The Pandemic’s Emotional Toll

A study led by Catherine Ettman, a doctoral student in Health Services Research, finds COVID-19 has led to a nearly a three-fold increase in depression.

ACCORDING TO A STUDY led by health services research doctoral student, Catherine Ettman, almost one quarter of U.S. adults are experiencing symptoms of depression. That’s nearly a three-fold increase since before the COVID-19 pandemic began.

The study, the first nationally representative U.S. study to examine the change in depression prevalence before and during the pandemic, found an increase in depression symptoms among all demographic groups. However those starting of with lower incomes, smaller savings, and those severely affected by the pandemic—because of a lost job or the death of a loved one, for example—were, unsurprisingly, found to be more likely to suffer from depressive symptoms.

Researchers expect a rise in mental illness in the weeks and months following a population-level trauma, such as a natural disaster. But the mental health toll of the coronavirus pandemic has been far greater than previous mass traumas.

“We were surprised at the high levels of depression,” Ettman said. “These rates were higher than what we’ve seen in the general population after other large-scale traumas like September 11, Hurricane Katrina, and the Hong Kong unrest.”

The study, conducted with colleagues in the Boston University School of Public Health, compared data from 5,065 respondents to the 2017-2018 National Health and Nutrition Examination Survey, and 1,441 respondents to the COVID-19 Life Stressors Impact on Mental Health and Well-Being study, which was conducted in the early spring of 2020 when much of the U.S. was under stay-at-home advisories.

Those with fewer social and economic resources were more likely to report probable depression, suggesting that inequity may increase during this time and that health gaps may widen.

Catherine Ettman study author and Ph.D. student in Health Services Research. Image courtesy of the Boston University School of Public Health.
Catherine Ettman

The results, published in the journal JAMA Network Open, follows other studies from the Centers for Disease Control and Prevention and Johns Hopkins University which found significant numbers of Americans reporting depression, anxiety, substance abuse, and thoughts of suicide during the pandemic.

Like the other effects of the pandemic, its mental health effects are being disproportionately suffered by those with fewer social supports and financial resources, the study finds.

“Those with fewer social and economic resources were more likely to report probable depression,” Ettman said, “suggesting that inequity may increase during this time and that health gaps may widen.” As cases continue to rise nation- wide, Ettman says policy changes that alleviate COVID-19 stressors could make a difference.

“There may be steps that policymakers can take now to help reduce the impact of COVID-19 stressors on depression,” she said, “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.”

In addition to these policy considerations, Ettman and her colleagues also hope their findings help those experiencing depression at this extraordinary time to recognize that they are not alone. In fact, one in four U.S. adults may be going through the same thing.

Other study authors: Salma Abdalla, M.D., MPH; Gregory Cohen, MPhil, SW, Ph.D.; Laura Sampson, Ph.D.; Patrick Vivier, M.D., Ph.D.; Sandro Galea, M.D., DrPH