One in four American adults is now likely to be experiencing symptoms of depression, a threefold increase from last year. As the COVID-19 pandemic claims the lives of thousands of people in the US, as millions of Americans have lost their jobs, as parents and teachers worry about kids going back to school, and as renters face eviction and homeowners face foreclosure, those findings-from a first-of-its-kind nationwide study-reveal that the global coronavirus pandemic is taking a dire toll on mental health in the US.
The study, conducted by researchers at Boston University's School of Public Health, found the prevalence of depression symptoms in the US more than tripled during the pandemic. Where 8.5 percent of adults were experiencing depression symptoms before the pandemic, the rate climbed to 27.8 percent of adults by mid-April. The findings are published in the journal JAMA Network Open.
"Depression in the general population after prior large-scale traumatic events has been observed to, at most, double," says the study's senior author Sandro Galea, BU School of Public Health dean and Robert A. Knox Professor. He cites examples such as September 11, the West Africa Ebola outbreak, and recent civil unrest in Hong Kong.
Galea's study is the first national study in the US to assess the change in depression prevalence before and during COVID-19 using the Patient Health Questionnaire-9 (PHQ-9), the leading self-administered depression screening tool used by mental healthcare professionals.
The researchers compared data from 5,065 respondents to the 2017-2018 National Health and Nutrition Examination Survey (NHANES), and 1,441 respondents from the COVID-19 Life Stressors Impact on Mental Health and Well-Being (CLIMB) study, which was conducted from March 31 to April 13, 2020, when 96 percent of the US population was under stay-at-home advisories or shelter-in-place policies.
Both surveys used the PHQ-9 to assess depression symptoms and gathered the same baseline of demographic data. The 2020 survey also gathered data on COVID-related stressors, including job loss, the death of a friend or loved one from COVID-19, and financial problems. Experiencing more COVID-related stressors was a major predictor of depression symptoms.
Across the board, the researchers found an increase in depression symptoms among all demographic groups. But the biggest difference in depression rates among demographics came down to a person's finances. After adjusting for all other factors, the researchers found that, since the onset of the coronavirus pandemic, someone with less than $5,000 in savings was 50 percent more likely to have depression symptoms than someone with more than $5,000.
"Persons who were already at risk before COVID-19, with fewer social and economic resources, were more likely to report probable depression," suggesting that inequity has increased during this time and that health gaps have widened, says the study's lead author Catherine Ettman, a doctoral student at the Brown University School of Public Health and director of strategic development in the Office of the Dean at the BU School of Public Health.
Ettman says the findings underline the importance of working to build a society "where a robust safety net exists, where people have fair wages, where equitable policies and practices exist, and where families can not only live on their income, but can also save money towards the future."
As COVID-19 continues to grip the country, Ettman says, "there may be steps that policymakers can take now to help reduce the impact of COVID-19 stressors on depression, such as eviction moratoria, providing universal health insurance that is not tied to employment, and helping people return to work safely for those able to do so."
At the same time, Ettman says she and her colleagues hope the study findings will also help those who are experiencing depression in this incredibly difficult time see that they are not alone: On the contrary, one in four US adults is going through the same thing.
This research was supported by the Rockefeller Foundation-Boston University 3-D Commission and the National Institutes of Health.
