxiety about the unpredictable future are significant stressors and are having both detectable and undetectable impacts on mental and physical wellbeing. Negative affectivity including depression, loneliness, boredom, self-harm, and domestic violence doubled shortly after, as well as financial burden and unemployment. Mental health silently affects everyone and could be a deciding factor in recovery and remission of many health conditions and disorders. This paper assesses the impact of psychosocial stressors and the pandemic on the human body, focusing on the unseen effects of mental health that could be keeping the door open for COVID-19 and could have public health ramifications long after the pandemic is fully resolved.Methods: We conducted a literature review of databases such as PubMed, Google Scholar, and ScienceDirect, using search words like “mental health”, “COVID-19”, “psychological effects”, “toxic stress”, and “SARS-CoV-2”, and included systematic reviews, reviews, case reports, and cohort studies.Results: Although it is challenging to quantify the stress people are being subjected to, it is possible to identify how stress affects the body in myriad ways (psychophysiology). Stress disrupts body homeostasis, prompting a cascade of hormones and factors (such as increased cortisol and DHEA) that mount a bodily response. Mental stress has been shown to cause structural changes in the brain, in the hippocampus and amygdala, which can lead to memory disorders and changes in cognition and learning. Long-term activation of the stress response system causes overexposure of cortisol and subsequent deleterious effects throughout the body. Moreover, psychological stress exacts a hidden toll, and chronic stress over time can leave a body more susceptible to not only illnesses, but other acute, stressful events as well, compounding the effect with potential for further harm. Emerging mental health issues from the cumulative effects of this pandemic’s psychosocial stressors could become chronic health issues or encourage isolation and increase the stigma that already surrounds mental health. Taken together, it seems that the pandemic’s effects are leading to more vulnerable states and worsening of mental health in the general population.Conclusion: As the world continues to seek answers to curtail the pandemic and bring life back to normal, attention must be given to how mental health is handled during this crisis. It is time to push for integrating mental health with primary care, to treat both mind and body regularly to optimize improvement. Research aimed at understanding the effects of the COVID-19 pandemic on psychological stress is warranted to mitigate the consequences and address mental health properly.