The COVID-19 pandemic has had an uneven impact on mental health, affecting young women more adversely in some regards than young men, a new study suggests.

Income loss likewise was associated with increases in depression. At the same time, however, the young people actually showed a reduction in binge drinking and alcohol problems. The combination of findings highlights the complexity of the pandemic’s behavioral health effects. The pandemic has raised widespread concern that its related stressors — such as social isolation, job loss, financial strain, and increased caregiving responsibilities — may have broadly aggravated substance use and mental health conditions.

People age 18–25 were thought to be especially vulnerable, because of their transitional life stage and relative propensity to risky behaviors such as heavy drinking. While some studies have indicated that the pandemic was associated with intensifying mental illness symptoms and substance use in this age group, most did not examine those changes over time; without pre-pandemic data, it’s hard to measure the extent of the impact. For the study in Alcoholism: Clinical and Experimental Research, researchers contrasted changes in drinking behaviors, depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms from before the pandemic to during it.

Researchers worked with 473 young adults in Ontario (average age 23, 70% White) who were part of an existing study tracking alcohol use over time. The participants underwent additional assessment relating specifically to COVID-19. During the summer of 2020, a period of acute public health restrictions, they filled out questionnaires on lost income, daily drinking, and mental health symptoms. The investigators conducted a longitudinal analysis — examining changes over time — by contrasting these reports with the participants’ pre-pandemic data from several months earlier. They used statistical analysis to explore changes in alcohol use, life disruption, depression, anxiety, and PTSD symptoms. They also considered the possible relevance of biological sex, since young women have reported more pandemic-associated distress than young men, and income loss.

Participants reported considerable disruption related to the pandemic. Sixty percent had experienced monthly income loss, including 22 percent whose income dropped by more than half. During the initial phase of the pandemic, these emerging adults reported reduced problematic drinking and adverse alcohol consequences, perhaps reflecting bar closures and reduced social opportunities. In contrast, they experienced more symptoms of internalized distress. Among women in particular, pandemic disruption was linked to increased irritability, sadness, and stress. This perhaps related to women’s perceived erosion of social support, higher susceptibility to job loss, and increased caregiver responsibilities.

Worsening depression symptoms were also related to income reduction of more than 50%. The changes in anxiety and depression symptoms were largely independent of drinking shifts, suggesting that alcohol use among these young adults may have been driven more by recreation and socializing than mental health or mood. Symptoms of PTSD did not change.

The increase in depression and anxiety symptoms among women, and in depression among those experiencing severe income loss, highlights disparities in the mental health burden of the pandemic. The investigators cautioned that the study sample did not have substantial representation of racial minorities or other high-risk groups. They noted substantial variation in changes in alcohol use, with evidence of dramatic increases and decreases at the individual level. This speaks to the complexity of the pandemic’s impact on drinking and mental health.

Story Credit: Research Society on Alcoholism/Newswise

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