While loving yourself is important, it turns out that having a solid group of friends is equally important. As the world is moving largely towards individualism–with an emphasis on working hard at your career, taking care of your body and focusing on your mental health–friendships can sometimes take a backseat. With the lockdown in place and people rarely stepping out due to the coronavirus outbreak, social isolation has only gotten worse, triggering a mental health crisis.
However, a new study conducted by the American Journal of Psychiatry has found that social connection is the ‘strongest protective factor’ against depression. The team of researchers also suggested that reducing sedentary activities, watching TV and napping during the day could help lower the risk of depression as well.
For the purpose of the study, the researchers identified a set of modifiable factors from a field of over 100 that could be important factors for preventing depression in adults. “Depression is the leading cause of disability worldwide, but until now researchers have focused on only a handful of risk and protective factors, often in just one or two domains,” said Karmel Choi, PhD, an investigator in the Department of Psychiatry and the Harvard T.H. Chan School of Public Health, and lead author of the paper. “Our study provides the most comprehensive picture to date of modifiable factors that could impact depression risk,” Choi added.
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The researchers took a two-stage approach to carry out the study. In the first stage, they drew on a database of over 100,000 participants in the UK Biobank — a world-renowned cohort study of adults. Then, they systematically scanned a wide range of modifiable factors that might be associated with the risk of developing depression. This included social interaction, media use, sleep patterns, diet, physical activity, and environmental exposures.
This method is known as an exposure-wide association scan (ExWAS). In the second stage, they took the strongest modifiable candidates from ExWAS and applied a technique called Mendelian randomization (MR) to investigate which factors may have a causal relationship to depression risk. (MR is a statistical method that treats genetic variation between people as a kind of natural experiment to determine whether an association is likely to reflect causation rather than just correlation.)
With the help of the two-stage approach, the researchers were able to narrow the field to a smaller set of promising and potentially causal targets for depression. “Far and away the most prominent of these factors was the frequency of confiding in others, but also visits with family and friends, all of which highlighted the important protective effect of social connection and social cohesion,” said Jordan Smoller, MD, ScD associate chief for research in the MGH Department of Psychiatry, and senior author of the study.
“These factors are more relevant now than ever at a time of social distancing and separation from friends and family,” Smoller added. The protective effects of social connection were noticed even for individuals who were at higher risk for depression owing to genetic vulnerability or early life trauma, found the researchers.
If you’ve become a couch potato during lockdown, other findings of this study might not be good news for you. Watching TV, daytime napping, and even consuming multi-vitamins were found to be associated with the risk of depression, although they noted that more research is needed to determine how they contribute to it.
“Depression takes an enormous toll on individuals, families, and society, yet we still know very little about how to prevent it,” says Smoller. “We’ve shown that it’s now possible to address these questions of broad public health significance through a large-scale, data-based approach that wasn’t available even a few years ago. We hope this work will motivate further efforts to develop actionable strategies for preventing depression,” he added.
The study is certainly eye-opening. And while it might be comforting to lie on the couch and watch Netflix all day when you’re feeling depressed, wash your face, put on clean clothes and video call your girlfriends instead!
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