The negative effects of the COVID-19 pandemic on mental health are well documented, showing increased psychological distress. The Psychological University Outpatient Clinic at Sigmund Freud Private University continued to provide low-threshold, income-based services throughout all phases of the pandemic. This study examines how distress levels among help-seekers at the outpatient clinic changed as a result of the pandemic.
The sample comprises 1,664 patients (59.4% female, 39.6% male) and includes medical history, interviews, and the Symptom Checklist SCL-90-R [1]. Analyses revealed a significant group differences (pre-, peri-, and post-pandemic) on the anxiety scale (scale 5 of the SCL-90-R; (F(2,1248.19)=4.41, p=.012, η²=.01). Post-hoc tests showed higher anxiety scores pre-pandemic (M=62.65, SD=11.30) than during the pandemic (M=60.84, SD=12.51; p=.019). No significant differences emerged between pre- and post-pandemic (p=.26) or peri- and post-pandemic groups (p=1.00). Help-seekers during the pandemic were also significantly younger (M=32.9) than those before (M=35.6) or after (M=35.8; p=.001/.012).
Findings suggest that in collective crises, anxiety may be depathologised—increasingly regarded as a normal, shared response rather than a clinical condition—even while stress persists. This potential normalization may explain why reported anxiety decreased despite widespread distress. The disproportionate presence of younger patients highlights shifts in age-related help-seeking and the relevance of resilience profiles. Moreover, heightened public discourse and reduced stigma around mental health likely encouraged individuals to seek support, even when their anxiety no longer seemed exceptional.
For clinical practice and theory, these results underscore a critical implication: crises may blur the boundary between pathological and normal anxiety. Outpatient services must therefore carefully differentiate adaptive from maladaptive anxiety, while expanding preventive and psychoeducational programs. Strengthening resilience—particularly among younger populations—is essential to mitigate long-term risks masked by the apparent normalization of anxiety.