The Experiences of Undergraduates with Depression in Online Science Learning Environments

INTRODUCTION

Increasingly, college students report struggling with depression, and colleges and universities are beginning to recognize the importance of improving undergraduate mental health (Mistler et al., 2012; National Council on Disability, 2017; Center for Collegiate Mental Health, 2020; Hsu and Goldsmith, 2021). Depression is defined as frequent feelings of unhappiness, hopelessness, and often a loss of motivation or interest in actions that an individual previously enjoyed (American Psychiatric Association, 2013). In the United States, depression is believed to affect about 23% of college students (American College Health Association, 2020). However, some studies estimate that depression affects a far greater percentage of undergraduates (Garlow et al., 2008; Mohammed et al., 2021). Additionally, depression rates among college students are currently estimated to be at an all-time high, likely due to the emotional stress caused by the COVID-19 pandemic (Kecojevic et al., 2020; Kujawa et al., 2020; Son et al., 2020; Wang et al., 2020; Lee et al., 2021).

College students perceive that depression can have a detrimental effect on their grades and ability to complete college courses (American College Health Association, 2019). Indeed, studies have shown that students with depression taking in-person courses underperform on assessments compared with students without depression (Hysenbegasi et al., 2005; DeRoma et al., 2009; Yasin and Dzulkifli, 2011). There are multiple explanations as to why depression may affect student performance. Depression has been shown to negatively affect one’s executive function, which is defined as one’s ability to coordinate thoughts and actions when working toward a goal (Miller and Wallis, 2009). As such, difficulties with executive function can make goal setting and goal achievement difficult (Boyd and Reuning-Elliott, 1998; Meltzer and Krishnan, 2007). In addition, students with depression are at risk for experiencing stereotype threat in academic environments (Quinn et al., 2004). Stereotype threat refers to the risk of confirming negative stereotypes about a group that one belongs to (Steele and Aronson, 1995); if students with depression perceive that others think that individuals with mental health conditions struggle academically, they may underperform compared with their counterparts without mental health conditions when they perceive their intelligence is being evaluated (Spencer et al., 1999). As researchers strive to further understand the experiences of college students with depression and create more inclusive academic environments, it is important to note that the majority of extant research regarding the experience and performance of undergraduates with depression has taken place in traditional, in-person courses (Hysenbegasi et al., 2005; DeRoma et al., 2009; Yasin and Dzulkifli, 2011).

Notably, depression affects undergraduates in academic environments beyond the traditional in-person classroom. For example, in an interview study of 35 undergraduate researchers with depression, participants described that depression can have a negative impact on their motivation, productivity, creativity, and concentration when engaging in undergraduate research experiences (Cooper et al., 2020a). In turn, the unstructured nature of research and the increased opportunities to experience failure often exacerbated depression among these undergraduate researchers. Depression has also been shown to affect undergraduates in study abroad programs. One study found that students were likely to express a negative mood if they perceived their study abroad experience as less challenging and their environment as more hostile and anxiety provoking (Savicki, 2013). Finally, there is emerging evidence that depression may also affect students who complete college courses online. A recent study found that needing to have the camera on, struggling to get to know the instructor, the potential for distractions to occur during online learning, the potential for surroundings to embarrass someone while on camera, and working with people one does not know increased feelings of anxiety among students with depression engaging in online college science courses (Mohammed et al., 2021).

The impact of online learning on students with depression is of particular interest given the increasing number of colleges and universities adopting online courses, especially considering the transition to online learning due to the COVID-19 pandemic (Son et al., 2020). Before the pandemic, many universities already offered completely online degree programs in science disciplines, reflecting the rapid growth in online education in recent years (Allen and Seaman, 2013; Varty, 2016; Cooper et al., 2019; Mead et al., 2020). Indeed, students have increasingly engaged in online learning experiences in the last two decades, leveraging the flexibility and accessibility that online courses provide (Song et al., 2004; Northrup, 2009; Daymont et al., 2011; Daniel, 2016; Soffer et al., 2019). Prior research suggests that depression persists as a significant concern for online students as well as for in-person students (Lindsey et al., 2009; Beiter et al., 2015; Sifat, 2020; Mohammed et al., 2021). A survey of 1886 students pursuing undergraduate degrees across an array of disciplines through an online university found that 32.1% of respondents indicated that they had been diagnosed with depression (Krasowski, 2018). In fact, depression may be more prevalent in online environments; compared with in-person degree programs, online degree programs often serve individuals who are disproportionately likely to experience depression, including women (Evans et al., 2018; Pelayo, 2018; Mead et al., 2020), first-generation college students (Jenkins et al., 2013; Mead et al., 2020), individuals from low socioeconomic backgrounds (Eisenberg et al., 2007; Mead et al., 2020), members of the LGBTQ+ community (Eisenberg et al., 2007; Evans et al., 2018), and people with disabilities (Turner and Noh, 1988).

Engaging in online science courses is thought to be challenging for students in general (Kim et al., 2005; Song et al., 2004). Science courses have been described as extremely rigorous, stressful, and competitive (Everson et al., 1993; Strenta et al., 1994; Seymour and Hunter, 2019), and students pursuing both science, technology, engineering, and mathematics (STEM) majors and non-STEM majors report that it is more difficult to pay attention and learn science content in online courses compared with in-person courses (Mohammed et al., 2021). Further, adapting to novel learning environments can cause any student to feel unsure about their skills (Bennett and Lockyer, 2004; Cameron and Rideout, 2020), and online students across disciplines frequently describe experiencing technological issues (Song et al., 2004; Smith, 2005; Bonk et al., 2018; Olt and Teman, 2018; Mohammed et al., 2021), which can lead to irritability and a disinterest in learning (Tank, 2020).

We hypothesize that students with depression may be particularly susceptible to experiencing challenges in online college science courses. Theories of depression provide some insight as to why specific aspects of online courses may exacerbate depression. However, no theory is widely accepted as an overarching framework that fully explains depression. As such, we draw from two prominent sets of theories to further understand the relationship between online science courses and student depression: The behavioral theories of depression posit that depression is a result of one’s interactions with one’s environment, resulting from decreased reward, negative reinforcement, and encouragement of depressive or passive behaviors (Lewinsohn, 1974; Martell et al., 2001; Carvalho et al., 2011). The cognitive theories of depression, which suggest that one’s way of thinking, particularly having a negative view of oneself, the world, and the future, can result in distorted thoughts and depressive symptoms (Beck, 1979; Leahy, 2002). Together, these sets of theories help explain why particular aspects of online courses, may exacerbate depressive symptoms among undergraduates.

Drawing from the behavioral and cognitive theories of depression (Lewinsohn, 1974; Beck, 1979; Martell et al., 2001; Leahy, 2002; Carvalho et al., 2011) and the limited research on the experiences of undergraduate science students with depression (Cooper et al., 2020a,b), we hypothesize that aspects of learning science online related to success/failure, social relationships/isolation, and flexibility may affect depression among undergraduates. While failure, which we define as the inability to meet the demands of an achievement (Henry et al., 2019), can be difficult for any undergraduate (Gin et al., 2018; Henry et al., 2019, 2021), recent research found that encountering failure has been reported to be particularly difficult for science undergraduates with depression (Cooper et al., 2020a). Specifically, cognitive theories of depression (Beck, 1979; Leahy, 2002) support the findings from a study of undergraduate researchers with depression; these students reported focusing excessively on a failure, inappropriately blaming themselves for a failure, and perceiving a failure as a reflection of their broader abilities to be successful (Cooper et al., 2020a). In the context of learning science online, we posit that aspects of science courses that relate to whether a student might fail an assignment or exam, such as having difficulty getting questions answered and the sometimes fast pace of online courses, may exacerbate student depression. Additionally, behavioral theories of depression (Lewinsohn, 1974) and prior research (Santini et al., 2015; Cooper et al., 2020a; Gin et al., 2021b) suggest that the extent to which science students can form social relationships that result in positive reinforcement would be protective against depression, while isolation can exacerbate depressive symptoms. Students report it is notoriously difficult to develop relationships with other students and instructors in online courses (Mohammed et al., 2021); as such, we predict this may negatively affect depression. Finally, the flexibility of not having to show up to class in person may present difficulties for undergraduates during a depressive episode; being required to be physically present in an education space may provide motivation for students to accomplish activities of daily living (ADL), defined as basic self-care tasks such as bathing, grooming, and dressing, which can be difficult for individuals with depression (Kazama et al., 2011). However, the relationship between flexible science academic environments and depression is complex (Cooper et al., 2020a; Gin et al., 2021b). There are instances in which the flexibility of completing academic work from where students want and when students want could be helpful for depression. For example, studies have shown that flexibility can be helpful for undergraduate science students with depression, because it affords them the ability to complete work when they feel best and avoid work when they are recovering from a depressive episode (Cooper et al., 2020a,b). Additionally, not needing to be seen by others, whether via online conferencing platforms or in person, may be helpful for students who have been crying or who have been unable to complete ADLs (Tricker et al., 2001). Why flexible academic environments are sometimes helpful and sometimes harmful for students with depression is not well studied; our previous work suggests that the severity of one’s depression may partially explain these conflicting findings; students who are moderately depressed may benefit from the motivation of needing to show up somewhere in person, while students undergoing a major depressive episode may benefit from the flexibility needed to recover from severe symptoms (Cooper et al., 2020a; Gin et al., 2021b), although more research is needed.

In addition to aspects of online courses affecting undergraduate depression, we also hypothesize that depression may in turn make the process of learning online especially difficult for students. For example, depression can negatively affect students’ cognitive domains, including their attention and time management, language and communication skills, executive function, problem solving, and social interactions (Grabinger et al., 2008), and studies have found that students from STEM disciplines may report more difficulty paying attention, staying motivated, and managing their time in online courses compared to in-person courses due to experiencing higher levels of anxiety (Mohammed et al., 2021). Additionally, online courses are thought to have fewer student–student and student–instructor interactions compared with in-person courses (Jaggars, 2014), primarily owing to the lack of opportunities for informal conversations online (Contreras-Castillo et al., 2004). The lack of interaction with peers and faculty can make learning more difficult (McBeath et al., 2018; Mohammed et al., 2021) and results in feelings of isolation and loneliness that can exacerbate depression (Cooper et al., 2020a; Gin et al., 2021b). In sum, learning science online may exacerbate students’ depression, and in turn, students’ depression may affect their abilities to learn science online.

CURRENT STUDY

Given the increase in the number of online science courses and the potential for depression to affect students’ experiences in their learning environments, we designed a study to examine how students perceive their depression affects their ability to learn science online, and in turn, how students perceive online college science courses affect their depression. Our specific research questions were:

1. To what extent do undergraduates perceive depression affects cognitive domains related to learning science online?

2. What aspects of online college science courses do undergraduates perceive exacerbate their depression?

3. What aspects of online college science courses do undergraduates perceive help their depression?

METHODS

This study was conducted with an approved Arizona State University Institutional Review Board protocol (no. 12862).

Study Context and Participants

Students who identified as having depression were recruited from a large, public research-intensive (R1) institution in the southwestern United States in the Fall 2020 semester. This specific institution offers students the opportunity to earn a BS in biological sciences in two ways: (1) through an in-person degree program or (2) through an online degree program. We intentionally recruited students who were enrolled in the completely online BS degree program in biological sciences. The degree requirements of each program are identical, but the online courses are most commonly offered over 7.5 weeks, while in-person courses are most commonly offered over 15 weeks. However, online students are advised to take half as many courses at a time compared with in-person students, because the courses are accelerated. Additionally, all online courses are offered asynchronously, meaning that students are not required to meet for class at a particular time.

We chose to recruit students from the online program because the focus of the study was to explore the relationship between students’ experiences in online science courses and depression. This study was conducted in Fall 2020, which was during the COVID-19 pandemic, shortly after the death of George Floyd and the rise of the Black Lives Matter movement, and during a polarizing U.S. presidential election. While it is expected that one or more of these events likely contributed to each student’s mental health (Dreyer et al., 2020; Kecojevic et al., 2020; Kibbey et al., 2020; Ni et al., 2020), examining such impact was beyond the scope of our study. Therefore, at the beginning of each interview, we informed students that we wanted to focus this study exclusively on the relationship between online learning and depression. We also explicitly asked students to discuss their depression as it related to aspects of online science courses that were present before, and would likely be present after, the COVID-19 pandemic (see the interview script in the Supplemental Material). We felt as though targeting this population of online students strengthened the study, as the mode of course delivery did not change as a result of COVID-19 for our participants; these students had been enrolled in online college science courses before and during the pandemic. Additionally, these students were exposed to many more online courses than in-person students who had only taken online courses for a semester or two solely as a result of COVID-19. While we only recruited students from the BS in biological sciences program, we asked students about their experiences in online science courses broadly.

Interviews

In Fall 2020, we sent a survey out to all instructors of biology courses within the online BS in biological sciences degree program and asked them to share it with their students. At the end of the survey, students were asked if they would be interested in participating in a follow-up interview. Of the 595 students who completed the survey, 492 indicated interest in participating in an interview (82.7%), 153 of whom identified as having depression (31.1%). We sent an email to each of the 153 students explaining that we were interested in interviewing students with depression about their experiences in online college science courses. We did not require students to be formally diagnosed with depression in order to participate in the interview, as we know that mental health care is disproportionately unavailable to Black and Latinx individuals as well as those coming from low-income backgrounds (Howell and McFeeters, 2008; Kataoka et al., 2011; Santiago, 2013). Of the 153 students with depression who were contacted, 24 students (15.7%) agreed to participate in the interview.

Research has established that depression can negatively affect one’s cognitive domain, which can in turn affect learning (Grabinger et al., 2008; Vives et al., 2015). As such, we asked students how they perceived their depression affects cognitive domains commonly associated with learning in the context of online college science courses (Grabinger et al., 2008; Vives et al., 2015). Specifically, we drew from research that has outlined five cognitive domains that can be affected by depression and that are hypothesized to specifically affect student learning in online environments (Grabinger et al., 2008): 1) attention and memory, which are related to perception, concentration, and regulation of emotion during learning; 2) language, which is related to students expressing ideas during class; 3) executive function, which includes time management and monitoring progress toward course goals; 4) problem solving, which encompasses strategizing and critical thinking; and 5) social function, defined as one’s ability to form social and professional relationships (Grabinger et al., 2008).

In the interview, we chose to explore the impact of depression on attention and memory symptoms by asking students about their memory, focus, and effort, the impact of depression on language symptoms by asking students about their ability to communicate their thoughts in an online course, and the impact of depression on executive function by asking about time management and goal setting in an online environment. We also asked directly about students’ abilities to problem solve and their social interactions. We probed to what extent students perceived that their depression affected each of these factors in the context of learning science online.

We also asked students whether specific aspects of online courses worsened their depression and whether specific aspects helped them manage their depression. We did not intend to identify aspects of courses that were entirely unique to online courses, but used the extant literature to identify aspects of online courses that were commonly associated with student affective outcomes and would likely affect student depression based on behavioral and cognitive theories of depression (Lewinsohn, 1974; Beck, 1979) as well as prior research on undergraduates with depression (Cooper et al., 2020a,b). The specific aspects of online courses that we asked about were identified as aspects of online courses that related to failure: 1) struggling to have questions about course material answered and 2) the fast pace of online courses; isolation: 3) struggling to make connections with other students and 4) struggling to communicate or connect with an instructor; and flexibility: 5) not needing to show up to a class in person. In contrast, we hypothesized that the converse of some of these factors related to success (as opposed to failure) and social relationships (as opposed to isolation) may be protective against student depression: success: 1) having questions about course material answered; social relationships: 2) making connections with other students and 3) making connections or communicating with an instructor. Additionally, because of the complex relationship between flexibility and depression, we anticipated that the flexible nature of online course may also be helpful for students’ depression: flexibility: 4) flexibility to learn on one’s own time and 5) feeling a sense of anonymity in online courses. Each of these factors has been identified in the literature as an aspect of online courses that can affect how students feel; a table of each factor, whether it is hypothesized to affect depression negatively or positively, and the corresponding citation(s) is included in the Supplemental Material.

During the interview, we first asked students whether they had ever experienced a particular aspect of an online science course (e.g., struggling to have their questions answered) that we hypothesized may affect their depression. Notably, the students in this study are completing their degrees completely online, and all but one had taken at least three online college science courses, with more than half having taken at least five online college science courses by the time they completed these interviews. As such, students had experienced opposite aspects of online science courses (e.g., difficulty developing relationships with other students as well as the ease of developing relationships with other students) during their time in college. If students confirmed they had experienced a particular aspect, we then asked them how, if at all, it affected their depression. We chose to ask students about how specific aspects of online courses affected their depression, because we assumed that students had not likely thought about how online courses may affect their depression, and we predicted that directing their attention to specific aspects of online courses may yield more fruitful responses (Warren, 2002; DiCicco-Bloom and Crabtree, 2006). To ensure that we did not miss any prominent aspects of online science courses that may affect student depression, we also asked open-ended questions about whether there were any additional aspects of online learning environments that students perceived affected their depression (Adamson et al., 2004).

To establish cognitive validity of the interview questions, we conducted think-aloud interviews with two individuals who had recently graduated with a BS in biology, had completed online course work, and identified as having depression (Trenor et al., 2011). The interview script was revised after the first think-aloud interview to improve interviewee understanding of the interview questions but functioned well during the second think-aloud interview and was not subsequently revised. A copy of the full interview script is provided in the Supplemental Material. Each interview was conducted via Zoom by one of two researchers (T.F.M. or L.E.G.). The average length of the interviews was about 1 hour, and students were compensated for their time with a $15 gift card.

Analysis

We used a hybrid approach of deductive and inductive coding to answer our research questions (Fereday and Muir-Cochrane, 2006). Specifically, the researchers used deductive coding to identify whether students experienced each of the five factors hypothesized to negatively affect their depression and each of the five factors hypothesized to positively affect depression, and also whether students reported that a factor they experienced affected their depression. Further, we identified whether each student reported that depression affected cognitive domains related to learning science online.

Inductive coding was used to analyze a question asking students whether any additional aspects of online college science courses negatively affected their depression and whether any additional factors positively affected their depression. We also used inductive coding to identify common themes about how specific factors affected depressive symptoms and to assess how students perceived depression affected their cognitive domains.

Two researchers (T.F.M. and K.M.C.) reviewed all interviews independently and took detailed analytic notes to identify themes that emerged from the interviews (Birks and Mills, 2015). They compared their notes and developed a detailed coding rubric of all themes they identified. Both researchers used the coding rubric to code a subset of five interviews (21% of interviews) and iteratively revised the codebook using constant comparison methods (Glesne, 2016). Using the final codebook (available in the Supplemental Material), two researchers (T.F.M. and N.J.W.) independently coded a randomly selected subset of eight interviews (33% of all interviews) and their Cohen’s κ interrater score was at an acceptable level (κ = 0.85; Landis and Koch, 1977). One researcher (T.F.M.) coded the remaining interviews. Data saturation was reached with the current sample; therefore, we determined that no further recruitment was needed (Guest et al., 2006). We chose not to examine trends in the data based on student demographics, because this was outside the scope of our research questions and not appropriate given the number of interviewees in the study (Vasileiou et al., 2018). Quotes were lightly edited for clarity, and pseudonyms were given to all students to protect their privacy.

Author Positionality

Some of the authors identify as having depression and some do not. Two of the authors (T.F.M. and N.J.W.) have completed undergraduate online science courses; however, neither was enrolled in the online biological sciences program described in this study.

RESULTS AND DISCUSSION

We present the results and discussion together to elaborate on our findings and contextualize them within the extant literature. When presenting our results regarding which cognitive domains students perceive their depression affected when learning online, we chose to present quotes in a table, as the quotes did not need to be further contextualized to answer the respective research question. Conversely, we chose to embed quotes in text to represent reasoning students gave as to why aspects of online courses negatively and positively affected their depression. The content of the quotes provided was often reflective of the experiences of most students in the study, and thus we felt that contextualizing each quote would be helpful in fully explaining the perceptions of students in this study (Lingard, 2019).

Participant Demographics

Participants in the study were primarily women (79.2%), white (75.0%), continuing-generation college students (79.2%), transfer students (79.2%), and in their third or fourth year of college (83.3%). Students most commonly identified as having moderate (29.2%) or severe (45.8%) depression during the time that they have been enrolled in online college science courses, and 91.7% of participants had been diagnosed with depression. All but one student had completed at least three online college science courses.

Notably, because all students were enrolled in a fully online degree program, their demographics differ substantially from those of students who are enrolled in traditional in-person degree programs at this particular institution (Mead et al., 2020). We found that students who agreed to participate in the study were representative of the broader population of the online program; these students are more likely to be women, older, first-generation college students, have higher financial need, and to begin their college careers at a different institution compared with undergraduates enrolled in the in-person biological sciences degree program at this particular institution (Mead et al., 2020). A summary of student demographics is reported in Table 1, and additional student-level demographics can be found in the Supplemental Material.

Research Question 1: Student-Perceived Effect of Depression on Cognitive Domains Related to Online Learning

We asked students whether they perceived their depression affects their cognitive domains in the context of learning science online by asking them specifically about: effort, focus, time management, their ability to communicate thoughts, goal setting, problem solving, memory, and social interactions. Students most commonly reported that their depression affected their effort (100% of students), focus (95.8%), time management (95.8%), and ability to communicate their thoughts (95.8%), followed by their goal setting (83.3%) and problem solving (83.3%), and finally their memory (70.8%) and social interactions (70.8%; Table 2).

While to our knowledge no studies have examined the impact of depression on student performance in online courses, our findings suggest that depression may be particularly detrimental to students learning science in online environments, especially in the fast-paced, accelerated online courses that the majority of these students were referencing. Research suggests that elements of online education may require disproportionate use of cognitive domains compared with in-person education. For example, a study of more than 300 undergraduates who had completed both in-person and online college science courses showed that students perceived learning to be more difficult in online courses and that there are a number of distractions specific to learning in an online environment that likely require students to expend additional effort and focus (Mohammed et al., 2021). Additionally, undergraduates highlight that online courses can be especially disorganized and unstructured (Mohammed et al., 2021) and online learning requires high self-regulation (Kauffman, 2015) and self-discipline (Waschull, 2005; Gorbunovs et al., 2016), which likely implies the need for time-management skills, because many online courses are asynchronous. Finally, students in this study acknowledge that making connections with instructors and students is substantially more difficult in online environments, which is also supported by other studies (Aragon, 2003; Bejerano, 2008; Erichsen and Bolliger, 2011; Gillett-Swan, 2017). Given the potential for depression to negatively impact student learning in online science courses, identifying aspects of online courses that exacerbate or alleviate depression may be integral to improving learning for this specific group of undergraduates.

Research Question 2: Aspects of Online Courses That Can Exacerbate Undergraduate Depression

We asked students about specific aspects of online science courses that we hypothesized would exacerbate their depression. We report the number of interviewees who confirmed that they had experienced a particular aspect in an online college science course, as well as the percent who reported that the aspect had a negative effect on their depression in Table 3. We explore here student explanations for why specific aspects of online science courses negatively affect their depression.

Students described that aspects of online courses related to failure, particularly the fast pace of online courses as well as struggling to have content questions answered, exacerbated their depression. Specifically, all students in the study identified that the fast pace of online science courses worsened their depression. For example, students like Abigail and John described that fast-paced courses can cause them to fall behind, which in turn can cause them to be critical of themselves or can decrease their motivation, making it even more difficult to catch up on their online course work.

Depression is highly related to burnout, defined as a chronic stress syndrome involving emotional exhaustion and reduced personal accomplishment (Maslach et al., 2001; Bianchi et al., 2014). While burnout is typically associated with one’s career, we argue that students in this study described symptoms of burnout as it relates to their course work. For example, students like Abigail and John highlight that the fast pace of online courses can cause them to fall behind, which appears to lead to a state of mental exhaustion. Time constraints and management of multiple deadlines are considered to be common academic stressors (DeRoma et al., 2009), which can lead to a circular relationship wherein such stressors and depression may intensify one another (Heiligenstein et al., 1996), as described by Abigail and John.

In addition, three-quarters of students struggled to have their questions answered in their online college science courses, and all of these students described that this worsened their depression. Students, like John, described that when they struggled to have their questions answered they sometimes blamed themselves, which exacerbated their depression.

John’s reaction to not having his questions answered by the instructor may be common among students with depression. Research shows that individuals with depression often blame themselves for rejection (or perceived rejection), whereas this is less common for individuals without depression (Abramson and Sackheim, 1977; Janoff-Bulman, 1979; Gilbert and Miles, 2000). As such, if instructors unintentionally fail to answer a student’s question, this may have an unintended but significant impact on a student with depression. Further, feeling as though they were unable to have questions answered caused some students to experience helplessness and a “depression spiral.” Specifically, Abigail describes this spiral; she explains how struggling to have a question answered led to an increasing number of negative thoughts.

Abigail’s reaction to not having her questions answered can be partially explained by ideas presented in the hopelessness theory of depression (Abramson et al., 1989), which posits that one’s negative cognitive styles combined with a negative event (such as not having a question answered) can engender a sense of hopelessness (Joiner et al., 2005). Providing online students with multiple outlets to have their questions answered, such as the option to email teaching assistants, submit questions through online platforms such as Blackboard or Canvas, or even to reach out to fellow students on more informal communication platforms such as WhatsApp, Discord, or GroupMe may help alleviate this issue for students (Kam and Hoop, 2013; Xiu and Thompson, 2020).

Additionally, we hypothesized that aspects of online courses that may contribute to feelings of social isolation may also contribute to students’ depression. A well-established challenge of online college learning environments is promoting community among students (Aragon, 2003; Anderson-Rowland et al., 2004; Shea et al., 2006; Erichsen and Bolliger, 2011). While a lack of student–student relationships in college has been suggested to negatively affect undergraduates (Rovai and Wighting, 2005; Croxton, 2014; Xerri et al., 2018), we were interested in understanding how a lack of relationships in the context of online courses affected depression. Nearly 88% of participants in our study reported struggling to develop relationships with other students in their online science courses, and 95.8% of those students identified that this negatively affected their depression. Students, like Jenna and Dakota, often described that struggling to develop relationships with other students made them feel isolated, which worsened their depression.

Students’ perceptions that the isolation exacerbated their depression aligns with a review of studies in psychiatry, which found that being connected to a large number of people is protective against depression (Santini et al., 2015). Further, life sciences undergraduates have reported that feelings of isolation worsened their depression in the context of research experiences (Cooper et al., 2020a). Unfortunately, developing relationships with other students has been found to be particularly difficult for students in online courses (Jaggars, 2014), and our study further supports this notion.

Relatedly, 83.3% of students confirmed that they struggled to develop relationships with instructors of their online science courses, and 95.0% of those students perceived that this worsened their depression. Students commonly described that not connecting with an instructor made them feel as though nobody cares or as though they did not belong in science. Hannah describes that these feelings ultimately led her to give up trying in her science course.

This study adds to a growing body of literature that suggests that developing student–instructor relationships is difficult in an online environment (Hara and Kling, 1999; Woods, 2002; Vonderwell, 2003; Song et al., 2004; Swan et al., 2006; Boling et al., 2012; Jaggars, 2014; Shaw et al., 2015). However, researchers have examined ways to build instructor immediacy, defined as the perception of physical and psychological intimacy between students and instructors (Mehrabian, 1971), and some strategies that have been shown to build instructor immediacy in person can likely be implemented in online courses, such as using humor (Gorham and Christophel, 1990; Cooper et al., 2018) and using students’ names when calling on or conversing with students (Cooper et al., 2017). Additionally, studies have identified strategies to build instructor immediacy in the specific context of online courses, including hosting small-group discussions during class (Kam and Hoop, 2013), consistently providing feedback to students (Sher, 2009), interacting with students on required discussion board posts (Redmond and Lock, 2006), and interfacing with students during virtual office hours (Haythornthwaite, 2006; Lowenthal et al., 2017; Alawamleh et al., 2020). Based on our data, we hypothesize that these efforts may be disproportionately beneficial for students with depression, given how the lack of relationship with an instructor can have a detrimental impact on their belonging in science. Further, behavioral theories of depression would suggest that, if these relationships provide positive reinforcement, it may further protect students from experiencing depressive symptoms (Lewinsohn, 1974; Martell et al., 2001; Carvalho et al., 2011).

In addition to aspects of online science courses that are related to failure and social isolation, we hypothesized that the flexible nature of online courses, particularly not needing to show up to class in person, may exacerbate depression. Indeed, two-thirds of the participants reported that this worsened their depression because they struggled to feel motivated to engage in activities of daily living or ADLs as described by Valeria.

It is well established that individuals with major depression sometimes experience difficulties accomplishing ADLs (Kazama et al., 2011). Unlike in-person courses that may motivate students to engage in ADLs to avoid being negatively evaluated by others (Tricker et al., 2001), it seems that asynchronous online courses may not elicit a fear of negative evaluation, as students are not required to see anyone while completing the course. Further, a study of 276 students taking online courses investigated why students did not turn on their cameras and found that the most frequent reason reported is students being concerned about personal appearance, often because of unbrushed hair or wearing pajamas (Castelli and Sarvary, 2021). This highlights a novel way that in-person social interactions may positively benefit students that is noticeably absent in online asynchronous environments that do not require students to be visible to others.

After examining students’ experiences with the five predetermined online factors that we hypothesized would negatively affect their depression, we asked students if there were any additional aspects of online courses that affected their depression. Forty-five percent of students described that another aspect of online courses related to the flexibility, the lack of structure, and accountability of online courses worsened their depression. Specifically, students like Maya explained that online courses are often self-paced in that the instructor sets a due date (often the end of the semester) when all work needs to be submitted. As such, it is up to the students to structure their time so that their course work is completed. Students described that this lack of structure and accountability worsened their depression.

A lack of structure has also been shown to worsen depression among life sciences graduate students, because a lack of guidance for what needs to be done and when something should be completed can hinder motivation (Gin et al., 2021a). Relatedly, major depression can make goal setting and goal achievement difficult (Boyd and Reuning-Elliott, 1998; Watkins and Brown, 2002). Researchers have found that individuals with depression develop less-detailed goals and less-specific explanations for approaching a goal than individuals who do not have depression (Dickson and Moberly, 2013), which helps explain why students reported the lack of structure and lack of accountability in online science courses as troublesome for their depression.

Research Question 3: Aspects of Online Courses That Can Help Undergraduate Depression

In addition to identifying aspects of online college science courses that negatively affect student depression, we also identified aspects that positively affect depression. We report the number of interviewees who reported experiencing each aspect, as well as the percent who reported that the aspect had a positive effect on their depression in Table 4.

Students confirmed that aspects of online science courses that minimized their chances of failing (or maximized their chances for success) were protective against their depression; 95.8% students described that at some point they were easily able to get their questions answered in this context, and nearly 96% of these students said that this positively affected their depression. Abigail, who earlier described that not having her questions answered could lead to a depressive spiral, highlighted how a simple response from an instructor can not only stop the spiral, but can also cause her to feel supported.

Participants’ responses further support that providing students with multiple outlets to have questions answered may be particularly impactful for students with depression.

Additionally, opportunities to build relationships with instructors and fellow students and avoid feeling socially isolated also positively affected depression. All students acknowledged instances when they were able to build a relationship with an instructor online and/or easily communicate with an instructor online, and all confirmed that this positively affected their depression, which aligns with previous literature highlighting the positive impact that student–instructor relationships can have on students (Sher, 2009; Nguyen, 2015; Cooper et al., 2018; Parnes et al., 2020). For example, Heather describes how connecting with an instructor made her feel less alone and that an instructor can help change a student’s mood and self-confidence.

Feeling alone or misunderstood, as Heather describes, can be common among individuals with depression (Matthews et al., 2016), which helps explain why a lack of a student–instructor relationship can be so problematic, while a short, positive interaction has the potential to have a lasting effect.

Nearly 80% of students highlighted that they were sometimes able to develop relationships with other students online, and all of those students said this also had a positive impact on their depression. For example, Sam described that connecting with other students helped him realize that he had similar interests to other students, which positively impacted his mood. He also highlighted that developing those relationships inspired him to complete ADLs and communicate with others.

While developing relationships with peers generally positively impacts students (Urdan and Schoenfelder, 2006; Kiuru et al., 2015; Ryan et al., 2019), this finding suggests that such relationships may be especially impactful in online environments, where students can often feel isolated (Aragon, 2003; Erichsen and Bolliger, 2011; Gillett-Swan, 2017; Kaplan-Rakowski, 2021; Orr, 2019). Indeed, studies have suggested that building peer support online can lead to a strong sense of belonging (Thomas et al., 2014), increases support for learners (Galvin, 2012), and enhances student satisfaction with their online experience (Fuller et al., 2015).

When investigating the relationship between the flexible nature of online courses and depression, we found that all but one student in the study agreed that they had the opportunity to be anonymous in their online college science courses, meaning they had the option to not show their face when completing online science course work. Nearly 87% of students said that this positively impacted their depression. Students, like Claire, often highlighted how depression affected their ability to execute ADLs like brushing their hair, so not having to be on camera for a particular day was helpful. Further, students described that when they are depressed, it is sometimes visible, because they look sad or have been crying. Students often feel uncomfortable revealing their depression to others (Cooper et al., 2020b), so it is helpful when they can remain anonymous or unseen.

This finding may appear to contradict students’ perceptions that not needing to go to class in person can be detrimental because it does not motivate them to complete ADLs. However, most students, like Claire, seemed to be referencing extremely bad days when which they would not be able to complete their ADLs regardless of their level of motivation. Further, all interview participants reported that online college science courses that are delivered asynchronously afford them the flexibility of learning on their own time, meaning that they are often able to learn online when and where they want. Interestingly, all students described that this could positively affect their depression. Students, like Deja, commonly described that this flexibility allowed them to tend to their depressive symptoms when they needed to.

Similarly, John described that not having to be in class at a certain time means that his depression does not negatively affect his grades by decreasing attendance points.

While a complete lack of structure and not having to show up in person seemed to have a negative effect on students’ depression, the flexibility to take some time off during a depressive episode seemed to positively impact students like Deja and John. A similar trend was found in an interview study of 50 life sciences PhD students with depression. Students described that the unstructured nature of PhD programs negatively impacts their depression, because it increases their need to be motivated and set their own goals, which can be difficult during a depressive episode (Gin et al., 2021b). However, the flexibility of deciding when to do their research allowed them time to recover from depressive episodes or seek medical treatment during the day. As such, creating online science courses that are structured with clear deadlines but that also have built-in flexibility that could accommodate students during a depressive episode would likely be helpful for students with depression (Gin et al., 2021a). No additional themes emerged from the open-ended question asking whether any other aspects of online science courses had a positive impact on students’ depression.

GENERAL DISCUSSION

In this study, we aimed to understand to what extent students perceive depression affects their cognitive domains when learning science online and identify aspects of online college science courses that affect student depression. We used the existing literature to identify a set of five aspects of online courses that we hypothesized might exacerbate student depression and five aspects that we hypothesized might help student depression. The data that emerged from the interviews revealed trends about overarching components of online education, success/failure, social relationships/isolation, and flexibility and the nuanced ways in which they affect depression and how depression, in turn, can affect student learning. Additionally, the analysis of the data spurred ideas for how institutions may make their online science courses more inclusive for students with depression.

Success/Failure

Cognitive theories of depression, particularly the hopelessness theory of depression, suggest that individuals with depression are prone to feeling as though they are not in control of events; feeling as though one is not in control of negative events is defined as “hopelessness” (Abramson et al., 1989). Our study identified that seemingly small aspects of online science courses, such as students being unable to have a question about content answered, can fuel feelings of hopelessness regarding success in the course. Conversely, having questions answered appeared to stop depressive feelings from spiraling and avoided the development of hopelessness.

Relationships with Other Students and Instructors

The experiences of students in this study reflect those of prior studies highlighting the importance of individuals with depression building strong social networks (Santini et al., 2015; Cooper et al., 2020a,b; Gin et al., 2021b). Specifically, having social support can be protective against depression (Charles et al., 2021) and this may be especially important in online college science courses. At this particular institution, a study found that online life sciences undergraduates lacked opportunities that are traditionally associated with going to college, such as participating in community service, leadership positions, and undergraduate research experiences (Cooper et al., 2019). Further, these online students were significantly less likely to develop relationships with students and faculty members compared with their peers pursuing in-person degrees (Cooper et al., 2019). As such, students pursuing fully online degrees may be particularly prone to experiencing social isolation, which is likely disproportionately difficult for individuals with depression.

Flexibility of Online Learning

The unique flexibility that online learning affords students is one of the primary reasons why students seek out online college courses (McLoughlin and Oliver, 2000; Song et al., 2004; Sit et al., 2005; Appana, 2008; Yukselturk and Yildirim, 2008; Northrup, 2009; Daymont et al., 2011; Daniel, 2016; Soffer et al., 2019; Stone et al., 2019). We found aspects related to such flexibility have differing impacts on depression. Specifically, students explained that the opportunity to learn when and where they wanted afforded them opportunities to recover from depressive episodes, which can be integral in helping students maximize their productivity upon re-engaging with course work (Judd et al., 2000; Cooper et al., 2020a,b). The opportunity to remain anonymous in online courses also positively impacted student depression, which aligns with previous research showing that individuals with depression value maintaining anonymity (Levine et al., 2003), especially if they are concerned about repercussions resulting from an unintentional reveal of their depression (Cooper et al., 2020b). Conversely, the lack of needing to show up to class in person and the lack of concrete due dates emerged as aspects of online learning that students with depression struggled with, likely owing to difficulty that individuals with depression can experience with motivation and goal setting (Street, 2002; Huang et al., 2016).

How Depression May Affect Student Learning

Given that students overwhelmingly agreed that their depression negatively affected cognitive domains and that these functions may be particularly integral to learning online (Grabinger et al., 2008), identifying ways to craft more inclusive online learning environments for individuals with depression is important for maximizing their academic experiences. Further, creating online science learning spaces where individuals with depression can thrive is an integral step to developing a more inclusive scientific enterprise, given that depression disproportionately affects individuals who are underrepresented and underserved in science (Turner and Noh, 1988; Eisenberg et al., 2007; Jenkins et al., 2013; Evans et al., 2018; Flaherty, 2018; Mead et al., 2020; National Science Foundation, 2021).

Recommendations to Create More Inclusive Online Science Courses for Undergraduates with Depression

Maximizing Students’ Control of Their Success.

Helping students feel in control of their success in a course is an important step in creating inclusive online college science courses. As such, ensuring that students have multiple ways to have questions answered (e.g., use of discussion boards, ability to email the instructor, using platforms such as Slack or WhatsApp) will likely reduce depressive symptoms by helping students avoid feeling hopeless regarding their understanding of science content. Further, the fast-paced nature of online courses is often inevitable, especially when institutions require online courses to be offered over an accelerated time period (e.g., 7.5 weeks instead of 15 weeks). Instructors can acknowledge this at the beginning of courses, so that students are aware of this challenge. This may also allow students with depression who are registered with the disability resource centers at their institutions to proactively identify accommodations that will be helpful as they navigate a particular course (Gin et al., 2020).

Facilitating Social Relationships.

We recommend that instructors make efforts to not only build relationships between themselves and students, but also provide opportunities to cultivate relationships among students in online science courses. Instructors could facilitate instructor–student relationships and engage students by sending electronic communications to students, incorporating humor into the course (Cooper et al., 2018; Lei et al., 2010), using student names in email correspondence (Cooper et al., 2017), and interacting with students through discussion boards or virtual office hours (Alawamleh et al., 2020; Haythornthwaite, 2006; Lowenthal et al., 2017). Displaying a positive attitude and clearly communicating expectations regarding students’ work are also ways instructors could foster relationships with their online students (Webb and Barrett, 2014).

Managing Flexibility.

Identifying the level of flexibility that is ideal for students with depression is difficult, and it seems that this ideal level may be different for each student depending on the severity of the individual’s depressive symptoms. However, common themes from student interviews indicate that students thrive when they have structure and accountability (e.g., having some deadlines as opposed to having all work due at the end of the semester). In contrast, some aspects of flexible online courses seemed to be generally helpful for depression, particularly allowing students to be anonymous during class and to complete work when they want (although this may conflict with the previously noted necessary amounts of structure in courses for other students). Creating a structured course with deadlines but inviting students to ask for an extension if their mental health is interfering with their ability to meet a deadline may serve as a possible solution.

Limitations and Future Directions

Our sample of students enrolled in a completely online biological sciences degree program is unique; students enrolled in this program are more likely to be women, older, and/or first-generation college students and to have higher financial need compared with undergraduates enrolled in an in-person BS in biological sciences degree program at this particular institution (Mead et al., 2020). As such, these findings should not be generalized beyond this particular student population. Relatedly, these students are online students, meaning that they were enrolled in online college science courses before and during the COVID-19 pandemic. We hypothesize that students with depression who were in in-person programs and completed online college science courses during the pandemic may share many experiences with the participants in this study, but likely faced additional challenges related to rapidly adapting to a new mode of learning in response to the pandemic (Mohammed et al., 2021).

The primary focus of the study was to document the experiences of students with depression and not to compare their experiences with those without depression; interviewing students within a marginalized group with the intent to capture their experience without comparing it to that of the majority group is common practice in biology education research (Cooper and Brownell, 2016; Cooper et al., 2020a,b; Pfeifer et al., 2021). However, future studies may want to assess how the particular aspects of online education that we report on in this study affect students without depression. A sample size of 24 students may be perceived as small. However, a sample of this size is common among other exploratory qualitative biology education studies (Cooper and Brownell, 2016; Cooper et al., 2017; Chatterjee et al., 2019; Daniels et al., 2019; Downing et al., 2020; Pfeifer et al., 2021). Additionally, we reached saturation in our data within the first 16 interviews, as is expected in qualitative studies (Guest et al., 2006), and therefore we did not perceive that recruiting additional students with depression would change our findings. We acknowledge that students’ depressive feelings may change each day, which may influence their responses to interview questions. However, we encouraged students to speak about their depression, on average, during their time taking online college science courses. It was neither feasible nor within the scope of our study to examine whether there were demographic differences among students’ experiences with depression in online science courses. We do propose that examining how student demographics affect their experience with depression in online science courses in a large-scale quantitative study would be an important step in creating a more diverse and inclusive scientific community. While we chose to examine our research questions within the confined context of online college science courses, we did not identify any finding that we hypothesize is specific to college science. Large-scale quantitative studies across different majors could examine this further.

Conclusion

In this interview study, we examined the experiences of undergraduate students with depression in online science courses. We probed how students perceived their depression affected their learning, and in turn, how online science courses negatively and positively affected students’ depression. Students commonly perceived that their depression negatively affected their ability to learn science online by interfering with their effort, focus, time management, ability to communicate thoughts, goal setting, problem solving, memory, and social interactions. Students also commonly agreed that struggling to develop relationships with instructors and students, struggling to have questions answered, not needing to show up to class in person, the lack of structure and accountability and the fast nature of online courses negatively affected their depression. Conversely, developing relationships with instructors and other students, having questions answered promptly, engaging in science courses anonymously, and being able to learn when and where a student wants positively impacted their depression.

Important Note

Resources are available for individuals who are experiencing depression. Most colleges and universities have crisis hotlines and counseling services designed to provide students, staff, and faculty with treatment for depression, which can often be found on the institution’s website. Furthermore, there are free 24/7 services such as Crisis Text Line, which allows you to text a trained live crisis counselor (Text “CONNECT” to 741741 (Text Depression Hotline, 2021), and phone hotlines such as the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). Additionally, the Anxiety and Depression Association of America website, https://adaa.org (Anxiety and Depression Association of America, 2021), and the Depression and Bipolar Support Alliance, http://dbsalliance.org (Depression and Bipolar Support Alliance, 2021), provide helpful information if you want to learn about depression, learn about help for depression, or learn about depression resources near you.

ACKNOWLEDGMENTS

REFERENCES