Lockdown feels like forever ago, doesn’t it? Endless bottles of hand sanitizer, hoarding toilet paper, wearing masks to leave the house, and only seeing family and friends from a distance in the local park… It feels like a dream we all had – or a collective nightmare. But that was our reality for nearly two years. For many, the daily fear of contracting COVID -19 or passing it on was overwhelming. We adapted to long periods of isolation with only a few close contacts. For some, the long-term effects have been life-changing – whether it’s losing loved ones, suffering from long Covid, or facing severe mental health challenges. But what about everyone else – have we really come through Covid unscathed?
Dr. Omid V. Ebrahimi, a newly-elected Magdalen Senior Demy, has been at the forefront of studying the effects of Covid on our mental health. His early research across Europe has provided crucial insights into pandemic-induced mental health issues. Omid’s work focuses on understanding the relationship between large-scale critical incidents – like pandemics, economic recessions, or global conflicts – and our mental health.
“A critical incident is an event that impacts a large group of individuals, like national or global populations,” says Omid, “that also have secondary consequences beyond their direct, primary effect.” The COVID-19 pandemic is a critical incident because, beyond the risk of being infected by Covid, it has also affected public services, and more. This is notwithstanding the long-lasting effects on our economy, and physical and mental health. His findings reveal that while most people have managed to adapt, a significant minority have faced enduring psychological challenges throughout the pandemic that continued even after social containment measures had been lifted and we returned to what resembled a pre-pandemic life.
Although most people’s mental health returned to pre-pandemic levels after restrictions were lifted, about 7% of the population continued to experience high levels of psychological distress.
During 2020, Omid was perfectly placed to undertake one of the earliest studies of the pandemic and our mental health. While working in Norway, he became aware that something potentially globally impactful was beginning to happen in Wuhan. As he was already researching in Norway, he undertook one of the first large-scale studies of the impacts of Covid on our mental health in the West, monitoring more than ten thousand people during the course of the pandemic. Omid’s research was among the first that showed that during social containment measures were related to changes in depression and anxiety symptoms. His research was part of the evidence base that formed the foundation modification on mental health of social containment policies across several states, including Norway.
“A pandemic is a complex, multi-faced incident, with multiple key perspectives that warrant simultaneous attention. The optimal way to address challenges from each of these perspectives do not necessarily pull in the same direction. During the pandemic, governments had to balance a medical perspective, necessitating distancing protocols and lockdowns, with a psychological and economical one, sometimes favouring different strategies to protect the market and mental health. These decisions are tough. We did our best to highlight the relationship between containment policies and mental health to help politicians make informed decisions.”
Although most people’s mental health returned to pre-pandemic levels after restrictions were lifted, about 7% of the population continued to experience high levels of psychological distress. In the early stages of COVID measures, individuals in this sub-population went from reporting no symptoms of psychiatric illness, to suddenly experiencing heightened symptom levels during the pandemic. Their heightened symptomatic state remained for as long as they were observed, up to March 2022 and 2023, and even after pandemic protocols were lessened, and then ultimately removed. For this 7%, the pandemic has had a marked and lasting impact on their mental health.
Although it feels like we’re leaving COVID now, we are just at the beginning of knowing its full long-term effects on mental health
In post-pandemic Norway, there has been a marked increase in treatment seeking for mental illnesses, particularly among young adults and adolescents. This trend mirrors the data in the UK, indicating a pattern. “Although it feels like we’re leaving COVID now, we are just at the beginning of knowing its full long-term effects on mental health,” Omid says.
So, what has COVID taught us about our collective mental health? We all went through the same experience, and while it may have affected us differently, the pandemic, and its containment protocols, have undoubtedly left a mark on us all. Perhaps most obviously, the pandemic has highlighted the importance of social connections. Omid explains, “During the pandemic, one of the most important predictors of increased depressive symptoms was loneliness.” This insight is critical for preparing for future crises. The data has shown that, in times of collective stress, anxiety, and worry, it is being able to connect with each other that can help assuage those very feelings.
“Loneliness has been a central aggravator of mental distress during the pandemic. To understand this, we need to look at the evolutionary roots of loneliness. Loneliness has had significant adaptive value to humans. Within an evolutionary context, as you moved further away from the group, loneliness increased, a feeling that activates similar brain regions as physical pain. This painful experience functioned as a motivator to reconnect us with our group, increasing our survival chances. Loneliness is therefore a feeling with a clear action potential: reconnecting us with our group. With this action potential being impacted by containment policies during the pandemic, many experienced prolonged distress, worry and rumination, which are processes involved in depression and anxiety.”
“Social connection is a protective factor of mental health”, Omid says. His research has highlighted how the use of strategies like social bubbles, which reduce transmission but simultaneously enable some contact, can be used as a strategy to protect against adverse mental health effects during these times. Beyond his scientific publication, Omid has been featured in over 70 news reports nationally and internationally to disseminate information about how to cope with challenges arising during the pandemic, including mental distress and how to address the global challenge of vaccine hesitance.
A key aspect of this is making sure that scientific findings and studies are accessible to the general public. As well as ensuring governments and policy bodies know how to respond to future crises, it’s important that we communicate ways to promote favourable health behaviours and maintain mental well-being during critical global incidents to the general population. “As scientists,” Omid says, “we have an obligation to make our research accessible. Our research is funded by the public, and so it’s our duty to make sure that our findings are communicated effectively.”
As a critical incident researcher, Omid’s work has naturally focused substantially on the pandemic during the past years. The main purpose of Omid’s research is really to figure out how to better react to future critical events; to use the data collected and Omid’s findings to find a better way to both protect ourselves from the primary and secondary effects of different global critical events. If we were to face a lockdown again in the future, Omid’s research would be instrumental in finding ways to stop the adverse effects on our collective mental health.
He says, “A key problem with critical incidents is that we often study them and learn how to respond to them as they occur to us. This is a major threat to public health and future preparedness. The heart of my research rests on findings similarities between elements relevant for and strategies employed during different critical incidents. If we can find some similarities across incidents, it gives us the opportunity to prepare for future global crises before they happen. So once a new global crisis hits, we can more optimally respond to it. That’s the motivation underlying my research.”
Beyond his focus on mental health, Omid researches human behaviour during crises. “When we are under pressure, we sometimes behave in ways that can be harmful both for our own and other individuals’ health. Examples of this includes hoarding behaviour or vaccination reluctance, two phenomena we observed during the pandemic”, he says. “A key component of critical incident research is to identify the psychological components underlying these behaviours. This enables us to address barriers and assist individuals toward behaviours that optimally protect their own and the collective societal health.”
Magdalen has an exceptionally intellectually stimulating sphere for cross-disciplinary scientists
It’s so exciting to welcome Omid to Magdalen for the next phase of his research. As an interdisciplinary situated between the fields of psychiatric epidemiology and clinical psychology, Omid expresses great enthusiasm and gratitude for being at the University. “Magdalen has an exceptionally intellectually stimulating sphere for cross-disciplinary scientists”, he says.
“Beyond this, it’s very exciting there’s such a wealth of expertise in clinical psychology in Oxford, and at Magdalen in particular,” says Omid. “It’s been a long-time dream of mine to work with the people who’ve changed the lives of so many, and pioneered and changed the field of clinical psychology as well.” Dr Omid Ebrahimi’s continuing research at Magdalen will go beyond the pandemic, focusing on the mental health impacts of global incidents including climate change, economic recessions, and cost-of-living challenges. Furthermore, his dedication to making scientific findings accessible will hopefully empower communities with the knowledge needed to navigate future crises effectively. We can’t wait to see the next phase of his work.