People experiencing depression actively fight to manage their emotions

A new study involving more than 200 St. Louis-area adults sheds light on the goals, motivations, and strategies involved in managing emotions during depression.

People who struggle with depression don’t simply give in to their negative emotions. A new study found that, compared to healthy adults, people with major depressive disorder are more likely to actively work to manage their emotions at any given moment. Findings from the study were recently published in the Journal of Psychopathology and Clinical Science, a leading clinical psychology journal. 

Renee Thompson

“Depressed people sometimes use different strategies for managing their feelings — some more successful than others depending on the context— but they’re clearly making an effort,” said Renee Thompson, associate professor of psychological and brain sciences and study co-author. “People with depression are clearly motivated and engaged to feel better,” she said.

The study’s co-authors include Tammy English, associate professor of psychological and brain sciences; graduate students Tabea Springstein and Alison Tuck; and Daphne Liu, a postdoctoral fellow at Stony Brook University who earned her PhD at WashU.

The study involved 215 adults in the St. Louis area, including 48 who had current major depressive disorder, 80 who had recovered from major depressive disorder, and 87 adults who had never been diagnosed with a mental health disorder.

The study used a phone app that would prompt participants to report on their emotional state five times a day for two weeks. Whenever they received a prompt, participants would describe their current emotions and indicate whether they were working to change or maintain them. If they were trying to manage their emotions, they were asked about their goals, motivations, and strategies for doing so.

The study found that at any given moment, people currently experiencing depression were especially likely to be attempting to manage their emotions — a demanding job. Thompson explained that the efforts that depressed people go through to manage emotions had previously been underestimated and misunderstood. These findings counter any beliefs that people with depression tend to let their feelings take over without much resistance. “Our findings are different than what you see in the established literature,” she said.

While previous studies asked people with depression about their general approach to emotions, this new study checked in with them in real time. “We’re not studying them in a controlled lab setting,” Thompson said. “We’re looking at them in the context of their own lives.”

Thompson and colleagues found that all three groups — people with depression, people who previously experienced depression, and healthy controls — had the same general goals for managing their emotions. Specifically, they usually wanted to tamp down negative feelings like anger and anxiety and enhance positive feelings like satisfaction and a sense of accomplishment.

While all the groups had practical motivations for managing their  emotions — such as avoiding conflict or trying to make a good impression — people currently experiencing depression more frequently reported trying to manage their emotions simply to feel better.

People experiencing depression sometimes reported using different coping strategies. Compared with others, they were more likely to employ distraction. “This is consistent with past research that has found that depressed people struggle to tolerate and have elevated fear of their negative feelings,” Thompson said. The surveys didn’t get into the specific ways people used distractions, so it’s not possible to know how many were exercising, how many were looking at their phones, and how many were doing something else entirely.

Importantly, the study also didn’t address whether participants’ attempts to manage their emotions were successful. "We don't know whether people with depression regulate emotion more frequently because they have difficulty identifying or implementing appropriate strategies in a particular context,” Thompson said. Ultimately, she hopes that new insights into the day-to-day realities of people with depression will lead to more effective therapies.

Thompson pointed to one especially optimistic finding from the study: The people who had struggled with depression in the past managed their emotions very similarly to the healthy control group. “It is a very hopeful story,” she said. “Many of the emotional experiences that people have when they are depressed may not persist after their depression remits.”