Lifestyle and mental health disruptions during COVID-19

Abstract

Using a longitudinal dataset linking biometric and survey data from several cohorts of young adults before and during the COVID-19 pandemic ([Formula: see text]), we document large disruptions to physical activity, sleep, time use, and mental health. At the onset of the pandemic, average steps decline from 10,000 to 4,600 steps per day, sleep increases by 25 to 30 min per night, time spent socializing declines by over half to less than 30 min, and screen time more than doubles to over 5 h per day. Over the course of the pandemic from March to July 2020 the proportion of participants at risk for clinical depression ranges from 46% to 61%, up to a 90% increase in depression rates compared to the same population just prior to the pandemic. Our analyses suggest that disruption to physical activity is a leading risk factor for depression during the pandemic. However, restoration of those habits through a short-term intervention does not meaningfully improve mental well-being.

Keywords: COVID-19; lifestyle disruptions; mental health; physical activity.

Fig. 1.

(A–D) The figure plots the average outcomes by day for study participants in the spring of 2019 (red) and spring of 2020 (blue). Gray shading indicates 95% confidence intervals for the locally weighted smoothing curve.

Fig. 2.

Screen time and social interactions. The figures show the average time spent with friends (social time) and the average screen time at the beginning (February) and end (April) of the semester during the spring 2019 and spring 2020 terms. Screen time includes time spent playing games, watching television, or surfing the Internet and does not include time spent working or studying on a device. Bars indicate 95% confidence intervals.

Fig. 3.

Depression. The figures show the average CES-D score at the beginning (February), middle (March 2020 only), and end (April) of the semester during the spring 2019 and spring 2020 terms. Bars indicate 95% confidence intervals.

Fig. 4.

Habit disruptions and depression. The figure reports the proportion of individuals reporting clinical depression (CES-D$>$15) below (smaller disruptions) and above (larger disruptions) median change in physical activity (steps and active minutes), sleep (duration and wake-up time), and time use (screen time and social interactions). Bars indicate 95% confidence intervals.

Fig. 5.

Risk factors for depression. (A) The relative importance (out of 1) in the 2019 pooled cohorts and 2020 cohort of variables grouped by baseline mental health; differences between endline and baseline levels of physical activity, sleep, and time use; demographics; and other (baseline self-reported health and treatment assignment in our sleep intervention). We report the top three most important features and their relative importance in the pooled 2019 and spring 2020 cohorts: CES-D measures baseline depression, GAD-7 measures baseline anxiety, Life sat. measures baseline life satisfaction, and Phys. act. diff. measures differences in average daily active minutes between endline and baseline. (B) Estimated SHAP values by physical activity differences for the pooled 2019 and spring 2020 cohorts, where higher SHAP values indicate higher risk of depression. Gray shading indicates 95% confidence intervals for the locally weighted smoothing curve.

Fig. 6.

Improved physical activity and depression. (A) Steps over time in the treatment and control groups for the subset of participants who elected to participate in the second phase of the study. The dashed vertical lines indicate the end of the first phase of the study (20 April), the beginning of the intervention (1 June), and the end of the intervention (14 June). (B) Average CES-D scores before the intervention (30 May) and after the intervention (16 June and 17 July) for the treatment and control groups.