The concept of infectious diseases like the flu or strep throat is well understood—these illnesses spread through physical exposure, such as airborne droplets. But what about mental health conditions like depression? Can they also be contagious?
A recent study published in JAMA Psychiatry has sparked discussions by suggesting that mental health disorders may spread socially, particularly during adolescence. However, the science behind this is complex and controversial.
The Study: Social Spread of Mental Disorders
Earlier this year, researchers from the University of Helsinki and other institutions published a study examining the potential social transmission of mental health disorders among adolescents. Using data from over 713,000 Finnish citizens born between 1985 and 1997, the researchers followed a cohort of ninth-grade students, analyzing the mental health diagnoses of their peers. The findings revealed that students who had classmates diagnosed with a mental disorder were at a 5% higher risk of developing a mental illness later in life, compared to those without peers diagnosed.
The risk was particularly pronounced in the year immediately following the peer’s diagnosis. For instance, students exposed to one diagnosed classmate had a 9% increased likelihood of developing a mental disorder, and this figure jumped to 18% for students exposed to multiple diagnosed peers. The conditions most impacted were mood, anxiety, and eating disorders.
Despite these results, the study remained observational and could not conclusively prove causality. Still, it raised questions about whether mental health issues could be socially transmitted, akin to emotional contagion—where someone’s laughter or pain triggers similar emotions in others.
The Controversy: Confounding Factors and Causality
While the study’s findings are compelling, critics argue that they don’t fully account for other potential influences. Eiko Fried, a clinical psychologist and associate professor at Leiden University, pointed out that factors like living in a disadvantaged neighborhood—which increases the risk of depression—could explain the apparent social clustering of mental health disorders in schools.
“These children often attend the same schools, creating an aggregation of depression,” Fried explained in an email to Undark. He emphasized that until such confounding factors are thoroughly accounted for, the results might incorrectly attribute the clustering of mental health issues to social contagion.
Jussi Alho, the lead author of the Finnish study, responded to such critiques by explaining that the study used school classes as proxies for social networks, reducing the potential for self-selection bias. Unlike most friendships, school classes are institutionally imposed, which makes them ideal for studying social influences. However, Alho acknowledged that residual confounding—factors that were not measured or accurately captured—remains a challenge.
Broader Research: Mixed Results on Social Contagion
The idea that mental health issues might spread through social networks is not new, but research in the area has yielded mixed results. A 2013 study published in Health Economics attempted to test for mental health contagion by examining the mental health status of college roommates—students who were paired randomly. The authors found little evidence of significant contagion, though they did note small effects in certain areas, such as general psychological distress and anxiety.
Even these minimal contagion effects, however, could be the result of shared environments. Students with similar academic and social backgrounds might naturally gravitate toward similar mental health outcomes, irrespective of direct social influence.
The Bigger Picture: Raising Awareness Through Exposure
Whether or not mental health conditions are socially contagious, increased exposure to peers with mental disorders may serve an important role in raising public awareness. The researchers behind the Finnish study suggested that being exposed to peers with mental health diagnoses could help “normalize” mental disorders, making individuals more aware and receptive to seeking diagnosis and treatment.
This normalization might explain the rising rates of mental health diagnoses seen in recent decades. For instance, Generalized Anxiety Disorder (GAD) was first recognized in 1980 with the release of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Since then, it has become far more prevalent, with studies showing GAD now affects up to 5% of people over their lifetime. This rise could be due to better awareness, changing diagnostic criteria, or improved access to mental health care.
As our understanding of mental health evolves, it’s possible that social exposure plays a dual role—spreading awareness and potentially increasing the risk of developing a disorder. However, whether this amounts to actual contagion, like in the case of viral infections, remains uncertain.
Conclusion: A Complex and Ongoing Debate
The question of whether depression and other mental health disorders are socially contagious is still up for debate. While some studies suggest that peer networks can influence mental health outcomes, the evidence remains inconclusive, and confounding factors continue to cloud the issue.
What is clear, however, is that exposure to mental health issues—whether through peers or society at large—has increased public awareness and encouraged more people to seek help. As researchers continue to explore the nuances of social contagion, the conversation surrounding mental health remains a vital part of understanding the broader impacts of our social environments.
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