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

The impact of the global COVID-19 pandemic, including the indirect effect of policy responses, on psychological distress has been the subject of much research. However, there has been little consideration of how levels of population distress rise and fall with the duration and repetition of lockdowns, or the rate of resolution of distress 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 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 regressed on lockdown duration and time since lockdown ended. Random effects reflecting the duration of each lockdown were included to account for varying effects on distress associated with lockdown length.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 subsided 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