Coronavirus and depression in adults, Great Britain: July to August 2021

• Around 1 in 6 (17%) adults experienced some form of depression in summer 2021 (21 July to 15 August); this is a decrease since early 2021 (21% during 27 January to 7 March) but is still above levels before the coronavirus (COVID-19) pandemic (10%).
• Rates of depressive symptoms peaked earlier in 2021 before falling to 17% at the end of March (31 March to 4 April); since then, levels have been largely stable.

Over the period 21 July to 15 August 2021:

• Younger adults and women were more likely to experience some form of depression, with around 1 in 3 (32%) women aged 16 to 29 years experiencing moderate to severe depressive symptoms, compared with 20% of men of the same age.
• Disabled (36%) and clinically extremely vulnerable (CEV) adults (28%) were more likely to experience some form of depression than non-disabled (8%) and non-CEV adults (16%).
• Around 3 in 10 (29%) adults who reported being unable to afford an unexpected expense of £850 experienced some form of depression, compared with around 1 in 10 (11%) adults who were able to afford this expense.
• Unemployed adults (31%) were twice as likely to experience some form of depression than those who were employed or self-employed (15%).
• Around 1 in 4 (24%) adults living in the most deprived areas of England experienced some form of depression; this compared with around 1 in 8 (12%) adults in the least deprived areas of England.
• Of adults experiencing some form of depression, almost three-quarters (74%) reported that the coronavirus pandemic was affecting their well-being; this compared with around one in three (32%) adults with no or mild depressive symptoms.

Around one in six (17%) adults aged 16 years and over in Great Britain experienced some form of depression in summer 2021 (21 July to 15 August 2021). This is fewer than in early 2021 (27 January to 7 March 2021) (21%) and November 2020 (11 to 29 November 2020) (19%). However, rates in summer 2021 remained higher than those observed before the coronavirus (COVID-19) pandemic (July 2019 to March 2020), where 10% of adults experienced some form of depression (Figure 1).

The presence of some form of depression was indicated by a score of 10 or more on the eight-item Patient Health Questionnaire (PHQ8), which is also referred to as moderate to severe depressive symptoms. Further information can be found in the Glossary. Previous estimates of adults experiencing some form of depression using the same measure were published in August 2020, December 2020 and May 2021.

Figure 1: One in six adults experienced some form of depression in summer 2021, compared with one in five in early 2021

Percentage of adults with moderate to severe depressive symptoms, Great Britain, July 2019 to August 2021

Notes:

1. Base population: All adults in Great Britain.

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It is important to note that reasons for changes in the prevalence of depressive symptoms over time are likely to be complex. Reasons may include the impact of changes to restrictions related to the coronavirus pandemic and seasonal variation in levels of depressive symptoms, as well as other factors. As such, we cannot determine the cause of these changes from the analysis presented in this article.

Comparison week-on-week

For the first time we have looked at weekly rates of adults experiencing some form of depression (indicated by moderate to severe depressive symptoms), covering the period 27 January to 22 August 2021.

Rates of moderate to severe depressive symptoms were highest earlier in the year before falling to 17% at the end of March (31 March to 4 April 2021). Since then, levels have been largely stable (Figure 2).

Figure 2: Rates of adults experiencing some form of depression fell at the end of March and have been relatively stable since

Percentage of adults with moderate to severe depressive symptoms, Great Britain, February to August 2021

Notes:

1. Base population: All adults in Great Britain.

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Weekly estimates of depressive symptoms by characteristics, including age, sex and region, can be found in the accompanying data tables.

Comparisons between population groups

Rates of some form of depression (indicated by moderate to severe depressive symptoms) in summer 2021 were lower across most population groups when compared to early 2021, although they remained higher than pre-pandemic levels (Figure 3).

For adults aged 16 to 39 years, rates in summer 2021 were lower (23%) than early 2021 (29%) but were still more than double when compared with before the pandemic (11%). In comparison, the proportion of adults aged 70 years and over experiencing some form of depression remained stable between summer 2021 (9%) and early 2021 (10%), having increased from 5% before the pandemic.

In summer 2021, over one in four (29%) adults who reported being unable to afford an unexpected but necessary expense of £850 experienced some form of depression, having fallen from over one in three (35%) in early 2021. For adults who were able to afford this expense, 11% experienced moderate to severe depressive symptoms in summer 2021, decreasing from 13% in early 2021.

Figure 3: In summer 2021, rates of some form of depression declined across most population groups but remained higher than pre-pandemic levels

Percentage of adults with moderate to severe depressive symptoms, Great Britain, July 2019 to August 2021

Notes:

1. Base population: All adults in Great Britain.
2. Afford an unexpected expense: Adults were asked if their household could afford an unexpected, but necessary, expense of £850. This gives us an indication of adults who may be struggling financially.
3. Child in household: Whether there is a child living in the household. A child is any person aged under 16 years.
4. Data on "Disability" and “Afford unexpected expense” were not collected before the coronavirus (COVID-19) pandemic (July 2019 - March 2020), therefore data for the time point are based on data collected in June 2020.
5. Time points refer to data collected July 2019 to March 2020 (pre-pandemic), June 2020, November 2020, January to March 2021 and July to August 2021 (summer 2021).

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Further information is available in the accompanying data tables.

This section explores the rates of some form of depression (indicated by moderate to severe depressive symptoms, a score of 10 or more on the eight-item Patient Health Questionnaire) in summer 2021 (21 July to 15 August 2021) by detailed characteristics.

Age

In summer 2021, adults aged 16 to 29 years were most likely to experience some form of depression (26%), while adults aged 70 years and over were least likely to experience some form of depression (9%) when compared with any other age group (Figure 4). This pattern has remained unchanged from early 2021.

Age and sex

Women were more likely than men to experience some form of depression across all age groups, except for those aged 70 years and over where there was no significant difference.

Around one in three (32%) women aged 16 to 29 years experienced some form of depression in summer 2021 compared with 20% of men of the same age (Figure 5).

Disabled or clinically extremely vulnerable adults

Around one in three (36%) disabled adults experienced some form of depression in summer 2021; this was over four times greater than non-disabled adults (8%). Adults who identified as clinically extremely vulnerable (CEV) were more likely to experience some form of depression (28%) than non-CEV adults (16%) (Figure 6).

For definitions of disability and CEV status, see the Glossary.

Employment status

Twice as many unemployed adults (31%) experienced some form of depression compared with employed or self-employed adults (15%). Adults who were retired (8%) were the least likely to experience some form of depression across all employment groups, while those who were economically inactive for reasons other than retirement (36%) had similar rates of moderate to severe depressive symptoms to those who were unemployed (31%) (Figure 7).

Financial characteristics

Around 3 in 10 (29%) adults who reported being unable to afford an unexpected but necessary expense of £850 experienced some form of depression, compared with 11% of adults who reported being able to afford this expense.

In addition, for working age adults aged 16 to 64 years, rates of moderate to severe depressive symptoms generally decreased as income increased. Around 3 in 10 (29%) working adults with a personal income of less than £10,000 a year experienced some form of depression; this was four times greater than working adults with a personal income of £50,000 or more (7%) (Figure 8).

Household size

In summer 2021, around one in four (23%) adults residing in single-person households experienced some form of depression, compared with one in six (16%) adults living in multi-person households (Figure 9).

Housing tenure

Adults renting their home were the most likely to experience some form of depression (26%) when compared with all other tenure groups. This compared with 11% of adults who reported owning their home outright (Figure 10).

Area deprivation

Adults living in the most deprived areas of England (based on the Index of Multiple Deprivation) were twice as likely to experience some form of depression in summer 2021 (24%) than adults living in the least deprived areas (12%) (Figure 11).

For a definition of area deprivation, see the Glossary.

Country and Region

Rates of moderate to severe depression appeared to vary between the regions of England, Wales and Scotland – ranging from 15% in Wales and the East of England to 22% in the North East. However, these differences were not statistically significant. Additional analysis by region, including comparisons over time, can be found in accompanying data tables.

Impact on life

Adults were asked, “In which way is the coronavirus (COVID-19) pandemic affecting your life?”. In summer 2021 (21 July to 15 August 2021), the impacts most commonly reported by adults experiencing some form of depression (indicated by moderate to severe depressive symptoms, a score of 10 or more on the eight-item Patient Health Questionnaire) were:

• well-being affected (74%)
• lack of freedom and independence (44%)
• access to healthcare and treatment for non-coronavirus (COVID-19) related issues being affected (40%)

The impact on well-being and lack of freedom and independence remained the most common types of impact reported from early 2021 (27 January to 7 March 2021), although they have both seen decreases (from 85% and 66% respectively). The proportion of adults experiencing some form of depression who reported access to healthcare and treatment for non-coronavirus related issues was affecting their life appeared to increase compared with early 2021 (36%), although this increase was not statistically significant (Figure 12).

Well-being

Of adults experiencing some form of depression in summer 2021, almost three-quarters (74%) reported that the coronavirus pandemic was affecting their well-being. This compared with around one in three (32%) adults with no or mild depressive symptoms.

The aspects of well-being most commonly reported as being affected by adults experiencing some form of depression were:

• feeling stressed or anxious (83%)
• feeling worried about the future (69%)
• making my mental health worse (64%)
• feeling lonely (61%)
• feeling bored (53%)

The aspects of well-being most commonly reported as being affected in summer 2021 were similar to those reported in early 2021 and earlier in the pandemic (June 2020 and November 2020).

Figure 13 shows the aspects of well-being with the biggest percentage point differences between summer 2021 and early 2021 among adults experiencing some form of depression. Of those who said the coronavirus pandemic was affecting their well-being, 53% experiencing some form of depression reported feeling bored (down from 68% in early 2021). A similar fall was seen in those reporting they were unable to exercise as normal (27% down from 40% in early 2021).

The proportion of adults with some form of depression that reported feeling like a burden or that they had no one to talk to about their worries (both 42% in summer 2021) increased over this time period (from 30% and 33% in early 2021, respectively).

Loneliness

Of those experiencing some form of depression in summer 2021, around 6 in 10 (61%) reported that they felt lonely “often or always” or “some of the time”. This compared with 17% of those with no or mild depressive symptoms. These estimates have remained stable since June 2020. For further information, see the accompanying data tables.

Area deprivation, England

Area deprivation is measured using the Index of Multiple Deprivation (IMD). This is the official measure of relative deprivation for small areas in England. The IMD ranks every small area in England from 1 (most deprived area) to 32,844 (least deprived area). We have grouped areas into five groups (quintiles), ranging from most deprived to least deprived areas.

Clinically extremely vulnerable

Clinically extremely vulnerable (CEV) status is self-reported. Those in this "high risk" group, known as clinically extremely vulnerable, will have received a letter from the NHS or their GP advising them of this; they may have also been advised to shield in the past.

Further information can be found on the NHS website.

Depressive symptoms

Respondents were asked the following questions from the eight-item Patient Health Questionnaire (PHQ-8):

a. Over the last two weeks, how often have you been bothered by having little interest or pleasure in doing things?

b. Over the last two weeks, how often have you been bothered by feeling down, depressed or hopeless?

c. Over the last two weeks, how often have you been bothered by having trouble falling or staying asleep, or sleeping too much?

d. Over the last two weeks, how often have you been bothered by feeling tired or having little energy?

e. Over the last two weeks, how often have you been bothered by having a poor appetite or overeating?

f. Over the last two weeks, how often have you been bothered by feeling negative about yourself or that you are a failure or have let yourself or your family down?

g. Over the last two weeks, how often have you been bothered by having trouble concentrating on things, such as reading the newspaper or watching television?

h. Over the last two weeks, how often have you been bothered by moving or speaking so slowly that other people could have noticed; or being so fidgety or restless that you have been moving around a lot more than usual?

These questions had four response options ranging from 0 (Not at all) to 3 (Nearly every day). A “depression score” was then derived by summing all responses chosen, resulting in a score ranging from 0 to 24. The higher the score, the greater the severity of depressive symptoms.

A person's PHQ-8 score sits in one of two categories:

• no or mild symptoms – this refers to a depression (PHQ-8) score of between 0 and 9 (inclusive)
• moderate to severe symptoms – this refers to a depression (PHQ-8) score of between 10 and 24 (inclusive)

Disability status

To define disability in this publication, we refer to the Government Statistical Service (GSS) harmonised "core" definition. This identifies "disabled" as a person who has a physical or mental health condition or illness that has lasted or is expected to last 12 months or more and that reduces their ability to carry-out day-to-day activities. As such, this group will include those with mental health conditions such as depression. The GSS harmonised questions are asked of the respondent in the survey, meaning that disability status is self-reported.

Opinions and Lifestyle Survey

This release contains data from a module being undertaken through the Office for National Statistics' (ONS) Opinions and Lifestyle Survey (OPN) to understand the impact of the coronavirus (COVID-19) pandemic on British society.

Background information on the OPN can be found in the Opinions and Lifestyle Survey QMI.

Sampling and weighting

The analysis throughout this report is based on adults aged 16 years and over in Great Britain with a valid depression score. The latest analysis in this report is based on 13,774 adults from a pooled dataset comprising four waves of data collection, covering the following periods: 21 to 25 July, 28 July to 1 August, 4 to 8 August and 11 to 15 August. Pooling four waves of data together increases sample sizes, allowing us to explore depressive symptoms for different groups of the population.

Earlier periods referenced in Section 2 cover the following periods: July 2019 to March 2020, 4 to 14 June 2020, 11 to 29 November 2020, and 27 January to 7 March 2021.

Changes in estimates over time could be attributed to seasonality effects. However, seasonality effects have not been adjusted for in this analysis.

Survey weights were applied to make estimates representative of the population (based on June 2021 population estimates).

Further information on the survey design and quality can be found in the Opinions and Lifestyle Survey QMI.

Statistical significance

This report presents a summary of results, with further data including confidence intervals for the estimates contained in the accompanying data tables. Where comparisons between groups are presented, 95% confidence intervals should be used to assess the statistical significance of the differences.

Quality

More quality and methodology information on strengths, limitations, appropriate uses, and how the data were created is available in the Opinions and Lifestyle Survey QMI.