The novel COVID-19 pandemic has created chaos around the globe. To curb its spread, the Government of India announced a nationwide lockdown on March 24th, 2020 for 21 days, which was extended further for a longer time. This long period of lockdown disrupted the routine of all citizens, affecting their psychological well-being. While recent studies showed the psychological burden of Indians during the pandemic, no study has assessed whether the psychological toll changed over time due to repeated extensions of the lockdown. We followed up 159 Indian adults during the first two months of the lockdown to assess any change in their anxiety, stress, and depressive symptoms. Multilevel linear regression models of repeated observations nested within individuals adjusted for sociodemographic covariates showed that anxiety (β = 0.81, 95% CI: 0.03, 1.60), stress (β = 0.51, CI: 0.32, 0.70), and depressive symptoms (β = 0.37, CI: 0.13, 0.60) increased over time during the lockdown. This increase was higher among women than men independent of covariates. Individual resilience was negatively associated with adverse psychological outcomes. Our findings suggested that while the lockdown may help in effectively addressing this pandemic, the state and society at large need to be sensitive to the mental health impacts of a long-drawnout lockdown. Such effects likely have long-term sequelae. The disproportionate impact on women needs immediate attention. Moreover, it behooves society to address the root causes driving the unequal distribution of psychological distress during such crises.

To curb the spread of the novel coronavirus, India announced a nationwide lockdown on 24th March 2020 for 21 days, later extended for a longer time. This long period of lockdown greatly disrupted routine life and likely affecting citizens psychological well-being. The psychological toll of the pandemic on Indians is documented. However, no study has assessed whether the psychological toll changed over time due to repeated extensions of the lockdown. We followed up 159 Indian adults during the first two months of the lockdown to assess any change in their anxiety, stress, and depressive symptoms. Multilevel linear regression models of repeated observations nested within individuals, adjusted for socio-demographic covariates, showed that anxiety (β=0.81, CI: 0.03, 1.60), stress (β=0.51, CI: 0.32, 0.70), and depressive symptoms (β=0.37, CI: 0.13, 0.60) increased over time during the lockdown. This increase was higher among women than men independent of covariates. Individual resilience was negatively associated with the psychological outcomes. This suggests that the state needs to address the current mental health impacts of a long-drawn out lockdown and its long-term sequelae. Disproportionate burden on women needs immediate attention. Sustainable change requires addressing the root causes driving the gender inequalities in psychological distress during such crises.