A new study finds that people with depression are less likely to use activities to help regulate their moods. This is something that is even more difficult to do during the COVID-19 pandemic.

The study, which now appears in JAMA, examined a selection of activities that people may use as a form of mood regulation to stave off depression. Its aim was to find out if people with depression are less likely to plan their activities for mood regulation.

Insufficient homeostasis — which is “the failure to stabilize mood via mood-modifying activities,” as the study puts it — is likely to be exacerbated by the limited activity choices available during lockdown.

Senior study author Guy Goodwin, from the University of Oxford in the United Kingdom, says:

“When we are down, we tend to choose to do things that cheer us up, and when we are up, we may take on activities that will tend to bring us down. However, in our current situation with COVID-19, lockdowns, and social isolation, our choice of activity is very limited.”

Depression

Globally, more than 264 million people have depression.

According to the National Institutes of Health (NIH), major depression is one of the most common mental health conditions in the United States.

The NIH estimate that 17.3 million people, or 7.1% of the country’s adult population, have had at least one major depressive episode.

Low mood regulation

To ascertain the degree to which a lack of mood regulation is a factor in depression, Goodwin and colleagues analyzed the histories of 58,328 participants, comparing those with low mood (depression) and high mood. The team included people from low, middle, and high income regions in the cohort.

In particular, the researchers tracked the extent to which people responded to their moods through their choice of activities throughout the day.

They found a significant link between rarely or never practicing this form of mood regulation and depression. Specifically, in computer simulations, the researchers found that insufficient mood regulation predicted more frequent and longer lasting episodes of depression.

People who proactively selected the sequence of activities in which they engaged were less likely to experience a low mood.

Goodwin notes, “Our research shows this normal mood regulation is impaired in people with depression, providing a new, direct target for further research and development of new treatments to help people with depression.”

The study authors propose that providing well-targeted activity suggestions to people with depression could help them regulate their moods and prevent depressive episodes.

Since medication only works for about 50% of people with depression, this could represent an important new direction for treatment.

As lead study author Maxime Taquet says, “By training people to increase their own mood homeostasis, how someone naturally regulates their mood via their choices of activities, we might be able to prevent or better treat depression.”

“This is likely to be important at times of lockdown and social isolation, when people are more vulnerable to depression and when choices of activities appear restricted.”

Activity choices

In analyzing the participants’ histories, the researchers also found that the types of activities the participants who did regulate their moods selected varied depending on their income level.

In high income countries, people were more likely to choose exercise for mood regulation. In lower income populations, individuals were more likely to choose religious activities.

There may also be other options. Taquet concludes:

“Our research findings open the door to new opportunities for developing and optimizing treatments for depression, and this could potentially be well adapted to treatments in the form of smartphone apps, made available to a large population, which sometimes lack access to existing treatments.”

All data and statistics are based on publicly available data at the time of publication; 5/3/2020. Some information may be out of date.