Research Spotlight: Social Support and Depression During a Global Crisis

Karmel Choi, PhD, and Jordan Smoller, MD, ScD, from the Mass General Department of Psychiatry and colleagues recently published an article in Nature Mental Health, titled Social Support and Depression During a Global Crisis.

What was the question you set out to answer with this study?

We wanted to investigate the relationship between social support and depression risk during challenging times including the height of the COVID-19 pandemic. We asked the following questions:

• To what extent might social support reduce the risk of depression during a global crisis?
• Which types of social support are most beneficial in mitigating depression risk? 
• Are there specific populations who may derive greater (or lesser) benefits from social support during a crisis?

What Methods or Approach Did You Use?

Our approach was unique in several ways. First, we drew on a large and diverse dataset of 69,000 participants from the national All of Us Research Program, which provided a rich and representative sample to study perceived social support during the early months of the COVID-19 pandemic.

This allowed us to understand the links between social support and mental health during the early stages of the COVID-19 pandemic, where many aspects of life were affected.

Second, our study focused on different types of social support, namely emotional and informational support, positive social interactions, and tangible support.

By investigating the individual and combined contributions of these support types, we gained more nuanced insights into what kinds of social support were most helpful in reducing the likelihood of elevated depressive symptoms.

Finally, we explored interactions between social support and several key factors that could modify its relationship with depression. These factors included age, sex, prior mood disorder history, and pandemic-related financial stressors.

This helped us to understand how different groups of people may respond to social support during a global crisis.

What Did You Find?

Through the study, we came to multiple conclusions:

• Approximately 16% of participants experienced elevated depressive symptoms during the COVID-19 pandemic.
• Higher overall social support was associated with 55% lower odds of depression.
• Emotional/informational support and positive social interactions showed the strongest protective associations with depression, followed by tangible support.
• The more, the better – participants who felt they had all three subtypes of support were six times less likely to be affected by depression.
• Individuals who were at higher risk for depression (based on sex, age, pre-pandemic mood disorder, or pandemic-related financial stressors) showed a larger reduction in their odds of depression.

What are the Implications?

The study highlights the importance of social connection as a public health priority. These findings could inform population-level efforts to promote social support during a global pandemic.

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 at a broader scale.

Our work also emphasizes the importance of tailoring interventions to meet individuals' social support needs, for example, enhancing the quality of support in targeted domains such as emotional support and positive social interactions.

By identifying vulnerable populations at higher risk for depression, such as those experiencing financial stressors or with pre-existing mood disorders, we could provide social support interventions to reduce the risk of depression.

Building resilience through enhanced social connections can help individuals better cope with the challenges of a crisis.

What are the next steps?

We want to examine longer-term outcomes and look at the impact of changes in social support from during the pandemic to the post-pandemic period. We also want to look at how social support may interact with other risk and protective factors.

Paper cited:

Choi, K. W., Lee, Y. H., Liu, Z., Fatori, D., Bauermeister, J. R., Luh, R. A., Clark, C. R., Brunoni, A. R., Bauermeister, S., & Smoller, J. W. (2022). Effects of social support on depression risk during the COVID-19 pandemic: What support types and for whom?. medRxiv : the preprint server for health sciences, 2022.05.15.22274976. https://doi.org/10.1101/2022.05.15.22274976

About the Massachusetts General Hospital

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. In July 2022, Mass General was named #8 in the U.S. News & World Report list of "America’s Best Hospitals." MGH is a founding member of the Mass General Brigham healthcare system.