Depression and loneliness during COVID-19

Americans experienced more depression and loneliness during the early COVID-19 pandemic, according to a new study by Indiana University researchers, but those who were able to keep frequent in-person social and sexual connections had better mental health outcomes.

The study, published as a preprint in MedRxiv, looked at the prevalence of depression and loneliness during the COVID-19 response and examined their associations with frequency of social and sexual connections.

“During the beginning of the pandemic, when social distancing and other restrictions were put into place, we found that depression and loneliness were being experienced at considerably heightened rates in the U.S.,” said Molly Rosenberg, lead author of the study and assistant professor of epidemiology and biostatistics at the IU School of Public Health-Bloomington. “While these restrictions were and continue to be critically important to protecting Americans from the virus, it is clear that the spread and response to the virus has had a tremendous mental health impact on Americans.”

According to the study, one-third of participants (31 percent) reported depressive symptoms in the past week, and they were more likely to be women, age 20-29, unmarried, in the lowest income bracket, and living alone. This number is nearly four times higher than previous estimates among American adults, Rosenberg said.

Researchers conducted an online cross-sectional survey of a nationally representative sample of American adults aged 18-94 from April 10-20, 2020. They assessed depressive symptoms, loneliness, frequency of in-person and remote social connections (hugging family member, video chats) and sexual connections (partnered sexual activity and dating app use).

The study also looked at relationship tension (increased tension or arguments due to the spread of COVID-19 and related restrictions) among participants reporting romantic relationships.

“Among those in romantic relationships, we found that increased relationship tension was associated with dramatically higher prevalence of both loneliness and depression compared to those not experiencing such conflict,” says Maya Luetke, co-author and doctoral student in the Department of Epidemiology and Biostatistics.

In terms of social connection, the study found that those who reported hugging or kissing a family member almost every day in the last month were 26 percent less likely to report major depressive symptoms and 28 percent less likely to report loneliness.

However, the same was not true for remote connections (video chats) which were not associated with lower depression or loneliness. 

“This data reaffirms our understanding of the importance of human connection for mental health and well-being,” Rosenberg said. “It also suggests that these kinds of connections are not easily recreated with remote technology where direct touch is not possible.”

In terms of sexual connections, the study found that those who reported the most frequent partnered sex were 57 percent less likely to report depressive symptoms. However, those who reported frequent remote sex or dating app usage tended to have slightly higher rates of depression and loneliness.

Furthermore, those who reported experiencing increased tension with their romantic partner due to COVID-19 were more likely to report major depressive symptoms and loneliness. 

Researchers of the study acknowledge the need for social restrictions as the country continues to curb the spread of the virus. Expanding mental health services during the pandemic to serve those most at-risk and identifying effective ways of maintaining social and sexual connections from a distance could help in combatting increased mental health issues during this time.

“Poor mental health was widespread during COVID-19 restrictions, but we know that these restrictions are a critical tool to fight the spread of COVID-19. Our findings should not be taken as supporting premature lifting of restrictions or against reinstating them as needed. Instead, we should be ensuring mental health services reach those who need them and coming up with better ways to support interpersonal connections from afar.” 

Devon Hensel, associate research professor of pediatrics at the IU School of Medicine; Sina Kianersi, doctoral student in Department of Epidemiology and Biostatistics at IU School of Public Health-Bloomington; Tsung-chieh Fu, postdoctoral fellow at IU Bloomington and Debby Herbenick, professor in sexual and reproductive health at the IU School of Public Health-Bloomington also contributed to the study.

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