Depression and Anxiety on Twitter During the COVID-19 Stay-At-Home Period in 7 Major U.S. Cities

•Twitter depression and anxiety scores were elevated across 7 U.S. cities.•Twitter depression trends were aligned with national COVID-19 case trends.•Twitter anxiety trends were consistently elevated throughout the pandemic.•Google search trends data showed noisy and inconsistent results.•Twitter can supplement surveys to assess psychological well-being in populations. IntroductionAlthough surveys are a well-established instrument to capture the population prevalence of mental health at a moment in time, public Twitter is a continuously available data source that can provide a broader window into population mental health. We characterized the relationship between COVID-19 case counts, stay-at-home orders because of COVID-19, and anxiety and depression in 7 major U.S. cities utilizing Twitter data.MethodsWe collected 18 million Tweets from January to September 2019 (baseline) and 2020 from 7 U.S. cities with large populations and varied COVID-19 response protocols: Atlanta, Chicago, Houston, Los Angeles, Miami, New York, and Phoenix. We applied machine learning‒based language prediction models for depression and anxiety validated in previous work with Twitter data. As an alternative public big data source, we explored Google Trends data using search query frequencies. A qualitative evaluation of trends is presented.ResultsTwitter depression and anxiety scores were consistently elevated above their 2019 baselines across all the 7 locations. Twitter depression scores increased during the early phase of the pandemic, with a peak in early summer and a subsequent decline in late summer. The pattern of depression trends was aligned with national COVID-19 case trends rather than with trends in individual states. Anxiety was consistently and steadily elevated throughout the pandemic. Google search trends data showed noisy and inconsistent results.ConclusionsOur study shows the feasibility of using Twitter to capture trends of depression and anxiety during the COVID-19 public health crisis and suggests that social media data can supplement survey data to monitor long-term mental health trends.