Trajectories of psychological distress over multiple COVID-19 lockdowns in Australia

The COVID-19 pandemic and its aftermath has stimulated substantial research in many different fields. One of these areas includes research that considers the impact of the COVID-19 pandemic, including the indirect effect of policy responses, on psychological distress and mental health. Most existing work has reported that mental health tended to be worse during the pandemic when compared to pre-COVID periods. Studies have also found that government-mandated lockdowns were detrimental to mental health, as compared to mental health in periods with no lockdowns. However, despite this burgeoning research, there has been little consideration of how levels of population distress rise and fall with the duration and repetition of lockdowns, or whether distress returns to initial levels once lockdowns ended.

This study describes the trajectories of psychological distress over multiple lockdowns during the first two years of the pandemic across five Australian states for the period May 2020 to December 2021 and examined whether these distress trajectories varied as a function of time spent in lockdown, or time since lockdown ended. A total of N = 574,306 Australian adults completed Facebook surveys over 611 days (on average 940 participants per day). Trajectories of psychological distress (depression and anxiety) were assumed to be a function of lockdown duration, time since lockdown ended, fear of infection, and perceived financial concerns.

The prevalence of distress was higher during periods of lockdown, more so for longer lockdowns relative to shorter lockdowns. Distress increased rapidly over the first weeks of lockdown, though less rapidly for short lockdowns. Distress levels tended to stabilise, or even decrease, after ten consecutive weeks of lockdown. After lockdown restrictions were lifted, distress rapidly declined again but did not return to pre-lockdown levels within four weeks, although continued to decline afterwards.

In Australia short pre-signaled duration lockdowns were associated with slower rises in distress. Lockdowns may have left some temporary residual population effect, but we cannot discern whether this reflects longer term trends in increasing distress. Overall, our results suggest that the negative mental health effects of the lockdowns themselves may not have been permanent, as there is evidence that levels of psychological distress declined significantly, even after very long lockdown periods.