**1. Introduction**

The novel, highly contagious corona virus SARS-CoV-2 is currently spreading all over the world. First cases of Coronavirus SARS-CoV-2 disease (COVID-19) were reported in Wuhan, China, in early December 2019. Symptoms mainly include respiratory distress, fever, coughing, and fatigue. As of 13 November 2020, 53,126,651 cases of COVID-19 and 1,312,170 COVID-19 related deaths have been confirmed worldwide (for Germany: 771,976 cases of COVID-19 and 12,270 COVID-19-related deaths) (John Hopkins University) [1]. The diseases' course has, thus, proven to be potentially fatal. In order to flatten the curve, measures like social distancing, wearing of a protective mask, enhanced hygiene concepts, and temporary lockdown have been taken in most countries worldwide. The current focus on COVID-19 infections, however, might distract attention from mental health issues related to the outbreak and the measures taken in order to prevent further spreading [2]. In fact, besides its impact on physical health for those infected, the pandemic and the measures taken seem to have a substantial impact on mental health and well-being. Preliminary data from China indicated increased levels of psychological distress, anxiety, depressive symptoms, and insomnia [3,4]. Another Chinese survey

found that more than half of the general population rated the outbreak's psychological impact as moderate or severe [5].

Studies related to mental health during the COVID-19 pandemic are still scarce, but more results indicate that anxiety and depression increase with an overall decrease in psychological well-being [6]. Increasing feelings of isolation, fear, worry, and sadness may cause depression and abuse of alcohol, drugs, and prescription medication and may also lead to violence toward the self or others [7]. Some authors even go so far as to describe the current situation as a public mental health crisis [8], the next mental health pandemic [9], or a mental health emergency [10]. Factors associated with a current decrease in mental health include female gender, lower socioeconomic status, lower education, and poor sleep quality [6]. Pandemic-related symptoms of depression and post-traumatic stress disorder (PTSD) have also been found to be linked to female gender and lower socioeconomic status [11].

In March 2020, the German government agreed upon a substantial catalogue of lockdown measures including contact bans that came into effect on 22 March 2020. Such measures were unprecedented for the majority of people and may affect their lives tremendously. As for now, few studies from Europe have been published [6] and yet it seems of vital importance to surveil the psychosocial consequences of the current pandemic. Here, we present data that was taken during the height of lockdown measures in Germany from 1 April 2020 to 15 April 2020.

For one, we assume an increase in depression, anxiety, impaired sleep, and domestic violence as well as changes in alcohol and food consumption. Measures taken against the spreading of the coronavirus included a strict social distancing protocol that also meant a nationwide lockdown with people being advised to stay at home and to only leave the house for essential activities such as work, shopping for essential goods, and care of pets. These measures lead to an involuntary decrease in social contact. Lack of contact with other humans can cause feelings of loneliness, which may lead to depression [12], negative self-esteem, anxiety, feeling unsafe [13], and impaired sleep [14,15]. Moreover, perceived loneliness impairs the capacity to self-regulate [16], which could lead to dysfunctional behavioral changes such as an increase in alcohol or food consumption [17,18]. In addition, when combined with confined domestic circumstances, a decrease in self-regulation could lead to an increase in domestic violence. Second, we assume that the sense of coherence decreased, leaving the German population vulnerable to stress. Sense of coherence is a theoretical concept that offers a framework for overall coping in life. It combines three key aspects: comprehensibility, manageability, and meaningfulness [19]. Whether we understand the things happening to us, whether we believe that we have the necessary resources and skills to manage, and whether things in life are worthwhile and have a purpose, greatly defines how we cope with and how we perceive stressful events. We believe that the pandemic and the measures taken against it constitute such a stressful event. At the beginning of the pandemic, there was little understanding concerning why and how the virus spread or which measures were useful. The uncertainty and the lockdown may have increased feelings of powerlessness and, thus, reduced feelings of manageability.

The current survey was developed in order to systematically assess mental health in response to the pandemic and the measures taken in order to contain it. We sought out to replicate and expand findings from China for the German population and to explore perceived risks and remedies in order to derive much-needed implications for politics and healthcare.
