ANN ARBOR—Having a sense of belonging with family, friends and coworkers can help relieve symptoms of depression, according to research from the University of Michigan.

A paper in the current issue of the Archives of Psychiatric Nursing shows that sense of belonging is a powerful predictor of depressive symptoms: when people feel connected to the world around them, they feel better, said Reg Williams, professor of nursing and psychiatry, and one of the paper’s authors.

"You can have lots of social support, but unless you feel you fit in, it doesn’t help," Williams said. 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, Williams said. "The things a spouse thinks might be supportive aren’t necessarily helpful," he said. 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 subjects rated their social support and a sense of belonging, the lower their ratings of depressive symptoms.

Williams said 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 coworkers and get reconnected to their support network," he said. "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 said. 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 said one of the problems with treating depression is that when the patient begins to feel better, the person might stop treatment, feeling "cured." However, in order to keep depression at bay, the patient needs to continue the treatment, so quitting treatment will cause a backslide.

If the treating doctor isn’t aware that the patient has stopped taking medication, the patient can suffer those ill effects without getting help.

In addition, Williams said he would like to do additional research to hone in on what the spouse of a depressed person can do to be most helpful. He said sometimes spouses inadvertently undermine depression treatment because they don’t know how to help.

Related links:

Archives of Psychiatric Nursing

Reg Williams

U-M School of Nursing

cnewvine@umich.edu