Health behaviors and mental health during the COVID-19 pandemic: A longitudinal population-based survey in Germany

Abstract

Objective To understand the mental health response to repeated and prolonged stress during the COVID-19 related lockdown and the role of specific health behaviors to buffer against this stress. Methods In a longitudinal study with several measurement points covering three months during the COVID-19 pandemic, about 3500 randomly selected participants representative of the German population reported on their mental health (anxiety, depression, loneliness) and health behaviors (screen time, snack consumption, physical activity). Results Symptoms of anxiety, depression, and loneliness were highest shortly after the lockdown came into effect. Over time, the symptoms were stable or went down slightly, corresponding to patterns of habituation. Among people with higher vulnerability to poor mental health during the lockdown (e.g., women), the proportion with high levels of anxiety, depression, and loneliness was considerably larger. These groups also reported fewer health-promoting behaviors. More screen time, more snacking, and less physical activity were related to higher symptoms of anxiety, depression, and loneliness across all time points. Changes in health behaviors over time mostly did not predict changes in mental health symptoms. Conclusions Mental health and engagement in protective health behaviors was lowest at the start of the lockdown. Health behaviors mostly returned to pre-lockdown levels within three months. Engaging in healthier behaviors was associated with better mental health. Policy implications of these findings are discussed. This study provides important insights into (unintended) side effects of an international crisis and can contribute to a better understanding of how to preserve mental health.

Physical Activity and Well-Being during the Second COVID19-Related Lockdown in Germany in 2021

“…Interestingly, in our sample, well-being was not related to PA. This is in line with the large Mannheim Corona Study [35] but in contrast to the aforementioned study in German students [33]. Investigations from the first wave of the pandemic also found positive associations between PA and well-being [36,37].…”

“…Based on our data, we cannot say whether PA has reverted to normal levels between the lockdowns. In the Mannheim Corona Study, PA levels in the overall sample surpassed pre-lockdown values in June 2020 (i.e., after the lifting of the restrictions), but certain groups, such as women, parents and people with compromised health, were less active [35]. In Canada, moderate-vigorous PA returned to pre-lockdown levels after the first wave; incidental PA and walking, however, remained significantly lower [38].…”

The longitudinal associations of physical activity, time spent outdoors in nature and symptoms of depression and anxiety during COVID-19 quarantine and social distancing in the United States

“…We found that depression and anxiety decreased over the 3-month follow-up period and was consistent for all demographic subgoups. In a German cohort over roughly the same time period (April to June 2020) as our study, Mata et al also noted a decline in anxiety and depression ( Mata et al, 2021 ). We do not know what may explain these results, although it is possible that respondents were adapting to the lockdown.…”

“…We do not know what may explain these results, although it is possible that respondents were adapting to the lockdown. Mata et al hypothesized habituation to stay at home orders would result in improved mental health symptoms ( Mata et al, 2021 ). We noted that prevalence of lockdown behaviors decreased somewhat over these months, which may have improved the respondents' mental health outlook.…”

A longitudinal seizure outcome following the COVID-19 pandemic in 2020 and 2021: Transient exacerbation or sustainable mitigation

“…This finding may contradict the evidence that PWE are sensitive to a dramatic social change due to the pandemic [ 9 ]. However, even if PWE had a psychological risk, we considered that they could have gradually adapted to ongoing social change and the new normal lifestyle [ 27 ]. Such habituation might be key for PWE during the long-term chronological change in the pandemic.…”