Why Pandemic Depression Is Not Going Away

This post was written by Sandro Galea and Catherine Ettman.

Today, our team published findings from a longitudinal study on depression conducted on a representative sample of U.S. adults followed from Spring 2020 to Spring 2021. We followed the same group of adults over one year to see how depression changed. Unlike other traumatic events in recent history, we found that depression stayed high during the COVID-19 pandemic and may have increased slightly between March-April 2020 and March-April 2021. Our team conducted one of the first studies to show that depression increased threefold from before COVID-19 to the start of it. We now see that depression went from 8.5 percent before COVID-19 to 27.8 percent in Spring 2020 up to 32.8 percent in Spring 2021.

Today’s study shows that depression is not relenting. Why?

Mental health is particularly responsive to our socioeconomic context. While socioeconomic status is known to change physical indicators over time, small changes in socioeconomic status can present themselves in mental health indicators much sooner. We found that the people who experienced stressors, such as challenges with child care, difficulties paying rent, and losing a job, were the ones who were more likely to report depression during COVID-19. In previous studies, we found that the persons who were reporting stressors like job loss were the very ones who had fewer assets going into the pandemic, and therefore had less buffering to protect themselves from the disruption caused by the pandemic.

Unlike other traumatic events, COVID-19 has been ongoing. As we lift COVID-19 precautions, we still see the economic consequences of the pandemic, with empty storefronts, half-filled public transport, and quiet city centers. As part of the world moves on with remote work options, the other part remains left behind, with stressors mounting and assets stagnating or declining. As the effects of the pandemic linger, they disproportionately affect people who had low assets going into this pandemic, leading to additional stressors and poor mental health.

Today’s study results show that low income may matter even more 12 months into the COVID-19 pandemic than it did at the start. While we found that persons making less than $20,000 had 2.3 times the odds of depression in Spring 2020 as people making $75,000 or more, those odds jumped to 7.0 in Spring 2021. Thus, we may be seeing bigger gaps in mental health between persons with low versus high income as the COVID-19 pandemic has continued.

What can help?

In the short term, it will be necessary to ensure that those who need mental health care can get it, whether through telemedicine or through in-person counseling. Funding mental health care will be critical to link patients to providers and ensure that all people can access the resources needed (not only those with the means to do so). In the medium and long term, we need to address the fundamental socioeconomic roots of poor mental health and, in particular, the inequalities that generate a disproportionate burden of poor health for certain groups.

When lack of money, housing, employment, child care, and other key assets means poor mental health, creating positive psychological outcomes means broadening access to these resources. Policies like the child tax credit and infrastructure bills can create contexts in which people with low income and high income can both thrive. Easing the burden of poor mental health will require us to re-build a society where all can access the resources they need to be healthy, both mentally and physically.

​​​​​​Catherine Ettman is a doctoral student at the Brown University School of Public Health and director of strategic development at the Boston University School of Public Health Office of the Dean. Follow her on Twitter: @CatherineEttman.