Long Covid and Mental Health: Five Years On, What Have We Learned?
- Schoen Clinic UK
- Jul 2
- 4 min read
Updated: 2 days ago
Author: Dr James Woolley, Consultant Psychiatrist at Schoen Clinic Chelsea
As we reach five years since the start of the Covid-19 pandemic, the long-term mental health impact of long Covid remains a critical concern for patients, clinicians, and health services.
Long Covid, defined as symptoms lasting more than four weeks after acute infection, affects millions worldwide. Alongside fatigue, breathlessness, and pain, persistent psychological and cognitive symptoms are now recognised as major and often disabling features of the condition.
Mental Health Symptoms in Long Covid: Depression, Anxiety and PTSD
Research shows that around one in four people with long Covid experience significant mental health symptoms, including:
These symptoms can persist for two years or more, far exceeding typical recovery timelines. Studies suggest that 30–40% of long Covid patients report depression and anxiety, a prevalence substantially higher than pre-pandemic levels.
Cognitive Impairment and Brain Fog After Covid-19
One of the most commonly reported issues in long Covid is 'brain fog', a constellation of symptoms including:
Difficulty concentrating
Memory lapses
Slowed thinking or processing
Recent data suggests that 40–60% of long Covid sufferers experience these cognitive difficulties, which can severely impair daily functioning, work, and quality of life.
A large UK Biobank study found that COVID-19 survivors have a "54% increased risk of developing new psychiatric disorders within a year", including mood, anxiety, sleep, and psychotic disorders, with risks heightened in those hospitalised and unvaccinated. Encouragingly, full vaccination appears to reduce these risks significantly.
Why Does Long Covid Cause Mental Health Problems?
There is growing evidence that long Covid mental health symptoms are caused by a combination of biological and psychosocial factors:
Persistent inflammation and immune disruption during and after infection may lead to neuroinflammation, affecting areas of the brain linked to mood and cognition.
Social isolation, loss of income, and fear about long-term health have also worsened mental health outcomes.
The unpredictable nature of symptoms, with good days followed by setbacks, can result in chronic stress, low mood, and anxiety.
Many patients report feelings of loneliness, frustration, and fear about their future health, which can worsen mental health outcomes.
How Long Covid Mental Health Symptoms Are Treated in 2025
The National Institute for Health and Care Excellence (NICE) guidelines for managing long Covid recommend a multidisciplinary approach that addresses both physical and psychological symptoms. Treatment includes symptom management, psychological support, and rehabilitation tailored to individual needs.
Innovative therapies such as breathing retraining programmes have shown promise in improving symptoms and quality of life, alongside standard mental health interventions like cognitive behavioural therapy (CBT) and medication when appropriate.
Key components include:
Pacing strategies to manage fatigue and brain fog
Breathing retraining and graded activity
Medication where appropriate for mood and sleep difficulties
Psychological support and validation
New therapies are emerging, but access remains uneven. Long Covid clinics are being scaled back across the UK. This shift underscores the importance of GPs and mental health teams being vigilant for long Covid-related psychiatric symptoms and providing timely support.
The Role of GPs and Mental Health Specialists in Long Covid Care
With specialist services under pressure, it’s more important than ever that primary care clinicians and mental health teams:
Recognise long Covid-related psychiatric symptoms
Offer early assessment and referral for therapy
Support patients with clear, compassionate communication
Patient-centred care and continuity, especially for those feeling isolated or stuck, are key to long-term recovery.
Looking Ahead: What We Still Need to Understand About Long Covid and Mental Health
While we now know more about the mental health burden of long Covid, there’s still much to learn. Key questions include:
Why do some people recover quickly while others don’t?
What are the most effective long-term interventions?
How can we support recovery at population level?
Ongoing research is essential. We need robust, long-term data, public investment in services, and deeper understanding of the patient experience.
Where to Get Support for Long Covid Mental Health Symptoms
If you're experiencing depression, anxiety, PTSD or brain fog after Covid-19, you're not alone—and help is available.
At Schoen Clinic Chelsea, our expert mental health team offers:
Specialist psychiatric assessment
CBT and therapy for long Covid-related anxiety or mood problems
Support with managing cognitive symptoms and returning to daily life
About the author: Dr Woolley
Dr James Woolley is a highly experienced Consultant Psychiatrist at Schoen Clinic Chelsea, with particular expertise in treating mental health conditions that overlap with physical illness.
Trained at the Maudsley Hospital and Institute of Psychiatry, he combines evidence-based medication with psychological therapies such as CBT.
Dr Woolley also holds Fellowships with both the Royal College of Psychiatrists and the Royal College of Physicians, and has published widely in leading scientific journals.
Sources:
- BBC: Coronavirus and long-term mental health impacts
- The Lancet Psychiatry: Mental health research priorities in COVID-19
- UK Biobank study on psychiatric risk post-Covid
- Systematic review on mental health prevalence in long Covid
https://pubmed.ncbi.nlm.nih.gov/39874315/ andhttps://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0312351
- NICE rapid guideline on managing long Covid
- Narrative review on neuropsychiatric manifestations of long Covid
- Recent UK research on brain fog and vaccination impact
- NHS North East London update on long Covid services
- Yale Medicine on depression and anxiety in long Covid
