The long-term effects of COVID: Do you have COVID depression?

Long COVID can be debilitating, with long-lasting physical symptoms like fatigue and breathing difficulties for months and even years after exposure. But we're now understanding that the mental health impacts of COVID-19 can be just as serious—and often last even longer.

Recent research reveals that mental health conditions, as well as brain fog, occurred in around one in five people between three months and two years after COVID-19 infection. For many, these psychological symptoms outlast their physical ones.

Here’s everything you need to know about the mental health impacts of long COVID, signs of COVID depression and how to get back to feeling like yourself.

What is long COVID?

Long COVID, medically known as post-acute sequelae of SARS-CoV-2 infection (PASC), occurs when symptoms persist following the initial COVID-19 illness. It's more prevalent among people who are older, female, hospitalized and unvaccinated. 

Long COVID affects millions of Americans who continue experiencing symptoms weeks or months after their initial infection. In fact, an estimated 28% of US adults who have had acute COVID-19 infections say they have experienced long COVID at some point.

Symptoms of long COVID vary but can include:

• Fatigue
• Brain fog
• Dizziness
• Digestive issues
• Heart palpitations
• Sexual concerns
• Change in smell or taste
• Thirst
• Chronic cough
• Chest pain
• Muscle twitching
• Worsening of symptoms after any type of physical or mental exertion

Understanding the long-term effects of COVID

The connection between COVID-19 and depression isn't simply about feeling down after being sick. And it isn't just a temporary mood dip—for many, it represents a fundamental shift in their mental health that requires professional support and treatment.

The relationship between long COVID and mental health involves both biological and psychological factors. Let’s break each of them down.

Biology plays a big part in the development of long COVID. When the virus enters the body, it can set off inflammation that affects not just your physical health but your brain, too. This brain inflammation can change how brain chemicals work, which might influence mood and mental well-being.

Some experts think that leftover traces of the virus or an immune system that hasn’t fully settled down could be behind ongoing mental health issues, even long after the initial illness is gone.

Experience of long COVID itself can create significant psychological stress. For some, unpredictable symptoms may make it difficult or impossible to work, exercise or socialize the way they once did.

Many people experiencing long COVID describe feeling trapped in a body that no longer functions as it should, leading to frustration, grief and a sense of lost identity.

Medical uncertainty adds to these challenges. Long COVID is still relatively new, and healthcare providers are still learning how best to diagnose and treat it. Some people feel dismissed or misunderstood when their symptoms don't show up on standard tests, leading to additional anxiety and feelings of isolation.

Social and economic consequences can't be overlooked. Reduced work capacity or job loss, financial strain, relationship difficulties and social withdrawal can all contribute to your mental health.

The invisible nature of many long COVID symptoms means that friends, family and employers may not fully grasp what someone is going through, creating further stress.

Do I have COVID depression?

COVID depression and anxiety can show up in many ways. Beyond the classic symptoms of persistent sadness or worry, you may notice:

• Difficulty concentrating or making decisions (which can overlap with cognitive long COVID symptoms)
• Changes in sleep patterns, either sleeping too much or struggling with insomnia
• Loss of interest in activities that once brought joy
• Feelings of hopelessness about recovery or the future
• Physical symptoms like headaches or stomach issues that worsen with stress
• Increased irritability or emotional reactivity
• Social withdrawal or isolation

If you're experiencing several of these symptoms and they're interfering with your daily life, it's important to reach out for help—even if you're unsure whether they're related to long COVID, depression or both.

6 ways to cope with COVID depression

The good news is that you’re not stuck with these challenges—mental health support can truly be a game changer for people experiencing long term effects of COVID. Whether you’re dealing with stress, anxiety or lingering mood shifts, there are practical steps you can take to feel better and regain balance.

These strategies aren’t just quick fixes; they can help you build resilience and improve your overall well-being. Here’s where to start:

1. Seek professional help early

Don't wait for symptoms to become severe. A mental health professional experienced with chronic illness can help you develop coping strategies and determine whether medication might be beneficial.

Many therapists now offer telehealth options, which can be especially helpful when physical symptoms make travel difficult.

2. Connect with others who understand

Long COVID support groups—both online and in-person—provide validation and practical advice from people living with similar experiences. Knowing you're not alone can be profoundly healing.

3. Communicate openly with your medical team

Make sure all your healthcare providers understand the full picture of your symptoms, including mental health concerns. An integrated treatment approach that addresses both your physical and psychological aspects tends to be most effective.

If you are not sure where to start, speak with your primary doctor to help coordinate care with any specialist if you continue to have symptoms or problems that are unresolved.

4. Try high-intensity exercise

In addition to working with a mental health specialist, regular exercise at moderate to high intensity for two months has shown to be an effective way to help combat depression symptoms that can be a secondary effect of long COVID 19.

5. Practice self-compassion

Recovery from long COVID isn't linear, and setbacks don't mean failure. Adjust your expectations and celebrate small victories. What you're dealing with is real, difficult and not your fault.

6. Focus on what you can control

While you may not be able to prevent every symptom flare, you can establish routines that support your mental health. This might include gentle movement when possible, connecting with supportive friends, engaging in activities that bring meaning, or practicing stress-reduction techniques like meditation or deep breathing.

Finding hope and healing after long COVID

As our understanding of the long-term effects of COVID-19 continues to evolve, one thing is clear: mental health care must be a central part of long COVID treatment, not an afterthought.

The journey through long COVID can feel isolating and overwhelming, but recovery is possible. With the right support, many people find ways to manage their symptoms, reconnect with meaningful activities and rebuild their quality of life.

Your mental health matters just as much as your physical health—and both deserve comprehensive, compassionate care.

To learn more about how to cope with the long-term effects of COVID, speak to your doctor.