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7 Depression Research Paper Topic Ideas

Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be.

Cara Lustik is a fact-checker and copywriter.

In psychology classes, it's common for students to write a depression research paper. Researching depression may be beneficial if you have a personal interest in this topic and want to learn more, or if you're simply passionate about this mental health issue. However, since depression is a very complex subject, it offers many possible topics to focus on, which may leave you wondering where to begin.

If this is how you feel, here are a few research titles about depression to help inspire your topic choice. You can use these suggestions as actual research titles about depression, or you can use them to lead you to other more in-depth topics that you can look into further for your depression research paper.

What Is Depression?

Everyone experiences times when they feel a little bit blue or sad. This is a normal part of being human. Depression, however, is a medical condition that is quite different from everyday moodiness.

Your depression research paper may explore the basics, or it might delve deeper into the definition of clinical depression or the difference between clinical depression and sadness .

What Research Says About the Psychology of Depression

Studies suggest that there are biological, psychological, and social aspects to depression, giving you many different areas to consider for your research title about depression.

Types of Depression

There are several different types of depression that are dependent on how an individual's depression symptoms manifest themselves. Depression symptoms may vary in severity or in what is causing them. For instance, major depressive disorder (MDD) may have no identifiable cause, while postpartum depression is typically linked to pregnancy and childbirth.

Depressive symptoms may also be part of an illness called bipolar disorder. This includes fluctuations between depressive episodes and a state of extreme elation called mania. Bipolar disorder is a topic that offers many research opportunities, from its definition and its causes to associated risks, symptoms, and treatment.

Causes of Depression

The possible causes of depression are many and not yet well understood. However, it most likely results from an interplay of genetic vulnerability and environmental factors. Your depression research paper could explore one or more of these causes and reference the latest research on the topic.

For instance, how does an imbalance in brain chemistry or poor nutrition relate to depression? Is there a relationship between the stressful, busier lives of today's society and the rise of depression? How can grief or a major medical condition lead to overwhelming sadness and depression?

Who Is at Risk for Depression?

This is a good research question about depression as certain risk factors may make a person more prone to developing this mental health condition, such as a family history of depression, adverse childhood experiences, stress , illness, and gender . This is not a complete list of all risk factors, however, it's a good place to start.

The growing rate of depression in children, teenagers, and young adults is an interesting subtopic you can focus on as well. Whether you dive into the reasons behind the increase in rates of depression or discuss the treatment options that are safe for young people, there is a lot of research available in this area and many unanswered questions to consider.

Depression Signs and Symptoms

The signs of depression are those outward manifestations of the illness that a doctor can observe when they examine a patient. For example, a lack of emotional responsiveness is a visible sign. On the other hand, symptoms are subjective things about the illness that only the patient can observe, such as feelings of guilt or sadness.

An illness such as depression is often invisible to the outside observer. That is why it is very important for patients to make an accurate accounting of all of their symptoms so their doctor can diagnose them properly. In your depression research paper, you may explore these "invisible" symptoms of depression in adults or explore how depression symptoms can be different in children .

How Is Depression Diagnosed?

This is another good depression research topic because, in some ways, the diagnosis of depression is more of an art than a science. Doctors must generally rely upon the patient's set of symptoms and what they can observe about them during their examination to make a diagnosis.

While there are certain laboratory tests that can be performed to rule out other medical illnesses as a cause of depression, there is not yet a definitive test for depression itself.

If you'd like to pursue this topic, you may want to start with the Diagnostic and Statistical Manual of Mental Disorders (DSM). The fifth edition, known as DSM-5, offers a very detailed explanation that guides doctors to a diagnosis. You can also compare the current model of diagnosing depression to historical methods of diagnosis—how have these updates improved the way depression is treated?

Treatment Options for Depression

The first choice for depression treatment is generally an antidepressant medication. Selective serotonin reuptake inhibitors (SSRIs) are the most popular choice because they can be quite effective and tend to have fewer side effects than other types of antidepressants.

Psychotherapy, or talk therapy, is another effective and common choice. It is especially efficacious when combined with antidepressant therapy. Certain other treatments, such as electroconvulsive therapy (ECT) or vagus nerve stimulation (VNS), are most commonly used for patients who do not respond to more common forms of treatment.

Focusing on one of these treatments is an option for your depression research paper. Comparing and contrasting several different types of treatment can also make a good research title about depression.

A Word From Verywell

The topic of depression really can take you down many different roads. When making your final decision on which to pursue in your depression research paper, it's often helpful to start by listing a few areas that pique your interest.

From there, consider doing a little preliminary research. You may come across something that grabs your attention like a new study, a controversial topic you didn't know about, or something that hits a personal note. This will help you narrow your focus, giving you your final research title about depression.

Remes O, Mendes JF, Templeton P. Biological, psychological, and social determinants of depression: A review of recent literature . Brain Sci . 2021;11(12):1633. doi:10.3390/brainsci11121633

National Institute of Mental Health. Depression .

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition . American Psychiatric Association.

National Institute of Mental Health. Mental health medications .

Ferri, F. F. (2019). Ferri's Clinical Advisor 2020 E-Book: 5 Books in 1 . Netherlands: Elsevier Health Sciences.

By Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be.

227 Depression Research Topics & Essay Titles + Examples

If you’re looking for a good depression research title, you’re at the right place! StudyCorgi has prepared a list of titles for depression essays and research questions that you can use for your presentation, persuasive paper, and other writing assignments. Read on to find your perfect research title about depression!

🙁 TOP 7 Depression Title Ideas

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Impact of Depression on a Family
Depression: Case Conceptualization and Treatment Planning
Teenage Depression: Causes and Symptoms
The Concept of Postpartum Depression
Depression and Solutions in Psychiatry
Depression as It Relates to Obesity
Depression in the Contemporary Society
Transition Phase of Depression and Its’ Challenges Providing psychoeducation to people with mild to moderate depression, strategies for recognizing and addressing conflict and reluctance are discussed in this paper
Adolescent Mental Health: Depression This paper includes depression background discussion, including its signs, prevalence, diagnosis, and treatment, and a plan of treatment with three interventions to address this chronic health disease.
Social Media as a Cause of Anxiety and Depression Anxiety and depression are considerable problems for world society. Numerous studies have linked high social media use with high levels of anxiety and depression.
Major Types of Depression This paper will review and analyze two scholarly articles concerning depression, its sings in male and female patients, and its connection and similarity to other disorders.
Depression in the Elderly Depression can be defined as a state of anxiety, sadness, hopelessness, and worthlessness. It can affect people across all ages, who present with diverse signs and symptoms
Components of the Treatment of Depression The most effective ways of treating people with depression include pharmacotherapy, psychotherapy or a combination of both.
Action Research in Treating Depression With Physical Exercise Depression is one of the most common mental health disorders in the United States. The latest statistics showed that depression does not discriminate against age.
History and Treatment of Depression Depression is currently one of the most common medical conditions among the adult population in the US. The paper aims to investigate the history and treatment of depression.
Depression and Depressive Disorders Depression is one of the leading causes of disability in the world. Symptoms are feelings of sadness and guilt, changes in sleeping patterns changes in appetite, and other.
Smoking Cessation and Depression It was estimated that nicotine affects the human’s reward system. As a result, smoking cessation might lead to depression and other mental disorder.
Major Depression’ Symptoms and Treatment – Psychology A continuous sense of tiredness, unhappiness, and hopelessness are key signs of clinical or major depression. Such mood changes alter the daily life programs of an individual for sometimes.
The Causes of Depression and How to Overcome It In this self-reflection essay, the author describes the causes of his depression and the steps he is taking to overcome it.
Geriatric Depression Scale, Clock Drawing Test and Mini-Mental Status Examination Depression is a common condition among geriatric patients. Around 5 million older adults in the US experience significant morbidity from depression.
Mitigating Postnatal Depression in New Mothers: A Recreational Program Plan Post-natal depression is a popular form of depression in women. This paper presents an activity plan for the use of leisure as a therapeutic response to post-natal depression.
Application of Analysis of Variance in the Analysis of HIV/AIDS-Related Depression Cases Analysis of variance (ANOVA) is a commonly used approach in the testing of the equality of various means using variance.
Depression in Hispanic Culture There are different ways in which culture or ethnicity can impact the treatment of the development of mental health disorders.
Depression and Anxiety in Mental Health Nurses Depression and anxiety are the most common mental diseases in humans. Nurses who work in mental health are at significant risk of getting psychiatric illnesses.
“Yoga for Depression” Article by The Minded Institute One can say that depression is both the biological and mental Black Death of modern humanity in terms of prevalence and negative impact on global health.
The Rise of Depression in the Era of the Internet Understanding how the Internet affects human lives is essential in ascertaining the reasons for the growing loneliness in the intrinsically connected world.
Effects of Music Therapy on Depressed Elderly People Music therapy has been shown to have positive effects among people, and thus the aim was to assess the validity of such claims using elderly people.
Depression Among Rich People Analysis Among the myriad differences between rich and poor people is the manner in which they are influenced by and respond to depression.
Theories in Depression Treatment This study analyzes the theories pertinent to depression treatment, reviews relevant evidence, defines key concepts of the project, and explains the framework chosen for it.
Evidence-Based Pharmacology: Major Depression In this paper, a certain attention to different treatment approaches that can be offered to patients with depression will be paid, including the evaluation of age implications.
Predicting Barriers to Treatment for Depression Mental health issues such as depression and drug abuse are the most frequent among teenagers and young adults. In this age range, both disorders tend to co-occur.
Depression: Psychoeducational Intervention This paper considers the peculiarities of the application of psychoeducation in depression, including advantages, limitations, and ethical aspects.
African American Children Suffering From Anxiety and Depression Depression and anxiety are common among African American children and adolescents, and they face significant barriers to receiving care and treatment.
Post-operative Breast Cancer Patients With Depression: Annotated Bibliography This paper is an annotated bibliography about risk reduction strategies at the point of care: Post-operative breast cancer patients who are experiencing depression.
What Are the Characteristics and Causes of Depression?
Why Are Athletes Vulnerable to Depression?
Why and How Adolescents Are Affected by Generalized Anxiety Disorder and Clinical Depression?
Does Depression Assist Eating Disorders?
What Should You Know About Depression?
How Can Mother Nature Lower Depression and Anxiety?
How Can Video Games Relieve Stress and Reduce Depression?
When Does Teacher Support Reduce Depression in Students?
Why Are Teenagers Affected by Depression?
How Teens and Depression Today?
Are Mental Health Issues Like Depression Related to Race?
What Does Depression Mean?
How Did the Depression Affect France?
How Does Depression Stop?
When Postpartum Depression Leads to Psychosis?
How Do Medication and Therapy Combat Depression?
What Are the Leading Causes of Depression?
What About Drugs for Anxiety and Depression?
What’s the Big Deal About Anxiety and Depression in Students?
How Should Childhood Depression and Anxiety Be?
How Do Gender Stereotypes Warp Our View of Depression?
What Are the Signs of Teenage Depression?
Are Testosterone Levels and Depression Risk Linked Based on Partnering and Parenting?
How Psychology Helps People With Depression?
How Should Childhood Depression and Anxiety Be Treated or Dealt With?
Is Creativity A Modern Panacea From Boredom and Depression? Communication, daily life, and working patterns become nothing but fixed mechanisms that are deprived of any additional thoughts and perspectives.
Does Social Media Use Contribute to Depression? Social media is a relatively new concept in a modern world. It combines technology and social tendencies to enhance interaction through Internet-based gadgets and applications.
Depression and Other Antecedents of Obesity Defeating the inertia about taking up a regular programme of sports and exercise can be a challenging goal. Hence, more advocacy campaigns focus on doing something about obesity with a more prudent diet.
Baby Blues: What We Know About Postpartum Depression The term Postpartum Depression describes a wide variety of physical and emotional adjustments experienced by a significant number of new mothers.
Self-Esteem and Depression in Quantitative Research The topic that has been proposed for quantitative research pertains to the problem of the relationship between self-esteem and depression.
Treating Mild Depression: Psychotherapy and Pharmacotherapy The project intends to investigate the comparative effectiveness of the treatments that are currently used for mild depression.
Anxiety, Depression, and Post-Traumatic Stress Disorder Currently, many people experience anxiety, depression, and post-traumatic stress disorder that affect their general health.
Women’s Mental Health Disorder: Major Depression The mental health disorder paper aims to explore major depression, its symptoms, assessment, and intervention strategies appropriate for women.
Early Diagnosis of Depression Among Young Adults The purpose of this study was to discover sociodemographic and health traits related to depression sufferers’ usage of various mental health services.
Depression in Middle-Aged African Women The research study investigates depression in middle-aged African women because the mental health of the population is a serious concern of the modern healthcare sector.
Early Diagnosis of Depression Among Young Adults The paper shows a need for early identification of depression symptoms in primary care practice. PHQ-2 and PHQ-9 are useful tools for portraying symptoms.
Early Diagnosis of Depression: Public Health Depression in young adults has become a significant health problem across the US. It causes persistent feelings of loss of interest in activities and sadness.
Depression and Social Media in Scientific vs. Popular Articles The damage can come in the form of misinformation, which can result in an unjustified and unnecessary self-restriction of social media.
Depression in Adolescence: Causes and Treatment Depression amongst young adults at the puberty stage comes in hand with several causes that one cannot imagine, and depression happens or is triggered by various reasons.
Addressing Depression Among Native Youths The current paper aims to utilize a Medicine Wheel model and a social work paradigm to manage depression among Native American Indian youths.
Psychological Assessments and Intervention Strategies for Depression The article presents two case studies highlighting the importance of psychological assessments and intervention strategies for individuals experiencing depression.
The Impact of Postpartum Maternal Depression on Postnatal Attachment This paper examines the influence of postpartum maternal depression on postnatal infant attachment, discusses the adverse effects of depression on attachment.
Marijuana Effects on Risk of Anxiety and Depression The current paper aims to find out whether medical cannabis can positively affect anxiety and depression and the process of their treatment.
Cognitive Behavioral Therapy for Anxiety and Depression Cognitive behavioral therapy analyzes the unconscious processes influencing the normal functioning of the human body, causing different pathologies.
Hypnotherapy as an Effective Method for Treating Depression This paper explores the use of hypnotherapy as a treatment for depression and highlights the advantages of hypnosis in addressing depressive symptoms.
Depression and Anxiety: Mary’s Case Mary’s husband’s death precipitated her depression and anxiety diagnosis. She feels lonely and miserable as she struggles with her daily endeavors with limited emotional support.
Postpartum Depression in Women and Men The focus of the paper is health problems that affect women after giving birth to a child, such as depression. The author proposes that men also experience postpartum depression.
Repression and Depression in “The Yellow Wallpaper” by Charlotte Perkins Gilman In “The Yellow Wallpaper” by Charlotte Perkins Gilman, the author highlighted the connection between repression and depression.
Men and Depression: Signs, Symptoms, Causes, and Treatment Depression in men and women has several incompatibilities as males suffer from health problems more often than women as they rarely express their emotions.
Promotion of Change Regarding Adolescent Depression In the essay, the author describes the methods to evaluate the symptoms of a patient who has been referred for counseling with depression.
Interventions to Cope With Depression Depression is characterized by sadness, anxiety, feelings of worthlessness, and helplessness. These feelings do not necessarily relate to life events.
Bipolar Depression and Bipolar Mania Although all bipolar disorders are characterized by periods of extreme mood, the main difference between them is the severity of the condition itself.
Post-Stroke Anxiety and Depression The purpose of the given study is to ascertain how cognitive behavior therapy affects individuals with post-stroke ischemia in terms of depression reduction.
Depression and Anxiety Management The medical staff will investigate the treatment modalities currently being utilized for the large population of patients experiencing symptoms of anxiety and depression.
Impacts of Stress of Low Income on the Risk of Depression in Children Socioeconomic hardships lead to a decline in the quality of parenting and the development of psychological and behavioral problems in children.
Depression: Diagnostics and Treatment Depression, when it remains unchecked, can cause detrimental effects to individuals, such as suicide, which will eventually equate to mental disorders.
Psychedelics in Depression and Anxiety Treatment Mental illnesses have become an essential part of health in the last few decades, with sufficient attention being devoted to interventions that resolve them.
Depression and Anxiety Among African-American Children Depression and anxiety are common among African-American children and adolescents, but they face significant barriers to receiving care and treatment due to their age and race.
Why Are Physical Activities Treatments for Depression? In this paper, the connection between physical activities and depression will be analyzed, and the common counterargument will be discussed.
Is depression a biological condition or a result of unrealistic expectations?
Should employers be legally required to provide support to workers with depression?
Do the media portrayals of depression accurately reflect people’s experiences?
Social media contributes to depression rates by eliciting the feeling of loneliness.
Should mental health screening be mandatory in schools?
Should depression be reclassified as a neurological disorder?
Antidepressants are an overused quick-fix solution to depression.
Should non-pharmacological treatments for depression be prioritized?
Should depression be considered a disability?
The use of electroconvulsive therapy for depression should be banned.
Depression in the Older Population The paper discusses depression is an actual clinical disorder for older people with specific reasons related to their age.
Nutrition and Depression: A Psychological Perspective When discussing nutrition in toddlers and certain behavioral patterns, one of the first standpoints to pay attention to is the humanistic perspective.
Social Media and Depression in Adolescents: The Causative Link This paper explores how social media causes depression in adolescents during the social-emotional stage of life.
Physical Activities as Treatment for Depression This paper will discuss what factors are improved via physical exercise and how they help with treating depression.
Therapeutic Interventions for the Older Adult With Depression and Dementia The paper researches the therapeutic interventions which relevant for the older people with depression and dementia nowadays.
Depression Among Patients With Psoriasis Considering psoriasis as the cause of the development of depressive disorders, many researchers assign a decisive role to the severe skin itching that accompanies psoriasis.
Qi Gong Practices’ Effects on Depression Qi Gong is a set of physical and spiritual practices aimed at the balance of mind, body, and soul and the article demonstrates whether it is good or not at treating depression.
The Effects of Forgiveness Therapy on Depression for Women The study analyzes the impact of forgiveness therapy on the emotional state of women who have experienced emotional abuse.
Relation Between the COVID-19 Pandemic and Depression The paper is to share an insight into the detrimental effects of the COVID-19 pandemic on the mental health of thousands of people and provide advice on how to reduce its impact.
How Covid-19 Isolation Contributed to Depression and Adolescent Suicide The pandemic affected adolescents because of stringent isolation measures, which resulted in mental challenges such as depression and anxiety, hence suicidal thoughts.
Depression and Anxiety in Older Generation Depression and anxiety represent severe mental disorders that require immediate and prolonged treatment for patients of different ages.
Coping with Depression After Loss of Loved Ones This case is about a 60-year-old man of African American origin. He suffered from depression after his wife’s death, which made him feel lonely and isolated.
Postpartum Depression Screening Program Evaluation In order to manage the depression of mothers who have just delivered, it is important to introduce a routine postpartum depression-screening program in all public hospitals.
Depression: Symptoms, Causes and Treatment Depression interferes with daily routine, wasting valuable time and lowering production. Persistent downs or blues, sadness, and anger may be signs of depression.
Adolescent Males With Depression: Poly-Substance Abuse Depression is the most crucial aspect that makes young males indulge in poly-substance abuse. There are various ways in which male adolescents express their depression.
The Health of the Elderly: Depression and Severe Emotional Disturbance This study is intended for males and females over the age of 50 years who are likely to suffer from depression and severe emotional disturbance.
Suicidal Ideation & Depression in Elderly Living in Nursing Home vs. With Family This paper attempts to compare the incidence of suicidal ideation and depression among elderly individuals living in nursing homes and those living with family in the community.
Major Depression: Symptoms and Treatment Major depression is known as clinical depression, which is characterized by several symptoms. There are biological, psychological, social, and evolutionary causes of depression.
Health Disparity Advocacy: Clinical Depression in the U.S. Recent statistics show that approximately more than 10 million people suffer from severe depression each year in the U.S..
Serum Neurotrophic Factors in Adolescent Depression by Pallavi et al. The research hypothesis of the article is to compare the serum concentration of neurotrophic factors in depression patients and healthy control.
The Treatment of Anxiety and Depression The meta-analysis provides ample evidence, which indicates that CES is not only effective but also safe in the treatment of anxiety and depression.
Depression Intervention Among Diabetes Patients The research examines the communication patterns used by depression care specialist nurses when communicating with patients suffering from diabetes.
Postnatal Depression in New Mothers and Its Prevention Leisure activities keep new mothers suffering from postnatal depression busy and enable them to interact with other members of the society.
Literature Evaluation on the Depression Illness The evaluation considers the articles that study such medical illness as depression from different planes of its perception.
Treatment of Major Depression The purpose of the paper is to identify the etiology and the treatment of major depression from a psychoanalytic and cognitive perspective.
Edinburgh Depression Screen for Treating Depression Edinburgh Depression screen is also known as Edinburgh Postnatal Depression Scale which is used to screen pregnant and postnatal women for emotional distress.
Depression Treatment Variants in the US There is a debate regarding the best formula for depression treatment whereby some argue for using drugs, whereas others are advocating for therapy.
Depression in the Elderly: Treatment Options Professionals may recommend various treatment options, including the use of antidepressants, psychotherapy such as cognitive-behavioral therapy.
Depression Treatments and Therapeutic Strategies This article examines the effectiveness of different depression treatments and reviews the therapeutic strategies, which can be helpful if the initial treatment fails.
Depression and the Nervous System Depression is a broad condition that is associated with failures in many parts of the nervous system. It can be both the cause and the effect of this imbalance.
Depression: Types, Symptoms, Etiology & Management Depression differs from other disorders, connected with mood swings, and it may present a serious threat to the individual’s health condition.
The Effect of Music Therapy on Depression One major finding of study is that music therapy alleviates depression among the elderly. Music therapy could alleviate depression.
Post-Natal Depression as an Affective Disorder Postpartum or post-natal depression (PPD) is a serious issue that can potentially be destructive to both infant and mother.
“Neighborhood Racial Discrimination and the Development of Major Depression” by Russell The study investigates how neighborhood racial discrimination influences this severe mental disorder among African American Women.
Can physical exercise alone effectively treat depression?
Art therapy as a complementary treatment for depression.
Is there a link between perfectionism and depression?
The influence of sleep patterns on depression treatment outcomes.
Can exposure to nature and green spaces decrease depression rates in cities?
The relationship between diet and depression symptoms.
The potential benefits of psychedelic-assisted therapy in treating depression.
The role of outdoor experiences in alleviating depression symptoms.
The relationship between depression and physical health in older adults.
The role of workplace culture in preventing employee depression.
Adolescent Depression and Physical Health Depression in adolescents and young people under 24 is a factor that affects their physical health negatively and requires intervention from various stakeholders.
Family Support to a Veteran With Depression Even the strongest soldiers become vulnerable to multiple health risks and behavioral changes, and depression is one of the problems military families face.
Alcohol and Depression Article by Churchill and Farrell The selected article for this discussion is “Alcohol and Depression: Evidence From the 2014 Health Survey for England” by Sefa Awaworyi Churchill and Lisa Farrell.
Negative Effects of Depression in Adolescents on Their Physical Health Mental disorders affect sleep patterns, physical activity, digestive and cardiac system. The purpose of the paper to provide information about adverse impacts of depression on health.
Elderly Depression: Symptoms, Consequences, Behavior, and Therapy The paper aims to identify symptoms, behavioral inclinations of older adults, consequences of depression, and treatment ways.
Depression in Feminist Literature of the 1890s The aim of the work is to analyze the cause of female sickness, which is their inability to express themselves and the pitiful place of a female in the society of that time.
Major Depression Disorder: Causes and Treatment Loss in weight and appetite are some of the symptoms that a patient diagnosed with Major Depression Disorder could manifest.
Mood Disorders: Depression Concepts Description The essay describes the nature of depression, its causes, characteristics, consequences, and possible ways of treatment.
Geriatric Depression Diagnostics Study Protocol The research question is: how does the implementation of the National Institute for Health and Care Excellence guidelines affect the accuracy of diagnosing of depression?
Mental Health Association of Depression and Alzheimer’s in the Elderly Depression can be a part of Alzheimer’s disease. Elderly people may have episodes of depression, but these episodes cannot be always linked to Alzheimer’s disease.
Protective Factors Against Youthful Depression Several iterations of multiple correlation, step-wise and hierarchical regression yielded inconclusive results about the antecedents of youthful depression.
Depression and Related Psychological Issues Depression as any mental disorder can be ascribed, regarding the use of psychoanalysis, to a person`s inability to control his destructive or sexual instincts or impulses.
Television Habituation and Adolescent Depression The paper investigates the theory that there is a link between heavy TV viewing and adolescent depression and assess the strength of association.
Physiological Psychology. Postpartum Depression Depression is a focal public health question. In the childbearing period, it is commoner in females than in males with a 2:1 ratio.
Adolescent Depression: Modern Issues and Resources Teenagers encounter many challenging health-related issues; mental health conditions are one of them. This paper presents the aspects of depression in adolescents.
Occupational Psychology: Depression Counselling The case involves a 28-year-old employee at Data Analytics Ltd. A traumatic event affected his mental health, causing depression and reduced performance.
Psychotherapeutic Group: Treatment of Mild-To-Moderate Depression The aim of this manual is to provide direction and employ high-quality sources dedicated to mild-to-moderate depression and group therapy to justify the choices made for the group.
“Depression and Ways of Coping With Stress” by Orzechowska et al. The study “Depression and Ways of Coping With Stress” by Orzechowska et al. aimed the solve an issue pertinent to nursing since depression can influence any patient.
Postpartum Depression: Evidence-Based Practice Postpartum or postnatal depression refers to a mood disorder that can manifest in a large variety of symptoms and can range from one person to another.
Effectiveness of Telenursing in Reducing Readmission, Depression, and Anxiety The project is dedicated to testing the effectiveness of telenursing in reducing readmission, depression, and anxiety, as well as improving general health outcomes.
Adult Depression Treatment in the United States This study characterizes the treatment of adult depression in the US. It is prompted by the findings of earlier studies, which discover the lack of efficient depression care.
Nurses’ Interventions in Postnatal Depression Treatment This investigation evaluates the effect of nurses’ interventions on the level of women’s postnatal depression and their emotional state.
Postpartum Depression: Evidence-Based Care Outcomes In this evidence-based study, the instances of potassium depression should be viewed as the key dependent variable that will have to be monitored in the course of the analysis.
Postpartum Depression: Diagnosis and Treatment This paper aims to discuss the peculiarities of five one-hour classes on depression awareness, to implement this intervention among first-year mothers, and to evaluate its worth during the first year after giving birth.
Homelessness and Depression Among Illiterate People There are various myths people have about homelessness and depression. For example, many people believe that only illiterate people can be homeless.
Postpartum Depression In First-time Mothers The most common mental health problem associated with childbirth remains postpartum depression, which can affect both sexes, and negatively influences the newborn child.
The Diagnosis and Treatment of Postpartum Depression Postpartum depression has many explanations, but the usual way of referring to this disease is linked to psychological problems.
What Is Postpartum Depression? Causes, Symptoms, and Treatment The prevalence of postpartum depression is quite high as one in seven new American mothers develops this health issue.
Depression in Adolescence as a Contemporary Issue Depression in adolescents is not medically different from adult depression but is caused by developmental and social challenges young people encounter.
Predictors of Postpartum Depression The phenomenon of postpartum depression affects the quality of women’s lives, as well as their self-esteem and relationships with their child.
Depression and Self-Esteem: Research Problem Apart from descriptively studying the relationship between depression and self-esteem, a more practical approach can be used to check how interventions for enhancing self-esteem might affect depression.
The Relationship Between Depression and Self-Esteem The topic which is proposed to be studied is the relationship between depression and self-esteem. Self-esteem can be defined as individual’s subjective evaluation of his or her worth.
The Impact of Depression on Motherhood This work studies the impact of depression screening on prenatal and posts natal motherhood and effects on early interventions using a literature review.
Depression and Workplace Violence The purpose of this paper is to provide an in-depth analysis how can workplace violence and verbal aggression be reduced or dealt with by employees.
Depression in Female Cancer Patients and Survivors Depression is often associated with fatigue and sleep disturbances that prevent females from thinking positively and focusing on the treatment and its outcomes.
Depression in Cardiac or Diabetic Patients The paper develops a framework through which risk factors associated with the development of MDD among adult patients with heart disease or diabetes can be easily identified.
The Geriatric Population’s Depression This paper discusses how does the implementation of National Institute for Health and Care guidelines affect the accuracy of diagnosing of depression in the geriatric population.
Problem of Depression: Recognition and Management Depression is a major health concern, which is relatively prevalent in the modern world. Indeed, in the US, 6.7 % of adults experienced an episode of the Major Depressive Disorder in 2015.
Health and Care Excellence in Depression Management The introduction of the National Institute for Health and Care Excellence guidelines can affect the accuracy of diagnosing and quality of managing depression.
Impact of COVID-19 on Depression and Suicide Rates among Adolescents and Young People The purpose of this paper is to explore the influence of coronavirus on these tragic numbers.
Mild Depression: Psychotherapy or Pharmacotherapy The research question in this paper is: in psychiatric patients with mild depression, what is the effect of psychotherapy on health compared with pharmacotherapy?
Postpartum Bipolar Disorder and Depression The results of the Mood Disorder Questionnaire screening of a postpartum patient suggest a bipolar disorder caused by hormonal issues and a major depressive episode.
Bipolar Disorder or Manic Depression Bipolar disorder is a mental illness characterized by unusual mood changes that shift from manic to depressive extremes. In the medical field, it`s called manic depression.
The Improvement of Depression Management The present paper summarizes the context analysis that was prepared for a change project aimed at the improvement of depression management.
Depression Management in US National Guidelines The project offers the VEGA medical center to implement the guidelines for depression management developed by the National Institute for Health and Care Excellence.
Women’s Health and Major Depression Symptoms The client’s complaints refer to sleep problems, frequent mood swings (she gets sad a lot), and the desire to stay away from social interactions.
Predictors of Postpartum Depression: Who Is at Risk? The article “Predictors of Postpartum Depression” by Katon, Russo, and Gavin focuses on the identification of risk factors related to postnatal depression.
Depression and Its Treatment: Racial and Ethnic Disparities The racial and ethnic disparities in depression treatment can be used for the development of quality improvement initiatives aimed at the advancement of patient outcomes.
Lamotrigine for Bipolar Depression Management Lamotrigine sold as Lamictal is considered an effective medication helping to reduce some symptoms that significantly affect epileptic and bipolar patients’ quality of life.
Citalopram, Methylphenidate in Geriatric Depression Citalopram typically ranges among 10-20 antidepressants for its cost-effectiveness and positive effect on patients being even more effective than reboxetine and paroxetine.
Depression and Self-Esteem Relationship Self-esteem can be defined as an “individual’s subjective evaluation of his or her worth as a person”; it does not necessarily describe one’s real talents.
Postpartum Depression: Methods for the Prevention Postpartum depression is a pressing clinical problem that affects new mothers, infants, and other family members. The prevalence of postpartum depression ranges between 13 and 19 percent.
Anxiety and Depression Among Females with Cancer The study investigated the prevalence of and the potential factors of risk for anxiety and/or depression among females with early breast cancer during the first 5 years.
Post-Partum Depression and Perinatal Dyadic Psychotherapy Post-partum depression affects more than ten percent of young mothers, and a method Perinatal Dyadic Psychotherapy is widely used to reduce anxiety.
VEGA Medical Center: Detection of Depression Practice guidelines for the psychiatric evaluation of adults, and they can be employed to solve the meso-level problem of the VEGA medical center and its nurses.
The Postnatal (Postpartum) Depression’ Concept Postnatal or postpartum depression (PPD) is a subtype of depression which is experienced by women within the first half a year after giving birth.
Depression in Obstetrics and Gynecology: Research This essay analyzes a clinical research article “Improving care for depression in obstetrics and gynecology: A randomized controlled trial” by Melville et al.
Postpartum Depression, Prevention and Treatment Postpartum depression is a common psychiatric condition in women of the childbearing age. They are most likely to develop the disease within a year after childbirth.
Smoking Cessation and Depression Problem The aim of the study is to scrutinize the issues inherent in the process of smoking cessation and align them with the occurrence of depression in an extensive sample of individuals.
The Efficacy of Medication in Depression’ Treatment This paper attempts to provide a substantial material for the participation in an argument concerning the clinical effectiveness of antidepressant medications.
Depression and Cognitive Psychotherapy Approaches Cognitive psychotherapy offers various techniques to cope with emotional problems. This paper discusses the most effective cognitive approaches.
Treatment of Depression in Lesbians The aim of this paper is to review a case study of 45 years old lesbian woman who seeks treatment for depression and to discuss the biophysical, psychological, sociocultural, health system.
Women’s Health: Predictors of Postpartum Depression The article written by Katon, Russo, and Gavin is focused on women’s health. It discusses predictors of postpartum depression (PPD), including sociodemographic and clinic risk factors.
Depression Treatment and Management Treatment could be started only after patient is checked whether he has an allergy to the prescribed pills or not. If he is not allergic, he should also maintain clinical tests for depression.
Depression and Thyroid Issues in Young Woman Young people are busy at studies or at work and do not pay much attention to primary symptoms unless they influence the quality of life.
Counseling Depression: Ethical Aspects This paper explores the ethical aspects required to work with a widower who diminished passion for food, secluding himself in the house, portraying signs of depression.
Postpartum Depression as Serious Mental Health Problem The research study aimed to evaluate the effectiveness of a two-step behavioral and educational intervention on the symptoms of postpartum depression in young mothers.
European Alliances, Wars, Dictatorships and Depression The decades leading to World War I had unusual alignments. The European nations were still scrambling for Asia, Africa and parts of undeveloped Europe.
Women’s Health: Depression as a Psychological Factor Women who identify themselves as lesbian are likely to experience depression. Biophysical, psychological, sociocultural, behavioral, and health system factors should be taken into consideration.
Childhood Obesity and Depression Intervention The main intervention to combat depressive moods in adolescents should be linked to improving the psychological health of young people in cooperation with schools.
Postnatal Depression Prevalence and Effects The paper analyzes the prevalence and risk factors of Postnatal (Postpartum) Depression as well as investigates the effect on the newborns whose mothers suffer from this condition.
Depression in Older Adults Depression is one of the most common mental illnesses in the world. Evidence-based holistic intervention would provide more effective treatment for elderly patients with depression.
Placebo and Treatments for Depression Natural alternative treatments for depression actually work better than the biochemical alternatives like antidepressants.
Care for Depression in Obstetrics and Gynecology This work analyzes the article developed by Melville et al. in which discusses the theme of depression in obstetrics and gynecology and improving care for it.
Depression Screening in Primary Care Screening for depression in patients suffering from long term conditions (LTCs) or persistent health problems of the body, could largely be erroneous.
Patients with Depression’ Care: Betty Case Betty, a 45 years old woman, is referred to a local clinic because of feeling depressed. She has a history of three divorces and thinks that she is tired of living the old way.
Clinical Depression Treatment: Issues and Solvings The paper describes and justifies the design selected for research on depression treatment. It also identifies ethical issues and proposes ways of addressing them.
Depression in Older Persons – Psychology This article presents the research findings of a study conducted in Iran to assess how effective integrative and instrumental therapies are in the management of depression in older persons.
Depression in the Elderly – Psychology This paper discusses how a person would know whether a relative had clinical depression or was sad due to specific changes or losses in life.
Postnatal Depression: Prevalence of Postnatal Depression in Bahrain The study was aimed at estimating the prevalence of postnatal depression among 237 Bahraini women who attended checkups in 20 clinical centres over a period of 2 months.

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These essay examples and topics on Depression were carefully selected by the StudyCorgi editorial team. They meet our highest standards in terms of grammar, punctuation, style, and fact accuracy. Please ensure you properly reference the materials if you’re using them to write your assignment.

This essay topic collection was updated on January 22, 2024 .

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Acta Biomed
v.92(3); 2021

A breakthrough in research on depression screening: from validation to efficacy studies

Luigi costantini.

1 Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy

Alessandra Costanza

2 Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland

3 Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy

4 Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy

Andrea Aguglia

5 Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy

6 IRCCS Ospedale Policlinico San Martino, Genoa, Italy

Andrea Escelsior

Gianluca serafini, mario amore, andrea amerio.

In the last two decades the awareness of depression as a public health issue has increased and the literature has flourished towards its primary and secondary prevention. Whereas timely targeting of depression risk factors is a frontier towards reducing the incidence of the disorder, nowadays the early diagnosis is of primary importance. Screening depressive disorders is paramount, since there are several types of depression. Besides, early diagnosis would improve the outcome of treatment, reduce the frequency of relapses and generally lead to higher levels of quality of life. We highlight the feasibility of depression screening in primary care and the need of a comprehensive public health approach. ( www.actabiomedica.it )

Introduction

Depression affects more than two hundred sixty million people across the world and is a leading cause of disability ( 1 ). The estimated prevalence of depressive disorders in 2016 was 3,627 per 100,000 and in the last decade the number of all-age years lived with disability (YLDs) increased of 14% ( 2 , 3 ). Resulting from a complex interaction of social, psychological and biological factors, depressive symptoms first appear during the late teens to mid-20s, they are often overlooked and untreated and they are accompanied by poor functioning. At its worst, depression can lead to suicide, the second leading cause of death in 15-29-year-olds ( 4 , 5 ).

Depressive disorders are independent risk factors for chronic diseases, such as cardiovascular diseases and diabetes, and are associated with elevated risk of early death ( 6 , 7 ). In 2016, depressive disorders caused the loss of an overall age-adjusted rate of 526 per 100,000 disability-adjusted life years (DALYs), being the most contributor to DALYs loss among mental and behavioural disorders ( 2 ). Encouraging self-care and positive lifestyle changes especially in vulnerable segments of population can help improve, resolve or prevent depression ( 8 , 9 ).

Reduced educational achievements, poor financial success and role performance, higher amount of days out of role, and increased risk of job loss represent the social costs of depression ( 10 ). Depressive disorders bring about direct and indirect costs ( 11 ). The overall costs of depression in Europe lay around €92 billion a year, much of which caused by loss of productivity ( 12 ).

In the last two decades the awareness of depression as a public health issue has increased and the literature has flourished towards its primary and secondary prevention ( 13 ). Whereas timely targeting of depression risk factors is a frontier towards reducing the incidence of the disorder, nowadays the early diagnosis is of primary importance ( 14 ).

Screening depressive disorders is paramount, as there are several types of depression that can affect the most vulnerable individuals ( 15 , 16 ).

For example, bipolar disorder usually presents with depressive symptoms and it is common to misidentify it with major depressive disorder, a diagnosis that can negatively influence the pharmacological treatment worsening the course of illness ( 17 ) and promoting mood instability especially in presence of comorbidities ( 18 - 20 ).

Therefore, early diagnosis would improve the outcome of treatment, reduce the frequency of relapses and generally lead to higher levels of quality of life.

The present paper would like to highlight the feasibility of depression screening in primary care and the need of a comprehensive public health approach in order to develop an in-field knowledge of the real outcomes of depression screening.

Is depression screening feasible?

In the last two decades, different screening tools have been validated in primary care settings. Recent systematic reviews and meta-analyses provided an overview to the psychometric properties of widely applied depression screening tools defining the Patient Health Questionnaire 9 (PHQ-9) as the most valid one in terms of sensitivity and specificity ( 21 , 22 ). Short Likert-scale questionnaire, like PHQ-9 and PHQ-8, have been successfully used ( 23 ), while scarce evidence accounts for the widespread primary care use of ultra-short screening tools (i.e. PHQ-2) ( 21 ).

Screening tools are rather easy to use, since they consist in structured questionnaires charted either by health care professionals, caregivers, or patients themselves. PHQ-9 is being used in higher income countries as well as in the lower ones ( 21 ). Depression screening fits the need of low-resource settings by promoting the task sharing ( 24 ).

Theoretically speaking, depression screening implies very low costs, since the process could be easily performed in the context of the routine activity of general practices. Nevertheless, few studies analysed the cost-effectiveness of the screening process.

Some researchers rose concerns on the lack of evidence of screening harmlessness: the psychological consequences of a false positive, as well as the risks and costs of over-diagnosis, require careful in-field analysis ( 25 ).

Standardising the diagnostic approach to psychiatric disorders is challenging. The more common screening tools have been developed for adult patients use in Western, high-income countries. Discrepancies have therefore come to light between rigid symptom definitions and different framework of illness depending on the social and cultural background as well as the age of the patients ( 26 , 27 ). Screening tools are flexible enough to be adapted to specific situations.

However, homogeneity must be a priority in order to produce high quality evidence.

The answer to the issues above, and many others, go along with two assumptions. First, screening is useless without in-depth diagnostic confirmation. The results of screening should never be proposed as a diagnosis. On the contrary, the screening process should always include the referral to a Mental Health Professional. Second, our knowledge of screening functioning is limited by the lack of longitudinal studies. Cross-sectional studies have been able to widely validate the screening tools in different countries. From now on, research should be directed toward a better comprehension of the impact of the screening on the efficacy of treatment and the quality of health services.

Screening: a first step against stigma and toward curing

Depression is a pathology largely still affected by stigma in many cultures ( 2 ). The administration of a questionnaire might help primary care practitioners to break the wall of stigma.

Screening tools, as the PHQ-9, offer a clear description of the main features of depressive disorders. Patients charting the questionnaire might discover aspects of the illness they have never known. Thus, patients would be able to recognize depressive symptoms in themselves and others and act as caregivers. PHQ-9 administration to adolescents highlighted the increased self-awareness of depressive symptoms ( 27 ). Therefore, depression screening might become a direct way towards therapeutic education, health literacy and patients’ empowerment.

Directions for future research

The accuracy of screening tools has been already widely investigated ( 21 ). Actual research questions are represented by the efficacy of screening protocols, the impact of screening on patients’ life and the cost-effectiveness of a widespread screening program.

It is clear that cross-sectional studies are not adequate to answer those questions and longitudinal protocols must be implemented. Screening protocols should be standardised in order to increase homogeneity across different studies ( 20 ). Some lessons can be learned from the literature to be applied in future studies.

The available literature suggests the use of PHQ-8 as a standard screening tool for depression in primary care ( 23 ). PHQ-8 is widely used, straightforward and highly consistent with the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders. A two-stage screening model has been implemented by several studies and should be adopted. Semi-structured diagnostic interview, i.e., the SCID and the SCAN, performed the most accurate diagnoses ( 28 ).

The questionnaire can be charted either by the patients themselves or by general practitioners, health care professionals, and lay health workers. The demographic questionnaire should include the past medical history with special stress on mental disorders, known depression risk factors as housing, instruction, employment, and health insurance coverage. Questionnaires should be adapted to be easily understood by all the patients, according to their age, culture and educational level.

Longitudinal protocols should include the most appropriate treatment for each case. Patients should be followed up and outcomes as reduction of morbidity and mortality, reduced DALYs, and increased social functioning, should be measured. The general practitioners would have a key role in explaining the process, revising the screening results, deepening the clinical investigation and reassuring about the possibility of false positives.

Digital technologies have been effectively implemented in only few studies ( 29 ). Technology could streamline procedures and make screening sustainable to the organizational needs of primary care practices and speed up data processing ( 30 ). Organizational factors, cost-effectiveness and compliance predictors should be properly included in research protocols.

Conclusions

The gap in evidence of primary care depression screening concerns its efficacy rather than its validity or safety. Different skills are necessary to produce high quality scientific evidence. We encourage epidemiologists, psychiatrists, and general practitioners to team up, in accordance with the translational research approach, to address the research questions about depression prevention.

Acknowledgements:

This work was developed within the framework of the DINOGMI Department of Excellence of MIUR 2018-2022 (Law 232/2016).

Conflicts of interest:

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article.

Author contributions:

Authors LC, AC, AO, AAg, AE, and AAm wrote the first draft of the manuscript. GS and MA carefully revised the final version of the manuscript. Our manuscript has been approved by all authors.

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Frequently Asked Questions about Depression

Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.

Impactful Depression Research Discoveries by Foundation Grantees:

Rapid-Acting Antidepressant Heralded as Biggest Breakthrough in Depression Research in 50 years
Development of TMS for Treatment-Resistant Depression
Interactive Parent-Child Therapy Reduced Depression Symptoms in Very Young Children
Foundation Grantee Shows Treating Inflammation May Improve Resistant Depression

Recent Depression Research Discoveries by Foundation Grantees:

Impact of Mother’s Depressive Symptoms Just Before and After Childbirth Upon Child’s Brain Development
Study Links Brain Connectivity Patterns with Response to Specific Antidepressant and Placebo
Over Two Decades, 90 BBRF Grants Helped Build a Scientific Foundation for the First Rapid-Acting Antidepressants
After 60 Years, Study Finds Children of Mothers with Bacterial Infections During Pregnancy Have Elevated Psychosis Risk

For more lay-friendly, summarized Depression Research Discoveries, click here .

Clinical depression is a serious condition that negatively affects how a person thinks, feels, and behaves. In contrast to normal sadness, clinical depression is persistent, often interferes with a person’s ability to experience or anticipate pleasure, and significantly interferes with functioning in daily life. Untreated, symptoms can last for weeks, months, or years; and if inadequately treated, depression can lead to significant impairment, other health-related issues, and in rare cases, suicide.

A person is diagnosed with a major depression when he or she experiences at least five of the symptoms listed below for two consecutive weeks. At least one of the five symptoms must be either (1) depressed mood or (2) loss of interest or pleasure. Symptoms include:

Depressed mood most of the day, nearly every day
Markedly diminished interest or pleasure in activities most of the day, nearly every day
Changes in appetite that result in weight losses or gains unrelated to dieting
Changes in sleeping patterns
Loss of energy or increased fatigue
Restlessness or irritability
Feelings of anxiety
Feelings of worthlessness, helplessness, or hopelessness
Inappropriate guilt
Difficulty thinking, concentrating, or making decisions
Thoughts of death or attempts at suicide

The first step to being diagnosed is to visit a doctor for a medical evaluation. Certain medications, and some medical conditions such as thyroid disorder, can cause similar symptoms as depression. A doctor can rule out these possibilities by conducting a physical examination, interview and lab tests. If the doctor eliminates a medical condition as a cause, he or she can implement treatment or refer the patient to a mental health professional. Once diagnosed, a person with depression can be treated by various methods. The mainstays of treatment for depression are any of a number of antidepressant medications and psychotherapy, which can also be used in combination.

For severe, treatment-resistant depression, studies have been done showing Deep Brain Stimulation may be an option. Learn more in this webinar featuring Dr. Helen Mayberg :

Depression is twice as common among women as among men. About 20 percent of women will experience at least one episode of depression across their lifetime. Scientists are examining many potential causes for and contributing factors to women’s increased risk for depression. Biological, life cycle, hormonal and psychosocial factors unique to women may be linked to women’s higher depression rates. Researchers have shown, for example, that hormones affect brain chemistry, impacting emotions and mood. Before adolescence, girls and boys experience depression at about the same frequency. By adolescence, however, girls become more likely to experience depression than boys. Research points to several possible reasons for this imbalance. The biological and hormonal changes that occur during puberty likely contribute to the sharp increase in rates of depression among adolescent girls. In addition, research has suggested that girls are more likely than boys to continue feeling bad after experiencing difficult situations or events, suggesting they are more prone to depression.

Women are particularly vulnerable to depression after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming. Many new mothers experience a brief episode of mild mood changes known as the “baby blues.” These symptoms usually dissipate by the 10th day. PPD lasts much longer than 10 days, and can go on for months following child birth. Acute PPD is a much more serious condition that requires active treatment and emotional support for the new mother. Some studies suggest that women who experience PPD often have had prior depressive episodes.

Menopause is defined as the state of an absence of menstrual periods for 12 months. Menopause is the point at which estrogen and progesterone production decreases permanently to very low levels. The ovaries stop producing eggs and a woman is no longer able to get pregnant naturally. During the transition into menopause, some women experience an increased risk for depression. Scientists are exploring how the cyclical rise and fall of estrogen and other hormones may affect the brain chemistry that is associated with depressive illness.

For older adults who experience depression for the first time later in life, other factors, such as changes in the brain or body, may be at play. For example, older adults may suffer from restricted blood flow, a condition called ischemia. Over time, blood vessels become less flexible. They may harden and prevent blood from flowing normally to the body’s organs, including the brain. If this occurs, an older adult with no family or personal history of depression may develop what some doctors call “vascular depression.” Those with vascular depression also may be at risk for a coexisting cardiovascular illness, such as heart disease or a stroke.

Researchers are looking for ways to better understand, diagnose and treat depression among all groups of people. Studying strategies to personalize care for depression, such as identifying characteristics of the person that predict which treatments are more likely to work, is an important goal.

The ability of ketamine to produce a rapid and efficacious antidepressant response by a completely novel mechanism is considered by many experts the most important finding in the depression field in 50 years. Originally developed as an anesthetic, ketamine is an antagonist of the NMDA receptor on a subset of brain cells. It often produces rapid (within hours) antidepressant actions in patients who have failed to respond to conventional antidepressants (i.e., are considered treatment-resistant). Ketamine is psychoactive and has potentially dangerous side effects; it has a past history of being abused as a street drug. Studies aimed at characterizing the mechanisms by which ketamine works rapidly and effectively in severely depressed individuals is likely to lead to novel targets and agents that are safer and more long-lasting, and could revolutionize the treatment of depression. Numerous BBRF Grants support this work , including a number that are attempting to develop ketamine analogs – compounds that act like ketamine but lack its side-effects.

Treatment-resistant depression (TRD) is a term used in clinical psychiatry to describe cases of major depressive disorder that do not respond to standard treatments (at least two courses of antidepressant treatments). For many people, antidepressant treatment and/or ‘talk’ therapy (such as Cognitive Behavioral Therapy) ease symptoms of depression, but with treatment-resistant depression, little to no relief is realized. Treatment-resistant depression symptoms can range from mild to severe and may require trying a number of approaches to identify what helps. (Source: Biological Psychiatry)

Treatment of resistant depression has most commonly been treated with electroconvulsive therapy (ECT). ECT has been modified to avoid the pain previously associated with it and is the most effective and quick-acting treatment for resistant depression. The downside is that it works by inducing brain seizures and can impair memory. Its therapeutic benefits can also fade over time. New methods of brain stimulation also offer the possibility of relief. These technologies exploit the fact that the brain is an electrical organ: it responds to electrical and magnetic stimulation to modulate brain circuits and change brain activity. Repetitive transcranial magnetic stimulation (rTMS), pioneered by Dr. Mark George with the support of NARSAD grants, was approved by the FDA in 2008 as a treatment for some otherwise untreatable depressions. rTMS is a noninvasive method that works through a coil held over the target area of the brain. A magnetic field passes through the skull to activate the appropriate brain circuit and no seizures are induced. Deep brain stimulation (DBS), a technique adapted for treating depression by Dr. Helen Mayberg with the support of NARSAD grants, works through electrodes planted deep in the brain. Another method, vagus nerve stimulation (VNS), stimulates the vagus nerve in the neck to therapeutically activate brain function. Magnetic seizure therapy (MST) combines rTMS and ECT to achieve a safer form of seizure therapy. MST has been supported through NARSAD Grants to Dr. Sarah Lisanby. Recently, Foundation grantees at the University of Pittsburgh have successfully experimented on a small number of patients with treatment-resistant depression, discovering underlying metabolic deficiencies and successfully treating these. In one subset of patients, a deficiency in cerebral folate was addressed by administering folinic acid. Patients’ depression symptoms declined significantly when these metabolic problems were treated. For some individuals, depression reached remission.

Learn more about TMS for depression in this webinar featuring Dr. Sarah Lisanby :

The first attempts at defining depression as a biologically-based illness hinged on a theory of a ‘chemical imbalance’ in the brain. It was thought that too much or too little of essential signal-transmitting chemicals—neurotransmitters—were present in the brain. This idea has been useful—that the brain is a kind of chemical soup in which there may be too much dopamine or too little serotonin, but it is now begin replaced by much more sophisticated knowledge about how the brain works, made possible by basic research. All the current antidepressants were developed during the period when the chemical-soup theory was in vogue. But now, many researchers are looking to understand in greater detail the brain biology that underlies depression’s symptoms so that novel therapies can be found.

Throughout this website you will find ideas for new depression treatments in greater detail. Efforts to create new classes of antidepressants, based on novel targets have borne fruit. A docking port on brain cells called the mu opioid receptor is the focus of one such effort. Other efforts focus not on the serotonin pathway, as do current “SSRI” drugs such as Prozac, but another pathway, that of another key neurotransmitter, called glutamate. A previously obscure brain area called the lateral habenula may be involved in depression pathology in some instances, due to glutamate hyperactivity. A drug able to specifically lower the activity in that region is a plausible drug discovery objective. Other researchers have been working on the idea that drugs that can mimic the biochemical and biological factors rendering certain people resilient to factors such as severe or chronic stress may have a future in depression treatment. A drug is now being tested that in preliminary trials has helped to reduce postpartum depression. Other researchers have been studying the ability to help women resist depression in the perinatal period through hormone treatments, or, in other work, via treatments that target the maternal immune system, which may be implicated in a subset of postpartum depression. Research has begun to see if administering certain strains of bacteria in depressed individuals might give a boost to their immune system and help reduce depression symptoms. Trying to alleviate depression via changes in diet – e.g., a Mediterranean diet, in one recent study – or omega-3 (“fish oil”) supplements is the subject of other Foundation-supported research. Yet another path that may lead to better outcomes in the future is bright-light therapy, which was first used to help people with seasonal affective disorder. It may have wider applications. It is also important to note research by grantees that has suggested the ability of even a short course of talk therapy to help alleviate depression in mothers with major depression, while at the same time helping their children. Such therapy worked best when it focused on the mother’s relationship with her child, the research revealed.

Dr. J. John Mann presented a webinar titled: Brain Plasticity: The Effects of Antidepressants on Major Depression in which he discusses why we need to better understand how antidepressants including SSRIs, lithium, and ketamine exert their therapeutic effects, so we can find newer more effective and rapidly acting treatments for depression:

Brain imaging has confirmed the biological nature of many psychiatric illnesses over the past twenty years. Yvette Sheline, M.D., in the mid-1990s, used functional magnetic resonance imaging (fMRI) to identify structural brain changes in depressed patients and established depression as a brain disease.

Using positron emission tomography (PET) scan images, Dr. Helen Mayberg of the Icahn School of Medicine at Mount Sinai, identified, in 2013, specific brain activity that can potentially predict whether people with major depressive disorder will best respond to an antidepressant medication or psychotherapy. This important new work offers a first potential imaging biomarker for treatment selection. A team of researchers including NARSAD Grantee Stefan G. Hoffman, Ph.D., of Boston University and Frida E. Polli, Ph.D., of Massachusetts Institute of Technology have used brain imaging to predict the success of cognitive behavioral therapy, a specific type of talk therapy often used to help treat a wide range of mental illnesses including anxiety disorders, depression, and schizophrenia. Research by Dr. Conor Liston of Weill Cornell Medical School, and colleagues, has used brain scans to identify four distinct “biotypes” of depression. Strikingly, patients in one of these four categories were about three times more likely to respond to a noninvasive treatment known as transcranial magnetic stimulation (TMS) than patients in two of the other categories. This is a good example of the power that biomarkers can have in the years just ahead to help direct people with depression to treatments most likely to help them.

Variations in genes – different kinds of DNA mutations, both common and rare – have been solidly linked to a number of serious psychiatric disorders including schizophrenia, bipolar disorder and autism. It is reasonable to wonder why similar progress has not been made yet in the study of the genetic factors contributing to depression. Researchers have made many attempts to search for such factors, but have not come up with results that statisticians consider “statistically meaningful.” One way of explaining the issue in studying depression concerns that very large number of people whom it affects. The power of massive genomic studies of patients (who are compared with unaffected individuals) evaporates if the people being compared have similar illnesses that have very different underlying genetic profiles. People with major depression might be grouped according to sex; whether or not they have recurrent depression; age at onset; symptom patterns; whether or not they were abused or under chronic stress early in life, for example. There is very good reason for progress on the genetic front, however. Foundation grantee Patrick Sullivan, M.D. and others have had success in finding the first reliable signals of commonly seen genetic variations in people with schizophrenia. To do so, they need to assemble a patient sample, across continents, numbering in the tens of thousands. They founded the Psychiatric Genomic Consortium to accomplish this. PGC scientists estimate that the inflection point in depression studies may be 75,000 to 100,000 study participants, a goal the PGC is working toward. It’s not that there is no genetic signal in depression, in other words. It’s a question of assembling a well-documented sample of patients of sufficient size to “tease out” the embedded genetic “signals,” which will point toward risk genes for the illness.

News and Events

Developing Biological Markers to Improve Clinical Care in Autism

ADVICE ON MENTAL HEALTH: Warning Signs & What to Look For: Anxiety and Depression in Childhood

‘Brains Within Brains’: Organoid Experiments Show How Pathologies Emerge in the Developing Brain

A RESEARCHER’S PERSPECTIVE: What Can We Do When Medicine is Not Enough in the Treatment of Schizophrenia?

2022 International Mental Health Research Symposium

OCD: Using Genome Data to Predict Risk, Symptoms and Treatment Response

Developing New Treatments for Mania Using Brain-Based Risk Markers

Self-Control Gone Awry: The Cognitive Neuroscience Behind Bulimia Nervosa

Cognitive Impairment in Psychosis: What it is and How it's Treated

Advice on Diagnosing and Treating Bipolar Disorder

2020 International Mental Health Research Symposium Presentations

Using Rapid-Acting Brain Stimulation for Treatment-Resistant Depression

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80 fascinating psychology research questions for your next project

Last updated

15 February 2024

Reviewed by

Brittany Ferri, PhD, OTR/L

Psychology research is essential for furthering our understanding of human behavior and improving the diagnosis and treatment of psychological conditions.

When psychologists know more about how different social and cultural factors influence how humans act, think, and feel, they can recommend improvements to practices in areas such as education, sport, healthcare, and law enforcement.

Below, you will find 80 research question examples across 16 branches of psychology. First, though, let’s look at some tips to help you select a suitable research topic.

How to choose a good psychology research topic

Psychology has many branches that break down further into topics. Choosing a topic for your psychology research paper can be daunting because there are so many to choose from. It’s an important choice, as the topic you select will open up a range of questions to explore.

The tips below can help you find a psychology research topic that suits your skills and interests.

Tip #1: Select a topic that interests you

Passion and interest should fuel every research project. A topic that fascinates you will most likely interest others as well. Think about the questions you and others might have and decide on the issues that matter most. Draw on your own interests, but also keep your research topical and relevant to others.

Don’t limit yourself to a topic that you already know about. Instead, choose one that will make you want to know more and dig deeper. This will keep you motivated and excited about your research.

Tip #2: Choose a topic with a manageable scope

If your topic is too broad, you can get overwhelmed by the amount of information available and have trouble maintaining focus. On the other hand, you may find it difficult to find enough information if you choose a topic that is too narrow.

To determine if the topic is too broad or too narrow, start researching as early as possible. If you find there’s an overwhelming amount of research material, you’ll probably need to narrow the topic down. For example, instead of researching the general population, it might be easier to focus on a specific age group. Ask yourself what area of the general topic interests you most and focus on that.

If your scope is too narrow, try to generalize or focus on a larger related topic. Expand your search criteria or select additional databases for information. Consider if the topic is too new to have much information published on it as well.

Tip #3: Select a topic that will produce useful and relevant insights

Doing some preliminary research will reveal any existing research on the topic. If there is existing research, will you be able to produce new insights? You might need to focus on a different area or see if the existing research has limitations that you can overcome.

Bear in mind that finding new information from which to draw fresh insights may be impossible if your topic has been over-researched.

You’ll also need to consider whether your topic is relevant to current trends and needs. For example, researching psychology topics related to social media use may be highly relevant today.

80 psychology research topics and questions

Psychology is a broad subject with many branches and potential areas of study. Here are some of them:

Developmental

Personality

Experimental

Organizational

Educational

Neuropsychology

Controversial topics

Below we offer some suggestions on research topics and questions that can get you started. Keep in mind that these are not all-inclusive but should be personalized to fit the theme of your paper.

Social psychology research topics and questions

Social psychology has roots as far back as the 18th century. In simple terms, it’s the study of how behavior is influenced by the presence and behavior of others. It is the science of finding out who we are, who we think we are, and how our perceptions affect ourselves and others. It looks at personalities, relationships, and group behavior.

Here are some potential research questions and paper titles for this topic:

How does social media use impact perceptions of body image in male adolescents?

2. Is childhood bullying a risk factor for social anxiety in adults?

Is homophobia in individuals caused by genetic or environmental factors?

What is the most important psychological predictor of a person’s willingness to donate to charity?

Does a person’s height impact how other people perceive them? If so, how?

Cognitive psychology research questions

Cognitive psychology is the branch that focuses on the interactions of thinking, emotion, creativity, and problem-solving. It also explores the reasons humans think the way they do.

This topic involves exploring how people think by measuring intelligence, thoughts, and cognition.

Here are some research question ideas:

6. Is there a link between chronic stress and memory function?

7. Can certain kinds of music trigger memories in people with memory loss?

8. Do remote meetings impact the efficacy of team decision-making?

9. Do word games and puzzles slow cognitive decline in adults over the age of 80?

10. Does watching television impact a child’s reading ability?

Developmental psychology research questions

Developmental psychology is the study of how humans grow and change over their lifespan. It usually focuses on the social, emotional, and physical development of babies and children, though it can apply to people of all ages. Developmental psychology is important for understanding how we learn, mature, and adapt to changes.

Here are some questions that might inspire your research:

11. Does grief accelerate the aging process?

12. How do parent–child attachment patterns influence the development of emotion regulation in teenagers?

13. Does bilingualism affect cognitive decline in adults over the age of 70?

14. How does the transition to adulthood impact decision-making abilities

15. How does early exposure to music impact mental health and well-being in school-aged children?

Personality psychology research questions

Personality psychology studies personalities, how they develop, their structures, and the processes that define them. It looks at intelligence, disposition, moral beliefs, thoughts, and reactions.

The goal of this branch of psychology is to scientifically interpret the way personality patterns manifest into an individual’s behaviors. Here are some example research questions:

16. Nature vs. nurture: Which impacts personality development the most?

17. The role of genetics on personality: Does an adopted child take on their biological parents’ personality traits?

18. How do personality traits influence leadership styles and effectiveness in organizational settings?

19. Is there a relationship between an individual’s personality and mental health?

20. Can a chronic illness affect your personality?

Abnormal psychology research questions

As the name suggests, abnormal psychology is a branch that focuses on abnormal behavior and psychopathology (the scientific study of mental illness or disorders).

Abnormal behavior can be challenging to define. Who decides what is “normal”? As such, psychologists in this area focus on the level of distress that certain behaviors may cause, although this typically involves studying mental health conditions such as depression, obsessive-compulsive disorder (OCD), and phobias.

Here are some questions to consider:

21. How does technology impact the development of social anxiety disorder?

22. What are the factors behind the rising incidence of eating disorders in adolescents?

23. Are mindfulness-based interventions effective in the treatment of PTSD?

24. Is there a connection between depression and gambling addiction?

25. Can physical trauma cause psychopathy?

Clinical psychology research questions

Clinical psychology deals with assessing and treating mental illness or abnormal or psychiatric behaviors. It differs from abnormal psychology in that it focuses more on treatments and clinical aspects, while abnormal psychology is more behavioral focused.

This is a specialty area that provides care and treatment for complex mental health conditions. This can include treatment, not only for individuals but for couples, families, and other groups. Clinical psychology also supports communities, conducts research, and offers training to promote mental health. This category is very broad, so there are lots of topics to explore.

Below are some example research questions to consider:

26. Do criminals require more specific therapies or interventions?

27. How effective are selective serotonin reuptake inhibitors in treating mental health disorders?

28. Are there any disadvantages to humanistic therapy?

29. Can group therapy be more beneficial than one-on-one therapy sessions?

30. What are the factors to consider when selecting the right treatment plan for patients with anxiety?

Experimental psychology research questions

Experimental psychology deals with studies that can prove or disprove a hypothesis. Psychologists in this field use scientific methods to collect data on basic psychological processes such as memory, cognition, and learning. They use this data to test the whys and hows of behavior and how outside factors influence its creation.

Areas of interest in this branch relate to perception, memory, emotion, and sensation. The below are example questions that could inspire your own research:

31. Do male or female parents/carers have a more calming influence on children?

32. Will your preference for a genre of music increase the more you listen to it?

33. What are the psychological effects of posting on social media vs. not posting?

34. How is productivity affected by social connection?

35. Is cheating contagious?

Organizational psychology research questions

Organizational psychology studies human behavior in the workplace. It is most frequently used to evaluate an employee, group, or a company’s organizational dynamics. Researchers aim to isolate issues and identify solutions.

This area of study can be beneficial to both employees and employers since the goal is to improve the overall work environment and experience. Researchers apply psychological principles and findings to recommend improvements in performance, communication, job satisfaction, and safety.

Some potential research questions include the following:

36. How do different leadership styles affect employee morale?

37. Do longer lunch breaks boost employee productivity?

38. Is gender an antecedent to workplace stress?

39. What is the most effective way to promote work–life balance among employees?

40. How do different organizational structures impact the effectiveness of communication, decision-making, and productivity?

Forensic psychology research questions

Some questions to consider exploring in this branch of psychology are:

41. How does incarceration affect mental health?

42. Is childhood trauma a driver for criminal behavior during adulthood?

43. Are people with mental health conditions more likely to be victims of crimes?

44. What are the drivers of false memories, and how do they impact the justice system?

45. Is the media responsible for copycat crimes?

Educational psychology research questions

Educational psychology studies children in an educational setting. It covers topics like teaching methods, aptitude assessment, self-motivation, technology, and parental involvement.

Research in this field of psychology is vital for understanding and optimizing learning processes. It informs educators about cognitive development, learning styles, and effective teaching strategies.

Here are some example research questions:

46. Are different teaching styles more beneficial for children at different times of the day?

47. Can listening to classical music regularly increase a student’s test scores?

48. Is there a connection between sugar consumption and knowledge retention in students?

49. Does sleep duration and quality impact academic performance?

50. Does daily meditation at school influence students’ academic performance and mental health?

Sports psychology research question examples

Sport psychology aims to optimize physical performance and well-being in athletes by using cognitive and behavioral practices and interventions. Some methods include counseling, training, and clinical interventions.

Research in this area is important because it can improve team and individual performance, resilience, motivation, confidence, and overall well-being

Here are some research question ideas for you to consider:

51. How can a famous coach affect a team’s performance?

52. How can athletes control negative emotions in violent or high-contact sports?

53. How does using social media impact an athlete’s performance and well-being?

54. Can psychological interventions help with injury rehabilitation?

55. How can mindfulness practices boost sports performance?

Cultural psychology research question examples

The premise of this branch of psychology is that mind and culture are inseparable. In other words, people are shaped by their cultures, and their cultures are shaped by them. This can be a complex interaction.

Cultural psychology is vital as it explores how cultural context shapes individuals’ thoughts, behaviors, and perceptions. It provides insights into diverse perspectives, promoting cross-cultural understanding and reducing biases.

Here are some ideas that you might consider researching:

56. Are there cultural differences in how people perceive and deal with pain?

57. Are different cultures at increased risk of developing mental health conditions?

58. Are there cultural differences in coping strategies for stress?

59. Do our different cultures shape our personalities?

60. How does multi-generational culture influence family values and structure?

Health psychology research question examples

Health psychology is a crucial field of study. Understanding how psychological factors influence health behaviors, adherence to medical treatments, and overall wellness enables health experts to develop effective interventions and preventive measures, ultimately improving health outcomes.

Health psychology also aids in managing stress, promoting healthy behaviors, and optimizing mental health, fostering a holistic approach to well-being.

Here are five ideas to inspire research in this field:

61. How can health psychology interventions improve lifestyle behaviors to prevent cardiovascular diseases?

62. What role do social norms play in vaping among adolescents?

63. What role do personality traits play in the development and management of chronic pain conditions?

64. How do cultural beliefs and attitudes influence health-seeking behaviors in diverse populations?

65. What are the psychological factors influencing the adherence to preventive health behaviors, such as vaccination and regular screenings?

Neuropsychology research paper question examples

Neuropsychology research explores how a person’s cognition and behavior are related to their brain and nervous system. Researchers aim to advance the diagnosis and treatment of behavioral and cognitive effects of neurological disorders.

Researchers may work with children facing learning or developmental challenges, or with adults with declining cognitive abilities. They may also focus on injuries or illnesses of the brain, such as traumatic brain injuries, to determine the effect on cognitive and behavioral functions.

Neuropsychology informs diagnosis and treatment strategies for conditions such as dementia, traumatic brain injuries, and psychiatric disorders. Understanding the neural basis of behavior enhances our ability to optimize cognitive functioning, rehabilitate people with brain injuries, and improve patient care.

Here are some example research questions to consider:

66. How do neurotransmitter imbalances in specific brain regions contribute to mood disorders such as depression?

67. How can a traumatic brain injury affect memory?

68. What neural processes underlie attention deficits in people with ADHD?

69. Do medications affect the brain differently after a traumatic brain injury?

70. What are the behavioral effects of prolonged brain swelling?

Psychology of religion research question examples

The psychology of religion is a field that studies the interplay between belief systems, spirituality, and mental well-being. It explores the application of the psychological methods and interpretive frameworks of religious traditions and how they relate to both religious and non-religious people.

Psychology of religion research contributes to a holistic understanding of human experiences. It fosters cultural competence and guides therapeutic approaches that respect diverse spiritual beliefs.

Here are some example research questions in this field:

71. What impact does a religious upbringing have on a child’s self-esteem?

72. How do religious beliefs shape decision-making and perceptions of morality?

73. What is the impact of religious indoctrination?

74. Is there correlation between religious and mindfulness practices?

75. How does religious affiliation impact attitudes towards mental health treatment and help-seeking behaviors?

Controversial topics in psychology research question examples

Some psychology topics don’t fit into any of the subcategories above, but they may still be worthwhile topics to consider. These topics are the ones that spark interest, conversation, debate, and disagreement. They are often inspired by current issues and assess the validity of older research.

Consider some of these research question examples:

76. How does the rise in on-screen violence impact behavior in adolescents.

77. Should access to social media platforms be restricted in children under the age of 12 to improve mental health?

78. Are prescription mental health medications over-prescribed in older adults? If so, what are the effects of this?

79. Cognitive biases in AI: what are the implications for decision-making?

80. What are the psychological and ethical implications of using virtual reality in exposure therapy for treating trauma-related conditions?

Inspiration for your next psychology research project

You can choose from a diverse range of research questions that intersect and overlap across various specialties.

From cognitive psychology to clinical studies, each inquiry contributes to a deeper understanding of the human mind and behavior. Importantly, the relevance of these questions transcends individual disciplines, as many findings offer insights applicable across multiple areas of study.

As health trends evolve and societal needs shift, new topics emerge, fueling continual exploration and discovery. Diving into this ever-changing and expanding area of study enables you to navigate the complexities of the human experience and pave the way for innovative solutions to the challenges of tomorrow.

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Latest articles

Self-report questionnaires

This type is specifically focused on individual experience. Individuals can measure themselves with questions related to their feelings, symptoms, sadness, loss of interest , and suicidal thoughts.

SELF-CARE/MOBILITY

1 - Have you experienced physical symptoms such as aches and pains, digestive issues, or changes in appetite?

2 - Have you noticed any changes in your sleep patterns, such as waking up too early or feeling unrested after a full night's sleep?

3 - Do you feel self-conscious or embarrassed about your movement or speech patterns?

4 - Do you feel like your movements or speech are slower than usual or that you have trouble getting your words out?

5 - How frequently did you feel drained of energy over the last two weeks?

USUAL ACTIVITIES

6 - How frequently did you struggle to fall asleep, stay asleep, or oversleep over the previous two weeks?

7 - Have you been crying more or more easily than usual?

8 - How frequently did you find it difficult to focus over the past two weeks on activities like reading the news or watching TV?

9 - Do you have difficulty falling asleep or staying asleep most nights?

10 - Are there any changes in your sexual desire compared to usual?

ANXIETY/ DEPRESSION

11 - How many times in the last two weeks have you felt dejected, miserable, or hopeless?

12 - How many times in the last two weeks have you felt little interest in or enjoyment from accomplishing things?

13 - How frequently have you felt inferior to yourself, like a failure, or like you have let yourself or your family down over the last two weeks?

14 - Do you consider yourself more impatient than usual?

15 - Have you been feeling self-conscious, like a failure, or having disappointed yourself or your family?

16 - Do you feel guilty about something you have done?

17 - Do you have any recent trust issues in your relationships?

18 - Have you been feeling bad or sad most days, or have you lost interest in activities that you once enjoyed?

19 - Have you had thoughts of self-harm or suicide?

Self-report depression question example

Observer-Rated Questionnaires

20 - This type of questionnaire can be used by professionals or anyone other than the patient. Typically, they evaluate a variety of symptoms, such as alterations in mood, behavior, and physical health .

21 - Have you felt like your mental health issues are negatively affecting your ability to function at work, school, or in your personal life?

22 - Have you discussed your sleep problems with your primary care physician or another healthcare provider?

23 - Have you received any mental health care in the past year, such as counseling or medication management?

24 - Have you observed any changes in the individual's social functioning or engagement with others over the past week?

25 - Have you observed any changes in the individual's movement or speech patterns, such as slowing down or appearing agitated?

26 - How frequently has the individual reported feeling fatigued or lacking in energy over the past week?

27 - Over the past week, how frequently has the individual exhibited symptoms of sadness, hopelessness, or low mood?

28 - Over the past week, how frequently has the individual exhibited symptoms of irritability or restlessness?

29 - Have you observed any changes in the individual's ability to engage in social or recreational activities over the past week?

30 - Have you observed any changes in the individual's communication patterns or ability to express themselves effectively over the past week?

Observer-rated depression question example

Suicide risk questionnaires

This type of questionnaire focuses on suicidal intentions or attempts . It should be considered that these questions must be used by professionals but can also help to create awareness. It should be noted that patients may not be aware of their suicidal behavior. For this reason, creating awareness can help to save a life.

31 - Have you ever considered harming yourself or taking your own life?

32 - Have you thought about dying or getting killed?

33 - Have you ever considered suicide or attempted it before?

34 - Have you cut yourself or burned yourself? Or have you engaged in other self-harming behaviors?

35 - Have you been feeling more agitated, irritable, or anxious lately? Does this make you think about committing suicide?

36 - Have you had a substantial behavioral shift that would point to a possible suicide attempt, such as giving away possessions or saying goodbye to loved ones?

37 - Have your concentration or focus decreased as a result of having suicidal thoughts?

38 - Have you recently gone through a big loss or trauma that could have triggered feelings of hopelessness or thoughts of suicide?

39 - Have you ever felt guilty or unworthy, which could be motivating your suicidal thoughts?

40 - Have you experienced an increase in your use of drugs or alcohol as a way of coping with your depression symptoms?

Suicide risk depression question example

How to create an online depression questionnaire

Creating a depression questionnaire is an easy task with forms.app. You can customize pre-made depression questionnaires or create yours from scratch . You can create well-developed questionnaires using features like conditional logic and a calculator, and in addition to these, you can add multiple layers to your survey with different form fields. Here are some form fields you can use in your questionnaire to enrich your question variety:

Single selection: Allows responders to pick up just one option.
Multiple selections: Allow responders to select from a variety of alternatives.
Picture selections: Enables responders with visual options to choose from.
Selection matrix: Offers a graphic alternative for multiple or single choices.
Short text: Short answer field for manual typing.
Long text: Long answer field for manual typing.
Yes/No: With only to possible outcomes, you can get conclusive responses.

How to automatically show results on your depression test

forms.app offers a calculator feature that can be used for measurement and showing results. You can give scores to each answer by setting up calculations. By assigning scores to necessary fields, you can get automated results for your depression surveys. Follow these 5 easy steps to use the calculator feature actively:

1 - Switch to the “Calculator” tab.

2 - Click on a score field of an option on the right side of each option.

3 - Enter a positive value directly or a negative value

4 - On the calculation settings, click on “show calculation result” to show people their score

5 - Lastly, enable “Customize thank you page message” to add ranges and custom messages for people in a certain score range.

In conclusion, it is a fact that professionals must use these types of questions. But creating awareness and creating a short and easy way as the first step before professional support can also be helpful. forms.app offers a fast and easy way to create and customize depression questionnaires that focus on different aspects and topics.

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60 Outstanding Depression Research Paper Topics

Depression has been a subject of interest for quite a while now. Teens have formed the majority of the victims. However, with the COVID-19 pandemic, depression has escalated to another level. That is why a research paper on depression is inevitable for you as a college student. First things first,

Depression Research Paper Outline

Whenever you’re confronted with such a paper, the groundbreaking step would be to determine the outline. It will act as a skeleton upon which you will fill with the meet. So, how does a depression research paper look like for you?

The topic contributes significantly to the scope of what you intend to write on in your paper. A research topic’s success depends on its originality, currency, and emotional appeal, especially on such a subject.
The Introduction – It contains opening remarks which bring to light the background of the topic. You can also include recent developments in depression. The thesis statement should give a clear idea of the arguments in the body paragraphs.
The body – You will arrange these in order of seniority – from the most relevant arguments to the least. Include reputable and authoritative statements as evidence for your paper. If you choose to include statistics, ensure that they are accurate.
The conclusion – You will summarize your results and findings and recommend them if possible. Since this is a practical topic in everyday life, include a call to action statement here.

Once you get your outline right, here are a few things to consider when writing this kind of paper:

Do not include topics resulting in high emotions Ensure that you have adequate information for the topic you choose Avoid using words that may cause more depression on the reader

Therefore, you can discuss any of the following areas:

Depression disorders
How to manage it
Ways of helping the victims

To get you jammed up, here are 60 of the best depression topics for research paper. Use them to draw inspiration for your next assignment. If you’re not inspired by the subject or don’t have the time to spend writing essays, it’s best to let professionals write a paper for you.

Depression Topics For Research Paper on the Causes

How upsetting or stressful life events such as death can lead to depression
Why people feel low after a severe illness or undergoing a major surgery
The role of the ‘downward spiral’ of events in triggering depression
Difficult social and economic circumstances that cause depression
Personality traits such as low self-esteem and their role in depression
Is depression a hereditary illness passed down to family members?
Why some women may be vulnerable to depression after giving birth
Why the feeling of loneliness is a significant risk
How alcohol and drugs can leave you in a state of depression
Longstanding illnesses that may trigger depression among people

Topic Ideas For a Postpartum Depression Research Paper

The impact of hormone level drop after giving birth
Why you may be depressed if you didn’t want to get pregnant
Reasons why new moms may be at risk of getting depressed
How long does postpartum take to subside in new mothers?
What causes intense irritability and anger after giving birth?
Why would one develop the fear of not being a good mother?
Can postpartum depression lead to a mother harming her child?
Impact of postpartum depression on a mother’s ability to think straight
Symptoms of postpartum depression in new fathers
How to help new fathers adopt responsibility

Research Paper on Depression in College Students

Why do most college students in their last year experience depression?
Are lecturers to blame for depression among students?
The role of homework in causing depression among students
Consequences and risks of depression among students
The problem of relationships in college
Increasing cases of suicide among students
Stressful college life events that stir depression
Self-harming behaviors among college students
How to diagnose and treat depression among college students
Depression and academic performance among students

Teen Depression Research Paper Topic Ideas

Excessive use of technology among teens and depression
Why most teens seek out drugs as a remedy for depression
Financial stresses on teens and how they are compelled to depression
Why most teens feel depressed after a relationship break-up
Debt and depression among teens
The role of parents in managing depression among teens
The place of peer pressure in causing depression among teenagers
Can parental over-involvement lead to the development of stress among teens?
Why most teens do not seek help why they are depressed
Who are the most vulnerable between the male and female teens, and why?

Topics For Coronavirus and Depression Research Papers

Why are there increased cases of depression during the COVID-19 pandemic?
How to deal with depression while staying at home
How the government can help alleviate depression among citizens
How to deal with a job loss during COVID-19
How loneliness is killing many people in their homes
Stigmatization and its impact on COVID-19 patients
Why the media is the most significant source of depression during the coronavirus
Activities you can engage in during the coronavirus pandemic
How journaling can help you overcome depression
Ways of fending for low-income families

Depression Research Questions To Consider in 2023

Can you trust a psychologist to help?
Why do most depression cases end up in suicide?
Should we have a national day on sensitization against depression?
What is the role of the family in combating depression?
How should we treat depressed friends?
Should we share our depression stories on Facebook?
Do children experience depression?
Why should you check up on your friends daily?
Is cyber-bullying killing people?
Why teens should not engage in relationships

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An Exploratory Study of Students with Depression in Undergraduate Research Experiences

Katelyn M. Cooper
Logan E. Gin
M. Elizabeth Barnes
Sara E. Brownell

*Address correspondence to: Katelyn M. Cooper ( E-mail Address: [email protected] ).

Department of Biology, University of Central Florida, Orlando, FL, 32816

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Biology Education Research Lab, Research for Inclusive STEM Education Center, School of Life Sciences, Arizona State University, Tempe, AZ 85281

Depression is a top mental health concern among undergraduates and has been shown to disproportionately affect individuals who are underserved and underrepresented in science. As we aim to create a more inclusive scientific community, we argue that we need to examine the relationship between depression and scientific research. While studies have identified aspects of research that affect graduate student depression, we know of no studies that have explored the relationship between depression and undergraduate research. In this study, we sought to understand how undergraduates’ symptoms of depression affect their research experiences and how research affects undergraduates’ feelings of depression. We interviewed 35 undergraduate researchers majoring in the life sciences from 12 research-intensive public universities across the United States who identify with having depression. Using inductive and deductive coding, we identified that students’ depression affected their motivation and productivity, creativity and risk-taking, engagement and concentration, and self-perception and socializing in undergraduate research experiences. We found that students’ social connections, experiencing failure in research, getting help, receiving feedback, and the demands of research affected students’ depression. Based on this work, we articulate an initial set of evidence-based recommendations for research mentors to consider in promoting an inclusive research experience for students with depression.

INTRODUCTION

Depression is described as a common and serious mood disorder that results in persistent feelings of sadness and hopelessness, as well as a loss of interest in activities that one once enjoyed ( American Psychiatric Association [APA], 2013 ). Additional symptoms of depression include weight changes, difficulty sleeping, loss of energy, difficulty thinking or concentrating, feelings of worthlessness or excessive guilt, and suicidality ( APA, 2013 ). While depression results from a complex interaction of psychological, social, and biological factors ( World Health Organization, 2018 ), studies have shown that increased stress caused by college can be a significant contributor to student depression ( Dyson and Renk, 2006 ).

Depression is one of the top undergraduate mental health concerns, and the rate of depression among undergraduates continues to rise ( Center for Collegiate Mental Health, 2017 ). While we cannot discern whether these increasing rates of depression are due to increased awareness or increased incidence, it is clear that is a serious problem on college campuses. The percent of U.S. college students who self-reported a diagnosis with depression was recently estimated to be about 25% ( American College Health Association, 2019 ). However, higher rates have been reported, with one study estimating that up to 84% of undergraduates experience some level of depression ( Garlow et al. , 2008 ). Depression rates are typically higher among university students compared with the general population, despite being a more socially privileged group ( Ibrahim et al. , 2013 ). Prior studies have found that depression is negatively correlated with overall undergraduate academic performance ( Hysenbegasi et al. , 2005 ; Deroma et al. , 2009 ; American College Health Association, 2019 ). Specifically, diagnosed depression is associated with half a letter grade decrease in students’ grade point average ( Hysenbegasi et al. , 2005 ), and 21.6% of undergraduates reported that depression negatively affected their academic performance within the last year ( American College Health Association, 2019 ). Provided with a list of academic factors that may be affected by depression, students reported that depression contributed to lower exam grades, lower course grades, and not completing or dropping a course.

Students in the natural sciences may be particularly at risk for depression, given that such majors are noted to be particularly stressful due to their competitive nature and course work that is often perceived to “weed students out”( Everson et al. , 1993 ; Strenta et al. , 1994 ; American College Health Association, 2019 ; Seymour and Hunter, 2019 ). Science course instruction has also been described to be boring, repetitive, difficult, and math-intensive; these factors can create an environment that can trigger depression ( Seymour and Hewitt, 1997 ; Osborne and Collins, 2001 ; Armbruster et al ., 2009 ; Ceci and Williams, 2010 ). What also distinguishes science degree programs from other degree programs is that, increasingly, undergraduate research experiences are being proposed as an essential element of a science degree ( American Association for the Advancement of Science, 2011 ; President’s Council of Advisors on Science and Technology, 2012 ; National Academies of Sciences, Engineering, and Medicine [NASEM], 2017 ). However, there is some evidence that undergraduate research experiences can add to the stress of college for some students ( Cooper et al. , 2019c ). Students can garner multiple benefits from undergraduate research, including enhanced abilities to think critically ( Ishiyama, 2002 ; Bauer and Bennett, 2003 ; Brownell et al. , 2015 ), improved student learning ( Rauckhorst et al. , 2001 ; Brownell et al. , 2015 ), and increased student persistence in undergraduate science degree programs ( Jones et al. , 2010 ; Hernandez et al. , 2018 ). Notably, undergraduate research experiences are increasingly becoming a prerequisite for entry into medical and graduate programs in science, particularly elite programs ( Cooper et al. , 2019d ). Although some research experiences are embedded into formal lab courses as course-based undergraduate research experiences (CUREs; Auchincloss et al. , 2014 ; Brownell and Kloser, 2015 ), the majority likely entail working with faculty in their research labs. These undergraduate research experiences in faculty labs are often added on top of a student’s normal course work, so they essentially become an extracurricular activity that they have to juggle with course work, working, and/or personal obligations ( Cooper et al. , 2019c ). While the majority of the literature surrounding undergraduate research highlights undergraduate research as a positive experience ( NASEM, 2017 ), studies have demonstrated that undergraduate research experiences can be academically and emotionally challenging for students ( Mabrouk and Peters, 2000 ; Seymour et al. , 2004 ; Cooper et al. , 2019c ; Limeri et al. , 2019 ). In fact, 50% of students sampled nationally from public R1 institutions consider leaving their undergraduate research experience prematurely, and about half of those students, or 25% of all students, ultimately leave their undergraduate research experience ( Cooper et al. , 2019c ). Notably, 33.8% of these individuals cited a negative lab environment and 33.3% cited negative relationships with their mentors as factors that influenced their decision about whether to leave ( Cooper et al. , 2019c ). Therefore, students’ depression may be exacerbated in challenging undergraduate research experiences, because studies have shown that depression is positively correlated with student stress ( Hish et al. , 2019 ).

While depression has not been explored in the context of undergraduate research experiences, depression has become a prominent concern surrounding graduate students conducting scientific research. A recent study that examined the “graduate student mental health crisis” ( Flaherty, 2018 ) found that work–life balance and graduate students’ relationships with their research advisors may be contributing to their depression ( Evans et al. , 2018 ). Specifically, this survey of 2279 PhD and master’s students from diverse fields of study, including the biological/physical sciences, showed that 39% of graduate students have experienced moderate to severe depression. Fifty-five percent of the graduate students with depression who were surveyed disagreed with the statement “I have good work life balance,” compared to only 21% of students with depression who agreed. Additionally, the study highlighted that more students with depression disagreed than agreed with the following statements: their advisors provided “real” mentorship, their advisors provided ample support, their advisors positively impacted their emotional or mental well-being, their advisors were assets to their careers, and they felt valued by their mentors. Another recent study identified that depression severity in biomedical doctoral students was significantly associated with graduate program climate, a perceived lack of employment opportunities, and the quality of students’ research training environment ( Nagy et al. , 2019 ). Environmental stress, academic stress, and family and monetary stress have also been shown to be predictive of depression severity in biomedical doctoral students ( Hish et al. , 2019 ). Further, one study found that self-esteem is negatively correlated and stress is positively correlated with graduate student depression; presumably research environments that challenge students’ self-esteem and induce stress are likely contributing to depressive symptoms among graduate students ( Kreger, 1995 ). While these studies have focused on graduate students, and there are certainly notable distinctions between graduate and undergraduate research, the research-related factors that affect graduate student depression, including work–life balance, relationships with mentors, research environment, stress, and self-esteem, may also be relevant to depression among undergraduates conducting research. Importantly, undergraduates in the United States have reported identical levels of depression as graduate students but are often less likely to seek mental health care services ( Wyatt and Oswalt, 2013 ), which is concerning if undergraduate research experiences exacerbate depression.

Based on the literature on the stressors of undergraduate research experiences and the literature identifying some potential causes of graduate student depression, we identified three aspects of undergraduate research that may exacerbate undergraduates’ depression. Mentoring: Mentors can be an integral part of a students’ research experience, bolstering their connections with others in the science community, scholarly productivity, and science identity, as well as providing many other benefits ( Thiry and Laursen, 2011 ; Prunuske et al. , 2013 ; Byars-Winston et al. , 2015 ; Aikens et al. , 2016 , 2017 ; Thompson et al. , 2016 ; Estrada et al. , 2018 ). However, recent literature has highlighted that poor mentoring can negatively affect undergraduate researchers ( Cooper et al. , 2019c ; Limeri et al. , 2019 ). Specifically, one study of 33 undergraduate researchers who had conducted research at 10 institutions identified seven major ways that they experienced negative mentoring, which included absenteeism, abuse of power, interpersonal mismatch, lack of career support, lack of psychosocial support, misaligned expectations, and unequal treatment ( Limeri et al. , 2019 ). We hypothesize negative mentoring experiences may be particularly harmful for students with depression, because support, particularly social support, has been shown to be important for helping individuals with depression cope with difficult circumstances ( Aneshensel and Stone, 1982 ; Grav et al. , 2012 ). Failure: Experiencing failure has been hypothesized to be an important aspect of undergraduate research experiences that may help students develop some the most distinguishing abilities of outstanding scientists, such as coping with failure, navigating challenges, and persevering ( Laursen et al. , 2010 ; Gin et al. , 2018 ; Henry et al. , 2019 ). However, experiencing failure and the stress and fatigue that often accompany it may be particularly tough for students with depression ( Aldwin and Greenberger, 1987 ; Mongrain and Blackburn, 2005 ). Lab environment: Fairness, inclusion/exclusion, and social support within one’s organizational environment have been shown to be key factors that cause people to either want to remain in the work place and be productive or to want to leave ( Barak et al. , 2006 ; Cooper et al. , 2019c ). We hypothesize that dealing with exclusion or a lack of social support may exacerbate depression for some students; patients with clinical depression react to social exclusion with more pronounced negative emotions than do individuals without clinical depression ( Jobst et al. , 2015 ). While there are likely other aspects of undergraduate research that affect student depression, we hypothesize that these factors have the potential to exacerbate negative research experiences for students with depression.

Depression has been shown to disproportionately affect many populations that are underrepresented or underserved within the scientific community, including females ( American College Health Association, 2018 ; Evans et al. , 2018 ), first-generation college students ( Jenkins et al. , 2013 ), individuals from low socioeconomic backgrounds ( Eisenberg et al. , 2007 ), members of the LGBTQ+ community ( Eisenberg et al. , 2007 ; Evans et al. , 2018 ), and people with disabilities ( Turner and Noh, 1988 ). Therefore, as the science community strives to be more diverse and inclusive ( Intemann, 2009 ), it is important that we understand more about the relationship between depression and scientific research, because negative experiences with depression in scientific research may be contributing to the underrepresentation of these groups. Specifically, more information is needed about how the research process and environment of research experiences may affect depression.

Given the high rate of depression among undergraduates, the links between depression and graduate research, the potentially challenging environment of undergraduate research, and how depression could disproportionately impact students from underserved communities, it is imperative to begin to explore the relationship between scientific research and depression among undergraduates to create research experiences that could maximize student success. In this exploratory interview study, we aimed to 1) describe how undergraduates’ symptoms of depression affect their research experiences, 2) understand how undergraduate research affects students’ feelings of depression, and 3) identify recommendations based on the literature and undergraduates’ reported experiences to promote a positive research experience for students with depression.

This study was done with an approved Arizona State University Institutional Review Board protocol #7247.

In Fall 2018, we surveyed undergraduate researchers majoring in the life sciences across 25 research-intensive (R1) public institutions across the United States (specific details about the recruitment of the students who completed the survey can be found in Cooper et al. (2019c) ). The survey asked students for their opinions about their undergraduate research experiences and their demographic information and whether they would be interested in participating in a follow-up interview related to their research experiences. For the purpose of this study, we exclusively interviewed students about their undergraduate research experiences in faculty member labs; we did not consider students’ experiences in CUREs. Of the 768 undergraduate researchers who completed the survey, 65% ( n = 496) indicated that they would be interested in participating in a follow-up interview. In Spring 2019, we emailed the 496 students, explaining that we were interested in interviewing students with depression about their experiences in undergraduate research. Our specific prompt was: “If you identify as having depression, we would be interested in hearing about your experience in undergraduate research in a 30–60 minute online interview.” We did not define depression in our email recruitment because we conducted think-aloud interviews with four undergraduates who all correctly interpreted what we meant by depression ( APA, 2013 ). We had 35 students agree to participate in the interview study. The interview participants represented 12 of the 25 R1 public institutions that were represented in the initial survey.

Student Interviews

We developed an interview script to explore our research questions. Specifically, we were interested in how students’ symptoms of depression affect their research experiences, how undergraduate research negatively affects student depression, and how undergraduate research positively affects student depression.

We recognized that mental health, and specifically depression, can be a sensitive topic to discuss with undergraduates, and therefore we tried to minimize any discomfort that the interviewees might experience during the interview. Specifically, we conducted think-aloud interviews with three graduate students who self-identified with having depression at the time of the interview. We asked them to note whether any interview questions made them uncomfortable. We also sought their feedback on questions given their experiences as persons with depression who had once engaged in undergraduate research. We revised the interview protocol after each think-aloud interview. Next, we conducted four additional think-aloud interviews with undergraduates conducting basic science or biology education research who identified with having depression to establish cognitive validity of the questions and to elicit additional feedback about any questions that might make someone uncomfortable. The questions were revised after each think-aloud interview until no question was unclear or misinterpreted by the students and we were confident that the questions minimized students’ potential discomfort ( Trenor et al. , 2011 ). A copy of the final interview script can be found in the Supplemental Material.

All interviews were individually conducted by one of two researchers (K.M.C. and L.E.G.) who conducted the think-aloud interviews together to ensure that their interviewing practices were as similar as possible. The interviews were approximately an hour long, and students received a $15 gift card for their participation.

Personal, Research, and Depression Demographics

All student demographics and information about students’ research experiences were collected using the survey distributed to students in Fall 2018. We collected personal demographics, including the participants’ gender, race/ethnicity, college generation status, transfer status, financial stability, year in college, major, and age. We also collected information about the students’ research experiences, including the length of their first research experiences, the average number of hours they spend in research per week, how they were compensated for research, who their primary mentors were, and the focus areas of their research.

In the United States, mental healthcare is disproportionately unavailable to Black and Latinx individuals, as well as those who come from low socioeconomic backgrounds ( Kataoka et al. , 2002 ; Howell and McFeeters, 2008 ; Santiago et al. , 2013 ). Therefore, to minimize a biased sample, we invited anyone who identified with having depression to participate in our study; we did not require students to be diagnosed with depression or to be treated for depression in order to participate. However, we did collect information about whether students had been formally diagnosed with depression and whether they had been treated for depression. After the interview, all participants were sent a link to a short survey that asked them if they had ever been diagnosed with depression and how, if at all, they had ever been treated for depression. A copy of these survey questions can be found in the Supplemental Material. The combined demographic information of the participants is in Table 1 . The demographics for each individual student can be found in the Supplemental Material.

a Students reported the time they had spent in research 6 months before being interviewed and only reported on the length of time of their first research experiences.

b Students were invited to report multiple ways in which they were treated for their depression; other treatments included lifestyle changes and meditation.

c Students were invited to report multiple means of compensation for their research if they had been compensated for their time in different ways.

d Students were asked whether they felt financially stable, particularly during the undergraduate research experience.

e Students reported who they work/worked with most closely during their research experiences.

f Staff members included lab coordinators or lab managers.

g Other focus areas of research included sociology, linguistics, psychology, and public health.

Interview Analysis

The initial interview analysis aimed to explore each idea that a participant expressed ( Charmaz, 2006 ) and to identify reoccurring ideas throughout the interviews. First, three authors (K.M.C., L.E.G., and S.E.B.) individually reviewed a different set of 10 interviews and took detailed analytic notes ( Birks and Mills, 2015 ). Afterward, the authors compared their notes and identified reoccurring themes throughout the interviews using open coding methods ( Saldaña, 2015 ).

Once an initial set of themes was established, two researchers (K.M.C. and L.E.G.) individually reviewed the same set of 15 randomly selected interviews to validate the themes identified in the initial analysis and to screen for any additional themes that the initial analysis may have missed. Each researcher took detailed analytic notes throughout the review of an interview, which they discussed after reviewing each interview. The researchers compared what quotes from each interview they categorized into each theme. Using constant comparison methods, they assigned quotes to each theme and constantly compared the quotes to ensure that each quote fit within the description of the theme ( Glesne and Peshkin, 1992 ). In cases in which quotes were too different from other quotes, a new theme was created. This approach allowed for multiple revisions of the themes and allowed the authors to define a final set of codes; the researchers created a final codebook with refined definitions of emergent themes (the final coding rubric can be found in the Supplemental Material). Once the final codebook was established, the researchers (K.M.C. and L.E.G.) individually coded seven additional interviews (20% of all interviews) using the coding rubric. The researchers compared their codes, and their Cohen’s κ interrater score for these seven interviews was at an acceptable level (κ = 0.88; Landis and Koch, 1977 ). One researcher (L.E.G.) coded the remaining 28 out of 35 interviews. The researchers determined that data saturation had been reached with the current sample and no further recruitment was needed ( Guest et al. , 2006 ). We report on themes that were mentioned by at least 20% of students in the interview study. In the Supplemental Material, we provide the final coding rubric with the number of participants whose interview reflected each theme ( Hannah and Lautsch, 2011 ). Reporting the number of individuals who reported themes within qualitative data can lead to inaccurate conclusions about the generalizability of the results to a broader population. These qualitative data are meant to characterize a landscape of experiences that students with depression have in undergraduate research rather than to make claims about the prevalence of these experiences ( Glesne and Peshkin, 1992 ). Because inferences about the importance of these themes cannot be drawn from these counts, they are not included in the results of the paper ( Maxwell, 2010 ). Further, the limited number of interviewees made it not possible to examine whether there were trends based on students’ demographics or characteristics of their research experiences (e.g., their specific area of study). Quotes were lightly edited for clarity by inserting clarification brackets and using ellipses to indicate excluded text. Pseudonyms were given to all students to protect their privacy.

The Effect of Depressive Symptoms on Undergraduate Research

We asked students to describe the symptoms associated with their depression. Students described experiencing anxiety that is associated with their depression; this could be anxiety that precedes their depression or anxiety that results from a depressive episode or a period of time when an individual has depression symptoms. Further, students described difficulty getting out of bed or leaving the house, feeling tired, a lack of motivation, being overly self-critical, feeling apathetic, and having difficulty concentrating. We were particularly interested in how students’ symptoms of depression affected their experiences in undergraduate research. During the think-aloud interviews that were conducted before the interview study, graduate and undergraduate students consistently described that their depression affected their motivation in research, their creativity in research, and their productivity in research. Therefore, we explicitly asked undergraduate researchers how, if at all, their depression affected these three factors. We also asked students to describe any additional ways in which their depression affected their research experiences. Undergraduate researchers commonly described five additional ways in which their depression affected their research; for a detailed description of each way students’ research was affected and for example quotes, see Table 2 . Students described that their depression negatively affected their productivity in the lab. Commonly, students described that their productivity was directly affected by a lack of motivation or because they felt less creative, which hindered the research process. Additionally, students highlighted that they were sometimes less productive because their depression sometimes caused them to struggle to engage intellectually with their research or caused them to have difficulty remembering or concentrating; students described that they could do mundane or routine tasks when they felt depressed, but that they had difficulty with more complex and intellectually demanding tasks. However, students sometimes described that even mundane tasks could be difficult when they were required to remember specific steps; for example, some students struggled recalling a protocol from memory when their depression was particularly severe. Additionally, students noted that their depression made them more self-conscious, which sometimes held them back from sharing research ideas with their mentors or from taking risks such as applying to competitive programs. In addition to being self-conscious, students highlighted that their depression caused them to be overly self-critical, and some described experiencing imposter phenomenon ( Clance and Imes, 1978 ) or feeling like they were not talented enough to be in research and were accepted into a lab by a fluke or through luck. Finally, students described that depression often made them feel less social, and they struggled to socially engage with other members of the lab when they were feeling down.

The Effect of Undergraduate Research Experiences on Student Depression

We also wanted to explore how research impacted students’ feelings of depression. Undergraduates described how research both positively and negatively affected their depression. In the following sections, we present aspects of undergraduate research and examine how each positively and/or negatively affected students’ depression using embedded student quotes to highlight the relationships between related ideas.

Lab Environment: Relationships with Others in the Lab.

Some aspects of the lab environment, which we define as students’ physical, social, or psychological research space, could be particularly beneficial for students with depression.

Specifically, undergraduate researchers perceived that comfortable and positive social interactions with others in the lab helped their depression. Students acknowledged how beneficial their relationships with graduate students and postdocs could be.

Marta: “I think always checking in on undergrads is important. It’s really easy [for us] to go a whole day without talking to anybody in the lab. But our grad students are like ‘Hey, what’s up? How’s school? What’s going on?’ (…) What helps me the most is having that strong support system. Sometimes just talking makes you feel better, but also having people that believe in you can really help you get out of that negative spiral. I think that can really help with depression.”

Kelley: “I know that anytime I need to talk to [my postdoc mentors] about something they’re always there for me. Over time we’ve developed a relationship where I know that outside of work and outside of the lab if I did want to talk to them about something I could talk to them. Even just talking to someone about hobbies and having that relationship alone is really helpful [for depression].”

In addition to highlighting the importance of developing relationships with graduate students or postdocs in the lab, students described that forming relationships with other undergraduates in the lab also helped their depression. Particularly, students described that other undergraduate researchers often validated their feelings about research, which in turn helped them realize that what they are thinking or feeling is normal, which tended to alleviate their negative thoughts. Interestingly, other undergraduates experiencing the same issues could sometimes help buffer them from perceiving that a mentor did not like them or that they were uniquely bad at research. In this article, we use the term “mentor” to refer to anyone who students referred to in the interviews as being their mentors or managing their research experiences; this includes graduate students, postdoctoral scholars, lab managers, and primary investigators (PIs).

Abby: “One of my best friends is in the lab with me. A lot of that friendship just comes from complaining about our stress with the lab and our annoyance with people in the lab. Like when we both agree like, ‘Yeah, the grad students were really off today, it wasn’t us,’ that helps. ‘It wasn’t me, it wasn’t my fault that we were having a rough day in lab; it was the grad students.’ Just being able to realize, ‘Hey, this isn’t all caused by us,’ you know? (…) We understand the stresses in the lab. We understand the details of what each other are doing in the lab, so when something doesn’t work out, we understand that it took them like eight hours to do that and it didn’t work. We provide empathy on a different level.”

Meleana: “It’s great to have solidarity in being confused about something, and it’s just that is a form of validation for me too. When we leave a lab meeting and I look at [another undergrad] I’m like, ‘Did you understand anything that they were just saying?’ And they’re like, ‘Oh, no.’ (…) It’s just really validating to hear from the other undergrads that we all seem to be struggling with the same things.”

Developing positive relationships with faculty mentors or PIs also helped alleviate some students’ depressive feelings, particularly when PIs shared their own struggles with students. This also seemed to normalize students’ concerns about their own experiences.

Alexandra: “[Talking with my PI] is helpful because he would talk about his struggles, and what he faced. A lot of it was very similar to my struggles. For example, he would say, ‘Oh, yeah, I failed this exam that I studied so hard for. I failed the GRE and I paid so much money to prepare for it.’ It just makes [my depression] better, like okay, this is normal for students to go through this. It’s not an out of this world thing where if you fail, you’re a failure and you can’t move on from it.”

Students’ relationships with others in the lab did not always positively impact their depression. Students described instances when the negative moods of the graduate students and PIs would often set the tone of the lab, which in turn worsened the mood of the undergraduate researchers.

Abby: “Sometimes [the grad students] are not in a good mood. The entire vibe of the lab is just off, and if you make a joke and it hits somebody wrong, they get all mad. It really depends on the grad students and the leadership and the mood that they’re in.”

Interviewer: “How does it affect your depression when the grad students are in a bad mood?”

Abby: “It definitely makes me feel worse. It feels like, again, that I really shouldn’t go ask them for help because they’re just not in the mood to help out. It makes me have more pressure on myself, and I have deadlines I need to meet, but I have a question for them, but they’re in a bad mood so I can’t ask. That’s another day wasted for me and it just puts more stress, which just adds to the depression.”

Additionally, some students described even more concerning behavior from research mentors, which negatively affected their depression.

Julie: “I had a primary investigator who is notorious in the department for screaming at people, being emotionally abusive, unreasonable, et cetera. (…) [He was] kind of harassing people, demeaning them, lying to them, et cetera, et cetera. (…) Being yelled at and constantly demeaned and harassed at all hours of the day and night, that was probably pretty bad for me.”

While the relationships between undergraduates and graduate, postdoc, and faculty mentors seemed to either alleviate or worsen students’ depressive symptoms, depending on the quality of the relationship, students in this study exclusively described their relationships with other undergraduates as positive for their depression. However, students did note that undergraduate research puts some of the best and brightest undergraduates in the same environment, which can result in students comparing themselves with their peers. Students described that this comparison would often lead them to feel badly about themselves, even though they would describe their personal relationship with a person to be good.

Meleana: “In just the research field in general, just feeling like I don’t really measure up to the people around me [can affect my depression]. A lot of the times it’s the beginning of a little spiral, mental spiral. There are some past undergrads that are talked about as they’re on this pedestal of being the ideal undergrads and that they were just so smart and contributed so much to the lab. I can never stop myself from wondering like, ‘Oh, I wonder if I’m having a contribution to the lab that’s similar or if I’m just another one of the undergrads that does the bare minimum and passes through and is just there.’”

Natasha: “But, on the other hand, [having another undergrad in the lab] also reminded me constantly that some people are invested in this and meant to do this and it’s not me. And that some people know a lot more than I do and will go further in this than I will.”

While students primarily expressed that their relationships with others in the lab affected their depression, some students explained that they struggled most with depression when the lab was empty; they described that they did not like being alone in the lab, because a lack of stimulation allowed their minds to be filled with negative thoughts.

Mia: “Those late nights definitely didn’t help [my depression]. I am alone, in the entire building. I’m left alone to think about my thoughts more, so not distracted by talking to people or interacting with people. I think more about how I’m feeling and the lack of progress I’m making, and the hopelessness I’m feeling. That kind of dragged things on, and I guess deepened my depression.”

Freddy: “Often times when I go to my office in the evening, that is when I would [ sic ] be prone to be more depressed. It’s being alone. I think about myself or mistakes or trying to correct mistakes or whatever’s going on in my life at the time. I become very introspective. I think I’m way too self-evaluating, way too self-deprecating and it’s when I’m alone when those things are really, really triggered. When I’m talking with somebody else, I forget about those things.”

In sum, students with depression highlighted that a lab environment full of positive and encouraging individuals was helpful for their depression, whereas isolating or competitive environments and negative interactions with others often resulted in more depressive feelings.

Doing Science: Experiencing Failure in Research, Getting Help, Receiving Feedback, Time Demands, and Important Contributions.

In addition to the lab environment, students also described that the process of doing science could affect their depression. Specifically, students explained that a large contributor to their depression was experiencing failure in research.

Interviewer: “Considering your experience in undergraduate research, what tends to trigger your feelings of depression?”

Heather: “Probably just not getting things right. Having to do an experiment over and over again. You don’t get the results you want. (…) The work is pretty meticulous and it’s frustrating when I do all this work, I do a whole experiment, and then I don’t get any results that I can use. That can be really frustrating. It adds to the stress. (…) It’s hard because you did all this other stuff before so you can plan for the research, and then something happens and all the stuff you did was worthless basically.”

Julie: “I felt very negatively about myself [when a project failed] and pretty panicked whenever something didn’t work because I felt like it was a direct reflection on my effort and/or intelligence, and then it was a big glaring personal failure.”

Students explained that their depression related to failing in research was exacerbated if they felt as though they could not seek help from their research mentors. Perceived insufficient mentor guidance has been shown to be a factor influencing student intention to leave undergraduate research ( Cooper et al. , 2019c ). Sometimes students talked about their research mentors being unavailable or unapproachable.

Michelle: “It just feels like [the graduate students] are not approachable. I feel like I can’t approach them to ask for their understanding in a certain situation. It makes [my depression] worse because I feel like I’m stuck, and that I’m being limited, and like there’s nothing I can do. So then I kind of feel like it’s my fault that I can’t do anything.”

Other times, students described that they did not seek help in fear that they would be negatively evaluated in research, which is a fear of being judged by others ( Watson and Friend, 1969 ; Weeks et al. , 2005 ; Cooper et al. , 2018 ). That is, students fear that their mentor would think negatively about them or judge them if they were to ask questions that their mentor thought they should know the answer to.

Meleana: “I would say [my depression] tends to come out more in being more reserved in asking questions because I think that comes more like a fear-based thing where I’m like, ‘Oh, I don’t feel like I’m good enough and so I don’t want to ask these questions because then my mentors will, I don’t know, think that I’m dumb or something.’”

Conversely, students described that mentors who were willing to help them alleviated their depressive feelings.

Crystal: “Yeah [my grad student] is always like, ‘Hey, I can check in on things in the lab because you’re allowed to ask me for that, you’re not totally alone in this,’ because he knows that I tend to take on all this responsibility and I don’t always know how to ask for help. He’s like, ‘You know, this is my lab too and I am here to help you as well,’ and just reminds me that I’m not shouldering this burden by myself.”

Ashlyn: “The graduate student who I work with is very kind and has a lot of patience and he really understands a lot of things and provides simple explanations. He does remind me about things and he will keep on me about certain tasks that I need to do in an understanding way, and it’s just because he’s patient and he listens.”

In addition to experiencing failure in science, students described that making mistakes when doing science also negatively affected their depression.

Abby: “I guess not making mistakes on experiments [is important in avoiding my depression]. Not necessarily that your experiment didn’t turn out to produce the data that you wanted, but just adding the wrong enzyme or messing something up like that. It’s like, ‘Oh, man,’ you know? You can get really down on yourself about that because it can be embarrassing.”

Commonly, students described that the potential for making mistakes increased their stress and anxiety regarding research; however, they explained that how other people responded to a potential mistake was what ultimately affected their depression.

Briana: “Sometimes if I made a mistake in correctly identifying an eye color [of a fly], [my PI] would just ridicule me in front of the other students. He corrected me but his method of correcting was very discouraging because it was a ridicule. It made the others laugh and I didn’t like that.”

Julie: “[My PI] explicitly [asked] if I had the dedication for science. A lot of times he said I had terrible judgment. A lot of times he said I couldn’t be trusted. Once I went to a conference with him, and, unfortunately, in front of another professor, he called me a klutz several times and there was another comment about how I never learn from my mistakes.”

When students did do things correctly, they described how important it could be for them to receive praise from their mentors. They explained that hearing praise and validation can be particularly helpful for students with depression, because their thoughts are often very negative and/or because they have low self-esteem.

Crystal: “[Something that helps my depression is] I have text messages from [my graduate student mentor] thanking me [and another undergraduate researcher] for all of the work that we’ve put in, that he would not be able to be as on track to finish as he is if he didn’t have our help.”

Interviewer: “Why is hearing praise from your mentor helpful?”

Crystal: “Because a lot of my depression focuses on everybody secretly hates you, nobody likes you, you’re going to die alone. So having that validation [from my graduate mentor] is important, because it flies in the face of what my depression tells me.”

Brian: “It reminds you that you exist outside of this negative world that you’ve created for yourself, and people don’t see you how you see yourself sometimes.”

Students also highlighted how research could be overwhelming, which negatively affected their depression. Particularly, students described that research demanded a lot of their time and that their mentors did not always seem to be aware that they were juggling school and other commitments in addition to their research. This stress exacerbated their depression.

Rose: “I feel like sometimes [my grad mentors] are not very understanding because grad students don’t take as many classes as [undergrads] do. I think sometimes they don’t understand when I say I can’t come in at all this week because I have finals and they’re like, ‘Why though?’”

Abby: “I just think being more understanding of student life would be great. We have classes as well as the lab, and classes are the priority. They forget what it’s like to be a student. You feel like they don’t understand and they could never understand when you say like, ‘I have three exams this week,’ and they’re like, ‘I don’t care. You need to finish this.’”

Conversely, some students reported that their research labs were very understanding of students’ schedules. Interestingly, these students talked most about how helpful it was to be able to take a mental health day and not do research on days when they felt down or depressed.

Marta: “My lab tech is very open, so she’ll tell us, ‘I can’t come in today. I have to take a mental health day.’ So she’s a really big advocate for that. And I think I won’t personally tell her that I’m taking a mental health day, but I’ll say, ‘I can’t come in today, but I’ll come in Friday and do those extra hours.’ And she’s like, ‘OK great, I’ll see you then.’ And it makes me feel good, because it helps me take care of myself first and then I can take care of everything else I need to do, which is amazing.”

Meleana: “Knowing that [my mentors] would be flexible if I told them that I’m crazy busy and can’t come into work nearly as much this week [helps my depression]. There is flexibility in allowing me to then care for myself.”

Interviewer: “Why is the flexibility helpful given the depression?”

Meleana: “Because sometimes for me things just take a little bit longer when I’m feeling down. I’m just less efficient to be honest, and so it’s helpful if I feel like I can only go into work for 10 hours in a week. It declutters my brain a little bit to not have to worry about all the things I have to do in work in addition the things that I need to do for school or clubs, or family or whatever.”

Despite the demanding nature of research, a subset of students highlighted that their research and research lab provided a sense of stability or familiarity that distracted them from their depression.

Freddy: “I’ll [do research] to run away from those [depressive] feelings or whatever. (…) I find sadly, I hate to admit it, but I do kind of run to [my lab]. I throw myself into work to distract myself from the feelings of depression and sadness.”

Rose: “When you’re sad or when you’re stressed you want to go to things you’re familiar with. So because lab has always been in my life, it’s this thing where it’s going to be there for me I guess. It’s like a good book that you always go back to and it’s familiar and it makes you feel good. So that’s how lab is. It’s not like the greatest thing in the world but it’s something that I’m used to, which is what I feel like a lot of people need when they’re sad and life is not going well.”

Many students also explained that research positively affects their depression because they perceive their research contribution to be important.

Ashlyn: “I feel like I’m dedicating myself to something that’s worthy and something that I believe in. It’s really important because it contextualizes those times when I am feeling depressed. It’s like, no, I do have these better things that I’m working on. Even when I don’t like myself and I don’t like who I am, which is again, depression brain, I can at least say, ‘Well, I have all these other people relying on me in research and in this area and that’s super important.’”

Jessica: “I mean, it just felt like the work that I was doing had meaning and when I feel like what I’m doing is actually going to contribute to the world, that usually really helps with [depression] because it’s like not every day you can feel like you’re doing something impactful.”

In sum, students highlighted that experiencing failure in research and making mistakes negatively contributed to depression, especially when help was unavailable or research mentors had a negative reaction. Additionally, students acknowledged that the research could be time-consuming, but that research mentors who were flexible helped assuage depressive feelings that were associated with feeling overwhelmed. Finally, research helped some students’ depression, because it felt familiar, provided a distraction from depression, and reminded students that they were contributing to a greater cause.

We believe that creating more inclusive research environments for students with depression is an important step toward broadening participation in science, not only to ensure that we are not discouraging students with depression from persisting in science, but also because depression has been shown to disproportionately affect underserved and underrepresented groups in science ( Turner and Noh, 1988 ; Eisenberg et al. , 2007 ; Jenkins et al. , 2013 ; American College Health Association, 2018 ). We initially hypothesized that three features of undergraduate research—research mentors, the lab environment, and failure—may have the potential to exacerbate student depression. We found this to be true; students highlighted that their relationships with their mentors as well as the overall lab environment could negatively affect their depression, but could also positively affect their research experiences. Students also noted that they struggled with failure, which is likely true of most students, but is known to be particularly difficult for students with depression ( Elliott et al. , 1997 ). We expand upon our findings by integrating literature on depression with the information that students provided in the interviews about how research mentors can best support students. We provide a set of evidence-based recommendations focused on mentoring, the lab environment, and failure for research mentors wanting to create more inclusive research environments for students with depression. Notably, only the first recommendation is specific to students with depression; the others reflect recommendations that have previously been described as “best practices” for research mentors ( NASEM, 2017 , 2019 ; Sorkness et al. , 2017 ) and likely would benefit most students. However, we examine how these recommendations may be particularly important for students with depression. As we hypothesized, these recommendations directly address three aspects of research: mentors, lab environment, and failure. A caveat of these recommendations is that more research needs to be done to explore the experiences of students with depression and how these practices actually impact students with depression, but our national sample of undergraduate researchers with depression can provide an initial starting point for a discussion about how to improve research experiences for these students.

Recommendations to Make Undergraduate Research Experiences More Inclusive for Students with Depression

Recognize student depression as a valid illness..

Allow students with depression to take time off of research by simply saying that they are sick and provide appropriate time for students to recover from depressive episodes. Also, make an effort to destigmatize mental health issues.

Undergraduate researchers described both psychological and physical symptoms that manifested as a result of their depression and highlighted how such symptoms prevented them from performing to their full potential in undergraduate research. For example, students described how their depression would cause them to feel unmotivated, which would often negatively affect their research productivity. In cases in which students were motivated enough to come in and do their research, they described having difficulty concentrating or engaging in the work. Further, when doing research, students felt less creative and less willing to take risks, which may alter the quality of their work. Students also sometimes struggled to socialize in the lab. They described feeling less social and feeling overly self-critical. In sum, students described that, when they experienced a depressive episode, they were not able to perform to the best of their ability, and it sometimes took a toll on them to try to act like nothing was wrong, when they were internally struggling with depression. We recommend that research mentors treat depression like any other physical illness; allowing students the chance to recover when they are experiencing a depressive episode can be extremely important to students and can allow them to maximize their productivity upon returning to research ( Judd et al. , 2000 ). Students explained that if they are not able to take the time to focus on recovering during a depressive episode, then they typically continue to struggle with depression, which negatively affects their research. This sentiment is echoed by researchers in psychiatry who have found that patients who do not fully recover from a depressive episode are more likely to relapse and to experience chronic depression ( Judd et al. , 2000 ). Students described not doing tasks or not showing up to research because of their depression but struggling with how to share that information with their research mentors. Often, students would not say anything, which caused them anxiety because they were worried about what others in the lab would say to them when they returned. Admittedly, many students understood why this behavior would cause their research mentors to be angry or frustrated, but they weighed the consequences of their research mentors’ displeasure against the consequences of revealing their depression and decided it was not worth admitting to being depressed. This aligns with literature that suggests that when individuals have concealable stigmatized identities, or identities that can be hidden and that carry negative stereotypes, such as depression, they will often keep them concealed to avoid negative judgment or criticism ( Link and Phelan, 2001 ; Quinn and Earnshaw, 2011 ; Jones and King, 2014 ; Cooper and Brownell, 2016 ; Cooper et al. , 2019b ; Cooper et al ., unpublished data ). Therefore, it is important for research mentors to be explicit with students that 1) they recognize mental illness as a valid sickness and 2) that students with mental illness can simply explain that they are sick if they need to take time off. This may be useful to overtly state on a research website or in a research syllabus, contract, or agreement if mentors use such documents when mentoring undergraduates in their lab. Further, research mentors can purposefully work to destigmatize mental health issues by explicitly stating that struggling with mental health issues, such as depression and anxiety, is common. While we do not recommend that mentors ask students directly about depression, because this can force students to share when they are not comfortable sharing, we do recommend providing opportunities for students to reveal their depression ( Chaudoir and Fisher, 2010 ). Mentors can regularly check in with students about how they’re doing, and talk openly about the importance of mental health, which may increase the chance that students may feel comfortable revealing their depression ( Chaudoir and Quinn, 2010 ; Cooper et al ., unpublished data ).

Foster a Positive Lab Environment.

Encourage positivity in the research lab, promote working in shared spaces to enhance social support among lab members, and alleviate competition among undergraduates.

Students in this study highlighted that the “leadership” of the lab, meaning graduate students, postdocs, lab managers, and PIs, were often responsible for establishing the tone of the lab; that is, if they were in a bad mood it would trickle down and negatively affect the moods of the undergraduates. Explicitly reminding lab leadership that their moods can both positively and negatively affect undergraduates may be important in establishing a positive lab environment. Further, students highlighted how they were most likely to experience negative thoughts when they were alone in the lab. Therefore, it may be helpful to encourage all lab members to work in a shared space to enhance social interactions among students and to maximize the likelihood that undergraduates have access to help when needed. A review of 51 studies in psychiatry supported our undergraduate researchers’ perceptions that social relationships positively impacted their depression; the study found that perceived emotional support (e.g., someone available to listen or give advice), perceived instrumental support (e.g., someone available to help with tasks), and large diverse social networks (e.g., being socially connected to a large number of people) were significantly protective against depression ( Santini et al. , 2015 ). Additionally, despite forming positive relationships with other undergraduates in the lab, many undergraduate researchers admitted to constantly comparing themselves with other undergraduates, which led them to feel inferior, negatively affecting their depression. Some students talked about mentors favoring current undergraduates or talking positively about past undergraduates, which further exacerbated their feelings of inferiority. A recent study of students in undergraduate research experiences highlighted that inequitable distribution of praise to undergraduates can create negative perceptions of lab environments for students (Cooper et al. , 2019). Further, the psychology literature has demonstrated that when people feel insecure in their social environments, it can cause them to focus on a hierarchical view of themselves and others, which can foster feelings of inferiority and increase their vulnerability to depression ( Gilbert et al. , 2009 ). Thus, we recommend that mentors be conscious of their behaviors so that they do not unintentionally promote competition among undergraduates or express favoritism toward current or past undergraduates. Praise is likely best used without comparison with others and not done in a public way, although more research on the impact of praise on undergraduate researchers needs to be done. While significant research has been done on mentoring and mentoring relationships in the context of undergraduate research ( Byars-Winston et al. , 2015 ; Aikens et al. , 2017 ; Estrada et al. , 2018 ; Limeri et al. , 2019 ; NASEM, 2019 ), much less has been done on the influence of the lab environment broadly and how people in nonmentoring roles can influence one another. Yet, this study indicates the potential influence of many different members of the lab, not only their mentors, on students with depression.

Develop More Personal Relationships with Undergraduate Researchers and Provide Sufficient Guidance.

Make an effort to establish more personal relationships with undergraduates and ensure that they perceive that they have access to sufficient help and guidance with regard to their research.

When we asked students explicitly how research mentors could help create more inclusive environments for undergraduate researchers with depression, students overwhelmingly said that building mentor–student relationships would be extremely helpful. Students suggested that mentors could get to know students on a more personal level by asking about their career interests or interests outside of academia. Students also remarked that establishing a more personal relationship could help build the trust needed in order for undergraduates to confide in their research mentors about their depression, which they perceived would strengthen their relationships further because they could be honest about when they were not feeling well or their mentors might even “check in” with them in times where they were acting differently than normal. This aligns with studies showing that undergraduates are most likely to reveal a stigmatized identity, such as depression, when they form a close relationship with someone ( Chaudoir and Quinn, 2010 ). Many were intimidated to ask for research-related help from their mentors and expressed that they wished they had established a better relationship so that they would feel more comfortable. Therefore, we recommend that research mentors try to establish relationships with their undergraduates and explicitly invite them to ask questions or seek help when needed. These recommendations are supported by national recommendations for mentoring ( NASEM, 2019 ) and by literature that demonstrates that both social support (listening and talking with students) and instrumental support (providing students with help) have been shown to be protective against depression ( Santini et al. , 2015 ).

Treat Undergraduates with Respect and Remember to Praise Them.

Avoid providing harsh criticism and remember to praise undergraduates. Students with depression often have low self-esteem and are especially self-critical. Therefore, praise can help calibrate their overly negative self-perceptions.

Students in this study described that receiving criticism from others, especially harsh criticism, was particularly difficult for them given their depression. Multiple studies have demonstrated that people with depression can have an abnormal or maladaptive response to negative feedback; scientists hypothesize that perceived failure on a particular task can trigger failure-related thoughts that interfere with subsequent performance ( Eshel and Roiser, 2010 ). Thus, it is important for research mentors to remember to make sure to avoid unnecessarily harsh criticisms that make students feel like they have failed (more about failure is described in the next recommendation). Further, students with depression often have low self-esteem or low “personal judgment of the worthiness that is expressed in the attitudes the individual holds towards oneself” ( Heatherton et al. , 2003 , p. 220; Sowislo and Orth, 2013 ). Specifically, a meta-analysis of longitudinal studies found that low self-esteem is predictive of depression ( Sowislo and Orth, 2013 ), and depression has also been shown to be highly related to self-criticism ( Luyten et al. , 2007 ). Indeed, nearly all of the students in our study described thinking that they are “not good enough,” “worthless,” or “inadequate,” which is consistent with literature showing that people with depression are self-critical ( Blatt et al. , 1982 ; Gilbert et al. , 2006 ) and can be less optimistic of their performance on future tasks and rate their overall performance on tasks less favorably than their peers without depression ( Cane and Gotlib, 1985 ). When we asked students what aspects of undergraduate research helped their depression, students described that praise from their mentors was especially impactful, because they thought so poorly of themselves and they needed to hear something positive from someone else in order to believe it could be true. Praise has been highlighted as an important aspect of mentoring in research for many years ( Ashford, 1996 ; Gelso and Lent, 2000 ; Brown et al. , 2009 ) and may be particularly important for students with depression. In fact, praise has been shown to enhance individuals’ motivation and subsequent productivity ( Hancock, 2002 ; Henderlong and Lepper, 2002 ), factors highlighted by students as negatively affecting their depression. However, something to keep in mind is that a student with depression and a student without depression may process praise differently. For a student with depression, a small comment that praises the student’s work may not be sufficient for the student to process that comment as praise. People with depression are hyposensitive to reward or have reward-processing deficits ( Eshel and Roiser, 2010 ); therefore, praise may affect students without depression more positively than it would affect students with depression. Research mentors should be mindful that students with depression often have a negative view of themselves, and while students report that praise is extremely important, they may have trouble processing such positive feedback.

Normalize Failure and Be Explicit about the Importance of Research Contributions.

Explicitly remind students that experiencing failure is expected in research. Also explain to students how their individual work relates to the overall project so that they can understand how their contributions are important. It can also be helpful to explain to students why the research project as a whole is important in the context of the greater scientific community.

Experiencing failure has been thought to be a potentially important aspect of undergraduate research, because it may provide students with the potential to develop integral scientific skills such as the ability to navigate challenges and persevere ( Laursen et al. , 2010 ; Gin et al. , 2018 ; Henry et al. , 2019 ). However, in the interviews, students described that when their science experiments failed, it was particularly tough for their depression. Students’ negative reaction to experiencing failure in research is unsurprising, given recent literature that has predicted that students may be inadequately prepared to approach failure in science ( Henry et al. , 2019 ). However, the literature suggests that students with depression may find experiencing failure in research to be especially difficult ( Elliott et al. , 1997 ; Mongrain and Blackburn, 2005 ; Jones et al. , 2009 ). One potential hypothesis is that students with depression may be more likely to have fixed mindsets or more likely to believe that their intelligence and capacity for specific abilities are unchangeable traits ( Schleider and Weisz, 2018 ); students with a fixed mindset have been hypothesized to have particularly negative responses to experiencing failure in research, because they are prone to quitting easily in the face of challenges and becoming defensive when criticized ( Forsythe and Johnson, 2017 ; Dweck, 2008 ). A study of life sciences undergraduates enrolled in CUREs identified three strategies of students who adopted adaptive coping mechanisms, or mechanisms that help an individual maintain well-being and/or move beyond the stressor when faced with failure in undergraduate research: 1) problem solving or engaging in strategic planning and decision making, 2) support seeking or finding comfort and help with research, and 3) cognitive restructuring or reframing a problem from negative to positive and engaging in self encouragement ( Gin et al. , 2018 ). We recommend that, when undergraduates experience failure in science, their mentors be proactive in helping them problem solve, providing help and support, and encouraging them. Students also explained that mentors sharing their own struggles as undergraduate and graduate students was helpful, because it normalized failure. Sharing personal failures in research has been recommended as an important way to provide students with psychosocial support during research ( NASEM, 2019 ). We also suggest that research mentors take time to explain to students why their tasks in the lab, no matter how small, contribute to the greater research project ( Cooper et al. , 2019a ). Additionally, it is important to make sure that students can explain how the research project as a whole is contributing to the scientific community ( Gin et al. , 2018 ). Students highlighted that contributing to something important was really helpful for their depression, which is unsurprising, given that studies have shown that meaning in life or people’s comprehension of their life experiences along with a sense of overarching purpose one is working toward has been shown to be inversely related to depression ( Steger, 2013 ).

Limitations and Future Directions

This work was a qualitative interview study intended to document a previously unstudied phenomenon: depression in the context of undergraduate research experiences. We chose to conduct semistructured interviews rather than a survey because of the need for initial exploration of this area, given the paucity of prior research. A strength of this study is the sampling approach. We recruited a national sample of 35 undergraduates engaged in undergraduate research at 12 different public R1 institutions. Despite our representative sample from R1 institutions, these findings may not be generalizable to students at other types of institutions; lab environments, mentoring structures, and interactions between faculty and undergraduate researchers may be different at other institution types (e.g., private R1 institutions, R2 institutions, master’s-granting institutions, primarily undergraduate institutions, and community colleges), so we caution against making generalizations about this work to all undergraduate research experiences. Future work could assess whether students with depression at other types of institutions have similar experiences to students at research-intensive institutions. Additionally, we intentionally did not explore the experiences of students with specific identities owing to our sample size and the small number of students in any particular group (e.g., students of a particular race, students with a graduate mentor as the primary mentor). We intend to conduct future quantitative studies to further explore how students’ identities and aspects of their research affect their experiences with depression in undergraduate research.

The students who participated in the study volunteered to be interviewed about their depression; therefore, it is possible that depression is a more salient part of these students’ identities and/or that they are more comfortable talking about their depression than the average population of students with depression. It is also important to acknowledge the personal nature of the topic and that some students may not have fully shared their experiences ( Krumpal, 2013 ), particularly those experiences that may be emotional or traumatizing ( Kahn and Garrison, 2009 ). Additionally, our sample was skewed toward females (77%). While females do make up approximately 60% of students in biology programs on average ( Eddy et al. , 2014 ), they are also more likely to report experiencing depression ( American College Health Association, 2018 ; Evans et al. , 2018 ). However, this could be because women have higher rates of depression or because males are less likely to report having depression; clinical bias, or practitioners’ subconscious tendencies to overlook male distress, may underestimate depression rates in men ( Smith et al. , 2018 ). Further, females are also more likely to volunteer to participate in studies ( Porter and Whitcomb, 2005 ); therefore, many interview studies have disproportionately more females in the data set (e.g., Cooper et al. , 2017 ). If we had been able to interview more male students, we might have identified different findings. Additionally, we limited our sample to life sciences students engaged in undergraduate research at public R1 institutions. It is possible that students in other majors may have different challenges and opportunities for students with depression, as well as different disciplinary stigmas associated with mental health.

In this exploratory interview study, we identified a variety of ways in which depression in undergraduates negatively affected their undergraduate research experiences. Specifically, we found that depression interfered with students’ motivation and productivity, creativity and risk-taking, engagement and concentration, and self-perception and socializing. We also identified that research can negatively affect depression in undergraduates. Experiencing failure in research can exacerbate student depression, especially when students do not have access to adequate guidance. Additionally, being alone or having negative interactions with others in the lab worsened students’ depression. However, we also found that undergraduate research can positively affect students’ depression. Research can provide a familiar space where students can feel as though they are contributing to something meaningful. Additionally, students reported that having access to adequate guidance and a social support network within the research lab also positively affected their depression. We hope that this work can spark conversations about how to make undergraduate research experiences more inclusive of students with depression and that it can stimulate additional research that more broadly explores the experiences of undergraduate researchers with depression.

Important note

If you or a student experience symptoms of depression and want help, there are resources available to you. Many campuses provide counseling centers equipped to provide students, staff, and faculty with treatment for depression, as well as university-dedicated crisis hotlines. Additionally, there are free 24/7 services such as Crisis Text Line, which allows you to text a trained live crisis counselor (Text “CONNECT” to 741741; Text Depression Hotline , 2019 ), and phone hotlines such as the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can also learn more about depression and where to find help near you through the Anxiety and Depression Association of American website: https://adaa.org ( Anxiety and Depression Association of America, 2019 ) and the Depression and Biopolar Support Alliance: http://dbsalliance.org ( Depression and Biopolar Support Alliance, 2019 ).

ACKNOWLEDGMENTS

We are extremely grateful to the undergraduate researchers who shared their thoughts and experiences about depression with us. We acknowledge the ASU LEAP Scholars for helping us create the original survey and Rachel Scott for her helpful feedback on earlier drafts of this article. L.E.G. was supported by a National Science Foundation (NSF) Graduate Fellowship (DGE-1311230) and K.M.C. was partially supported by a Howard Hughes Medical Institute (HHMI) Inclusive Excellence grant (no. 11046) and an NSF grant (no. 1644236). Any opinions, findings, conclusions, or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the NSF or HHMI.

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Submitted: 4 November 2019 Revised: 24 February 2020 Accepted: 6 March 2020

© 2020 K. M. Cooper, L. E. Gin, et al. CBE—Life Sciences Education © 2020 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

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Depression Questionnaire: 30 Survey Questions

In our dynamic and demanding contemporary society, the prevalence of mental health challenges, particularly depression, has become an increasingly pressing concern affecting countless lives worldwide. Amidst this backdrop, the need for practical assessment tools to decipher the intricacies of individuals’ mental well-being has grown significantly. Enter the depression questionnaire—a vital instrument meticulously structured to unravel the emotional, cognitive, and behavioral dimensions of one’s mental landscape.

In a world where stress and uncertainties abound, the ability to comprehend and address mental health concerns has never been more critical. Depression, with its wide-ranging symptoms and varying degrees of severity, requires nuanced evaluation, making depression questionnaires an indispensable asset. This piece explores the subtle nature of these questionnaires, elucidating their role in comprehensively assessing individuals’ mental health statuses and providing invaluable insights into their emotional states.

What is Depression Questionnaire?

A depression questionnaire is a set of depression screening questions asked to gather information that will give you insights into a person’s mental health and well being. Good mental health and well being improve the quality of life.

In the current fast-paced world, stress is a major factor that is affecting people all across the globe. Major corporations have started using mindfulness and meditation techniques to reduce work stress on their employees. Depression affects people in many ways and can have various symptoms. They can range from mild to severe. Mild depression can mean you are simply feeling low in spirit, while depression severity can have fatal thoughts like being suicidal or feeling that your life has no meaning to it. There has been an increase in such cases in recent years and hence it has become quite important for detecting depression at an early stage and tackle the issue appropriately.

Examples of Severe Depression

For example, a person has been laid-off by a company and it is getting very difficult to find a new job. Because of such an incident, the individual has started feeling hopeless, has low self-esteem, and lacks sleep. Such bad times can make an individual feel they have been a failure and can cause depression severity. In such a case, a depression questionnaire can help to assess the severity of the condition and thus appropriate actions can be taken to cure depression.

Similarly, another example is a student is feeling depressed because of constant bullying, low grades, and peer pressure. In such a situation, a depression survey for students can shed some light on how severe the condition is and the facilities provided by the school/college to tackle such cases. A student interest survey helps customize teaching methods and curriculum to make learning more engaging and relevant to students’ lives. It is difficult for people to identify if the mental illness is depression or temporary sadness. You can use a free mental health survey template to identify the type of mental health care survey .

This information can help them get back to academic life and be more productive in the tasks they are required to perform.

Types of Depression Questionnaires

Understanding the diverse approaches used in assessing depression is pivotal in comprehensively evaluating mental health. Various types of depression questionnaires cater to different aspects of an individual’s mental well-being. These assessments range from standardized scales to culturally adapted tools, each offering unique insights into the complexities of depression.

Standardized Questionnaires:

These assessments, such as the Beck Depression Inventory (BDI), Patient Health Questionnaire (PHQ-9), and Hamilton Depression Rating Scale (HAM-D), employ structured questions and scoring systems to quantify the severity of depressive symptoms. They serve as standardized metrics in clinical evaluations.

Screening Tools:

Quick and targeted assessments like the PHQ-2 assist in preliminary screenings to identify individuals who may require further evaluation for depression. These concise tools play a vital role in initial assessments.

Self-Report Measures:

Tools such as the Zung Self-Rating Depression Scale depend on individuals’ self-assessments to measure their emotional state and symptomatology, providing valuable insights into their experiences.

Clinician-Rated Scales:

Utilized by healthcare professionals, clinician-rated scales like the HAM-D involve observations and assessments of patients’ symptoms, providing an expert evaluation of their depressive state.

Adolescent-Specific Questionnaires:

Tailored assessments such as the Children’s Depression Inventory (CDI) or the Mood and Feelings Questionnaire (MFQ) are designed to evaluate depression symptoms in younger populations, considering their unique developmental aspects.

Cultural Adaptations:

Adaptations and translations of questionnaires ensure inclusivity across diverse cultural backgrounds and languages, enabling accurate assessments while respecting individual differences.

These assessments consider symptoms like poor appetite, feeling tired, having little energy, and other indicators from the depression module, aiding in collaborative management and identifying individuals experiencing reduced pleasure in doing things, feeling depressed or hopeless, hurting, restless, or experiencing these symptoms on half the days.

Importance of Depression Surveys

Depression surveys serve as vital tools in the field of mental health assessment and care, providing an extensive framework for understanding and evaluating various facets of an individual’s mental and emotional well-being. They’re valuable because they systematically evaluate personal experiences and collect vital information for healthcare providers. Here are vital reasons highlighting their importance:

Early Identification and Intervention:

Depression surveys are instrumental in detecting early signs of common mental disorders by presenting a comprehensive array of questions that cover a broad spectrum of mental health concerns. These surveys encompass crucial aspects such as feeling low in energy, experiencing moderately severe symptoms, little interest or pleasure in activities, and other indicators that aid in detecting depression.

Holistic Assessment:

Structured to evaluate diverse aspects of an individual’s life affected by depression, these surveys delve into emotional well-being, behavioral patterns, cognitive functions, and physical health. They are designed to capture crucial details related to self-harm, feeling bad, trouble falling or staying asleep, and other problems associated with depression.

Personalized Treatment Plans:

The information gathered from depression surveys aids healthcare providers, especially those in general internal medicine or primary care, in formulating personalized treatment plans tailored to an individual’s specific symptoms and needs.

Monitoring Progress and Effectiveness of Treatment:

Continual assessment through follow-up depression surveys is crucial in tracking an individual’s progress during treatment, allowing for adjustments and ensuring the effectiveness of interventions.

Contribution to Research and Population Studies:

The aggregated data from depression surveys significantly contributes to research endeavors and population studies in mental health, providing valuable insights into the prevalence, trends, and impact of depression on individuals and communities.

Depression surveys play a pivotal role in early detection, personalized care, treatment monitoring, and advancing our collective understanding of depression, ensuring that healthcare providers in primary care settings have the necessary tools to detect and address depression effectively.

30 Depression survey questions for a questionnaire

Here’s how to create a good survey design for a depression questionnaire using appropriate wellness survey questions.

Depression survey questions to evaluate mental health and identify the level of depression.

Please state to your level of agreement, for the following things that have been observed in the last week

Completely agree
Somewhat agree
Somewhat disagree
Completely disagree

Depression questions to test an individual’s knowledge about depression (Used to test the knowledge of new doctors)

Not depressed
Mild depression
Moderate depression
Severe depression
Prescribe an antidepressant
Prescribe venlafaxine
Advise self-help or psychological intervention
Advise psychological intervention along with SSRI.
Fluvoxamine
Venlafaxine
Mirtazapine
Antidepressants
A combination of CBT and Antidepressants
Other psychological therapies
In your words, please elaborate on the step care model for depression and what it does? (Open-ended question)
Benzodiazepines
Sedating antihistamines
Clomipramine
Antipsychotics
Increased likelihood of patient stopping treatment because of side effects
Withdrawal symptoms
Toxicity in overdose
Tricyclic antidepressants
Course of Venlafaxine
Do you have any comments/suggestions regarding improvement in depression treatment?

The above questions are used by depression specialists to test the knowledge of new doctors. Such questions are very specific and can be understood by medical professionals only.

Depression questionnaires are fundamental tools in modern mental health practices, serving as an initial step in identifying, evaluating, and addressing the intricate spectrum of depressive symptoms individuals may encounter. They encompass various indicators such as the depression severity measure, trouble concentrating, interest levels, fatigue, and other vital markers. These questionnaires establish a structured framework for assessing emotional, cognitive, and behavioral aspects, aiding in evaluating mental health status comprehensively.

Beyond assessment, these questionnaires hold significant value in destigmatizing mental health conversations. They shine a light on critical elements like depression severity, trouble concentrating, reduced interest in activities, persistent fatigue, and more. Doing so encourages open dialogues about emotional well-being, empowering individuals to articulate their challenges and facilitating early intervention. As mental health awareness progresses, these tools remain pivotal in recognizing and supporting individuals grappling with depression, equipping healthcare providers with valuable insights like trouble falling.

Among these questionnaires, the brief depression severity measure and the PHQ-9 are notable instruments. They gauge vital aspects such as little interest, concentration difficulties, and severity of depressive symptoms, contributing significantly to the overall understanding and management of depression. These tools play a crucial role in the ongoing efforts to identify and assist individuals dealing with depression, ensuring that healthcare providers have essential insights for practical support and intervention strategies.

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What is depression?

Depression (also known as major depression, major depressive disorder, or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how a person feels, thinks, and handles daily activities, such as sleeping, eating, or working.

To be diagnosed with depression, the symptoms must be present for at least 2 weeks.

There are different types of depression, some of which develop due to specific circumstances.

Major depression includes symptoms of depressed mood or loss of interest, most of the time for at least 2 weeks, that interfere with daily activities.
Persistent depressive disorder (also called dysthymia or dysthymic disorder) consists of less severe symptoms of depression that last much longer, usually for at least 2 years.
Perinatal depression is depression that occurs during pregnancy or after childbirth. Depression that begins during pregnancy is prenatal depression, and depression that begins after the baby is born is postpartum depression.
Seasonal affective disorder is depression that comes and goes with the seasons, with symptoms typically starting in the late fall or early winter and going away during the spring and summer.
Depression with symptoms of psychosis is a severe form of depression in which a person experiences psychosis symptoms, such as delusions (disturbing, false fixed beliefs) or hallucinations (hearing or seeing things others do not hear or see).

People with bipolar disorder (formerly called manic depression or manic-depressive illness) also experience depressive episodes, during which they feel sad, indifferent, or hopeless, combined with a very low activity level. But a person with bipolar disorder also experiences manic (or less severe hypomanic) episodes, or unusually elevated moods, in which they might feel very happy, irritable, or “up,” with a marked increase in activity level.

Other depressive disorders found in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR) include disruptive mood dysregulation disorder (diagnosed in children and adolescents) and premenstrual dysphoric disorder (that affects women around the time of their period).

Who gets depression?

Depression can affect people of all ages, races, ethnicities, and genders.

Women are diagnosed with depression more often than men, but men can also be depressed. Because men may be less likely to recognize, talk about, and seek help for their feelings or emotional problems, they are at greater risk of their depression symptoms being undiagnosed or undertreated.

Studies also show higher rates of depression and an increased risk for the disorder among members of the LGBTQI+ community.

What are the signs and symptoms of depression?

If you have been experiencing some of the following signs and symptoms, most of the day, nearly every day, for at least 2 weeks, you may have depression:

Persistent sad, anxious, or “empty” mood
Feelings of hopelessness or pessimism
Feelings of irritability, frustration, or restlessness
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in hobbies and activities
Fatigue, lack of energy, or feeling slowed down
Difficulty concentrating, remembering, or making decisions
Difficulty sleeping, waking too early in the morning, or oversleeping
Changes in appetite or unplanned weight changes
Physical aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not go away with treatment
Thoughts of death or suicide or suicide attempts

Not everyone who is depressed experiences all these symptoms. Some people experience only a few symptoms, while others experience many. Symptoms associated with depression interfere with day-to-day functioning and cause significant distress for the person experiencing them.

Depression can also involve other changes in mood or behavior that include:

Increased anger or irritability
Feeling restless or on edge
Becoming withdrawn, negative, or detached
Increased engagement in high-risk activities
Greater impulsivity
Increased use of alcohol or drugs
Isolating from family and friends
Inability to meet the responsibilities of work and family or ignoring other important roles
Problems with sexual desire and performance

Depression can look different in men and women. Although people of all genders can feel depressed, how they express those symptoms and the behaviors they use to cope with them may differ. For example, men (as well as women) may show symptoms other than sadness, instead seeming angry or irritable. And although increased use of alcohol or drugs can be a sign of depression in anyone, men are more likely to use these substances as a coping strategy.

In some cases, mental health symptoms appear as physical problems (for example, a racing heart, tightened chest, ongoing headaches, or digestive issues). Men are often more likely to see a health care provider about these physical symptoms than their emotional ones.

Because depression tends to make people think more negatively about themselves and the world, some people may also have thoughts of suicide or self-harm.

Several persistent symptoms, in addition to low mood, are required for a diagnosis of depression, but people with only a few symptoms may benefit from treatment. The severity and frequency of symptoms and how long they last will vary depending on the person, the illness, and the stage of the illness.

If you experience signs or symptoms of depression and they persist or do not go away, talk to a health care provider. If you see signs or symptoms of depression in someone you know, encourage them to seek help from a mental health professional.

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org . In life-threatening situations, call 911 .

What are the risk factors for depression?

Depression is one of the most common mental disorders in the United States . Research suggests that genetic, biological, environmental, and psychological factors play a role in depression.

Risk factors for depression can include:

Personal or family history of depression
Major negative life changes, trauma, or stress

Depression can happen at any age, but it often begins in adulthood. Depression is now recognized as occurring in children and adolescents, although children may express more irritability or anxiety than sadness. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in childhood.

Depression, especially in midlife or older age, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, chronic pain, and Parkinson’s disease. These conditions are often worse when depression is present, and research suggests that people with depression and other medical illnesses tend to have more severe symptoms of both illnesses. The Centers for Disease Control and Prevention (CDC) has also recognized that having certain mental disorders, including depression and schizophrenia, can make people more likely to get severely ill from COVID-19.

Sometimes a physical health problem, such as thyroid disease, or medications taken for an illness cause side effects that contribute to depression. A health care provider experienced in treating these complicated illnesses can help determine the best treatment strategy.

How is depression treated?

Depression, even the most severe cases, can be treated. The earlier treatment begins, the more effective it is. Depression is usually treated with psychotherapy , medication , or a combination of the two.

Some people experience treatment-resistant depression, which occurs when a person does not get better after trying at least two antidepressant medications. If treatments like psychotherapy and medication do not reduce depressive symptoms or the need for rapid relief from symptoms is urgent, brain stimulation therapy may be an option to explore.

Quick tip : No two people are affected the same way by depression, and there is no "one-size-fits-all" treatment. Finding the treatment that works best for you may take trial and error.

Psychotherapies

Several types of psychotherapy (also called talk therapy or counseling) can help people with depression by teaching them new ways of thinking and behaving and helping them change habits that contribute to depression. Evidence-based approaches to treating depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). Learn more about psychotherapy .

The growth of telehealth for mental health services , which offers an alternative to in-person therapy, has made it easier and more convenient for people to access care in some cases. For people who may have been hesitant to look for mental health care in the past, virtual mental health care might be an easier option.

Medications

Antidepressants are medications commonly used to treat depression. They work by changing how the brain produces or uses certain chemicals involved in mood or stress. You may need to try several different antidepressants before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered first.

Antidepressants take time—usually 4–8 weeks—to work, and problems with sleep, appetite, and concentration often improve before mood lifts. It is important to give a medication a chance to work before deciding whether it’s right for you. Learn more about mental health medications .

New medications, such as intranasal esketamine , can have rapidly acting antidepressant effects, especially for people with treatment-resistant depression. Esketamine is a medication approved by the U.S. Food and Drug Administration (FDA) for treatment-resistant depression. Delivered as a nasal spray in a doctor’s office, clinic, or hospital, it acts rapidly, typically within a couple of hours, to relieve depression symptoms. People who use esketamine will usually continue taking an oral antidepressant to maintain the improvement in their symptoms.

Another option for treatment-resistant depression is to take an antidepressant alongside a different type of medication that may make it more effective, such as an antipsychotic or anticonvulsant medication. Further research is needed to identify the role of these newer medications in routine practice.

If you begin taking an antidepressant, do not stop taking it without talking to a health care provider . Sometimes people taking antidepressants feel better and stop taking the medications on their own, and their depression symptoms return. When you and a health care provider have decided it is time to stop a medication, usually after a course of 9–12 months, the provider will help you slowly and safely decrease your dose. Abruptly stopping a medication can cause withdrawal symptoms.

Note : In some cases, children, teenagers, and young adults under 25 years may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. The FDA advises that patients of all ages taking antidepressants be watched closely, especially during the first few weeks of treatment.

If you are considering taking an antidepressant and are pregnant, planning to become pregnant, or breastfeeding, talk to a health care provider about any health risks to you or your unborn or nursing child and how to weigh those risks against the benefits of available treatment options.

To find the latest information about antidepressants, talk to a health care provider and visit the FDA website .

Brain stimulation therapies

If psychotherapy and medication do not reduce symptoms of depression, brain stimulation therapy may be an option to explore. There are now several types of brain stimulation therapy, some of which have been authorized by the FDA to treat depression. Other brain stimulation therapies are experimental and still being investigated for mental disorders like depression.

Although brain stimulation therapies are less frequently used than psychotherapy and medication, they can play an important role in treating mental disorders in people who do not respond to other treatments. These therapies are used for most mental disorders only after psychotherapy and medication have been tried and usually continue to be used alongside these treatments.

Brain stimulation therapies act by activating or inhibiting the brain with electricity. The electricity is given directly through electrodes implanted in the brain or indirectly through electrodes placed on the scalp. The electricity can also be induced by applying magnetic fields to the head.

The brain stimulation therapies with the largest bodies of evidence include:

Electroconvulsive therapy (ECT)
Repetitive transcranial magnetic stimulation (rTMS)
Vagus nerve stimulation (VNS)
Magnetic seizure therapy (MST)
Deep brain stimulation (DBS)

ECT and rTMS are the most widely used brain stimulation therapies, with ECT having the longest history of use. The other therapies are newer and, in some cases, still considered experimental. Other brain stimulation therapies may also hold promise for treating specific mental disorders.

ECT, rTMS, and VNS have authorization from the FDA to treat severe, treatment-resistant depression. They can be effective for people who have not been able to feel better with other treatments; people for whom medications cannot be used safely; and in severe cases where a rapid response is needed, such as when a person is catatonic, suicidal, or malnourished.

Additional types of brain stimulation therapy are being investigated for treating depression and other mental disorders. Talk to a health care provider and make sure you understand the potential benefits and risks before undergoing brain stimulation therapy. Learn more about these brain stimulation therapies .

Natural products

The FDA has not approved any natural products for treating depression. Although research is ongoing and findings are inconsistent, some people use natural products, including vitamin D and the herbal dietary supplement St. John’s wort, for depression. However, these products can come with risks. For instance, dietary supplements and natural products can limit the effectiveness of some medications or interact in dangerous or even life-threatening ways with them.

Do not use vitamin D, St. John’s wort, or other dietary supplements or natural products without talking to a health care provider. Rigorous studies must be conducted to test whether these and other natural products are safe and effective.

Daily morning light therapy is a common treatment choice for people with seasonal affective disorder (SAD). Light therapy devices are much brighter than ordinary indoor lighting and considered safe, except for people with certain eye diseases or taking medications that increase sensitivity to sunlight. As with all interventions for depression, evaluation, treatment, and follow-up by a health care provider are strongly recommended. Research into the potential role of light therapy in treating non-seasonal depression is ongoing.

How can I find help for depression?

A primary care provider is a good place to start if you’re looking for help. They can refer you to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker, who can help you figure out next steps. Find tips for talking with a health care provider about your mental health.

You can learn more about getting help on the NIMH website. You can also learn about finding support and locating mental health services in your area on the Substance Abuse and Mental Health Services Administration (SAMHSA) website.

Once you enter treatment, you should gradually start to feel better. Here are some other things you can do outside of treatment that may help you or a loved one feel better:

Try to get physical activity. Just 30 minutes a day of walking can boost your mood.
Try to maintain a regular bedtime and wake-up time.
Eat regular, healthy meals.
Break up large tasks into small ones; do what you can as you can. Decide what must get done and what can wait.
Try to connect with people. Talk with people you trust about how you are feeling.
Delay making important decisions, such as getting married or divorced, or changing jobs until you feel better. Discuss decisions with people who know you well.
Avoid using alcohol, nicotine, or drugs, including medications not prescribed for you.

How can I find a clinical trial for depression?

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions, including depression. The goal of a clinical trial is to determine if a new test or treatment works and is safe. Although people may benefit from being part of a clinical trial, they should know that the primary purpose is to gain new scientific knowledge so that others can be better helped in the future.

Researchers at NIMH and around the country conduct many studies with people with and without depression. We have new and better treatment options today because of what clinical trials have uncovered. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you.

To learn more or find a study, visit:

Clinical Trials – Information for Participants : Information about clinical trials, why people might take part in a clinical trial, and what people might experience during a clinical trial
Clinicaltrials.gov: Current Studies on Depression : List of clinical trials funded by the National Institutes of Health (NIH) being conducted across the country
Join a Study: Depression—Adults : List of studies currently recruiting adults with depression being conducted on the NIH campus in Bethesda, MD
Join a Study: Depression—Children : List of studies currently recruiting children with depression being conducted on the NIH campus in Bethesda, MD
Join a Study: Perimenopause-Related Mood Disorders : List of studies on perimenopause-related mood disorders being conducted on the NIH campus in Bethesda, MD
Join a Study: Postpartum Depression : List of studies on postpartum depression being conducted on the NIH campus in Bethesda, MD

Where can I learn more about depression?

Free brochures and shareable resources.

Chronic Illness and Mental Health: Recognizing and Treating Depression : This brochure provides information about depression for people living with chronic illnesses, including children and adolescents. It discusses signs and symptoms, risk factors, and treatment options.
Depression : This brochure provides information about depression, including different types of depression, signs and symptoms, how it is diagnosed, treatment options, and how to find help for yourself or a loved one.
Depression in Women: 4 Things to Know : This fact sheet provides information about depression in women, including signs and symptoms, types of depression unique to women, and how to get help.
Perinatal Depression : This brochure provides information about perinatal depression, including how it differs from “baby blues,” causes, signs and symptoms, treatment options, and how to find help for yourself or a loved one.
Seasonal Affective Disorder : This fact sheet provides information about seasonal affective disorder, including signs and symptoms, how it is diagnosed, causes, and treatment options.
Seasonal Affective Disorder (SAD): More Than the Winter Blues : This infographic provides information about how to recognize the symptoms of SAD and what to do to get help.
Teen Depression: More Than Just Moodiness : This fact sheet is for teens and young adults and provides information about how to recognize the symptoms of depression and what to do to get help.
Digital Shareables on Depression : These digital resources, including graphics and messages, can be used to spread the word about depression and help promote depression awareness and education in your community.

Federal resources

Depression (MedlinePlus - also en español )
Moms’ Mental Health Matters: Depression and Anxiety Around Pregnancy ( Eunice Kennedy Shriver National Institute of Child Health and Human Development)

Research and statistics

Journal Articles : This webpage provides articles and abstracts on depression from MEDLINE/PubMed (National Library of Medicine).
Statistics: Major Depression : This webpage provides the statistics currently available on the prevalence and treatment of depression among people in the United States.
Depression Mental Health Minute : Take a mental health minute to watch this video on depression.
NIMH Experts Discuss the Menopause Transition and Depression : Learn about the signs and symptoms, treatments, and latest research on depression during menopause.
NIMH Expert Discusses Seasonal Affective Disorder : Learn about the signs and symptoms, treatments, and latest research on seasonal affective disorder.
Discover NIMH: Personalized and Targeted Brain Stimulation Therapies : Watch this video describing repetitive transcranial magnetic stimulation and electroconvulsive therapy for treatment-resistant depression. Brain stimulation therapies can be effective treatments for people with depression and other mental disorders. NIMH supports studies exploring how to make brain stimulation therapies more personalized while reducing side effects.
Discover NIMH: Drug Discovery and Development : One of the most exciting breakthroughs from research funded by NIMH is the development of a fast-acting medication for treatment-resistant depression based on ketamine. This video shares the story of how ketamine infusions meaningfully changed the life of a participant in an NIMH clinical trial.
Mental Health Matters Podcast: Depression: The Case for Ketamine : Dr. Carlos Zarate Jr. discusses esketamine—the medication he helped discover—for treatment-resistant depression. The podcast covers the history behind the development of esketamine, how it can help with depression, and what the future holds for this innovative line of clinical research.

Last Reviewed: March 2024

Unless otherwise specified, the information on our website and in our publications is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content.

89 Postpartum Depression Essay Topic Ideas & Examples

🏆 best postpartum depression topic ideas & essay examples, 👍 most interesting postpartum depression topics to write about, ⭐ good research topics about postpartum depression, ❓ postpartum depression research questions.

Postpartum Depression and Its Peculiarities The major peculiarity of PPD in terms of its adverse effects is that it is detrimental to both the mother and the newborn child.
Activity During Pregnancy and Postpartum Depression Studies have shown that women’s mood and cardiorespiratory fitness improve when they engage in moderate-intensity physical activity in the weeks and months after giving birth to a child. We will write a custom essay specifically for you by our professional experts 808 writers online Learn More
Complementary Therapy for Postpartum Depression in Primary Care Thus, the woman faced frustration and sadness, preventing her from taking good care of the child, and the lack of support led to the emergence of concerns similar to those in the past.
Technology to Fight Postpartum Depression in African American Women I would like to introduce the app “Peanut” the social network designed to help and unite women exclusively, as a technology aimed at fighting postpartum depression in African American Women.
The Postpartum Depression in Afro-Americans Policy The distribution of the funds is managed and administered on the state level. Minnesota and Maryland focused on passing the legislation regulating the adoption of Medicaid in 2013.
Breastfeeding and Risk of Postpartum Depression The primary goal of the research conducted by Islam et al.was to analyze the correlation between exclusive breastfeeding and the risk of postpartum depression among new mothers.
Postpartum Depression in African American Women As far as African American women are concerned, the issue becomes even more complex due to several reasons: the stigma associated with the mental health of African American women and the mental health complications that […]
Postpartum Depression Among the Low-Income U.S. Mothers Mothers who take part in the programs develop skills and knowledge to use the existing social entities to ensure that they protect themselves from the undesirable consequences associated with the PPD and other related psychological […]
In-Vitro Fertilization and Postpartum Depression The research was conducted through based on professional information sources and statistical data collected from the research study used to further validate the evidence and outcome of this study.
Postpartum Depression and Its Impact on Infants The goal of this research was “to investigate the prevalence of maternal depressive symptoms at 5 and 9 months postpartum in a low-income and predominantly Hispanic sample, and evaluate the impact on infant weight gain, […]
Postpartum Depression: Statistics and Methods of Diagnosis The incorporation of the screening tools into the existing electronic medical support system has proved to lead to positive outcomes for both mothers and children.
Postpartum Psychosis: Impact on Family By the ties of kinship, the extended families of both parents are often intricately involved in the pregnancy and maybe major sources of support for the pregnant woman.
Postpartum Depression: Treatment and Therapy It outlines the possible treatment and therapy methods, as well as the implications of the condition. A 28-year-old patient presented in the office three weeks after giving birth to her first son with the symptoms […]
A Review of Postpartum Depression and Continued Post Birth Support In the first chapter – the introduction – the problem statement, background, purpose, and nature of the project are mentioned. The purpose of the project is to explain the significance of managing postpartum depression by […]
Postpartum Depression: Understanding the Needs of Women This article also emphasizes the need to consider and assess the needs of the mother, infant as well as family members during the treatment of PPD.
Postpartum Depression and Acute Depressive Symptoms It is hypothesized that the authors of the study wished to establish, with certainty, the effect of the proposed predictors for the development of PPD.
Supporting the Health Needs of Patients With Parkinson’s, Preeclampsia, and Postpartum Depression The medical history of the patient will help the doctor to offer the best drug therapy. Members of the family might also be unable to cope with the disorder.
Postpartum Depression and Comorbid Disorders For example, at a public hospital in Sydney, Australia, the psychiatrists used a Routine Comprehensive Psychosocial Assessment tool to study the chances of ‘low risk’ women developing the postpartum symptoms.
Correlation Between Multiple Pregnancies and Postpartum Depression or Psychosis In recognition of the paucity of information on the relationship between multiple pregnancies and postpartum depression, the paper reviews the likely relationship by understanding the two variables, multiple pregnancies and postpartum depression, in terms of […]
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Is Psychotherapy the Best Treatment for Postpartum Depression?
What Should Be the Knowledge of Nurses in the Diagnosis of Postpartum Depression?
How Does Postpartum Depression Affect the Family Experience?
What Is the Relationship Between Sleep Quality and Postpartum Depression in Mothers?
Can Postpartum Depression Be Managed with Medication and Therapy?
What Treatment Options Are Available for People with Postpartum Depression?
How Long After Childbirth Can Postpartum Depression Occur?
Are Physical Activity Interventions Effective in the Treatment of Postpartum Depression?
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222 Depression Research Topics & Essay Examples

📝 depression research papers examples, 💡 essay ideas on depression, 🎓 simple research topics about depression, 👍 good depression essay topics to write about, 🏆 best depression essay titles, ✍️ depression essay topics for college, 📣 depression discussion questions, ❓ depression research questions.

The Correlation Between Discrimination/Prejudice and Depression/Anxiety Psychology essay sample: The purpose of this research proposal is to identify the components of the study about the correlation between discrimination/prejudice and depression/anxiety.
Depression in Children: Symptoms and Treatments Psychology essay sample: Depression can make children not perform the duties they are assigned to do well. A caregiver can easily discover a small child’s depression by change of bowel habit.
Depression and Postpartum Depression Relationship Psychology essay sample: This article discusses the relationship between depression and postpartum depression, the possible causes, and forms of the disease, its consequences for the woman's psyche.
Depression as Bad a Clinical Condition Psychology essay sample: Specialists in mental health state that depression is the most common disorder they encounter on the daily basis. The following paper aims to provide evidence of the existence of it.
Different Types of Training in Managing the Symptoms of Depression Psychology essay sample: The proposed study will compare the effectiveness of different types of training in managing the symptoms of depression. It will be considered by people with moderate depression.
Postpartum Depression (PPD) and Its Identification Psychology essay sample: Katon, Russo, and Gavin focused on the problem of postpartum depression and its identification, because it is a common issue that leads to adverse health outcomes.
Diseases of Modern Life Psychology essay sample: Bipolar disorder and major depression are two very similar mood disorders that are often confused and misdiagnosed.
Mental Illness: Treatment Approaches and Challenges Psychology essay sample: The treatment of forensic populations, as with any clinical population, must be tailored to the individuals as well as to their mental illness.
Schizophrenia, Bipolar Disorder and Antidepressants Psychology essay sample: The variety of mental disorders may often confuse terms of disease differentiation due to the lack of proper education. Schizophrenia and bipolar disorder are examples of such confusion.
Adult Depression and Anxiety as a Complex Problem Psychology essay sample: The presence of a physical disability is a major factor in developing a mental health condition due to the increase in dissatisfaction and the presence of multiple irritants.
Abnormal Psychology: Anxiety and Depression Case Psychology essay sample: Abnormal psychology has many theories that emerged to describe the concept. It has components like biological, cognitive, behavioral as well as social-cultural models.
American Adolescence. Teenage Problems Psychology essay sample: There are those psychological problems that youngsters cannot omit simply because of the society they currently live in.
Treatment for Depressive and Bipolar Disorders Psychology essay sample: The study shows that an online intervention can be a part of treatment for people with BD, providing support not only for mania but also for depression.
Psychology: Mental Health Issues Psychology essay sample: This paper contains a review of primary causes leading to mental illnesses along with available social and individual measures intended to cope with them.
Depression Caused by Hormonal Imbalance, Socialisation of Children Psychology essay sample: Social life is utterly important for the mental health and socialization of children. They need parents to care about them and help to become a part of society.
Divorce Effect on Children's Mental Health Psychology essay sample: The family dissolution process, a conflict between parents, custody issues, and negative post-divorce relationships adversely influence the mental health of children.
Psychological Assessment Report Psychology essay sample: The client, Kyle Jones, is a 45-year-old professor working full-time at the Catholic University. The client’s cognitive functioning was impaired after a car accident.
What You Need to Know About Depression Psychology essay sample: The article is devoted to depression: a definition is given, the causes, signs, types, and methods of therapy are considered.
Personality Psychology and Depression Psychology essay sample: This paper presents an analysis of the connection between personality psychology and depression. Today, many attempts are made to investigate depressive symptoms.
Interacting in the Workplace: Depression Psychology essay sample: Depression is a menace that affects a number of people in different ways. In the workplace, there are a number of ways used to tell whether a person is undergoing mental stress.
Postpartum Depression. Consequences Psychology essay sample: These days more and more women approach the decision to have a baby very consciously, choosing the time when they are physically and emotionally prepared.
Cognitive Behavior and Depression in Adolescents Psychology essay sample: People of different ages are prone to various psychological and emotional issues, especially in the current world that is transforming at a high pace.
Social Problems Associated With Mental Illness and Health Promotion Psychology essay sample: Troubles with psychological health can create barriers to being employed, partially because mental illnesses are commonly stigmatized.
Females’ Instagram Use and Psychological Well-Being Psychology essay sample: Sherlock and Wagstaff tested the hypothesis that the time spent by women on Instagram was positively correlated with body dissatisfaction, depression, and social comparison.
Rational Emotive Behavior Therapy Psychology essay sample: Rational emotive behavior therapy is a therapy approach that involves the identification and replacement of negative behaviors with positive ones.
Lack of Sleep at King Fahd University of Petroleum and Minerals Psychology essay sample: This paper aims to explore the detrimental effects of sleep deprivation among KFUPM students and techniques for how they can manage time and stress to get adequate sleep.
Aggression in Psychology Psychology essay sample: This emotion is difficult to define, and psychologists, judges, and lawyers have been trying to determine what actions should and should not be considered aggressive for a long time.
Childhood Trauma: Disorders and Risky Behavior Psychology essay sample: Young people with a history of childhood abuse have a higher likelihood of participating in HIV risk behaviors such as having sex with multiple partners and having unprotected sex.
Personality Psychology and Depression Psychology essay sample: The depression study in the personality psychology scope assesses the psychology models connection with personality traits, analyzing the depression propagation among adolescents.
Depression in Young People: Articles Review Psychology essay sample: Depression is one of the mental health disorders progressively observed among the world population. The articles included in the annotated bibliography research this disease.
Bipolar Type II Diagnosis and Treatment Psychology essay sample: The article examines the clinical differences between bipolar disorder type I and bipolar disorder type II since the difficulty in choosing a correct diagnosis.
Concepts of Clinical Psychology Psychology essay sample: This paper revises three scholarly articles about mental disorders. Psychological disorders are a list of ailments with behavioral symptoms and can affect different areas of life.
“Living With Depression” by Karp Psychology essay sample: In the article “Living with Depression: Illness and Identity Turning Points”, the author tries to investigate how different patients tend to interpret this incoherent illness.
Resource Listing on Depression and Anxiety Psychology essay sample: This paper aims at creating a list of resources, including private agencies, counselors, websites, and publications that can help individuals.
Two Sides of Depression Disease Psychology essay sample: Depression is a widespread disease in the modern world, and that is why people often do not fully understand how it works.
Assessment of Counseling Methods: The Case Study Psychology essay sample: This paper explores the fallacies that emerge during the therapy of John, a young man indulging in substance abuse.
Depression Among Minority Groups Psychology essay sample: Mental disorders stem from the existing or non-existence of internal emotional and psychological threats from which the individual lacks the mechanisms for control.
Community of Single Mothers in California Psychology essay sample: This study is focused on the community of single mothers in San Bernardino County, California. The primary focus is on those single moms that have been diagnosed with depression.
Causes and of Treatment Mood Disorders Psychology essay sample: Mood disorders are a group of mental diseases caused by chemical imbalances in the brain which causes the patient to have irregular changes in their moods.
Early Separation and Suicide Psychology essay sample: When early separation occurs, a child who is not well taken care of can potentially succumb to mental problems, which can, in turn, act as a motivation for suicide.
Mood Disorder: Depression and Bipolar Psychology essay sample: This discourse explores the link between depression and bipolar disorder, insofar as their etiology, assessment, diagnosis, and treatment are concerned.
Postpartum Depression in the Twenty- First Century Psychology essay sample: A major assumption posited by researchers is that ‘social support’ is a key determinant in the prevention of postpartum depression.
Differents Forms to Stress, Pandemic of Stress Psychology essay sample: In this paper, stress is a major problem in the world today. Many countries and many individuals and families are victims of stress-related problems.
Depression: A Serious Mental and Behavioral Problem Psychology essay sample: Depression is a health problem that is difficult to diagnose. One way to help improve the detection of diagnosis is to use a genogram.
Grief Response of Patients Diagnosed With Cancer Psychology essay sample: The beginning of anticipatory grief begins when as children, we realize that we will all die or lose a loved one at some point in life. This should prepare us for the loss.
Depression Management in Adolescent Psychology essay sample: Adolescents are men and women in their transitional age from childhood to youth. Their age bracket is from ten to twenty-two.
Depression and Physical Exercise Psychology essay sample: Physical activity and cognitive health are two inseparable concepts. Physical activity is a great way to reduce stress and cure depression.
Psychological Disorder Analysis - Marla`S Diagnosis Psychology essay sample: In this case, the social cultural model is highly recommended as a form of treatment. This is because individuals from minority groups abandon therapy earlier than those from other groups.
Depression in Older Person Psychology essay sample: The rising incidence of depression in older person has a correlation with age, gender, genetics, lifestyle, interpersonal relationship and the level of education.
Maternal Mood Symptoms in Pregnancy and Postpartum Depression Psychology essay sample: As a woman, it is essential to understand postpartum depression and the fact that it can happen to any woman during or after pregnancy.
Childhood Trauma Etiology Associated With Social and Mental Disorders Psychology essay sample: This paper will showcase the five themes that were revealed during the review process to better understand the associations between childhood trauma and various disorders.
Stress and Anxiety Sources Amongst Students Psychology essay sample: This paper discusses some of the major sources of physiological, social, and psychological stress and anxiety in students.
Group Therapy in Psychology: Strengths and Limitations Psychology essay sample: This paper aims to gather relevant data on group therapy in psychology, present its strengths and limitations, and outline the differences between group and individual approaches.
Suicide in Adolescence Psychology essay sample: In the paper psychoeducational intervention for adolescents is developed and evaluated to improve suicide-related outcomes for high-risk students.
Counselling Clients with Depression and Addiction Psychology essay sample: Clinicians should "understand that depression is associated with the racism or sexism that marginalized groups experience in their daily lives".
Measurement of an Individual’s Level of Depression Psychology essay sample: Beck Depression Inventory is a systematic measurement of an individual's level of depression. Individuals who fall in the age group of 15 to 19 are the most vulnerable.
Postpartum Depression Among Low-Income U.S. Mothers Psychology essay sample: Postpartum depression is a major issue, which takes place after a woman gives birth. The problem is more prominent and prevalent among mothers who have a low-socioeconomic status.
Autism Spectrum Disorder (ASD): Case Study Psychology essay sample: The case study about the patient with ASD will involve the identification of specific problems, the assessment of risk factors, and a review of models of abnormality.
Psychological and Emotional Conditions of Suicide and Depression Psychology essay sample: Art and literature have been the niches that have allowed dissecting the issue of suicide without significant social reprimand toward the authors.
Joan’s Case Conceptualization Psychology essay sample: The paper discusses Joan’s case. She is a 48-year-old woman who reports stress and depression. She has lost interest in relationships, exercise, and things she enjoys.
Postpartum Depression: Symptoms, Role of Cultural Factors, and Ways To Support Psychology essay sample: Symptoms of postpartum depression differ from one woman to another and often range from mild to severe, they include intense irritability coupled with anger, insomnia, etc.
Researching: Illness and Mental Health Psychology essay sample: The following paper will explain how mental health can be considered in ill patients and focused on a particular population
Psychological Complications of Illness and Injuries Psychology essay sample: Depression associated with illness is a serious concern for patients, families, and healthcare professionals, as it might affect health outcomes
Psychology of Depression Among College Students Psychology essay sample: Depression has serious effects among college students: poor academic performance, the development of suicidal thoughts, failed relationships, and loss of zeal for goal achievement.
Military Resiliency Counseling and Care-Giving Psychology essay sample: This course aims to identify the key fears of people who have the problem of adapting to real life after participating in hostilities.
Depression Associated with Cognitive Dysfunction Psychology essay sample: Low episodic memory performance precedes depression, which demonstrates that depression is associated with cognitive dysfunctions.
Childhood Traumatic Experience Psychology essay sample: This paper examines the effect of childhood traumas on adulthood, including cognitive abilities, social behavior, and mental health, through the prism of scientific evidence.
Depression and Anxiety Among College Students Psychology essay sample: The research question this paper tries to answer whether depression and anxiety are common in college students, and if so, what are the causes and possible consequences.
Anxiety Disorder and Its Characteristics Psychology essay sample: This paper focuses on the fundamental characteristics of anxiety and its theories and treatment options imperially supported.
People with Asperger's Syndrome: The Effects of Group Trainings Psychology essay sample: To effectively determine how group training affects adults and children with Asperger's syndrome, many researchers do use experimental research design.
Resilience and Exposure to Trauma Relationship Psychology essay sample: This essay will discuss the relationship between stress, psychological stability, and mental health outcomes after distressing events.
Emotion Regulation Therapy for Generalized Anxiety Disorder Psychology essay sample: Emotional Regulation Therapy demonstrates significant improvement in treating anxiety, depression, life satisfaction, ruminating, worrying, and being unable to manage feelings.
Depression and Impact of Human Services Worker Psychology essay sample: Depression is a feeling of constant sadness and loss of interest, affecting how a person performs their day-to-day activities, it can stay for long without being recognized.
DSM-5 Anxiety Disorders: Causes and Treatment Psychology essay sample: This research paper discusses the DSM-5 anxiety disorders reviewing the diagnosis, a case conceptualization, and a treatment plan.
Cell Phones and Mental Health Psychology essay sample: Limited use of smartphones, current human companions, makes life easier and enjoyable, while excessive screen time may bring severe mental health consequences.
Literature Review on Depression Psychology essay sample: The paper summarizes other researchers' work addressing the issue of depression using several databases and carries out a curative study on depression in full text.
The Role of Family in Depression Treatment Psychology essay sample: Psychologists do a great job of helping people deal with their worries and fears because sometimes the patients have no one who could be trusted apart from the counselor.
Stress Among Ethnic Minority Adolescents and Mindfulness Intervention Psychology essay sample: The purpose of the proposed research is to investigate the effect of a school-based mindfulness-based intervention on stress among ethnic minority adolescents.
Professional Psychology: Obtaining a Counselor License Psychology essay sample: The paper is dedicated to the analysis of the profession of a psychologist. The aim is to create an algorithm, adherence to which will help obtain a license of a counselor.
Couple Separation and Family Counseling Techniques Psychology essay sample: This paper aims to discuss advisory deliberations, expected effects due to separation, and the most effective family counseling techniques.
Depression Disassembling and Treating Psychology essay sample: Depression is a pathology in its neglected form when the individual begins to have more severe symptoms - persistent nervous system disorders.
Depressive Symptoms Statistics in the 1990s and Now Psychology essay sample: Between 1990 and 2010, the incidence of mental health problems and depression diagnoses in patients declined modestly.
Anxiety and Decision Making: Literature Review Psychology essay sample: It is important to continue collecting the evidence to establish connections between levels of anxiety and computations that support decision-making.
Psychology: Pluralism, Counselling Psychology Psychology essay sample: The reviewed articles were chosen for several reasons. First, they explore different topics in the field of counseling psychology.
Experience of Childhood Trauma from Child Abuse/Maltreatment Psychology essay sample: This paper aims to analyze the experience of childhood trauma from child abuse/maltreatment, outcomes included, and relevant literature search results and annotated bibliography.
Child Abuse and Depression Psychology essay sample: This essay argues that neglect, emotional distress, and limited access to psychological treatment during childhood alleviate depression and other mental conditions.
Polysubstance Abuse Among Adolescent Males With Depression Psychology essay sample: Substance abuse among adolescents can be caused by depression. In this case, the adolescents down ply the idea of seeking psychological support
Depression in Adolescents and Suitable Interventions Psychology essay sample: Critically, the issue of depression is pronounced in the age bracket due to confusion brought on by the changes happening and also peer pressure.
Early-Life Stress and Behavioral Outcomes Psychology essay sample: The study aims to understand the mechanisms behind the long-lasting consequences of early-life stress exposure. It is accomplished by comparing the results of tests.
Reducing Depressive Symptoms and Suicidal Tendencies in Adolescents Psychology essay sample: Cognitive-behavioral therapy addresses children, teenagers, adult survivors overcoming the harmful repercussions of early trauma for their unique mental and emotional needs.
Aspects of Abnormal Psychology Psychology essay sample: Abnormal psychology studies psychological disorders and ways to improve the lives of those affected by them. There are several perspectives on the pathology.
Depression: Symptoms and Treatment Psychology essay sample: Depression symptoms may be divided into three categories. The three categories are psychological, physical and social symptoms.
Preventing Child Suicide: The Role of Family Therapy Psychology essay sample: Due to the increasing number of child suicide cases, more studies need to be done on various types of family therapy and other psychotherapies in preventing suicide.
Experience of Trauma from Child Maltreatment Psychology essay sample: Summing up the findings of various researchers as well as using databases, studies confirm an undeniable influence of maltreatment on the later development and life of a child.
Approaches for Treating Depression Psychology essay sample: Dialectical Behavioral Therapy (DBT) is a type of Cognitive Behavioral Therapy (CBT) and one of the most effective approaches for treating depression.
Managing Anxiety in Evidence-Based Practice Psychology essay sample: This EBP project proposal focuses on nonpharmacological treatment that does not involve the administration of drugs. It tries to effectively manage anxiety.
Andrew Solomon: Why We Can't Talk About Depression Psychology essay sample: The main difficulty of depression lies in communicating the patient's condition to those around him. Many people use the word "depression" to describe a bad mood.
Mental Health Disorders Most Commonly Found in Teenagers Psychology essay sample: The present essay focuses on anxiety, depression, and behavioral disorders because these mental health disorders are the most widely spread among teenagers.
Approaches a Therapist Could Use to Help Lawrence Psychology essay sample: Lawrence thought he would never come out from underneath the hiding spot while he was despondent. Even some of the most severe depression, nonetheless, can be treated.
The Link Between the Birth Experience and Postnatal Depression Psychology essay sample: This study offers an overview of the latest scholarly research surrounding postnatal depression to determine whether the birth experience contributes to postpartum depression.
Evidence-Based Screening for Depression in Acute Care Psychology essay sample: EB analysis for the topic of depression to identify the need for an appropriate screening tool in addition to the PHQ-9 in the assessment evaluation process.
Beck’s Postpartum Depression Theory: Purpose, Concepts, and Significance Psychology essay sample: This paper aims to describe, analyze and evaluate Beck's Postpartum Depression Theory, and discuss its purpose, concepts, and significance.
Cognitive-Behavioral Therapy for Generalized Anxiety Disorder and Depression Psychology essay sample: Treatment of psychological disorders requires the application of additional methods that might help with the physical state of people and their mental well-being.
Teen Depression and Suicide in Soto “The Afterlife” Psychology essay sample: In “The Afterlife,” Gary Soto scrutinizes the challenges to teen mental health by portraying the protagonist observing from a side perspective the challenges faced by teenagers.
Depression and Anxiety Run in the Family Psychology essay sample: This paper examines the possibilities of depression and anxiety in one family through the study of literature and applying one of the family theories.
Humanistic Therapy of Depression Psychology essay sample: The mental health of the population is becoming a topical concern for numerous countries around the world, and, the need for effective and holistic treatments arises.
Treating Mood Disorders and Depression Psychology essay sample: This paper discusses treating mood disorders. Medications, which are used to cure people with such diseases, always include a combination of various drugs.
Major Depressive Disorder: Symptoms and Treatment Psychology essay sample: In the case described in the paper, symptoms can be observed that stand out in Major Depressive Disorder, which is characterized by losing interest in activities.
Depression in Older Adults: Causes and Treatment Psychology essay sample: The main factors in the progression of depressive disorder in old age are traumatic life events, lifestyle, and chronic illness.
Bullying: Collaborating with Parents to Increase Proactive Bystander Message Psychology essay sample: Bullying could potentially lead to anxiety, depression, and post-traumatic stress. These symptoms could be typical also to the bystanders.
Mental Illness, Depression, and Wellness Issues Psychology essay sample: Mental illness and depression are a silent plague and a sleeper problem that has slipped into millions' brains, hence being highlighted in various forms of media.
Anxiety and Depression During Childhood and Adolescence Psychology essay sample: Attachment can be defined as the bond shared between two or more persons. People may have emotional closeness with one another.
Depression as a Widespread Mental Condition Psychology essay sample: The paper investigates depression among individuals as it is a widespread mental condition. It focuses on the effects of depression that result from this condition.
Teenagers’ Depression Experiment Psychology essay sample: There are many reasons why teenagers become depressed. All of these traumatize the child's psyche and prevent him or her from feeling like a full member of society.
The Best Solution to Predict Depression Because of Bullying Psychology essay sample: This paper examines interventions to prove that the Olweus Bullying Prevention Program is the most effective solution for predicting depression provoked by bullying.
Depression Among Students at Elon University Psychology essay sample: This paper entails an analysis of the problem of depression in colleges, specifically, at Elon University, and it includes its causes and suggested remedies.
Effects of Depression Among Adolescents Psychology essay sample: Depression is a problem that affects all demographics, but this paper focuses on adolescents as its main point of discussion. Depression is a major cause of mental health.
Social Aspects of Depression and Anxiety Psychology essay sample: Depression and anxiety disorders are problems that bring the mental state out of balance and significantly complicate normal life.
Discussion Board-Anxiety and Depression Psychology essay sample: The article addresses the urgent need for early intervention and support to prevent suicide in individuals suffering from severe depression.
Exercise Therapy for Patients With Depression and Anxiety
Acceptance and Commitment Therapy for Depression
Yoga Therapy and Depression Symptom in Adult Patients
Dysthymic Disorder Depression Therapy Symptoms
Depression in Later Life Overview Older populations have significantly high rates of depression due to life contexts or underlying medical conditions leading to poor quality of life and other health risks.
Childhood Mistreatment and Adolescent and Young Adult Depression
Transcranial Direct Current Stimulation as an Add-on Treatment to Cognitive-Behavior Therapy in First Episode Drug-Nave Major Depression Patients
Cognitive Behavioral Therapy and the Application for Psychotic Depression
Cognitive Behavioral Therapy for Depression and Anxiety Attacks
Herbal and Complementary Therapies for Depression The paper dwells on the pharmacological effects of herbal and complementary therapies used for depression and nursing implications.
Metacognitive Therapy for Depression in Adults
Relationship Between Depression and Subtypes of Early Life Stress in Adult Psychiatric Patients
Family Therapy and Chronic Depression
Cognitive Group Therapy for Depression in Adults
Social Media: The Rise of Depression and Anxiety The increased use of social media in contemporary society adversely affects individuals resulting in depression and anxiety, particularly in those who use it regularly.
Depression and Anxiety Among Adult Children of Alcoholics
Managing Postpartum Depression Through Medications and Therapy
Electroconvulsive Therapy for Severe Depression
Mindfulness-Based Cognitive Therapy and Its Effects on Depression
Depression and Workplace Violence Workplace violence is a growing problem and is recognized as “a critical safety and health hazard” in the United States.
Flowers Therapy and Easiest Ways to Deal With Depression
Risk Factors for Adult Depression: Adverse Childhood Experiences and Personality Functioning
Depression: Medication Versus Cognitive Behavioral Therapy in Adolescents
Approaching Depression Through the Solution Focused Brief Therapy Approach
Depression in the Elderly Depression normally makes the elderly not to take pleasure in life as fully as they would wish. Normally, depression poses a serious threat on vigor.
Adjunctive Bright Light Therapy for Bipolar Depression
Depression and Anxiety Prevention Based on Cognitive Behavioral Therapy for At-Risk Adolescents
Resting-State Functional Connectivity of Brain With Electroconvulsive Therapy in Depression
Depression: Major Depressive Disorder and Major Life Changes
Depression in the Elderly Male The research is dedicated to the problems and dangers that may be caused by depression and how it can be avoided or resolved.
Multimodal Psychotherapeutic Inpatient Therapy of Depression in Patients With High Cytokine Production
Music Therapy Improve Depression Among Older Adults
Talk Therapy for Depression or Bipolar Disorder
Clinical Improvement and Neural Reactivity in Adolescents Treated With Behavioral Therapy for Anxiety and Depression
How Depression and Physical Issues Are Connected Depression is commonly associated with various symptoms, such as guilt, sadness, hopelessness, and irritability.
Life After Depression With Hypno Psychotherapy
Antidepressant Treatment for Depression: Total Therapy Duration
Cognitive Group Therapy for Adult Depression
The Relationship Between Adult Attachment Classification and Symptoms of Depression
Anxiety and Depression in the Workplace This paper looks at the issues of anxiety and depression in the workplace with the focus on causes and ways of dealing with it as part of daily management exercise.
Adolescent Depression and Cognitive Behavior Therapy
Virtual Reality Group Therapy for the Treatment of Depression
The New Therapy Technique for Depression
Group Therapy for Heart Patients With Depression
Depression Screening & Treatment in the Workplace The current paper states that depression and treatment have the potential of changing the financial position of employees and employers.
Oriental Therapy: Alternative Treatment for Depression
Cognitive-Behavioral Therapy Treatment for Adult Severe Depression
Aaron Becks and Cognitive Behavior Therapy for Depression
Massage Therapy Reducing Pain, Depression, and Anxiety in Hand Osteoarthritis Patients
How Does Depression Affect an Individual’s Overall Quality of Life?
Why Is Depression Hard to Overcome?
How Does Depression Affect an Individual’s Overall Quality of Life?
What Are the Major Types of Depression, and How Do They Differ?
Why Is Early Diagnosis and Treatment Crucial in Managing Depression?
Is Meditation a Good Way to Help People in Depression?
Who Is More Susceptible to Depression, and Are There Specific Risk Factors?
What Are the More Inconspicuous Symptoms of Depression?
Can Depression Be a Chronic Condition, and How Is It Managed Over Time?
What Is the Difference Between Clinical Depression and Normal Depression?
Is Overthinking One of the Main Causes of Depression?
How Does Depression Impact the Brain’s Functioning and Chemistry?
Are There Physical Health Complications Associated with Long-Term Depression?
What Role Do Genetics Play in the Development of Depression?
Can Marijuana Help with Depression?
What Is the Relationship Between Depression and Other Mental Health Disorders?
Are There Good Habits That Help Overcome Depression?
How Does Depression Affect Different Age Groups, From Children to Seniors?
What Are Some Common Misconceptions About Depression? Why Is It Essential to Seek Professional Help for Depression?
Is There an Evolutionary Explanation for Depression?
Can Depression Be Managed Without Medication, Using Therapy Alone?
How Does Depression Affect Our Daily Life?
What Is the Difference Between Depression and Laziness?
Are There Lifestyle Changes That Can Help Alleviate the Symptoms of Depression?
What Is the Relationship Between Anxiety and Depression?
Can Antidepressants Really Help Ease or Cure Depression?
Who Are the Key Figures in the History of Depression Research and Treatment?
Do Certain Life Events or Traumas Trigger Episodes of Depression?
How Is Major Depression Different from Bipolar Depression?
Can Depression in Children Manifest Differently Than in Adults?
Does Brain-Derived Neurotrophic Factor Have an Effect in Depression Level?
How Does Depression Affect the Teenage Generation?
Does Working Past Age 65 Protect Against Depression?
Does Regular Exercise Reduce Stress Levels and Thus Reduce Symptoms of Depression?
How Medication and Therapy Combat Depression?
Does Depression Lead to Suicide and Decreased Life Expectancy?
How Does Diabetes Not Cause Depression?
Does Emotional Intelligence Mediate the Relation Between Mindfulness and Anxiety and Depression in Adolescents?
How Does the Cognitive Theory Explain the Etiology of Depression?
Does Parent Depression Correspond With Child Depression?
Does Social Anxiety and Stress Lead to Depression?
Does Positive Psychology Ease Symptoms of Depression?
How Does Depression Affect Productivity?
Does Depression Cause Cancer?
Does Poverty Impact Depression in African American Adolescents and the Development of Suicidal Ideations?
How Cognitive Reserves Does Moderates Effects of White Matter Hyperintensity on Depressive Symptoms and Cognitive Function in Late-Life Depression?
How Cognitive Therapy for Depression Reduces Interpersonal Problems?
How Does Self-Esteem Interact With Adolescent Depression?
Does Maternal Depression Hurt Parent-Child Attachment?
Does Fruit and Vegetable Consumption During Adolescence Predict Adult Depression?
How Can Depression Take Over Someone’s Life?
How Has Depression Changed My Life Essay?
Does the Average Person Experience Depression Throughout Their Life?
Can Experiencing Depression Throughout All Life?

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Depression Research Paper

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Even for professionals the use of the term depression can vary. In 1987, Kendall and colleagues noted that “The professional use of the term depression has several levels of reference: symptom, syndrome, nosologic disorder . . . . Depression itself can be a symptom – for example, being sad. As a syndrome, depression is a constellation of signs and symptoms that cluster together . . . . The syndrome of depression is itself a psychological dysfunction but can also be present, in secondary ways, in other diagnosed disorders. Finally, for depression to be a nosologic category careful diagnostic procedures are required during which other potential diagnostic categories are excluded. The presumption, of course, is that a discrete nosologic entity will ultimately prove to be etiologically distinct from other discrete entities, with associated differences likely in course, prognosis, and treatment response.” It is this likely nosologic disorder of depression that we will discuss.

I. Definition of Depression

A. symptoms of depression, b. comorbidity: the relationship between depression and anxiety, ii. diagnostic classification, a. major depressive disorder, b. dysthymic disorder, c. bipolar i disorder, d. bipolar ii disorder, e. cyclothymic disorder, iii. exploratory categories of depressive disorders, a. premenstrual dysphoric disorder, b. minor depressive disorder, c. recurrent brief depressive disorder, d. mixed anxiety-depressive disorder, iv. epidemiology, a. prevalence, 1. national prevalence, 2. international prevalence, b. age differences, c. sex and ethnic differences, d. environmental correlates, v. etiological theories of depression, a. psychological theories, 1. psychoanalytic approaches, 2. interpersonal approaches, 3. cognitive approaches, b. biological theories, 1. genetic approaches, 2. neurotransmitter approaches, vi. protective factors, a. social support, b. coping styles.

Any definition of depression must begin with the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The DSM-IV represents the official diagnostic classification system of the American Psychiatric Association and provides the criteria that are used to diagnosis depression. These criteria consist of the symptoms of depression. In order to make a diagnosis of depression, at least five out of nine possible symptoms must be present. These include (1) depressed mood; (2) diminished pleasure or interest in activities; (3) significant weight loss or weight gain; (4) insomnia or hypersomnia; (5) agitation; (6) fatigue or loss of energy; (7) thoughts of worthlessness or inappropriate guilt; (8) diminished concentration ability; and (9) thoughts of death or suicide.

Symptoms of depression may vary according to an individual’s age and culture. Children who are depressed, for instance, may express symptoms of irritability rather than sadness. They may also fail to make expected weight gains rather than lose weight. On the other end of the age continuum, older adults are more likely than younger adults to experience symptoms such as loss of appetite, loss of interest, and thoughts of death. Cultural differences also exist in report of depressive symptoms. One study, for example, found that depressed Jewish patients reported more somatic symptoms, and less guilt, than did non-Jewish patients. Another study that examined depressive symptomatology in American, Korean, Philippine, and Taiwanese college students found that Taiwanese students reported the lowest numbers of somatic symptoms and the highest numbers of affective symptoms. The other ethnic groups reporting similar levels of these symptoms. One’s age and culture thus seems to affect how depression is expressed.

Comorbidity refers to the occurrence of more than one disorder at the same time. Although researchers and clinicians generally acknowledge depression as a distinct disorder, it does overlap with a variety of other difficulties. Much current research on this overlap has focused on the relationship between anxiety and depression. This is not surprising, given the high rates of comorbidity found in studies of the two disorder types. For example, one study found that 63% of a group of patients with panic disorder also experienced major depression. One possible explanation provided for such overlap lies in the concept of “negative affectivity.” In 1984, Watson and Clark described individuals with high levels of negative affectivity as having a tendency “to be distressed and upset and have a negative view of self, whereas those low on the dimension are relatively content and secure and satisfied with themselves.” Other characteristics of high negative affectivity include nervousness, tension, worry, anger, scorn, revulsion, guilt, self-dissatisfaction, rejectedness, and sadness.

Both anxiety and depression seem to consist of high negative affectivity. There are however, important differences between depression and anxiety. While both depression and anxiety are characterized by high levels of negative affect, only depression is related to lowered levels of positive affect. Thus, depressed individuals tend to display both high negative affect and low positive affect, whereas anxious individuals display high negative affect and may or may not have lowered positive affect–the level of positive affect is unrelated to one’s anxiety state. Research on negative affect as a link between anxiety and depression is continuing at a rapid pace.

Earlier we noted the DSM-IV. The DSM-IV is the most widely used classification scheme for psychiatric disorders in North America. According to this manual, there are five types of mood disorders that include depression as a significant component. These are (1) Major Depressive Disorder; (2) Dysthymic Disorder; (3) Bipolar I Disorder; (4) Bipolar II Disorder; and (5) Cyclothymic Disorder. Each of these classifications differs in terms of etiology, course, and symptomatology.

For a diagnosis of Major Depressive Disorder (MDD), DSM-IV specifies that at least five symptoms must occur for a period of at least 2 weeks. Chief among these symptoms is depressed mood that occurs most of the day, nearly every day for at least 2 weeks, or significantly diminished interest or pleasure in virtually all activities most of the day, nearly every day for the 2-week period.

MDD can be further classified according to severity (i.e., mild, moderate, severe without psychotic features, severe with psychotic features), course (e.g., single episode versus recurrent episodes), and presentation (e.g., with catatonic features, with melancholic features). Psychotic features of depression include such experiences as delusions (i.e., false beliefs) and hallucinations (i.e., sensory experiences that have no basis in reality). A delusion, for example, would be a person who believes that she is dead. Catatonic features of depression involve psychomotor disturbances such as excessive movement or stupor. Melancholic features include the inability to experience pleasure even when good things happen and a lack of interest in previously pleasurable activities. No matter what the specific characteristics of a given individual’s disturbance, MDD is, by definition, extremely distressing to the sufferer and is associated with significant impairment in important areas of the person’s life (e.g., at work, home or school).

Dysthymic Disorder is characterized by a chronic depressed mood that lasts at least 2 years in adults and at least 1 year in children and adolescents. This depressed mood is accompanied by at least two of the following six depressive symptoms: (1) poor appetite or overeating; (2) insomnia or hypersomnia; (3) low energy or fatigue; (4) low self-esteem; (5) poor concentration or difficulty making decisions; and (6) feelings of hopelessness. As fewer depressive symptoms are required to make a diagnosis, Dysthymic Disorder is often considered a milder form of depression than MDD. However, it can be just as upsetting to the sufferer and can cause just as much impairment. In addition, Dysthymic Disorder may occur in combination with episodes of major depression. When Dysthymic Disorder occurs along with major depression, the individual is considered to be suffering from a “double depression.” The co-occurrence of MDD and dysthymia is not uncommon.

The hallmark characteristic of Bipolar I Disorder is mania. According to DSM-IV, a manic episode is characterized by elevated, expansive, or irritable mood that is persistent and distinctly different from normal elevated or irritable moods. This period is accompanied by at least three of seven possible symptoms. These symptoms include (1) inflated self-esteem; (2) a decreased need for sleep; (3) unusual talkativeness; (4) the feeling that one’s thoughts are racing; (5) increased distractibility; (6) increased activity; (7) involvement in pleasurable but potentially harmful activities (e.g., sexual indiscretions).

Bipolar I Disorder is typically recurrent; according to DSM-IV, additional episodes occur in more than 90% of individuals who have had a single manic episode. The manic episodes of those with Bipolar I Disorder are often intermixed with periods of depression. Like those with MDD, people with Bipolar I Disorder may exhibit psychotic, catatonic, and melancholic features as part of either their mania or their depression.

Bipolar II Disorder is characterized by periods of hypomania intermixed with periods of depression. Hypomanic episodes are characterized by the same symptoms as manic episodes. However, hypomanic episodes are shorter (e.g., 4 days in duration) and are associated with less impairment. While manic episodes may include psychotic features, interrupt daily functioning, and require hospitalization, hypomanic episodes typically do not. The depression experienced as part of Bipolar II Disorder, however, can be just as severe as that experienced in MDD and Bipolar I Disorder.

Cyclothymic disorder is characterized by hypomanic periods intermixed with depressive periods that are not as severe as those experienced in MDD, Bipolar I Disorder, and Bipolar II Disorder. In Cyclothymia, the periods of mood disturbance may alternate rapidly, with little respite from affective difficulties. For a diagnosis of Cyclothymia these periods of shifting moods must be problematic for at least 2 years in adults and at least i year in children and adolescents.

In addition to the five official diagnoses, DSM-IV has denoted four classifications for further study that include depression as a significant component. Such classifications are not yet considered to be disorders and more information is needed on factors such as symptom presentation, etiology, and degree of impairment to sufferers before these might be considered disorders in their own right. Nevertheless, these may represent serious problems and even though they are currently exploratory, we describe them here. They are: (1) Premenstrual Dysphoric Disorder; (2) Minor Depressive Disorder; (3) Recurrent Brief Depressive Disorder; and (4) Mixed Anxiety-Depressive Disorder.

Premenstrual Dysphoric Disorder is characterized by several hallmark symptoms of depression (e.g., decreased interest in usual activities, depressed mood, difficulty sleeping or sleeping too much) in addition to symptoms such as affective lability, feelings of being overwhelmed or out of control, and food cravings. In order to meet the criteria that have been proposed for this diagnosis, such symptoms must have occurred during the late luteal phase of most of a woman’s menstrual cycles in the past year. As a number of authors have pointed out, such a classification has potentially serious social, political, and legal ramifications for women. For example, some have argued that if this classification is adopted as an orificial diagnosis then women might be stigmatized as more unstable than or inferior to men. Arguments such as this keep the classification of Premenstrual Dysphoric Disorder a topic of considerable debate.

Minor Depressive Disorder is characterized by fewer depressive symptoms than are seen in MDD. The level of impairment is also less than that associated with MDD. To meet the proposed criteria for Minor Depressive Disorder, a person must demonstrate either a depressed mood or loss of interest and two additional symptoms of a Major Depressive Episode. If this classification were included in future DSM editions as a disorder, it would constitute a residual category to be used only after the other mood disorders have been ruled out.

The principle difference between Recurrent Brief Depressive Disorder and MDD is one of duration. Recurrent Brief Depressive Disorder is characterized by periods of depression that meet all of the criteria for a Major Depressive Episode except for the duration requirement. While in major depressive episodes, symptoms must last at least 2 weeks, in recurrent brief depressive episodes, symptoms must last at least 2 but less than 14 days. In addition, these brief episodes must occur at least once a month for 12 months to meet criteria for the classification of Recurrent Brief Depressive Disorder. Recurrent Brief Depressive Disorder is quite similar to MDD in its age of onset and family incidence rates, thus raising questions as to whether this should be considered a distinct disorder.

The impetus behind a mixed anxious-depressed category lies in the finding that there are many people suffering from symptoms of anxiety and depression who do not meet criteria for any DSM anxiety or mood disorder, but who are nonetheless significantly impaired by their difficulties. The classification of Mixed Anxiety-Depressive Disorder is characterized by a dysphoric mood for at least 1 month in addition to at least four additional symptoms that primarily reflect anxiety (e.g., mind going blank, worry, hypervigilance). The primary argument in favor of adopting this proposed disorder is that it would cover the large number of people who have significant impairment linked to depression and anxiety but who do not fall into any currently existing diagnostic category. The primary argument against this classification is that people suffering from both depression and anxiety could in fact be categorized into already existing disorders with the use of more precise assessment methods.

Epidemiology refers to information about the incidence and prevalence of disorders in a population. A prevalence rate refers to the number of people who have a given disorder during a particular time period (e.g., the percentage of people in given location diagnosed with MDD within a 1-year period of time). An incidence rate refers to the number of new cases of a disorder which occur during a given time period (e.g., the number of people diagnosed with Dysthymic Disorder during April 1996). Because the distribution of a disorder can be examined to determine whether it correlates with other factors, epidemiological information can be important for understanding some of the possible causes and correlates of depression.

Two recent large-scale surveys of psychopathology in the United States have provided differing prevalence data on depression. Using diagnostic criteria from the revised 3rd Edition of the DSM (DSM-III-R), the Epidemiologic Catchment Area (ECA) study examined the rates of depression in five sites: New Haven, Baltimore, St. Louis, Los Angeles, and Durham. The ECA study found the lifetime prevalence of major depression (i.e., the number of people experiencing major depression during any point in life) to be 4.9% and the lifetime prevalence of dysthymia to be 3.2%. Alternatively, the National Comorbidity Survey (NCS) reported much higher prevalence rates: 14.9% for lifetime major depression and 6.4% for dysthymia. The discrepancies between these two studies may be accounted for by the different assessment instruments used, slightly different diagnostic criteria employed, and different age ranges studied (i.e., the ECA sample was 18 years of age or older, whereas the NCS sample ranged in age from 15 to 54 years). According to the ECA study, prevalence rates for bipolar disorders were much lower; lifetime prevalence of these disorders was .8% for Bipolar I and .5% for Bipolar II. The NCS lifetime prevalence for manic episode was somewhat higher: 1.6 %. Even though these epidemiological studies reported somewhat discrepant rates, they are in agreement that mood disorders are relatively common in the United States.

A number of studies have examined the community prevalence of major depression in countries besides the United States. International lifetime prevalence rates vary widely, from a low of 3.3% in Seoul to a high of 15.1% among New Zealand residents aged 25 to 46. While such differences may indeed reflect true international differences in the occurrence of depression, other factors such as cultural differences in the sensitivity of the instruments used to assess disorder and different sample ages may also account for this range. In prevalence studies focusing on bipolar illness, ranges from .07% in Sweden to 7% in Ireland have been reported. Most studies, however, place prevalence at about 1% for bipolar illnesses, consistent with data from the ECA and NCS studies.

The ECA study also reported incidence rates of depression for various age groups. For men, major depression was highest among those aged 18 to 29. A large decline in incidence was noted for men aged 45 and older. For women, the incidence of major depression was highest in the group aged 30 to 44 and did not decline until age 65.

According to the ECA study, lifetime prevalence rates of major depression, dysthymia, and all mood disorders are approximately twice as high for women as for men. Women’s lifetime rates were 7.0%, 4.1%, and 10.2%, respectively, while rates for men were 2.6%, 2.2 %, and 5.2 %, respectively. These differences occur across a variety of ethnic groups (e.g., African American, Hispanic, Caucasian) even when differences in education, income, and occupations are controlled. Sex differences are also found in countries besides the United States. While sex differences in depression are among the most stable of findings across studies, no sex differences in the rates of bipolar disorder are reliably found.

Although sex difference in the incidence of depression occur across different ethnic groups, there are some differences among these groups overall. For instance, the ECA study found higher rates of Major Depression and Dysthymia among Caucasians and Hispanics than among African Americans. However, few difference in the rates of bipolar disorders among the three groups were found.

The ECA study also examined a number of environmental correlates of depression and bipolar disorders. This study found that people who were separated or divorced had higher 1-year prevalence rates of major depression (6.3%) than those who were never married (2.8%), currently married (2.1%), or widowed (2.1%). This was also true of those with bipolar disorders, although the rates for those separated or divorced versus never married were nearly identical (1.7% versus 1.6%). The 1-year prevalence rate of major depression was also higher among the unemployed than the employed (3.4% versus 2.2%), but the rate was nearly identical for those with bipolar disorders (1.1% versus 1.0%). In addition, the ECA study found higher rates of major depression among white-collar workers and those with at least 12 years of education, but lower rates of depression among those with annual incomes of $15,000 or more. Consistent with the major depression findings, bipolar disorders were also less prevalent among those with annual incomes of $15,000 or more. Bipolar disorders were also found to be the most prevalent among none-white-collar workers with less than 12 years of education. Overall, these socioeconomic status differences were quite small.

A variety of different psychological theories of the causes of depression have been proposed. These can be grouped in psychoanalytic, interpersonal, and cognitive.

The first psychoanalytic writers to theorize about the etiology of depression were Sigmund Freud and his student, Karl Abraham. As would be expected, there are a number of similarities in the theories proposed by Freud and Abraham. First, both Freud and Abraham believed that some people are predisposed to experience depression. For Abraham, this predisposition consisted of anatomical anomalies that allowed a person to experience a great deal of oral eroticism. For Freud, this predisposition consisted of narcissistic object choices (e.g., object choices which are so similar to the self that love of the object is truly love of self). Second, both believed that a predisposition to experience depression was not, in and of itself, enough to cause depression. In order to experience a depression, a predisposed individual must also experience the loss of a loved object (e.g., through death or rejection).

Despite these basic similarities, the two theorists diverge somewhat on how depression occurs once a loss has been experienced. For Abraham, the loss of a loved object in a person predisposed to depression triggers a regression to the oral stage of psychosexual development. Such a regression is meant to achieve three purposes: (1) to increase pleasure; (2) to hold on to the object through oral incorporation; and (3) to discharge one’s aggressive impulses on to the object. Such a regression manifests itself most saliently in the depressive symptoms of eating too much or too little. For Freud, the loss of a loved object possesses different implications. Since the lost object was a narcissistic choice and thus represented the self, loss of the object means loss of the self. This loss of self triggers feelings of anger and depression. The energy associated with these negative feelings is withdrawn from the lost object and brought inward, in a process called introjection. Thus, depression as conceptualized by Freud is often summarized as “anger turned inward.” For Freud, the difference between sadness and “true” depression was the difference between “this is awful” and “I am awful.” Freud further extended his theory to account for the mania characteristic of bipolar depressive disorders. He hypothesized that, once the feelings of anger and depression over loss of the object are resolved, the energy associated with these negative feelings is freed for other purposes. In a person with bipolar disorder, this freed energy is used to zealousy search for new objects, thus accounting for the symptoms of mania.

More recent psychoanalytic theorists have focused on the superego’s role in depression. Some theorists, for example, have suggested that depression is distinguished from other states such as shame, apathy, or resentment by the presence of guilt. As guilt results only from an intrapsychic conflict of the superego, the superego is necessarily implicated in depression. One result of these differences in etiological focus has been the proposition of two forms of depression: anaclitic and introjective. Anaclitic depression is characterized by feelings of helplessness, inferiority, and being unloved. Anaclitic depression is proposed to be associated with the earlier stages of development and is most closely associated with the theorizing of Abraham and Freud. Alternatively, introjective depression focuses on feelings of unworthiness and failure to measure up to expectations and standards. It is associated with later stages of development, and more closely aligned with the works of later psychoanalytic theorists. Although much of psychoanalytic theory has been criticized on grounds that it has not been empirically tested, the distinction between anaclitic and introjectire depressions has been empirically examined and found to be valid. Psychoanalytic theorists have accounted for the development of bipolar disorders as well. Most notable amongst these theorists is Melanie Klein, who expanded upon the work of Freud.

Interpersonal approaches to the etiology and maintenance of depression focus on the interplay between a depressed person and his or her relations with others. Empirical research in this area has taken several directions. For example, some researchers focus on the role of social skills in depression, asking such questions as whether depressed people have poor social skills and whether the lack of such skills results in decreased reinforcement from others and consequent depression. Other research has evaluated the types of communications depressed people emit (e.g., sadness, hopelessness) and the effects these communications have on others. If others find the communications of depressed persons aversive, they will likely avoid such persons, which may then exacerbate depressive symptoms such as isolation and loneliness. Still others address the interplay between stress, social support, and depression. All of these lines of research have found some support; interpersonal research highlights the fact that depression is caused by a multitude of factors in interplay with one another.

Much of the research converges on the theoretical idea that depression is maintained by a vicious cycle that is caused by disruptions in interpersonal interactions. For instance, many depressed individuals quite understandably seek out social support from others. If this support does not alleviate the negative feelings, further support is sought. This intensified support seeking, however, has the paradoxical effect of pushing away those who have been supportive. That is, as individuals begin to feel that their support capacity has been exhausted they pull back from the depressed person, leading to an even further intensification of social support seeking, and the further distancing of potentially supportive people.

Interpersonal factors in the etiology of bipolar depressive disorders have not received as much research attention as such factors in unipolar depressive disorders. Nonetheless, persons with both types of depressive disorders seem to have difficulties in retaining social support. Indeed, in one recent study, people with bipolar disorder perceived their social supports as less available to them and as less adequate in the amount of support received than people in a community sample. Furthermore, perceptions of social support availability seemed to decrease as the duration of illness increased. Thus, it seems likely that social support plays a role in bipolar as well as unipolar depressive disorders.

Currently, cognitive approaches are among the most widely studied theories in the etiology of depression. One of the most influential of these theories was proposed by Aaron Beck in 1967. Beck argued that all individuals possess cognitive structures called schemas that guide the ways information in the environment is attended to and interpreted. Such schemas are determined from childhood by our interactions with the external world. For example, a child who is constantly criticized may begin to believe she is worthless. She might then begin to interpret every failure experience as further evidence of her worthlessness. If this negative processing of information is not changed, it will become an enduring part of her cognitive organization, that is, a schema. When this schema is activated (e.g., by a poor grade on a test or any other failure experience), it will predispose her to depressive feelings (e.g., I’m no good). Beck stated that, as a result of this faulty information processing, depressed persons demonstrate a cognitive triad of negative thoughts about themselves, the world, and the future. He further extended his argument to include the manic phases of bipolar depressive disorders. Beck stated that such phases are characterized by a manic triad of irrationally positive thoughts about oneself, the world, and the future. Like the depressive triad in unipolar depressive disorders, the manic triad in bipolar depressive disorders was hypothesized to lead to the symptoms of mania, such as inflated selfesteem and extremely elevated mood.

There is widespread agreement that depression can be caused by different factors. Some theorists have argued that dysfunctional cognitions cause only a subset of depressions. Termed the “negative cognition” subtype, this type of depression is brought about by either the kinds of schemas discussed by Aaron Beck or by dysfunctional attributional patterns that lead depressed people to take responsibility for the occurrence of negative events, and to avoid taking responsibility for positive events. This dysfunctional attributional pattern can lead to a sense of hopelessness that results in a “hopelessness depression,” a component of negative cognition depression.

Although there are a variety of biologically based theories of depression, they can be broken down into two general approaches: genetic and neurotransmitter.

Genetic approaches suggest that depression is the result of inheriting genes that predispose to occurrence of depression. Three types of studies that are used to investigate genetic inheritance of depression illustrate this approach. These studies consist of family studies, twin studies, and adoption studies. In a typical family study, families with a depressed member are interviewed to determine how many other family members have or had an affective disorder. In twin studies, the concordance rate of affective disorder between monozygotic and dizygotic twin pairs is compared. Because monozygotic twins have identical genes, if genetic theories are correct then concordance rates of depression should be higher than for dizygotic twins (who have similar but not identical genes). In adoption studies, two strategies are most often used. In the first, the rate of depressive disorder in the biological parents of adopted persons with and without affective disorders is compared. In the second, the rate of depressive disorders is compared between adopted children with and without affectively disordered biological parents. Adoption studies have an advantage over family and twin studies, as the effects of environment on affective disorder are reduced in this design. However, adoption studies constitute the least-used approach to investigating genetic factors in depression; the difficulty of obtaining complete records on adoptees and their biological parents makes this design quite prohibitive.

Despite design differences, all three genetic approaches to the etiology of depression have yielded similar results: depression is heritable to at least some degree. A recent review of the research literature, for example, found rates of affective disorders among first-degree relatives of unipolar-disordered individuals ranging from 11.8% to 32.2%. Rates of affective disorders among first-degree relatives of bipolardisordered individuals ranged from 10.6% to 33.1%. Rates of affective disorder among first-degree relatives of normal individuals ranged from 4.8% to 6.3. In twin studies of unipolar and bipolar depression, concordance rates ranged from .04 to 1.0 for monozygotic twins, and from 0.0 to .43 to dizygotic twins, with the majority of studies reviewed reporting no concordance for dizygotic twins. The results of genetic investigations clearly suggest that there is a genetic component to depression, although the exact nature and functioning of this component is thus far still unknown.

Research on brain chemistry as an etiological factor in unipolar depression has focused on two monoamine neurotransmitters: norepinephrine (NE) and serotonin (5-HT). Initially, researchers believed that depression was due to a lack of NE in the brain, and later, to a lack of both NE and 5-HT. However, several difficulties with these hypotheses arose: (1) While the effects of antidepressants on monoamine levels start within hours of taking the medication, decreased depression levels do not become apparent until weeks later. (2) Some drugs that do not affect monoamine levels alleviate depression. (3) Some drugs that increase monoamine levels do not alleviate depression. Thus, researchers have directed their efforts to investigating more complicated relations between these neurotransmitters and depression. Recent efforts have included the study of receptor site hyposensitivity, relationships between NE and 5-HT, and relationships between. 5-HT and the neurotransmitter dopamine (DA).

Research on brain chemistry as in etiological factor in bipolar depression has followed much the same course as such research on unipolar depression. Initially, researchers believed that the mania characteristic of bipolar disorders was due to excesses of the neurotransmitters NE and 5-HT, exactly opposite the belief for depression. However, difficulties arose with this hypothesis, including findings that (1) lithium, the medical treatment of choice for bipolar disorder which seems to affect both NE and 5-HT, was effective at controlling both depression and mania, and (2) both depression and mania may be characterized by lower levels of 5-HT. Thus, as with unipolar depression, researchers of bipolar depression have begun investigating more complicated relationships between bipolar depression and neurotransmitters. Similar to the recent efforts concerning unipolar depression, researchers have investigated interactions between 5-HT and DA, interactions between NE and DA, and receptor site hypersensitivity. These types of investigations represent promising areas of research in elucidating the multifaceted etiology of depression. Certainly, biology and psychology are implicated in the causes of depression, both unipolar and bipolar forms.

Given the potentially devastating effects of depression, many researchers have devoted their efforts to studying factors that decrease the likelihood of becoming depressed or decrease the amount of time spent in depressive episodes. Among the most widely studied of such protective factors are social support and coping styles.

There are numerous facets to the concept of social support. For example, social support can be conceived as the number of persons one can rely on for support. Social support can also be conceived as the amount of support received, regardless of the number of persons one receives support from. In addition, socially supportive relationships can be conceptualized on a continuum of quality from very poor to very good. Examination of all these facets has proven important in understanding relationships between depression and social support.

Overall, people in contact with numerous socially supportive persons are less likely to have mental health difficulties, including depression. In addition, those who perceive a great deal of support from others are less likely to be negatively affected by stressors that might lead to depression. For people who have become depressed, having a confidant such as a spouse or best friend and a supportive family is related to greater success in treatment. The quality of such relationships is also important to treatment. In one study, for example, depressed persons with good-quality confidant relationships needed shorter periods of treatment than those with poor-quality confidant relationships.

The effects of social support for people with bipolar depressive disorders have not been as well studied as the effects for people with unipolar depressive disorders. Nonetheless, research suggests that social support is indeed beneficial for people with bipolar disorders. In one study, for example, a great deal of available social support was related to fewer psychological symptoms, better social adjustment, and better overall functioning.

Ways of coping with stressors can be roughly divided into two categories: approach strategies and avoidance strategies. Approach strategies are characterized by identifying the problematic situation, devising reasonable solutions to it, an implementing those solutions. Avoidance strategies include trying not to think about the problem, wishing the problem did not exist, and fantasizing about life without the problem. Overall, approach strategies seem to help people cope with stressors that might otherwise lead to depression. In addition, use of approach strategies is associated with better treatment outcome for those who become depressed. Conversely, people who use avoidance strategies to cope with stress seem more likely to become depressed and to have poorer treatment outcomes.

As with the effects of social support, research on coping styles among people with bipolar depressive disorders is scarce. Nonetheless, one recent study that examined differences in coping between high- and low-functioning people with bipolar disorders suggested that avoidant coping styles are associated with poorer functioning. Thus, relationships between coping styles and bipolar depressive disorders and coping and unipolar depressive disorders may be similar.

Bibliography:

Beck, A. T. (1967). Depression: Causes and treatment. Philadelphia: University of Pennsylvania Press.
Beckham, E. E., & Leber W. R. (1995). (Eds.). Handbook of depression (2nd ed. ). New York: Guilford Press.
Cicchetti, D., & Toth, S. L. (1992). (Eds.). Developmental perspectives on depression. Rochester, NY: University of Rochester Press.
Craig, K. D., & Dobson, K. S. (1995). (Eds.). Anxiety and depression in children and adults. Thousand Oaks, CA: Sage.
Kendall, P. C., Hollon, S. D., Beck, A. T., Hammen, C. L., & Ingram, R. E. (1987). Issues and recommendations regarding use of the Beck Depression Inventory. Cognitive Therapy and Research, 11,289-299.
Ingrain, R. E., Miranda, J., & Segal, Z. V. (in press). Cognitive vulnerability to depression. New York: Guilford Press.
Robins, L. N., & Regier, D. A. (1991). (Eds.). Psychiatric disorders in America. New York: The Free Press.

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Research in Context: Treating depression

Finding better approaches.

While effective treatments for major depression are available, there is still room for improvement. This special Research in Context feature explores the development of more effective ways to treat depression, including personalized treatment approaches and both old and new drugs.

Woman standing on a road between a bleak, desolate area and a lush, green area.

Everyone has a bad day sometimes. People experience various types of stress in the course of everyday life. These stressors can cause sadness, anxiety, hopelessness, frustration, or guilt. You may not enjoy the activities you usually do. These feelings tend to be only temporary. Once circumstances change, and the source of stress goes away, your mood usually improves. But sometimes, these feelings don’t go away. When these feelings stick around for at least two weeks and interfere with your daily activities, it’s called major depression, or clinical depression.

In 2021, 8.3% of U.S. adults experienced major depression. That’s about 21 million people. Among adolescents, the prevalence was much greater—more than 20%. Major depression can bring decreased energy, difficulty thinking straight, sleep problems, loss of appetite, and even physical pain. People with major depression may become unable to meet their responsibilities at work or home. Depression can also lead people to use alcohol or drugs or engage in high-risk activities. In the most extreme cases, depression can drive people to self-harm or even suicide.

The good news is that effective treatments are available. But current treatments have limitations. That’s why NIH-funded researchers have been working to develop more effective ways to treat depression. These include finding ways to predict whether certain treatments will help a given patient. They're also trying to develop more effective drugs or, in some cases, find new uses for existing drugs.

Finding the right treatments

The most common treatments for depression include psychotherapy, medications, or a combination. Mild depression may be treated with psychotherapy. Moderate to severe depression often requires the addition of medication.

Several types of psychotherapy have been shown to help relieve depression symptoms. For example, cognitive behavioral therapy helps people to recognize harmful ways of thinking and teaches them how to change these. Some researchers are working to develop new therapies to enhance people’s positive emotions. But good psychotherapy can be hard to access due to the cost, scheduling difficulties, or lack of available providers. The recent growth of telehealth services for mental health has improved access in some cases.

There are many antidepressant drugs on the market. Different drugs will work best on different patients. But it can be challenging to predict which drugs will work for a given patient. And it can take anywhere from 6 to 12 weeks to know whether a drug is working. Finding an effective drug can involve a long period of trial and error, with no guarantee of results.

If depression doesn’t improve with psychotherapy or medications, brain stimulation therapies could be used. Electroconvulsive therapy, or ECT, uses electrodes to send electric current into the brain. A newer technique, transcranial magnetic stimulation (TMS), stimulates the brain using magnetic fields. These treatments must be administered by specially trained health professionals.

“A lot of patients, they kind of muddle along, treatment after treatment, with little idea whether something’s going to work,” says psychiatric researcher Dr. Amit Etkin.

One reason it’s difficult to know which antidepressant medications will work is that there are likely different biological mechanisms that can cause depression. Two people with similar symptoms may both be diagnosed with depression, but the causes of their symptoms could be different. As NIH depression researcher Dr. Carlos Zarate explains, “we believe that there’s not one depression, but hundreds of depressions.”

Depression may be due to many factors. Genetics can put certain people at risk for depression. Stressful situations, physical health conditions, and medications may contribute. And depression can also be part of a more complicated mental disorder, such as bipolar disorder. All of these can affect which treatment would be best to use.

Etkin has been developing methods to distinguish patients with different types of depression based on measurable biological features, or biomarkers. The idea is that different types of patients would respond differently to various treatments. Etkin calls this approach “precision psychiatry.”

One such type of biomarker is electrical activity in the brain. A technique called electroencephalography, or EEG, measures electrical activity using electrodes placed on the scalp. When Etkin was at Stanford University, he led a research team that developed a machine-learning algorithm to predict treatment response based on EEG signals. The team applied the algorithm to data from a clinical trial of the antidepressant sertraline (Zoloft) involving more than 300 people.

Young woman undergoing electroencephalography.

EEG data for the participants were collected at the outset. Participants were then randomly assigned to take either sertraline or an inactive placebo for eight weeks. The team found a specific set of signals that predicted the participants’ responses to sertraline. The same neural “signature” also predicted which patients with depression responded to medication in a separate group.

Etkin’s team also examined this neural signature in a set of patients who were treated with TMS and psychotherapy. People who were predicted to respond less to sertraline had a greater response to the TMS/psychotherapy combination.

Etkin continues to develop methods for personalized depression treatment through his company, Alto Neuroscience. He notes that EEG has the advantage of being low-cost and accessible; data can even be collected in a patient’s home. That’s important for being able to get personalized treatments to the large number of people they could help. He’s also working on developing antidepressant drugs targeted to specific EEG profiles. Candidate drugs are in clinical trials now.

“It’s not like a pie-in-the-sky future thing, 20-30 years from now,” Etkin explains. “This is something that could be in people's hands within the next five years.”

New tricks for old drugs

While some researchers focus on matching patients with their optimal treatments, others aim to find treatments that can work for many different patients. It turns out that some drugs we’ve known about for decades might be very effective antidepressants, but we didn’t recognize their antidepressant properties until recently.

One such drug is ketamine. Ketamine has been used as an anesthetic for more than 50 years. Around the turn of this century, researchers started to discover its potential as an antidepressant. Zarate and others have found that, unlike traditional antidepressants that can take weeks to take effect, ketamine can improve depression in as little as one day. And a single dose can have an effect for a week or more. In 2019, the FDA approved a form of ketamine for treating depression that is resistant to other treatments.

But ketamine has drawbacks of its own. It’s a dissociative drug, meaning that it can make people feel disconnected from their body and environment. It also has the potential for addiction and misuse. For these reasons, it’s a controlled substance and can only be administered in a doctor’s office or clinic.

Another class of drugs being studied as possible antidepressants are psychedelics. These include lysergic acid diethylamide (LSD) and psilocybin, the active ingredient in magic mushrooms. These drugs can temporarily alter a person’s mood, thoughts, and perceptions of reality. Some have historically been used for religious rituals, but they are also used recreationally.

In clinical studies, psychedelics are typically administered in combination with psychotherapy. This includes several preparatory sessions with a therapist in the weeks before getting the drug, and several sessions in the weeks following to help people process their experiences. The drugs are administered in a controlled setting.

Dr. Stephen Ross, co-director of the New York University Langone Health Center for Psychedelic Medicine, describes a typical session: “It takes place in a living room-like setting. The person is prepared, and they state their intention. They take the drug, they lie supine, they put on eye shades and preselected music, and two therapists monitor them.” Sessions last for as long as the acute effects of the drug last, which is typically several hours. This is a healthcare-intensive intervention given the time and personnel needed.

In 2016, Ross led a clinical trial examining whether psilocybin-assisted therapy could reduce depression and anxiety in people with cancer. According to Ross, as many as 40% of people with cancer have clinically significant anxiety and depression. The study showed that a single psilocybin session led to substantial reductions in anxiety and depression compared with a placebo. These reductions were evident as soon as one day after psilocybin administration. Six months later, 60-80% of participants still had reduced depression and anxiety.

Psychedelic drugs frequently trigger mystical experiences in the people who take them. “People can feel a sense…that their consciousness is part of a greater consciousness or that all energy is one,” Ross explains. “People can have an experience that for them feels more ‘real’ than regular reality. They can feel transported to a different dimension of reality.”

About three out of four participants in Ross’s study said it was among the most meaningful experiences of their lives. And the degree of mystical experience correlated with the drug’s therapeutic effect. A long-term follow-up study found that the effects of the treatment continued more than four years later.

If these results seem too good to be true, Ross is quick to point out that it was a small study, with only 29 participants, although similar studies from other groups have yielded similar results. Psychedelics haven’t yet been shown to be effective in a large, controlled clinical trial. Ross is now conducting a trial with 200 people to see if the results of his earlier study pan out in this larger group. For now, though, psychedelics remain experimental drugs—approved for testing, but not for routine medical use.

Unlike ketamine, psychedelics aren’t considered addictive. But they, too, carry risks, which certain conditions may increase. Psychedelics can cause cardiovascular complications. They can cause psychosis in people who are predisposed to it. In uncontrolled settings, they have the risk of causing anxiety, confusion, and paranoia—a so-called “bad trip”—that can lead the person taking the drug to harm themself or others. This is why psychedelic-assisted therapy takes place in such tightly controlled settings. That increases the cost and complexity of the therapy, which may prevent many people from having access to it.

Better, safer drugs

Despite the promise of ketamine or psychedelics, their drawbacks have led some researchers to look for drugs that work like them but with fewer side effects.

Depression is thought to be caused by the loss of connections between nerve cells, or neurons, in certain regions of the brain. Ketamine and psychedelics both promote the brain’s ability to repair these connections, a quality called plasticity. If we could understand how these drugs encourage plasticity, we might be able to design drugs that can do so without the side effects.

Dr. David Olson at the University of California, Davis studies how psychedelics work at the cellular and molecular levels. The drugs appear to promote plasticity by binding to a receptor in cells called the 5-hydroxytryptamine 2A receptor (5-HT2AR). But many other compounds also bind 5-HT2AR without promoting plasticity. In a recent NIH-funded study, Olson showed that 5-HT2AR can be found both inside and on the surface of the cell. Only compounds that bound to the receptor inside the cells promoted plasticity. This suggests that a drug has to be able to get into the cell to promote plasticity.

Moreover, not all drugs that bind 5-HT2AR have psychedelic effects. Olson’s team has developed a molecular sensor, called psychLight, that can identify which compounds that bind 5-HT2AR have psychedelic effects. Using psychLight, they identified compounds that are not psychedelic but still have rapid and long-lasting antidepressant effects in animal models. He’s founded a company, Delix Therapeutics, to further develop drugs that promote plasticity.

Meanwhile, Zarate and his colleagues have been investigating a compound related to ketamine called hydroxynorketamine (HNK). Ketamine is converted to HNK in the body, and this process appears to be required for ketamine’s antidepressant effects. Administering HNK directly produced antidepressant-like effects in mice. At the same time, it did not cause the dissociative side effects and addiction caused by ketamine. Zarate’s team has already completed phase I trials of HNK in people showing that it’s safe. Phase II trials to find out whether it’s effective are scheduled to begin soon.

“What [ketamine and psychedelics] are doing for the field is they’re helping us realize that it is possible to move toward a repair model versus a symptom mitigation model,” Olson says. Unlike existing antidepressants, which just relieve the symptoms of depression, these drugs appear to fix the underlying causes. That’s likely why they work faster and produce longer-lasting effects. This research is bringing us closer to having safer antidepressants that only need to be taken once in a while, instead of every day.

—by Brian Doctrow, Ph.D.

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5 Strategies for Improving Mental Health at Work

Morra Aarons-Mele

Benefits and conversations around mental health evolved during the pandemic. Workplace cultures are starting to catch up.

Companies are investing in — and talking about — mental health more often these days. But employees aren’t reporting a corresponding rise in well-being. Why? The author, who wrote a book on mental health and work last year, explores several key ways organizations haven’t gone far enough in implementing a culture of well-being. She also makes five key suggestions on what they can do to improve the mental health of their employees.

“I have never felt so seen.”

Morra Aarons-Mele is a workplace mental health consultant and author of The Anxious Achiever: Turn Your Biggest Fears Into Your Leadership Superpower (Harvard Business Review Press, 2023). She has written for The New York Times, The Wall Street Journal, O the Oprah Magazine, TED, among others, and is the host of the Anxious Achiever podcast from LinkedIn Presents. morraam

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Writing Survey Questions

Perhaps the most important part of the survey process is the creation of questions that accurately measure the opinions, experiences and behaviors of the public. Accurate random sampling will be wasted if the information gathered is built on a shaky foundation of ambiguous or biased questions. Creating good measures involves both writing good questions and organizing them to form the questionnaire.

Questionnaire design is a multistage process that requires attention to many details at once. Designing the questionnaire is complicated because surveys can ask about topics in varying degrees of detail, questions can be asked in different ways, and questions asked earlier in a survey may influence how people respond to later questions. Researchers are also often interested in measuring change over time and therefore must be attentive to how opinions or behaviors have been measured in prior surveys.

Surveyors may conduct pilot tests or focus groups in the early stages of questionnaire development in order to better understand how people think about an issue or comprehend a question. Pretesting a survey is an essential step in the questionnaire design process to evaluate how people respond to the overall questionnaire and specific questions, especially when questions are being introduced for the first time.

For many years, surveyors approached questionnaire design as an art, but substantial research over the past forty years has demonstrated that there is a lot of science involved in crafting a good survey questionnaire. Here, we discuss the pitfalls and best practices of designing questionnaires.

Question development

There are several steps involved in developing a survey questionnaire. The first is identifying what topics will be covered in the survey. For Pew Research Center surveys, this involves thinking about what is happening in our nation and the world and what will be relevant to the public, policymakers and the media. We also track opinion on a variety of issues over time so we often ensure that we update these trends on a regular basis to better understand whether people’s opinions are changing.

At Pew Research Center, questionnaire development is a collaborative and iterative process where staff meet to discuss drafts of the questionnaire several times over the course of its development. We frequently test new survey questions ahead of time through qualitative research methods such as focus groups , cognitive interviews, pretesting (often using an online, opt-in sample ), or a combination of these approaches. Researchers use insights from this testing to refine questions before they are asked in a production survey, such as on the ATP.

Measuring change over time

Many surveyors want to track changes over time in people’s attitudes, opinions and behaviors. To measure change, questions are asked at two or more points in time. A cross-sectional design surveys different people in the same population at multiple points in time. A panel, such as the ATP, surveys the same people over time. However, it is common for the set of people in survey panels to change over time as new panelists are added and some prior panelists drop out. Many of the questions in Pew Research Center surveys have been asked in prior polls. Asking the same questions at different points in time allows us to report on changes in the overall views of the general public (or a subset of the public, such as registered voters, men or Black Americans), or what we call “trending the data”.

When measuring change over time, it is important to use the same question wording and to be sensitive to where the question is asked in the questionnaire to maintain a similar context as when the question was asked previously (see question wording and question order for further information). All of our survey reports include a topline questionnaire that provides the exact question wording and sequencing, along with results from the current survey and previous surveys in which we asked the question.

The Center’s transition from conducting U.S. surveys by live telephone interviewing to an online panel (around 2014 to 2020) complicated some opinion trends, but not others. Opinion trends that ask about sensitive topics (e.g., personal finances or attending religious services ) or that elicited volunteered answers (e.g., “neither” or “don’t know”) over the phone tended to show larger differences than other trends when shifting from phone polls to the online ATP. The Center adopted several strategies for coping with changes to data trends that may be related to this change in methodology. If there is evidence suggesting that a change in a trend stems from switching from phone to online measurement, Center reports flag that possibility for readers to try to head off confusion or erroneous conclusions.

Open- and closed-ended questions

One of the most significant decisions that can affect how people answer questions is whether the question is posed as an open-ended question, where respondents provide a response in their own words, or a closed-ended question, where they are asked to choose from a list of answer choices.

For example, in a poll conducted after the 2008 presidential election, people responded very differently to two versions of the question: “What one issue mattered most to you in deciding how you voted for president?” One was closed-ended and the other open-ended. In the closed-ended version, respondents were provided five options and could volunteer an option not on the list.

When explicitly offered the economy as a response, more than half of respondents (58%) chose this answer; only 35% of those who responded to the open-ended version volunteered the economy. Moreover, among those asked the closed-ended version, fewer than one-in-ten (8%) provided a response other than the five they were read. By contrast, fully 43% of those asked the open-ended version provided a response not listed in the closed-ended version of the question. All of the other issues were chosen at least slightly more often when explicitly offered in the closed-ended version than in the open-ended version. (Also see “High Marks for the Campaign, a High Bar for Obama” for more information.)

Researchers will sometimes conduct a pilot study using open-ended questions to discover which answers are most common. They will then develop closed-ended questions based off that pilot study that include the most common responses as answer choices. In this way, the questions may better reflect what the public is thinking, how they view a particular issue, or bring certain issues to light that the researchers may not have been aware of.

When asking closed-ended questions, the choice of options provided, how each option is described, the number of response options offered, and the order in which options are read can all influence how people respond. One example of the impact of how categories are defined can be found in a Pew Research Center poll conducted in January 2002. When half of the sample was asked whether it was “more important for President Bush to focus on domestic policy or foreign policy,” 52% chose domestic policy while only 34% said foreign policy. When the category “foreign policy” was narrowed to a specific aspect – “the war on terrorism” – far more people chose it; only 33% chose domestic policy while 52% chose the war on terrorism.

In most circumstances, the number of answer choices should be kept to a relatively small number – just four or perhaps five at most – especially in telephone surveys. Psychological research indicates that people have a hard time keeping more than this number of choices in mind at one time. When the question is asking about an objective fact and/or demographics, such as the religious affiliation of the respondent, more categories can be used. In fact, they are encouraged to ensure inclusivity. For example, Pew Research Center’s standard religion questions include more than 12 different categories, beginning with the most common affiliations (Protestant and Catholic). Most respondents have no trouble with this question because they can expect to see their religious group within that list in a self-administered survey.

In addition to the number and choice of response options offered, the order of answer categories can influence how people respond to closed-ended questions. Research suggests that in telephone surveys respondents more frequently choose items heard later in a list (a “recency effect”), and in self-administered surveys, they tend to choose items at the top of the list (a “primacy” effect).

Because of concerns about the effects of category order on responses to closed-ended questions, many sets of response options in Pew Research Center’s surveys are programmed to be randomized to ensure that the options are not asked in the same order for each respondent. Rotating or randomizing means that questions or items in a list are not asked in the same order to each respondent. Answers to questions are sometimes affected by questions that precede them. By presenting questions in a different order to each respondent, we ensure that each question gets asked in the same context as every other question the same number of times (e.g., first, last or any position in between). This does not eliminate the potential impact of previous questions on the current question, but it does ensure that this bias is spread randomly across all of the questions or items in the list. For instance, in the example discussed above about what issue mattered most in people’s vote, the order of the five issues in the closed-ended version of the question was randomized so that no one issue appeared early or late in the list for all respondents. Randomization of response items does not eliminate order effects, but it does ensure that this type of bias is spread randomly.

Questions with ordinal response categories – those with an underlying order (e.g., excellent, good, only fair, poor OR very favorable, mostly favorable, mostly unfavorable, very unfavorable) – are generally not randomized because the order of the categories conveys important information to help respondents answer the question. Generally, these types of scales should be presented in order so respondents can easily place their responses along the continuum, but the order can be reversed for some respondents. For example, in one of Pew Research Center’s questions about abortion, half of the sample is asked whether abortion should be “legal in all cases, legal in most cases, illegal in most cases, illegal in all cases,” while the other half of the sample is asked the same question with the response categories read in reverse order, starting with “illegal in all cases.” Again, reversing the order does not eliminate the recency effect but distributes it randomly across the population.

Question wording

The choice of words and phrases in a question is critical in expressing the meaning and intent of the question to the respondent and ensuring that all respondents interpret the question the same way. Even small wording differences can substantially affect the answers people provide.

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An example of a wording difference that had a significant impact on responses comes from a January 2003 Pew Research Center survey. When people were asked whether they would “favor or oppose taking military action in Iraq to end Saddam Hussein’s rule,” 68% said they favored military action while 25% said they opposed military action. However, when asked whether they would “favor or oppose taking military action in Iraq to end Saddam Hussein’s rule even if it meant that U.S. forces might suffer thousands of casualties, ” responses were dramatically different; only 43% said they favored military action, while 48% said they opposed it. The introduction of U.S. casualties altered the context of the question and influenced whether people favored or opposed military action in Iraq.

There has been a substantial amount of research to gauge the impact of different ways of asking questions and how to minimize differences in the way respondents interpret what is being asked. The issues related to question wording are more numerous than can be treated adequately in this short space, but below are a few of the important things to consider:

First, it is important to ask questions that are clear and specific and that each respondent will be able to answer. If a question is open-ended, it should be evident to respondents that they can answer in their own words and what type of response they should provide (an issue or problem, a month, number of days, etc.). Closed-ended questions should include all reasonable responses (i.e., the list of options is exhaustive) and the response categories should not overlap (i.e., response options should be mutually exclusive). Further, it is important to discern when it is best to use forced-choice close-ended questions (often denoted with a radio button in online surveys) versus “select-all-that-apply” lists (or check-all boxes). A 2019 Center study found that forced-choice questions tend to yield more accurate responses, especially for sensitive questions. Based on that research, the Center generally avoids using select-all-that-apply questions.

It is also important to ask only one question at a time. Questions that ask respondents to evaluate more than one concept (known as double-barreled questions) – such as “How much confidence do you have in President Obama to handle domestic and foreign policy?” – are difficult for respondents to answer and often lead to responses that are difficult to interpret. In this example, it would be more effective to ask two separate questions, one about domestic policy and another about foreign policy.

In general, questions that use simple and concrete language are more easily understood by respondents. It is especially important to consider the education level of the survey population when thinking about how easy it will be for respondents to interpret and answer a question. Double negatives (e.g., do you favor or oppose not allowing gays and lesbians to legally marry) or unfamiliar abbreviations or jargon (e.g., ANWR instead of Arctic National Wildlife Refuge) can result in respondent confusion and should be avoided.

Similarly, it is important to consider whether certain words may be viewed as biased or potentially offensive to some respondents, as well as the emotional reaction that some words may provoke. For example, in a 2005 Pew Research Center survey, 51% of respondents said they favored “making it legal for doctors to give terminally ill patients the means to end their lives,” but only 44% said they favored “making it legal for doctors to assist terminally ill patients in committing suicide.” Although both versions of the question are asking about the same thing, the reaction of respondents was different. In another example, respondents have reacted differently to questions using the word “welfare” as opposed to the more generic “assistance to the poor.” Several experiments have shown that there is much greater public support for expanding “assistance to the poor” than for expanding “welfare.”

We often write two versions of a question and ask half of the survey sample one version of the question and the other half the second version. Thus, we say we have two forms of the questionnaire. Respondents are assigned randomly to receive either form, so we can assume that the two groups of respondents are essentially identical. On questions where two versions are used, significant differences in the answers between the two forms tell us that the difference is a result of the way we worded the two versions.

One of the most common formats used in survey questions is the “agree-disagree” format. In this type of question, respondents are asked whether they agree or disagree with a particular statement. Research has shown that, compared with the better educated and better informed, less educated and less informed respondents have a greater tendency to agree with such statements. This is sometimes called an “acquiescence bias” (since some kinds of respondents are more likely to acquiesce to the assertion than are others). This behavior is even more pronounced when there’s an interviewer present, rather than when the survey is self-administered. A better practice is to offer respondents a choice between alternative statements. A Pew Research Center experiment with one of its routinely asked values questions illustrates the difference that question format can make. Not only does the forced choice format yield a very different result overall from the agree-disagree format, but the pattern of answers between respondents with more or less formal education also tends to be very different.

One other challenge in developing questionnaires is what is called “social desirability bias.” People have a natural tendency to want to be accepted and liked, and this may lead people to provide inaccurate answers to questions that deal with sensitive subjects. Research has shown that respondents understate alcohol and drug use, tax evasion and racial bias. They also may overstate church attendance, charitable contributions and the likelihood that they will vote in an election. Researchers attempt to account for this potential bias in crafting questions about these topics. For instance, when Pew Research Center surveys ask about past voting behavior, it is important to note that circumstances may have prevented the respondent from voting: “In the 2012 presidential election between Barack Obama and Mitt Romney, did things come up that kept you from voting, or did you happen to vote?” The choice of response options can also make it easier for people to be honest. For example, a question about church attendance might include three of six response options that indicate infrequent attendance. Research has also shown that social desirability bias can be greater when an interviewer is present (e.g., telephone and face-to-face surveys) than when respondents complete the survey themselves (e.g., paper and web surveys).

Lastly, because slight modifications in question wording can affect responses, identical question wording should be used when the intention is to compare results to those from earlier surveys. Similarly, because question wording and responses can vary based on the mode used to survey respondents, researchers should carefully evaluate the likely effects on trend measurements if a different survey mode will be used to assess change in opinion over time.

Question order

Once the survey questions are developed, particular attention should be paid to how they are ordered in the questionnaire. Surveyors must be attentive to how questions early in a questionnaire may have unintended effects on how respondents answer subsequent questions. Researchers have demonstrated that the order in which questions are asked can influence how people respond; earlier questions can unintentionally provide context for the questions that follow (these effects are called “order effects”).

One kind of order effect can be seen in responses to open-ended questions. Pew Research Center surveys generally ask open-ended questions about national problems, opinions about leaders and similar topics near the beginning of the questionnaire. If closed-ended questions that relate to the topic are placed before the open-ended question, respondents are much more likely to mention concepts or considerations raised in those earlier questions when responding to the open-ended question.

For closed-ended opinion questions, there are two main types of order effects: contrast effects ( where the order results in greater differences in responses), and assimilation effects (where responses are more similar as a result of their order).

An example of a contrast effect can be seen in a Pew Research Center poll conducted in October 2003, a dozen years before same-sex marriage was legalized in the U.S. That poll found that people were more likely to favor allowing gays and lesbians to enter into legal agreements that give them the same rights as married couples when this question was asked after one about whether they favored or opposed allowing gays and lesbians to marry (45% favored legal agreements when asked after the marriage question, but 37% favored legal agreements without the immediate preceding context of a question about same-sex marriage). Responses to the question about same-sex marriage, meanwhile, were not significantly affected by its placement before or after the legal agreements question.

Another experiment embedded in a December 2008 Pew Research Center poll also resulted in a contrast effect. When people were asked “All in all, are you satisfied or dissatisfied with the way things are going in this country today?” immediately after having been asked “Do you approve or disapprove of the way George W. Bush is handling his job as president?”; 88% said they were dissatisfied, compared with only 78% without the context of the prior question.

Responses to presidential approval remained relatively unchanged whether national satisfaction was asked before or after it. A similar finding occurred in December 2004 when both satisfaction and presidential approval were much higher (57% were dissatisfied when Bush approval was asked first vs. 51% when general satisfaction was asked first).

Several studies also have shown that asking a more specific question before a more general question (e.g., asking about happiness with one’s marriage before asking about one’s overall happiness) can result in a contrast effect. Although some exceptions have been found, people tend to avoid redundancy by excluding the more specific question from the general rating.

Assimilation effects occur when responses to two questions are more consistent or closer together because of their placement in the questionnaire. We found an example of an assimilation effect in a Pew Research Center poll conducted in November 2008 when we asked whether Republican leaders should work with Obama or stand up to him on important issues and whether Democratic leaders should work with Republican leaders or stand up to them on important issues. People were more likely to say that Republican leaders should work with Obama when the question was preceded by the one asking what Democratic leaders should do in working with Republican leaders (81% vs. 66%). However, when people were first asked about Republican leaders working with Obama, fewer said that Democratic leaders should work with Republican leaders (71% vs. 82%).

The order questions are asked is of particular importance when tracking trends over time. As a result, care should be taken to ensure that the context is similar each time a question is asked. Modifying the context of the question could call into question any observed changes over time (see measuring change over time for more information).

A questionnaire, like a conversation, should be grouped by topic and unfold in a logical order. It is often helpful to begin the survey with simple questions that respondents will find interesting and engaging. Throughout the survey, an effort should be made to keep the survey interesting and not overburden respondents with several difficult questions right after one another. Demographic questions such as income, education or age should not be asked near the beginning of a survey unless they are needed to determine eligibility for the survey or for routing respondents through particular sections of the questionnaire. Even then, it is best to precede such items with more interesting and engaging questions. One virtue of survey panels like the ATP is that demographic questions usually only need to be asked once a year, not in each survey.

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ABOUT PEW RESEARCH CENTER Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of The Pew Charitable Trusts .

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Physical activity in nature helps prevent several diseases, including depression and type 2 diabetes

Physical activity in natural environments prevent almost 13,000 cases of non-communicable diseases a year in England and save treatment costs of more than £100m, new research from the University of Exeter has found.

According to the World Health Organization (WHO) the most common non-communicable diseases -- including heart disease, stroke, cancer, diabetes, and chronic lung disease -- cause 74 percent of global mortality. Non communicable diseases, also known as chronic diseases, are not passed from person to person and deaths attributed to these diseases are increasing in most countries.

Physical inactivity is associated with a range of non-communicable diseases, including cardiovascular diseases, type-2 diabetes, cancers, and mental health outcomes. In their Global Status Report on Physical Activity 2022, the WHO estimated 500 million new cases will occur globally between 2020 and 2030 should physical activity remain at today's levels, incurring more than £21b a year in treatment costs.

Natural environments support recreational physical activity, with this new study focusing particularly on places such as beaches and coast, countryside, and open spaces in towns and cities like parks. Using data including a representative cross-sectional survey of the English population, researchers at the University of Exeter have estimated how many cases of six non-communicable diseases -- major depressive disorder, type 2 diabetes, ischaemic heart disease, ischaemic stroke, colon cancer, and breast cancer -- are prevented through nature-based recreational physical activity.

Speaking about the findings, published in Environment International, Dr James Grellier from the University of Exeter Medical School said: "We believe this is the first time an assessment like this has been conducted on a national scale and we've almost certainly underestimated the true value of nature-based physical activity in terms of disease prevention. Although we have focused on six of the most common non-communicable diseases, there are several less common diseases that can be prevented by physical activity, including other types of cancer and mental ill health. It's important to note that our estimates represent annual costs. Since chronic diseases can affect people for many years, the overall value of physical activity at preventing each case is certainly much higher."

Increasing population levels of physical activity is an increasingly important strategic goal for public health institutions globally. The WHO recommends that adults aged 18 to 64?should do at least 150 to 300 minutes of moderate intensity aerobic physical activity (or at least 75 to 150?minutes of vigorous-intensity aerobic physical activity) per week to maintain good health. However, globally 27.5 percent of adults do not meet these recommendations.

In 2019, 22-million adults in England aged 16 years or older visited natural environments at least once a week. At reported volumes of nature-based physical activity, Exeter researchers estimate this prevented 12,763 cases of non-communicable diseases, creating annual healthcare savings of £108.7m.

Population-representative data from the Monitor of Engagement with the Natural Environment survey were used to estimate the weekly volume of nature-based recreational physical activity by adults in England in 2019. Researchers used epidemiological dose-response data to calculate incident cases of six non-communicable diseases prevented through nature-based physical activity, and estimated associated savings using published costs of healthcare, informal care, and productivity losses. It's estimated the healthcare cost of physical inactivity in England in 2019 is approximately £1b.

Dr James Grellier from the University of Exeter Medical School said: "For people without the access, desire, or confidence to take part in organised sports or fitness activities, nature-based physical activity is a far more widely available and informal option. We believe that our study should motivate decision-makers seeking to increase physical activity in the local population to invest in natural spaces, such as parks, to make it easier for people to be physically active."

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Story Source:

Materials provided by University of Exeter . Original written by Tom Seymour. Note: Content may be edited for style and length.

Journal Reference :

James Grellier, Mathew P. White, Siân de Bell, Oscar Brousse, Lewis R Elliott, Lora E Fleming, Clare Heaviside, Charles Simpson, Tim Taylor, Benedict W Wheeler, Rebecca Lovell. Valuing the health benefits of nature-based recreational physical activity in England . Environment International , 2024; 187: 108667 DOI: 10.1016/j.envint.2024.108667

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