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USAToday.com

Kam-Mira Joy Edwards hasn’t been able to sleep in weeks. She hasn’t menstruated since March, maybe February. Her headaches seem unending.

Edwards, a 32-year-old graduate student in clinical mental health counseling, knows she’s struggling. Since COVID-19 emerged in the United States, she’s felt both symptoms of both depression and anxiety, she said. 

“I come out of it, and it’s like I’ll drop back in it. But every time I drop back in it, it gets worse,” she said. “Especially with everything that’s going on.”

Edwards is going through a divorce, and her sister died in April. Either event would incur a heavy psychological toll on its own, but the pandemic has made it almost unbearable: The single mother of two, who also helps care for her father, is also trying to figure out how to approach education for her kids. Money is tight, and she can’t find full-time work. 

And through it all, the isolation inherent to social distancing means she can’t lean on her usual in-person support networks. She’s tried booking appointments with a psychiatrist, but she can’t find any openings.

“This is not something I’ve ever experienced before,” she said. “I’m surprised my hair hasn’t fallen out.”

The devastating spread of COVID-19 has put a spotlight not only on physical vulnerabilities, but also on the nation’s mental health. Both depression and anxiety were already far more prevalent in women and, as early data pours in, it’s becoming increasingly clear that the pandemic has exacerbated that disparity. Experts say that much of the growth stems from the pandemic’s cultural and economic fallout: child care burdens, lost income, and efforts to navigate children’s education — all of which are disproportionately affecting women. Researchers are also finding that transgender and non-binary people — who are also already at greater risk for depression and anxiety — may be facing greater psychological stress as well.

Altogether, the surge threatens to create a new stress-test for the nation’s already fragmented mental health care system, with ramifications that could play out for years.

“The pandemic, it widens existing disparities,” said Dr. Cindy Liu, an assistant professor at Harvard Medical School. “It’s going to have long-term consequences.”

Behavioral health scientists haven’t determined why women are more susceptible to depression and anxiety. But a key factor is that women typically work in lower-paying jobs and are more often put in caregiving roles. A robust body of research shows that lower wages are linked to mental disorders.

“When you don’t have enough money, when you’re taking care of someone, that is a risk factor,” said Dr. Karen Martinez Gonzalez, an associate professor of psychiatry at the University of Puerto Rico. “From what we know about women and jobs and how they are being paid, they will probably be more affected by this pandemic.” 

Since the end of April, higher rates of women than men have reported symptoms of anxiety or depression, per data collected by the federal Centers for Disease Control and Prevention. As of July 14, 44 percent of women reported symptoms of at least one of the conditions, compared to 36 percent of men. About 30 percent of women indicated symptoms of only depression, compared to 26 percent of men; for only anxiety, the gap was 39.4 percent versus 31.5 percent.

Since May, polling from the Kaiser Family Foundation, a nonprofit health care research group, has consistently shown women are more likely than men to say the pandemic has negatively affected their psychological well-being. The latest data, from July, found that 57 percent of women were likely to say COVID-19 had negatively affected their mental health, compared to 50 percent of men. Women were also more likely than men to report that their deteriorating psychological health translated to adverse physical effects. 

Race further compounds the issue. Since the end of April, Black and Latina women have been generally more likely than White women to report symptoms of depression or anxiety, though the gap has varied over the course of the pandemic, according to data the CDC shared with The 19th. At the end of June, 47.9 percent of Latina women and 45.8 percent of Black women reported symptoms of at least one condition, compared to 38.7 percent of White women. (In general, the difference between Black and Latina women has not been statistically significant.) 

None of those datasets or surveys look specifically at nonbinary or transgender people. But observational research published this June in the Journal of General Internal Medicine found that they also experienced increases in depression and anxiety that accompanied the onset of COVID-19, a change the researchers suggest could be influenced by factors like the weakening economy, fear of the virus and social isolation. In March and April, Trans Lifeline — a peer support mental health hotline for transgender people — experienced a 78 percent increase in crisis calls, said Bri Barnett, a spokesperson for the organization. 

Job insecurity is a risk factor for anxiety and depression. In general, the economic downturn has generally hit women harder than men, and Latina women have been affected more than any other group, seeing a 21 percent loss in jobs, per data analyzed by the Pew Charitable Trusts. Black women experience a 17 percent drop. Black women and Latinas also have far greater likelihood of working a job that’s been deemed essential, meaning they’re at heightened risk of going out in the world, contracting the virus and potentially passing it onto others — yet another psychological burden.