Introduction

COVID-19 appeared on January 15th, 2020 in the United States as a novel coronavirus about which scientists and doctors knew very little (1). In efforts to mitigate the spread of the virus and not tax healthcare resources, a “quarantine” began in March. Most state governments imposed stay-at home orders, requiring schools, restaurants, and non-essential businesses to close, forbidding large gatherings, prohibiting travel and enforcing spatial distancing. Nationwide restrictions did not start to ease until May, and as of this writing, many of these restrictions remain in place in certain regions of the country (2).

The COVID-19 pandemic and subsequent quarantine and lockdown restrictions have negatively impacted virtually every segment of the U.S. population. The healthcare system has been strained due to mounting COVID-19 cases¹. Hospitals have suffered economic losses from reductions in elective procedures, limitations on routine medical services and the high cost of personal protective equipment (PPE) (3). Individually, people were faced seemingly overnight with fears over contracting this virus with unknown outcomes, altered life responsibilities including juggling home-schooling of children, worries about the health of their families and friends, and, in some cases, experiences of food insecurity, isolation and job loss.

It is important to note, while COVID-19 has often been referred to as a pandemic, and it is from a purely scientific standpoint, the term syndemic, coined first by anthropologist Merrill Singer in the 1990s has been used to describe this outbreak as well. The specificity of a syndemic is that it involves biological and social interactions and takes into account socioeconomic disparities that cause certain communities to be more heavily affected by the virus than others. These communities usually lack access to healthcare and tend to be low-income communities. They often have higher occurrences of comorbidities that make them more susceptible to the novel coronavirus. It is important to take this social aspect into account when tallying the effects of COVID-19 on the US population (4).

One of these tragic effects is the impact COVID-19 has had on the mental health of millions of Americans. Many individuals were already experiencing depression and anxiety “pre-pandemic,” with an estimated 9.5 percent of Americans utilizing mental health services in 2019. The pandemic likely exacerbated these conditions. Studies of the psychological impacts of quarantines during the SARS (severe acute respiratory syndrome) (2003) and Ebola (2014) epidemics demonstrated that individuals under government-imposed quarantines exhibited greater psychological distress (5), including higher levels of depression, stress, irritability, fear, exhaustion and insomnia (6). According to a study that assessed the psychological effects of quarantine measures in response to the SARS epidemic in Toronto, 31.2% of participants exhibited signs of depression and 28.9% exhibited signs of posttraumatic stress disorder. The study also showed that family and friends connected to infected individuals experienced heightened feelings of distress and depression (7). SARS was considered a serious epidemic that infected over 8,000 people worldwide and took 774 lives (8). In comparison, there have been over 22 million COVID-19 cases and over 379,000 deaths in the United States alone (9). It is also important to note, while not the main focus of this article, there has been evidence that shows that SARS-CoV2 can actually disrupt the central nervous system and create “acquired vulnerability” which can make an individual who is recovering from the virus more susceptible to developing psychiatric conditions after they have had COVID-19 (10). This is another element to consider when cataloging the impacts of COVID-19 on mental health.

When people experience increased psychological distress, they may rely on maladaptive coping mechanisms, including using alcohol and drugs, gambling and overeating. Over half of U.S. adults reported that the coronavirus outbreak has had a negative impact on their mental health. Of those adults, 12% reported an increase in alcohol or drug use (11). Gambling has also increased considerably between March and August of 2020 with Global Poker, a gambling research firm, reporting a 43% growth in the poker industry (12). Along with drugs, alcohol and gambling, Americans have turned to food to alleviate stress. A WebMD poll in May 2020 reported that 44% of women and 22% of men had already experienced weight gain just 2 months into government-imposed shutdowns. The “Quarantine 15” and #quarantineweightgain have been trending on social media since the early days of the pandemic (13).

This article will address the various ways in which the past months' quarantine has impacted the mental health of many and led to detrimental behaviors including substance, gambling and food addictions. Although others have already written about the challenges (and opportunities) emerging from these interacting phenomena (14–17), this article will add to this discussion and also address how access to treatment for mental health has changed in this new, more virtual world. The research for this publication was conducted using PubMed (Medline) and United States government resources. The keywords used to find the sources that are cited include: COVID-19, lockdown, substance use disorder, alcohol use disorder, food addiction, mental health, depression.

Substance Use Behaviors and Disorders

Pandemic-related stress, anxiety and isolation, in addition to disrupted treatment and recovery programs, can increase the likelihood of substance misuse, addiction and relapse. Unemployment tends to contribute to increased spikes in substance abuse (18). As of May 2020, 39% of Americans lost their jobs or had their work hours curtailed due to the pandemic (19). The stress of financial uncertainty along with an increase in free time and the absence of employment repercussions can lead people to seek ongoing solace from illicit drugs. Data from the first quarter of 2020 demonstrate the effects of COVID-19 on substance abuse among Americans. From January to March of 2020, 19,146 people died from drug overdoses, compared to 16,682 people in the same quarter of 2019. The CDC estimated a record number of US drug-related deaths in 2020 (20).

A survey of 1,079 individuals with substance use disorders (SUDs) and SUD-impacted individuals was conducted by the Addiction Policy Forum (21). This study, which examined the impact of COVID-19 on individuals with SUDs, found that 74% of respondents said they had noticed changes in their emotions since the pandemic began (21). Twenty percent of respondents reported an increase in substance use, and 1% reported being impacted by experiencing a fatal overdose since the onset of the pandemic (21). Close to 5% (4.2%) of respondents reported an overdose. Other challenges that were identified included COVID-19 impacting treatment services and difficulties accessing specific services like naloxone and needle exchanges (22). The Addiction Policy Forum cited some perspectives from individuals in recovery or those with an active SUD. Some examples include: “During the last months I have felt more at risk of relapse than I ever have,” and “I have never felt true depression like I have in the past month. I know alcohol makes it worse, but I feel like I just want to make it through this time by staying comfortably numb” (21).

To make matters worse, seeking treatment for SUDs during quarantine has been extremely difficult for many. In-person treatment for opioid use disorder (OUD) and other SUDs has been offered virtually, but many who need these services do not have regular access to a computer or the internet. Unfortunately, the amount of attention healthcare providers can give to those in recovery, especially in the first few months of the pandemic, has been severely limited by the demand of attending to COVID-19 patients. PPE and hospital space are often difficult to spare for anyone not gravely ill with the virus (23).

Alcohol Use

Amid isolation, financial difficulties and lockdowns, many have turned to alcohol to cope with anxiety and uncertainties during the pandemic. There are positive correlations between exposure to stress and alcohol and SUDs. For example, in the months following the September 11 terrorist attacks, around 30% of surveyed New York City residents reported significant increases in their consumption of cigarettes, alcohol or marijuana (24). Although bars, restaurants, and liquor stores were closed at the peak of the pandemic in March and April, studies reveal a 54% increase in national sales of alcohol during the week ending March 15, compared to this same week 1 year prior, with online alcohol sales increasing 234%. Consumers are ordering alcohol in bulk to limit their purchase frequency and buying mostly brands that they trust, increasing the number of favorable alcoholic beverages in people's households (25). While working from home, people may have access to alcohol during all hours of the day, which may contribute to drinking in the morning or during lunch breaks. One study reported that on average, alcohol was consumed 1 more day per month by 75% of adults. The frequency of alcohol consumption among adults in this study increased by 14% from 2019 to 2020 (26). Heavy-drinking episodes increased by 41% in women since the COVID-19 lockdown (27). Additionally, many states have changed their policies on carry-out purchases of liquor to help restaurants cope with the impact on restaurant business during the pandemic. According to the New York State Liquor Authority, as of March 16th 2020, businesses that sold alcoholic beverages on premise were allowed to begin selling for off-premise consumption as long as the beverages were in closed containers (28).

While many people turn to alcohol to relieve their stress and worries, the relief is typically only temporary. Instead, alcohol generally increases the symptoms of anxiety and depression, often leading to binge drinking. Those who use alcohol as a coping mechanism are more likely to develop SUDs (29). Alcohol can have serious neurological impacts, especially when used heavily and for prolonged periods of time. Alcohol interacts with several neurotransmitter receptor sites in the brain including GABA, glutamate and dopamine. Alcohol temporarily stimulates brain reward regions thus promoting drinking, but over time alcohol tends to act as a depressant (30). A common result of long-term alcohol use is the development or exacerbation of depression (31).

Family Stress

The stress of the pandemic is taking a particular toll on parents with children at home. By the middle of March 2020, public and private elementary and secondary schools closed across the country and students were forced to transition to online learning. An August 2020 report by the U.S. Census Bureau stated that nearly 93% of households with school-age children reported some form of distance learning during the pandemic (32). Parents were often forced to facilitate online learning throughout the school day while juggling their own employment and attending to basic household needs. Over 70% of parents reported that managing distance learning for their children during the pandemic was a significant source of stress (33).

The American Psychological Association surveyed 3,000 adults between April 24 and May 4, 2020. The survey showed that the average stress level reported by parents of children under 18 was 6.7 out of 10 compared with 5.5 out of 10 for adults with no children living at home. Additionally, 46% of adults with children under 18 stated that their stress level was “high” (between 8 and 10) compared with 28% of adults without children reporting the same level of stress (33).

Gaming and Gambling

Physical distancing, lockdowns and self-quarantines amid the coronavirus outbreak have been associated with increases in online gaming and gambling, which in turn have placed people at risk for gaming and gambling disorders. In addition, financial difficulties and unemployment may encourage gambling as people are encouraged to gamble to win money. Global Poker reported that the number of first-time online poker players increased by 255% since stay-at-home orders began (12).

College students may be particularly vulnerable to stress during the pandemic due to changes in their social lives, uncertainties regarding career prospects and shifts to online learning. In a study involving about 400 college students, 50.8% reported that their gaming had increased during the COVID-19 lockdown (34). These students acknowledged that gaming helped manage their stress related to the pandemic. General and specific practices to promote healthy gaming and internet use more generally have been suggested (35).

Food Addiction

The term “freshman 15” is an expression that refers to the arbitrary weight that a student gains during his/her first year of college. Since the onset of the pandemic, the term “quarantine 15” has been used to refer to a 15-pound weight gain during self-isolation. Eating as a result of stress, specifically the stress during the outbreak of an infectious disease, is not uncommon among Americans (37). According to a 2013 study conducted by the American Psychological Association, 38% of adults reported overeating or eating more unhealthy foods due to stress, with 33% of these adults saying they do so because it helps distract them (36). Emotional eating tends to occur because when people are stressed, the stress hormone cortisol increases, which in turn, increases our appetite and motivations to eat (38). Eating may serve as a distraction or respite from pandemic isolation. Some highly palatable foods may trigger an addictive-like process in some individuals, activating reward-processing brain regions like drugs of abuse. Parallels exist between clinical and behavioral features of binge eating and substance use disorders (39, 40). Similar to how individuals become dependent on drugs or alcohol to manage depression and anxiety, the reliance on highly palatable foods for comfort and stress reduction may be considered as aspects of a “food addiction” (39, 41). Food addictions or eating disorders may include abnormal eating behaviors, such as excessive food intake or restriction and binging and purging, to cope with one's negative emotions. The National Eating Disorders Association reported a 78 percent increase in calls to their hotline and online chats in March and April this year compared to the same period in 2019 (42).

Among 602 Italians surveyed online between April and May 2020, almost half reported feeling anxious due to their eating habits and admitted to increasing their consumption of comfort foods to feel better. In addition, 86% of respondents reported that they felt unable to sufficiently control their diet (43). While emotional eating is not necessarily considered disordered, these habits may become problematic and unhealthy if one is routinely turning to food to manage stress and anxiety.

How the Pandemic Has Changed the Treatment Landscape

For individuals with SUDs, the COVID-19 pandemic has resulted in changes in treatment including access to therapy, physician availability and adjustments to medication schedules. Moreover, fears associated with contracting the virus combined with rigid screening of patients resulted in a sharp decrease in psychiatric emergency room visits early in the pandemic (44). Inpatients traditionally shared bedrooms and common spaces. COVID-19 has put this system in jeopardy and strict admission criteria – including vigorous COVID-19 testing – has in part led to a reduced number of voluntary admissions to psychiatric facilities (45). Disruptions in treatment and difficulties obtaining treatment have intensified emotional distress associated with the pandemic. On March 17, 2020, the US federal government waived regulations pertaining to telemedicine and loosened restrictions to enable physicians to cross state lines for treatment (46). The last week of March saw a 154% increase in telehealth visits compared to the same period in 2019 (47). While these unprecedented changes arguably increased access to treatment for many individuals, even slight adjustments to traditional mental health care can be traumatizing and magnify the risk for an exacerbation or a recurrence of symptoms (48).

Relative to in-person treatment, online therapy may result in poorer communication and lower quality for some. Online therapy is often not ideal for people who are homeless, lack regular cell phone access or work outside of the home. Individuals in recovery may be enduring particular hardships as support group meetings such as Alcoholics Anonymous are being held virtually instead of in-person (21). Data from communication science and telemedicine group therapy show that online recovery and support services are not as beneficial as in-person services (48). A survey by the Addiction Policy Forum on 1,079 individuals with or impacted by SUDs was conducted between April 27 and May 8. The findings revealed that 34% of respondents reported changes or disruptions in their treatment or recovery support services since the onset of the COVID-19 pandemic, with 14% reporting that they have been unable to receive their needed services (21). Individuals with poly-substance use may have been particularly impacted (49). Other drawbacks of online recovery-related services include the absence of in-person activities, a lack of peer-to-peer social and emotional connections, and online distractions interfering with patients' engagement (48).

Arguably, there have been advantages to switching to online therapy. According to the American Psychological Association, online therapy can be more accessible to people living in areas where psychologists and psychiatrists are scarce (50). Teletherapy can provide more flexibility for people who previously found it difficult to visit an office, a greater sense of anonymity than in-person services, and 24/7 access to social support (48). In addition, research by Simpson and Reid (2014) discussing the therapeutic alliance in videoconference psychotherapy suggests that the relationship between therapist and patient is generally as good for telemedicine as it is for in-person therapy (48). Teletherapy may be more flexible for people who previously found it difficult to visit an office (50). A recent study found evidence that supports the importance of teletherapy by documenting the changes in mental health of a sample demographic after the beginning of the pandemic. The results from this study concluded that there was an increase in stress, fear, and other states of poor mental well-being that began after quarantine in March 2020. The fact that a survey of this type was able to be conducted in a fully virtual format bodes well for the future of telemedicine during and after the pandemic (51). In short, mental health treatment has been significantly altered by the COVID-19 pandemic, and while online therapy may present some drawbacks, new opportunities also exist.

While the COVID-19 pandemic has negatively impacted essentially every corner of the U.S. population, there is a distinctly disproportionate effect on disadvantaged, vulnerable populations. Reports from state and city health departments have revealed that Black, Latinx, and Native Americans test positive for and die of COVID-19 at a higher rate than other racial and ethnic groups. For example, while black Americans represent only 13% of the U.S. population, about 30% of all COVID-19 cases occurred in this racial group. Or, Latinx Americans, who constitute 18% of the U.S. population, accounted for 34% of total COVID-19 cases (52).

The unequal access to health care, greater dependency on low-wage or hourly paid employment, heightened psychological distress, and less access to treatment among racial minorities in the United States became undoubtedly evident this past year. There were noticeable racial and ethnic disparities in outpatient visits for substance use disorders during the surge of COVID-19. In Massachusetts, for example, a state with an early and considerable COVID-19 outbreak, outpatient visits for mental health and/or substance use disorders decreased by Hispanics (−33.0%) and non-Hispanic Blacks (−24.6%) while visits by non-Hispanic Whites increased by 10.5%. This decrease in mental health and/or substance use disorder visits among certain ethnic minority groups is likely due to lower access to employer-sponsored commercial insurance as well as a lack of access to digital technology (53).

Conclusions

Nationwide closures and reduced mental health services have been detrimental to peoples, well-being. Many individuals will encounter repercussions from the COVID-19 pandemic for years to come. The U.S. will need to reevaluate how mental health treatment is provided during these times and when faced with future crises. The COVID-19 pandemic has demonstrated that many Americans may turn to maladaptive coping mechanisms when faced with significant disruptions to their daily lives. Future research should focus on creating adequate delivery of mental health resources and implementing strategies and methods to respond better when other crises occur (Table 1).

Table 1. Highlights and relevant sources.

Author Contributions

NA: drafted outline and sections of the paper and edited paper. JS: collected research and drafted sections of the paper and edited paper. AL: collected research and drafted sections of the paper. MG: drafted and edited sections of paper. MP: drafted and edited sections of paper. All authors contributed to the article and approved the submitted version.

Funding

MP was supported by the Connecticut Council on Problem Gambling. Beyond funding, the funding agencies had no further role in the writing of the report or in the decision to submit the paper for publication.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Summary

The COVID-19 pandemic and associated public health measures profoundly impacted the mental health of the U.S. population. The imposition of quarantines and lockdowns, coupled with widespread economic disruption and uncertainty, exacerbated pre-existing mental health conditions and created new challenges. The impact extended beyond the immediate effects of infection, encompassing the syndemic nature of the crisis, highlighting the interplay of biological factors and socioeconomic disparities in determining vulnerability.

Substance Use Behaviors and Disorders

The pandemic's stress, anxiety, and isolation, compounded by disruptions to treatment and recovery programs, contributed to increased substance misuse, addiction, and relapse. High rates of unemployment further fueled this trend. Data reveals a concerning rise in drug overdose deaths during the early stages of the pandemic, underscoring the severity of the situation. Studies of individuals with substance use disorders showed significant emotional changes, increased substance use, and challenges in accessing vital treatment services.

Alcohol Use

The pandemic led to a surge in alcohol consumption, driven by factors such as isolation, financial insecurity, and readily available alcohol through altered retail practices. Increases in both overall alcohol sales and frequency of consumption are noted, particularly among women, who experienced a significant increase in heavy drinking episodes. The use of alcohol as a coping mechanism further intensified the risk of developing alcohol use disorders.

Family Stress

The transition to distance learning imposed significant stress on parents, forcing them to balance work, household responsibilities, and the facilitation of their children's education. Studies demonstrated a substantial increase in parental stress levels compared to adults without children at home, emphasizing the unique challenges faced by families.

Gaming and Gambling

Social isolation measures were associated with increased engagement in online gaming and gambling. The pandemic's economic fallout also created a climate where financial desperation may have driven individuals to gamble as a means to alleviate financial strains. Studies show a remarkable increase in first-time online poker players.

Food Addiction

The pandemic gave rise to the term "quarantine 15," reflecting a widespread increase in weight gain linked to increased consumption of comfort foods. The use of food as a coping mechanism for pandemic-related stress represents a concerning trend, mirroring addictive patterns observed in substance use disorders. Increased calls to eating disorder hotlines further underline this issue.

How the Pandemic Has Changed the Treatment Landscape

The pandemic significantly altered the mental health treatment landscape. Reductions in in-person psychiatric services, driven by infection control measures, led to a decrease in emergency room visits and voluntary admissions. The expansion of telehealth services provided some degree of access, but it also created new challenges. Online therapy, while offering increased access and flexibility for some, presented limitations in terms of communication quality and suitability for all demographics. Disruptions to traditional recovery support services further compounded the difficulties faced by individuals with substance use disorders.

Conclusions

The pandemic had a detrimental effect on mental health, revealing the need for better mental health resource delivery systems and improved crisis response strategies. Disparities in access to care, particularly among racial minority groups, were highlighted. The long-term impact of the pandemic on the mental health of the U.S. population remains a significant concern.

Summary

The COVID-19 pandemic and resulting lockdowns significantly impacted the mental health of many Americans. The initial lack of information surrounding the virus, coupled with stay-at-home orders and widespread business closures, created a climate of fear and uncertainty. This was further exacerbated by socioeconomic disparities, with certain communities experiencing higher rates of infection and more significant consequences due to limited healthcare access and pre-existing conditions. The pandemic's effect on mental health is best described as a syndemic, a complex interplay of biological and social factors.

Substance Use Behaviors and Disorders

The pandemic's stress, anxiety, isolation, and disruptions to treatment programs led to increased substance misuse, addiction, and relapse. Unemployment, a significant consequence of the pandemic, further fueled this trend. Data from the first quarter of 2020 revealed a concerning rise in drug overdose deaths. Surveys of individuals with substance use disorders highlighted emotional changes, increased substance use, and challenges accessing treatment services. The transition to virtual treatment, while intended to improve access, presented hurdles for those lacking consistent internet access or computer literacy.

Alcohol Use

Increased alcohol consumption emerged as a common coping mechanism during the pandemic. National alcohol sales surged, and online sales experienced even greater increases. Working from home contributed to altered drinking patterns, with more frequent and heavier drinking episodes reported. While alcohol provided temporary relief, it ultimately exacerbated anxiety and depression symptoms, increasing the risk of developing alcohol use disorders. The long-term neurological effects of heavy alcohol use further complicate the situation.

Family Stress

The shift to online learning placed significant stress on parents, forcing them to juggle work, childcare, and household responsibilities. Surveys revealed higher stress levels among parents of school-aged children compared to those without children at home, underscoring the significant burden placed on families.

Gaming and Gambling

Social distancing measures and lockdowns contributed to increased online gaming and gambling, increasing the risk of developing related disorders. Financial difficulties and unemployment further exacerbated this trend. Studies among college students revealed a notable increase in gaming activity as a stress-coping mechanism.

Food Addiction

The pandemic introduced the term “quarantine 15,” reflecting weight gain associated with increased emotional eating. Stress-related overeating and the consumption of less healthy foods became more prevalent. The reliance on food for comfort and stress relief mirrors addictive behaviors, highlighting the potential for developing food addiction. Increased calls to eating disorder hotlines underscore this trend.

How the Pandemic Has Changed the Treatment Landscape

The pandemic drastically altered mental health treatment. Restrictions on in-person care, coupled with fears of infection, led to decreased emergency room visits. The shift to telehealth, while expanding access for some, presented challenges for others, particularly those lacking technology or stable housing. Virtual support groups proved less effective than in-person meetings for many in recovery. Despite some drawbacks, telehealth offered increased flexibility and accessibility for certain individuals.

Conclusions

The pandemic's consequences on mental health are far-reaching and will likely persist. The need for improved mental health resource delivery and more effective crisis response strategies is evident. Significant disparities exist in the impact of the pandemic, with racial and ethnic minorities experiencing disproportionately negative outcomes. Future research is needed to address these issues and enhance future crisis responses.

Summary

The COVID-19 pandemic and resulting lockdowns significantly impacted the mental health of many Americans. The virus itself, coupled with job losses, isolation, and disruptions to daily life, exacerbated existing mental health issues and led to increased substance abuse, gambling, and unhealthy eating habits. These challenges were particularly pronounced in vulnerable and minority communities due to existing healthcare disparities.

Substance Use Behaviors and Disorders

The pandemic's stress, coupled with unemployment and disrupted treatment programs, fueled increased substance misuse and relapse. A surge in drug overdose deaths occurred during the early months of the pandemic, highlighting the devastating consequences. Studies on individuals with substance use disorders showed increased emotional distress, substance use, and difficulties accessing treatment due to the pandemic. Many faced challenges accessing in-person treatment, especially those lacking internet access or relying on in-person support groups.

Alcohol Use

Increased alcohol consumption emerged as a coping mechanism for many during lockdowns and financial uncertainty. National alcohol sales rose significantly, with a shift towards online purchasing and bulk buying. Working from home increased the accessibility of alcohol throughout the day, leading to changes in drinking patterns. While alcohol provided temporary relief, it often worsened existing anxiety and depression, increasing the risk of alcohol use disorder.

Family Stress

Parents faced immense stress managing distance learning while juggling work and household responsibilities. Surveys indicated that parents of school-aged children experienced significantly higher stress levels than those without children at home. This further contributed to the overall mental health strain of the pandemic.

Gaming and Gambling

Lockdowns and social distancing contributed to increased online gaming and gambling, raising concerns about potential gaming and gambling disorders. Financial hardship and unemployment also fueled gambling as a means to earn money. The increase was particularly noticeable among college students grappling with academic and social disruptions.

Food Addiction

The pandemic led to increased emotional eating, often referred to as the "quarantine 15." Stress-induced overeating and consumption of unhealthy foods were common coping mechanisms. The parallels between food addiction and substance use disorders highlight the potential for problematic eating habits to develop into serious issues. Increased calls to eating disorder hotlines further underscored this trend.

How the Pandemic Has Changed the Treatment Landscape

The pandemic significantly altered mental health treatment. Reduced in-person visits to psychiatric facilities were partially due to safety protocols. The shift toward telehealth expanded access for some, but presented challenges for others, particularly those without reliable internet access or facing socioeconomic barriers. While teletherapy offered increased accessibility and flexibility, it also presented communication and quality-of-care concerns for certain individuals. The shift away from in-person support groups also negatively impacted some struggling with addiction.

Conclusions

The pandemic’s impact on mental health has been extensive and far-reaching. The need for reevaluating mental health treatment delivery and developing strategies for future crises is evident. The increased reliance on maladaptive coping mechanisms highlights the urgency of accessible and effective mental health resources for all members of society. The disproportionate impact on vulnerable populations needs specific attention.

Summary

In early 2020, a new sickness called COVID-19 appeared in the United States. To stop it from spreading quickly, many places closed down and people had to stay home. This was hard for everyone.

How COVID-19 Affected People's Health

COVID-19 made many people sick and worried. Hospitals had trouble keeping up. People also worried about their jobs, their families, and even getting enough food. Some people felt really lonely. It wasn't just a sickness; it also caused lots of problems because of the things people had to do to stay safe.

Mental Health Problems

Lots of people already had problems like feeling sad or worried before COVID-19. The pandemic made these problems worse for many people. Being stuck at home and worried made some people feel even sadder or more stressed. Some people started using drugs or drinking more alcohol to cope. Others gained weight because they ate more.

Dealing with Substance Use

Losing a job during the pandemic caused more stress, and some people used drugs or alcohol to feel better. Sadly, more people died from drug overdoses. Getting help for these problems became harder because many treatment centers changed how they worked, and some people couldn't get the help they needed.

Alcohol Use Increased

Many adults drank more alcohol during the pandemic because they were stressed and bored. It was easier to buy alcohol. Drinking too much alcohol makes depression and anxiety worse.

Stress at Home

Parents with kids at home had a tough time. Schools closed and parents had to help their children with online learning while trying to work and take care of their homes. This caused a lot of extra stress.

Gaming and Gambling

People spent more time playing video games and gambling online because they were stuck at home. For some, this became a bigger problem.

Food and Weight Gain

Many people gained weight during the pandemic. Some people ate more than usual because of stress. For some, this led to unhealthy eating habits.

Getting Help

The way people got mental health help changed during the pandemic. Many appointments moved online. This helped some people, but it made things harder for others who didn't have internet access or a computer. Online support groups weren't as good as meeting in person.

Differences in Who Was Affected

Sadly, not everyone was affected equally. Some groups of people were hit harder by the pandemic and had less access to healthcare and support.

What We Learned

The pandemic showed that we need better ways to help people with their mental health, especially during difficult times. We need to make sure everyone can get the support they need.