Internet Searches for Anxiety Attacks Take Off During COVID-19

Many health experts are concerned that the COVID-19 pandemic could be having widespread effects on people's mental health, but assessing these concerns is difficult without data.

"Traditional public health surveillance lacks the agility to provide on-demand insights. As a result, when public leaders need real time data to inform their responses to COVID-19's mental health burdens, all that can be mustered is theoretical speculation," said Dr. John W. Ayers who specializes in monitoring the health needs of the public.

As it turns out, a new study published in JAMA Internal Medicine led by Dr. Ayers and Dr. Alicia L. Nobles of the Center for Data Driven Health at the Qualcomm Institute within the University of California San Diego in collaboration with Johns Hopkins University, Barnard College, and Institute for Disease Modeling, finds evidence of a record high in potential anxiety attacks or panic attacks through Google searches.

Identifying Trends in Mental Health Problems

The research team analyzed Google search queries that mentioned "panic attack" or "anxiety attack" emerging from the United States from January 2004 through May 9, 2020. These included queries like "am I having a panic attack?," "signs of anxiety attack" or "anxiety attack symptoms."

The team studied anxiety attacks because they are a common mental health problem, can lead to other mental health problems like depression, are triggered by outside stressors, and (especially relevant during a pandemic) are socially contagious.

Evaluating trends after President Trump first declared a national emergency (March 13, 2020) to assess the impact of COVID-19 the team discovered severe acute anxiety related searches reached record highs.

The largest increases in queries occured between March 16, 2020 and April 14, 2020, cumulatively increasing 17 percent. These increases coincided with the roll out of national social distancing guidelines (March 16th) and their extension (March 29th), the US surpassing China with the most reported cases (March 26th), the CDC recommending facemasks (April 3rd), and the US surpassing Italy for most deaths (April 11th). Queries returned to typical levels by April 15, 2020 through the end of the study.

"In practical terms, over the first 58 days of the COVID-19 pandemic there were an estimated 3.4 million total searches related to severe acute anxiety in the United States," said Dr. Benjamin Althouse, a Principal Scientist at the Institute for Disease Modeling. "In fact, searches for anxiety and panic attacks were the highest they've ever been in over 16 years of historical search data. "

A Call to Action to Address Mental Health Needs During COVID-19

"The pandemic and our public health response, while warranted based on early evidence, could have many unintended and collateral health impacts. Our results provide among the first insights into understanding those impacts," said Dr. Eric C. Leas, an Assistant Professor in the UCSD Department of Family Medicine and Public Health and study coauthor.

"A panic attack is not to be taken lightly as it can land someone in the emergency room with shortness of breath, a pounding heart, chest pain, and an intense feeling of fear" added Dr. Ayers. "As a result, our results unquestionably warrant a need for increased mental health services."

The team notes one such example is Illinois' Call4Calm hotline that supports those suffering with acute anxiety. "Similar hotlines should be rolled out nationally and prominently featured in the search results of those seeking help online," added Dr. Derek Johnson, a Research Fellow in the UCSD Department of Medicine and study coauthor. "Similar applications to suicide have had tremendous benefits on public health and saved lives."

"The value of monitoring queries goes beyond acute anxiety," said Dr. Mark Dredze, the John C. Malone Associate Professor of Computer Science at Johns Hopkins University and study coauthor. "For instance, during the COVID-19 pandemic we first detected spikes in shopping for unproven therapies and shopping for guns using similar methods, and these can be further extended across public and mental health topics."

"It may take years to fully comprehend the societal fallout of COVID-19," added Dr. Adam Poliak, a Roman Family Teaching and Research Fellow in Computer Science at Barnard College and study coauthor. "With time, we may find that many more wraparound services will be needed to respond to other collateral impacts and our rapid data driven approach could be used for targeting and prioritizing responses to those impacts."

"In theory, decision makers could track searches for hundreds of mental health problems, identify the subset that have greatest volume, and target resources to meet those needs," concluded Dr. Nobles. "As political and policy leaders debate where to spend health resources to address the mental health burdens of COVID-19, timely, empirical evidence like we provide can ensure that limited resources are allocated to the most dire needs."

Ayers JW, Leas EC, Johnson DC, et al.
Internet Searches for Acute Anxiety During the Early Stages of the COVID-19 Pandemic.
JAMA Intern Med. Published online August 24, 2020. doi: 10.1001/jamainternmed.2020.3305

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