Sense of belonging helps people suffering depression

Having a sense of belonging with family, friends and co-workers can help relieve symptoms of depression, according to U-M research.

Reg Williams, professor of nursing and psychiatry and co-author of a paper in the current issue of the Archives of Psychiatric Nursing, says people who feel connected to the world around them feel better.

"You can have lots of social support, but unless you feel you fit in, it doesn't help," Williams says. He teamed up for the research with graduate student Chanokruthai Choenarom and long-time collaborator Bonnie Hagerty, associate professor of nursing.

The researchers studied 90 people, and separated them into two groups—one diagnosed with depressive symptoms and the other without. They looked at perceived stress, sense of belonging, social support and spousal support for one year, taking data every three months.

Notably, spousal support did not help with depression. In fact, it sometimes had a negative effect. "The things a spouse thinks might be supportive aren't necessarily helpful," Williams says. For example, some spouses might think they're giving cheerful pep talks, but they might be received as nagging or minimizing their mate's suffering.

The higher that subjects rated their social support and a sense of belonging, the lower they rated their depressive symptoms. Williams says there are implications for this research both for clinicians and for those suffering from depression.

"When I first see a patient who is suffering depression, I ask them to reach out to friends, family members and co-workers and get re-connected to their support network," he says. "It really works."

"When a person is depressed, the natural tendency is to want to withdraw from the very people they need. That's what's so wicked about this illness," he adds. The depressed person might have a support network of concerned people who love him or her, but the depression will make the person unlikely to return phone calls or go out to social events. Eventually, those in the support network might feel rejected and stop trying.

Hagerty and Williams recently received funding from the Blue Cross and Blue Shield Foundation to do a two-year study of adherence to antidepressant medications when prescribed by primary care physicians.

Williams says one of the problems with treating depression is that when the patient begins to feel better, the person might stop treatment. To keep depression at bay, the patient needs to continue treatment, as quitting will cause a backslide.

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