A new study published in JAMA Psychiatry in May finds that an online guided self-help program significantly reduced the risk of depression in a group of people at high risk for the mental disorder.

Depression affects an estimated 7% of adults in any given year, and one in six people will experience depression at some time in their life. The COVID-19 pandemic and the resulting stay-at-home orders and economic impacts have led to significant increases in rates of depression and anxiety. According to the U.S. Census, approximately one in three Americans are showing signs of anxiety or depression and one in four are experiencing significant symptoms of major depressive disorder. The rates are highest among young adults 18-29, with nearly half showing signs of anxiety or depression.

The new study involved a group of nearly 300 individuals at high risk of depression because of persistent back pain. They were randomly assigned to an intervention or control group. The test group received a guided, online self-help intervention that is based on cognitive behavioral therapy (CBT). Each of the participants completed six required modules and had an opportunity to complete three additional optional modules. Each module takes about 40 minutes to complete. Trained psychologists guided the participants by providing feedback after each module and answering questions. Participants could also choose to receive motivational texts with brief exercises.

Over a 12-month period, participants taking the online self-help program were 52% less likely to experience a major depressive episode than those in the control group. Those participants also saw improvements in quality of life and pain-related functioning.

Lead author Lasse B. Sander, Ph.D., with Freiburg University in Germany and colleagues concluded that shifting the focus from depression treatment to preventing depression might be a viable way to prevent the distress and suffering of depression and its  impacts on  health. In a commentary on the research, Steven Dubovsky, M.D., noted an advantage of this type of program: “this kind of approach can be easily implemented in non-psychiatric practices for patients with chronic illnesses who are prone to depression.”

Previous research has identified several other factors that can help prevent depression. For example, studies have shown physical activity and exercise reduce the risk of depressive symptoms, and these results are consistent across people of all ages and across different countries and cultures. Healthy eating can also contribute to reduced risk of developing depression. Nutrition recommendations include increasing fruits, vegetables, legumes, wholegrain cereals, nuts, seeds and foods rich in omega-3 polyunsaturated fatty acids. Nutrition guidelines also call for limiting processed foods, 'fast' foods, and commercial bakery goods. There is also some evidence that school-based psychological programs can help reduce the risk of depression among adolescents.