How sustainable is resilience? A mixed-methods study on the COVID-19-pandemic as a challenge to resilience resources of older adults who previously recovered from depression

Objectives: Despite expanding knowledge about the internal and external resources that contribute to resilience among individuals who have experienced depression, the long-term accessibility and protectiveness of these resources across different stressors is unknown. We investigated whether and how the resilience resources of individuals who previously recovered from late-life depression remained protective during the COVID-19 pandemic. Methods: We used a sequential explanatory mixed methods design. Quantitative data were derived from two psychiatric case-control cohorts and included twelve repeated measures during the COVID-19 pandemic (n = 465, aged ≥ 60). Qualitative data included two sequential interviews held in 2020 (n = 25) and 2021 (n = 19). We used thematic analysis to determine the protective resources after depression and during the COVID-19 pandemic and linear mixed models to examine the effect of these resources on change in depressive symptoms during the COVID-19 pandemic. Results: While resources of ‘Taking agency’, ‘Need for rest’, ‘Managing thought processes’ and ‘Learning from depression’ remained accessible and protective during the pandemic, ‘Social support’ and ‘Engaging in activities’ did not. ‘Negotiating with lockdown measures’, ‘changing social contact’ and ‘changing activities’ were compensating strategies. Quantitative data confirmed the protectiveness of social contact, social cohesion, sense of mastery, physical activity, staying active and entertained and not following the media. Conclusion: Many of the resources that previously helped to recover from depression also helped to maintain good mental health during the COVID-19 pandemic. Where accessibility and protectiveness declined, compensatory strategies or new resources were used. Hence, the sustainability of resilience is enabled through adaptation and compensation processes.