Living through a historic pandemic while handling the stress of the first year of college sent one-third of students in a new University of Michigan study into clinical depression. That’s double the percentage seen in previous years of the same study.
And while certain genetic factors appeared to shield first-year students in pre-pandemic years from depression, even students with these protective factors found themselves developing symptoms in the pandemic years.
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In fact, much of the overall rise in student depression during the pandemic was among young women with this kind of “genetic resilience.”
But the research has a silver lining.
By studying these students’ experiences and backgrounds in depth and over time, scientists may have discovered a way to go beyond genetics to predict which students might be more or less vulnerable to stress-related depression.
The new study is published in the Proceedings of the National Academy of Sciences by a team from the Michigan Neuroscience Institute at U-M.
Potential for prediction and prevention
The team used its findings to develop a tool called an Affect Score, that combines answers from a range of standard mental health questionnaires. The score could help colleges and universities offer more social and mental health support to those most at risk.
The score might work in other groups of people, too, alone or in combination with genetic risk prediction for depression. But further research is needed.
The new findings come from a multiyear longitudinal effort to study the mental health, genetics, personal history, physical activity and sleep of successive groups of first-year college students. It began several years before the pandemic and continues today.
“These students’ experiences during such a stressful time can help us understand the factors that contribute to a rise in depression risk, and inform future efforts to prevent it,” said Huda Akil, senior author of the new paper and a research professor and former co-director of the institute. “Understanding enough to predict is a key initial step to prevention, early detection and early treatment of depression.”
Akil also is the Gardner C. Quarton Distinguished University Professor of Neurosciences, the Gardner C. Quarton Collegiate Professor of Neurosciences and a professor of psychiatry in the Medical School.
Lead author Cortney Turner, an associate research scientist at MNI and in the Medical School’s Department of Pharmacology, said, “The possibility of preventing depression is what I’m most excited about, because the variables at baseline that appear to play the largest role in Affect Score may be modified with training.” That might include summer programs before the start of freshman year to help students feel more confident and positive as they arrive on campus.
Harnessing massive data
The team developed the Affect Score with the help of a machine-learning tool that was used to comb through all the students’ responses on thousands of standardized questionnaires and Fitbit data on their activity and sleep.
The data in the paper come from students in three cohorts, one that completed their freshman year before the pandemic, and two whose freshman experience was affected by the pandemic.
At the start of their freshman year, all took 14 standard questionnaires and gave in-depth interviews conducted by Virginia Murphy-Weinberg, an experienced research nurse. They provided samples of blood, saliva or both to be analyzed in U-M’s Advanced Genomics Core. Each student also received a Fitbit to monitor daily activity and sleep patterns.
The team also followed up with them multiple times with some of the same questionnaires during the rest of their freshman year and into the summer or next academic year to assess symptoms of depression or anxiety in each student.
By looking at which genetic variations each student carried on hundreds of thousands of genes, the researchers calculated their individual depression genetic risk score, called an MDD-PRS. Because of limitations in genetic research on depression, the score was only able to be calculated for students of European heritage.
Men and women with a high MDD-PRS score were more likely than their classmates to develop depression as freshmen in the pre-pandemic era. But when the pandemic hit, genetics became less important.
Men with lower MDD-PRS scores were still less likely to develop depression during the pandemic, but not women with similarly low scores. Meanwhile, the overall risk for the group of students with high MDD-PRS scores didn’t change much from the pre-pandemic classes.
The pandemic increased not only the incidence of depression in females, but how long it lasts, or its chronicity. No matter their genetic profile, women whose freshman year of college started in 2020 had more than eight times the risk of chronic depression symptoms that lasted across that first year and into the summer, compared with those who entered college before the year the pandemic hit, the study showed.
The study also identified what is termed “psychological resilience” in individuals whose genetic profiles might make them seem more prone to depression, but who didn’t develop it despite going through all or part of their freshman year during a pandemic.
“This suggests that when the stress gets strong enough, genetic resilience alone is not enough to buffer against it, especially in females,” Akil said. “But by using machine learning to analyze the components of the psychological profiles at baseline, our ability to predict who became depressed was truly remarkable.
“Both the genetic and nongenetic data tell us that nothing is predestined, and there are multiple kinds of resilience. Colleges and universities need to think about strategies for helping young people walk into their freshman year with the positive state of mind and social support that can help them weather stress, no matter what their background.”
The team continues to test the Affect Score tool on freshmen who entered in 2021, 2022 and this fall. They’re also preparing to test a validated psychiatric intervention digital tool that they hope will help with risk.
In addition to Akil and Turner, the research team included Huzefa Khalil and Murphy-Weinberg, as well as other MNI faculty, staff and trainees.
The students in the study were all from U-M, which offers mental health care through its Counseling and Psychological Services. Akil and Turner are members of the U-M Eisenberg Family Depression Center, which offers multiple programs to support the mental health of college students including athletes and veterans.
