Did lockdown increase depression in teens?

What impact did long periods of lockdown with little or no contact with friends, peers and families have on older individuals, and specifically teens? Nicky Wright is senior lecturer in psychology at Manchester Metropolitan University and she put together an elegant study that was one of the few to help unpick the confounding effect of the ageing process, disclosing in the process a formerly hidden impact on young boys…

Nicky - There has been a lot of interest as to whether these kinds of interventions such as lockdowns will negatively impact the mental health of the general population. And overall there does seem to be evidence mental health symptoms increased during the lockdown. Of course it's difficult to separate out what's the effect of actual lockdown and what's the effect of other aspects of the pandemic. So for example, fear of Covid. There are some studies which have compared different countries that had different levels of restrictions, which suggest that there may have been an effect of greater restrictions on worsening depression symptoms.

Chris - Were any groups particularly susceptible?

Nicky - Yeah, so the evidence seemed to suggest that women were more aversely affected and younger people. So that includes young adults and children and adolescents. People from lower socioeconomic circumstances were more aversely affected, but some studies have actually shown that people living in higher or middle socioeconomic circumstances, mental health was more affected. We actually found that in our data and we speculated that it might be that people who were doing okay before the lockdowns and the pandemic might have experienced more changes to their lives.

Chris - That's an interesting perspective because you wouldn't automatically jump to the conclusion someone who's got a nice life, who's robbed of it, would end up worse off than someone with a worse life with less to lose.

Nicky - Not worse off, the same. We actually called it a levelling up in our analysis because people who were worse off already had higher mental health symptoms. There was more change in those who were better off.

Chris - As you saw this when we went into a pandemic with those restrictions being applied, one would therefore anticipate that things should improve on the way out. Again, if there is a cause and effect type relationship. Do the sorts of studies that got done bear that out? Do we see that as restrictions, these things go back to normal, these levels go back to normal? Or is there a lasting psychological scar on the population as it were and we're seeing a legacy effect on people's mental health?

Nicky - When we look at overall mean levels, there does seem to be evidence consistent with what you suggest, that in the months after the lockdown symptoms do improve. But again, these effects are always quite small and there'll be certain subgroups that continue to be affected, absolutely.

Chris - You went after adolescence specifically, why were you very interested in them?

Nicky - From age 11 onwards, females experience this rapid increase in depression symptoms. And that marks the start of a lifelong transition that we're all aware of. We were really interested to ask, firstly, did the pandemic exacerbate this increase but also to try and disentangle the effect of the pandemic from this developmental effect that we know is there. So we know that, with time passing, young adolescent female depression symptoms will increase anyway, whereas boys' depression symptoms will slightly decrease over that time.

Chris - Yes, I understand the subtlety and the nuance of what you're saying, which is if you've got something going on over a long-ish period of time, which the pandemic did, multiple years, people are going to grow up over that time. So you could be misled into thinking a person's becoming depressed because of the pandemic, but just through the aging process they were going to become depressed anyway. So I suppose the question becomes, did we see an excess risk of depression in these young women or the boys accordingly in response to the pandemic?

Nicky - Exactly. So we were in a really fortunate position to answer this question because I work on a birth cohort of parents and children. And we have a group of young people who were born in 2007 to 2009 who had been following up repeatedly since birth. And we just so happened to be collecting data on them before the pandemic hit. And they were 11, 12 years old. And then we collected two other Covid surveys, one in June 2020 just after the lockdown measures were easing and children were returning to school and then another a year later. So this allowed us to carry out this analysis that actually separated out the changes with age from the time in relation to the pandemic onset. What we found when we just looked at the data simply, which is what most studies have done, it appeared as if girls did experience a dramatic increase in depression symptoms immediately following the first lockdown and again a year later. But then when we actually corrected for the age related change over that period, it really reduced the effects of the lockdowns. For boys, when you looked at their simple scores, it looked like they did have a small increase after the first lockdown. But then actually when we corrected for that age related change, we saw that an effect of the pandemic had been masked. Boys were actually more aversely affected by the pandemic. And it's not to say that girls aren't suffering because girls have very high rates of depression in adolescence, but boys were actually more aversely affected by the pandemic. And we also measured behavioural problems. And behavioural problems actually decrease during early adolescence as children grow up and learn to regulate themselves better. And we saw that behavioural problems had increased in both boys and girls in response to the pandemic.

Chris - We spoke recently to a researcher in America, Patricia Kuhl, who has done MRI scans on older individuals, they're the late teens into early twenties, over the pandemic. And she found accelerated brain ageing, but it was very pronounced in the girls compared to the boys. So it seems interesting that when you look at the younger ones and you look at specific aspects of behaviour, you see this effect in boys and girls are relatively shielded. Whereas when you look at the brain changes that were being detected in these other groups who were otherwise relatively comparable to those that you've looked at, you see a different story. So why do you think you are getting this impact on the boys and what's helping the girls?

Nicky - Patricia Kuhl's work, which is quite similar to ours in that it does correct the age as well, they haven't measured the emotional outcomes. So they've observed these differences in girls, but they haven't yet linked them to outcomes. So it may be that that's created a vulnerability in girls that will express later. Another kind of explanation I would have is that it does seem that the mechanisms for mental health problems in males and females are different. So female mental health problems are more linked to social connectedness, whereas male mental health problems are more linked to achievement. So you can imagine that during the lockdowns, boys' ability to achieve in school was reduced, extracurricular activities that boys would normally achieve in such as sports access to that were removed. Also because of these differences in how males and females typically spend their time, males do spend more time outside and physical activities and so their peer interactions are conducted more in those settings, whereas girls may have been better able to maintain their peer interactions with texts and phone calls remotely. So our data that we collected was actually a year after the pandemic. So we don't know what the long lasting effects are. So we're collecting more data from our sample now to try and try and establish whether these changes that we saw have persisted.