David and Rhonda are joined in today’s podcast by Drs. Alex Clarke and Diane Schiano, as well as Jeremy Karmel, who are all members of David's Tuesday training group at Stanford. Alex is a clinical psychiatrist and TEAM therapist who practices at the Feeling Good Institute in Mountain View, California, and Diane is a research psychologist and licensed marriage and family therapist. All three helped in the design and analysis of the survey data. We published the survey in a blog entitled "How Are You Feeling Now?" on March 26, 2020 . To review the full report of our findings, you can click here.

I (David) have been curious about occasional polls of our listeners to see if we can get  meaningful results to potentially interesting questions. So this was a kind of pilot study to see if negative and positive feelings have changed in our fans since the advent of the corona pandemic.

You are probably aware of the Brief Mood Survey that TEAM therapists ask patients to complete prior to and just after each session to find out how effective the session was. This tool has been incredibly powerful, because therapists and patients alike can find out right away how much improvement the patient experienced in depression, suicidal urges, anxiety, anger, happiness and relationship satisfaction in every single session.

I developed an even shorter version of my Brief Mood Scale to measure similar negative and positive feelings, and all variables can range from 0 (not at all) to 100 (extremely.) So for example, a score of 25 on depression would indicate mild depression, and a score of 100 on happiness would indicate extreme happiness. In other words, high scores on the negative feelings indicate greater distress, while high scores on the positive feelings indicate greater feelings of happiness and relationship satisfaction.

In the survey, we asked people like you how you are feeling right now, and how you were feeling just before learning about the corona virus. The goals of the informal survey were to answer these questions:

1. Will people respond to the survey and can they provide meaningful information that can be analyzed statistically?
2. Are people feeling more distress now?
3. If so, have the negative feelings of depression, anxiety, anger and hopelessness changed more in men or women?
4. Have the positive feelings of happiness and relationship satisfaction changed in men or women since just before the start of the pandemic?
5. How have therapists fared, as compared with non-therapists?

The five of us discussed the survey findings, which can be summarized in this way:

205 of the people who subscribe to my WordPress blogs completed the survey within a couple days. 62% of them were women and 37% were therapists. There were no gender differences in the therapists.

How are You Feeling Now?

Changes in Negative Feelings Since Corona

1. Prior to the corona pandemic, the means of the negative mood variables varied from 13.2 (on a scale of 0 to 100) for hopelessness to 24.1 for anxiety. Keeping in mind that a score of 25 indicates "mild" symptoms, this means that all of these negative feelings were slightly elevated, but the elevations were minimal to mild.
2. At the current time, all four negative feelings have increased significantly, ranging from 23.7 for hopelessness to 38.5 for anxiety, so the negative feelings are now mild to moderate.
3. Prior to the corona pandemic, there were no significant differences in any of the negative mood variables in men vs. women. There have been significant increases in negative feelings since that time, but the greatest increases occurred in women. In fact, in women, the negative feelings approximately doubled. This means that the women who completed the survey, on average, now report feeling moderately  depressed, anxious, angry and hopeless.
4. For men, in contrast, the only negative feeling that increased significantly was anger.
5. There were no statistically significant differences in anger levels in men vs. women before the corona pandemic and there are no significant differences now.

How are You Feeling?

Changes in Positive Feelings Since Corona

1. Prior to the corona pandemic, the means of the happiness and relationship satisfaction scales were 55.6 and 58.6 (on a scale from 0 to 100), meaning they were just a tad better than moderate. This indicates that there was quite a bit of room for improvement in positive feelings prior to the pandemic.
2. At the current time, the mean of happiness has dropped to 41,1 but relationship satisfaction has held steady at 56.8 (not a significant change.)
3. There were no significant differences in happiness in men vs women before the pandemic, and there are no differences now. Happiness has decreased in both men and women, and the decreases have been similar in men and women.
4. In contrast, relationship satisfaction did not differ in men vs. women at either time point, and there have been changes in relationship satisfaction in men or women since the pandemic. This is encouraging, and means that although men and women are more distressed now, feelings of intimacy and closeness to others have not diminished. In other words, social distancing has not led to feelings of isolation or emotional distancing in our population.

How Are Therapists Feeling Now?

Do you think that the therapists who completed the survey will have significantly different scores than non-therapists on the negative and positive mood variables? And if so, do you think the mean therapist scores will be higher or lower?

Here are the findings:

1. Therapists scored 9.85 points higher on happiness as well as relationship satisfaction than non-therapists at both time points. This was highly significant. For example, non-therapists scored 50.2 on happiness and relationship satisfaction at time 1 (moderately happy and moderate relationship satisfaction), while therapists scored 60.1 on happiness and relationship satisfaction. Of course, there's a lot of room for improvement in both groups, since these variables range from 0 to 100.
2. Therapists also scored better than non-therapists on the negative variables at time 1, and the magnitude of the difference was 7.7. So for example, on depression, the non-therapist mean at time one was 21.2 (approaching mildly depressed), while the therapist mean was only 13.5. However, at the current time, things have changed. Now the therapists scores on depression, anxiety, anger and hopelessness are no different, on average, from the scores
   

   Open-Ended Questions: The People Behind the Numbers

   Dr. Diane Schiano led the charge in the discussion of several open-ended questions in our survey. The results can be summarized like this:

   • People are feeling concerned about getting sick, dying or something bad happening to a loved one.
   • People are coping by connecting with friends and loved ones and trying to keep up physical and mental health.
   • People think digital therapy is a good idea, even if it’s not ideal

   For example, one respondent wrote:

   "I remember hearing about the [the corona virus] when [the pandemic] first started in China, but I wasn't overly concerned. I felt like it was a bad flu and would likely blow over. Then I watched the news unfold, particularly in Italy, and realized how serious this is. Once they started shutdowns in California, I realized how serious and close to home this is."

   Rhonda pointed out the discrepancy between our findings and a recent UN reports of increases in domestic violence since the start of the pandemic. While our survey of podcast fans did document increases in anger in men and women since the outbreak, satisfaction in personal relationships was absolutely unchanged in men and women, and was identical in men and women. At the same time, the mean relationship satisfaction level in our group was only "moderate," which is not especially high.

   There are a few disclaimers. First, the findings in this survey probably do reflect the people who receive my Word Press blogs, but may not reflect the US population as a whole. The individuals who receive my blogs or listen to my podcasts are therapists, patients, and general citizens with a fairly strong interest in mental health topics as well as self-help, so the feelings in our group might easily be skewed in a somewhat more negative direction.

   Second, we are measuring peoples' perceptions of their feelings prior to learning of the pandemic. We did not actually measure their feelings prior to the corona epidemic.

   Thanks for tuning in, and please let us know what you thoughts about today’s program! If you'd like me to publish more polls, suggest some interesting poll questions, if any come to mind.

   Rhonda, Jeremy, Diane, Alex, and David