Many studies have documented higher than expected rates of depression and anxiety among adults during the course of the COVID-19 pandemic, with up to 25% of adults in the United States reporting moderate to severe depressive symptoms. Given a substantial body of literature indicating that social support may protect individuals from developing depression, Karmel Choi, PhD, Jordan Smoller, MD, ScD and colleagues from the Center for Precision Psychiatry and the Psychiatric and Neurodevelopmental Genetics Unit at Mass General Hospital, were interested in understanding the role of social supports in vulnerability to depression in the setting of a global crisis.
What happens when there is a crisis, more specifically a global crisis that requires social distancing and disrupts traditional social networks? Choi and colleagues investigated the relationship between social support and depression risk, focusing specifically on the early months of the COVID-19 pandemic. The study asked the following questions:
- To what extent does social support reduce the risk of depression during a global crisis?
- Which types of social support are most beneficial in terms of mitigating depression risk?
- Are there specific populations who may derive greater benefit from social support during a crisis?
Choi and her team analyzed a large and diverse dataset of 69,000 adults (66% female) participating in the national All of Us Research Program. Data were obtained from a nationally representative sample of participants who responded to the COVID-19 Participant Experience (COPE) survey administered monthly from May 2020 to July 2020 . The participants answered questions about three types of social support: emotional/informational support (e.g., someone to confide in or talk to), positive social interaction support (e.g., someone to do things with in order to help get one’s mind off things), and tangible support (e.g., someone to help with daily chores if sick).
Depressive symptoms were measured using the Patient Health Questionnaire (PHQ-9).
In this study, approximately 16% of the participants experienced elevated depressive symptoms during the COVID-19 pandemic. However, those who reported higher levels of social support had a 55% lower risk of depression.
They also looked at the impact of different types of social support.
- Emotional/informational support and positive social interactions demonstrated the strongest protective effect, followed by tangible support.
- The more support, the better – participants who felt they had all three types of support were six times less likely to be affected by depression.
- The individuals most likely to benefit were those at higher risk for depression (based on sex, age, pre-pandemic mood disorder, or pandemic-related financial stressors).
Social Support as a Target for Future Public Health Interventions
This study allows us to better understand the link between social support and mental health during the early stages of the COVID-19 pandemic, where many aspects of life were affected. The current study highlights the importance of social support as a means of reducing risk for depression, demonstrating the greatest benefits in those at higher risk for depression (based on sex, age, pre-pandemic mood disorder, or pandemic-related financial stressors). These findings could help to inform population-level efforts to promote social support during a global crisis.
At the beginning of the pandemic, we were told to check in on the older people in our networks. Older family members formed bubbles with their younger relatives, and everybody learned how to use Zoom. While older adults were most vulnerable to the medical complications of COVID-19, it turns out that, when compared to other age groups, rates of depression were the lowest in older adults. Maybe these community-wide efforts to connect with older adults helped to reduce the risk of depression in a vulnerable population during the pandemic.
On the other hand, we saw the sharpest increase in the prevalence of depression in teens and young adults. With school and work closures, adolescents and young adults experienced the most significant disruptions in their social network.
Choi suggests that future public health initiatives may focus on community-level interventions, support group programs, or educational campaigns to foster social connections and reduce the burden of depression on a broader scale. This work also emphasized the importance of tailoring interventions to meet individuals’ needs. For example, enhancing the quality of support in targeted domains such as emotional support and positive social interactions may have a greater impact than tangible support.
Other researchers involved in the project included Younga Heather Lee, Zhaowen Liu, Daniel Fatori, Joshua R Bauermeister, Rebecca A Luh, Cheryl R Clark, André R Brunoni, and Sarah Bauermeister.
Read More
Choi KW, Lee YH, Liu Z, Fatori D, Bauermeister JR, Luh RA, Clark CR, Brunoni AR, Bauermeister S, Smoller JW. Social support and depression during a global crisis. Nat. Mental Health 1, 428–435 (2023).
