Emotional Adaptation During a Crisis: Decline in Anxiety and Depression after the Initial Weeks of COVID-19 in the United States

Background: Crises such as the COVID-19 pandemic are known to exacerbate mental health issues such as depression and anxiety. The temporal trajectories of depression and anxiety under crises, however, remain unclear.Methods: 1,512 adults living in the U.S. enrolled in this online study on April 2nd, 2020 and were assessed weekly for 10 weeks (until June 4th, 2020; final n=537). We measured depression and anxiety using the Zung Self-Rating Depression scale and State-Trait Anxiety Inventory (state subscale), respectively, along with demographic and COVID-related questions. Mixed-effects linear regression models were used to examine factors contributing to longitudinal changes in depression and anxiety.Outcomes: Depression and anxiety levels were high in early April, but declined over time ( F (9,4824)=17·53, p <·001 and F (9,4824)=23·35, p <·001, respectively). In addition to demographic factors such as sex, age, income, and psychiatric diagnoses, we identified some overlapping and some distinct dynamic factors contributing to changes in depression and anxiety: worsening of weekly individual economic impact of COVID-19 increased both depression and anxiety, while increased seven-day change in COVID-19 cases, social media use, and projected pandemic duration were positively associated with anxiety, but not depression.Interpretation: Alongside evidence for overall emotional adaptation, these findings highlight overlapping (economic), yet distinct (change in COVID-19 cases, social media use, and projected COVID-19 duration) factors contributing to fluctuations in depression and anxiety throughout the first wave of COVID-19. These results provide insight into socioeconomic policies and behavioral changes that can be made to increase emotional adaptation in times of crisis.Funding Statement: Internal institutional funding.Declaration of Interests: The authors declare no conflicts of interest.Ethics Approval Statement: Participants provided informed consent via an online form. The Institutional Review Board of the Icahn School of Medicine at Mount Sinai determined this research to be exempt following review.