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Lockdown low mood: does mental health history hold the key?

Research co-authored by Esade’s Jordi Quoidbach suggests that people found it more difficult to regulate low moods during periods of lockdown caused by the Covid-19 pandemic, than during non-lockdown times. The problems with regulating low moods were found to be more pronounced for people with a history of mental illness, who were three times more likely to experience depressive episodes during lockdown.

In a research letter published in the academic journal JAMA Psychiatry, Quoidbach and co-authors Eiko I Fried (Leiden University, the Netherlands), Maxime Taquet and Guy Goodwin (University of Oxford and Oxford Health NHS Trust, United Kingdom) outlined the results of a 14-day study conducted during March 2020.

Examining the “lockdown blues”

Using a final sample of 78 students at Leiden University, the study examined the impact of lockdown on the ability of individuals to seek out activities that would help them to experience a more positive mood. Over the two-week research period, the measures implemented by the Dutch government to contain the virus changed from relatively lax, to strict limitations enforced by fines.

During the first week of data collection, the Dutch prime minister announced that the government would not introduce confinement measures and chose instead to limit gatherings to 100 people and close some non-essential businesses. On 23rd March, the beginning of the second week of the study, stricter rules were announced that banned all social gatherings and limited contact with people from other households.

The participants reported their feelings four times a day for two weeks using a smartphone app especially designed for the study

The participants reported their feelings four times a day for two weeks using a smartphone app especially designed for the study. On each occasion, they indicated their levels of relaxation, irritability, worry, nervousness and anxiety, whether they felt they had something to look forward to, and if they experienced any positive feelings at all.

Participants were also asked how much time they spent on a set of eight activities: social interaction; social media; listening to music; procrastination; outdoor activity; being occupied with the coronavirus (watching news, talking to friends about it, thinking about it); thinking about their own health or that of their family or close friends in relation to coronavirus; being at home.

Vicious or virtuous circles of mood: predicting the pattern

The study revealed that before strict lockdown measures were introduced, participants consistently sought out activities that would enhance their mood when they were feeling low. But, when the lockdown measures intensified, people experiencing low mood took part in activities that either decreased their mood further or increased it only slightly. This difficulty in regulating mood during periods of strict lockdown was significantly more marked in people with a history of low mood or mental illness. As a result, Quoidbach and colleagues found that the risk of depression was three times higher during lockdown for this vulnerable group.

Quoidbach and colleagues found that the risk of depression was three times higher during lockdown for this vulnerable group

The impact of the pandemic on mental health has been a significant cause for concern. In April last year, a group of experts called for high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups. Their positioning paper, published in The Lancet, stressed the “urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions… to address the psychological, social, and neuroscientific aspects of the pandemic.”

The ‘perfect storm’ pandemic for poor mental health

A significantly larger study by Quoidbach and co-authors, unrelated to the pandemic, revealed that people with low mood or a history of depression found it more difficult to regulate moods. This led to increased incidence and longer duration of depressive episodes. With the psychological impact of the pandemic feared to trigger a ‘perfect storm’ of suicide mortality, understanding the impact of lockdown measures on the ability to regulate mood and identifying potential interventions is an important area of research.

And, while Quoidbach and his co-authors acknowledge in their letter that their Dutch study has some limitations, it provides valuable insight into the impact of lockdown on mental health and opens a fruitful avenue for further exploration.

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