Awe reduces depressive symptoms and improves well-being in a randomized-controlled clinical trial

The nascent science of awe suggests that this emotion, which is often ineffable, has beneficial effects on physical and psychological health¹. We expand on this literature by examining the efficacy of an awe intervention to improve psychological health—specifically stress, anxiety, depression, and well-being—of patients living with post-acute sequelae after SARS-CoV-2 infection, otherwise known as long COVID.

Psychological health in the time of COVID-19

The COVID-19 pandemic has proven to be a profound source of mental and physical malaise for people around the world. Evidence suggests that over the course of the pandemic, there was a 25% rise in the prevalence of anxiety and major depression worldwide². This is consistent with other work suggesting that during the acute phase of the pandemic, people in the United States reported worse psychological health, including elevated anxiety, depression, stress, sleeplessness, and loneliness^3,4.

For some individuals, such as those who are currently suffering from long COVID, the negative effects of the pandemic linger beyond 12 weeks^5,6 and are likely amplified by this prolonged duration. For example, studies show that people suffering from long COVID report elevated levels of stress, anxiety, and depression^6,7,8,9. Longitudinal evidence of long COVID patients suggests that while physical symptoms such as bodily aches subside over time, psychological health issues such as anxiety and depression persist years after the initial infection⁶. This evidence highlights the need for an intervention that can improve the psychological health of people living with long COVID. In the present work, we developed a brief awe intervention that can be delivered remotely and examined its effects on psychological health outcomes of long COVID patients.

Awe as a pathway to greater psychological health

The study of positive emotions is a rich area of inquiry revealing numerous benefits for physical and psychological health^10,11,12,13. Within this rich emotion space, recent research has focused on investigating positive emotions as potential targets for intervention^12,14,15. Evidence is robust and suggests awe, the focus of this work, as a promising pathway to greater psychological health outcomes^1,16,17,18.

Awe is an emotion elicited by stimuli that are vast, or beyond one’s current perceptual frame of reference¹⁹. This vastness can be physical, conceptual, or semantic, and requires that extant knowledge structures be accommodated to make sense of what is being perceived¹⁹. Awe is often experienced through encounters with other people’s courage and kindness, nature, collective gatherings, art, religious and/or spiritual practices, epiphanies, birth and death^{1,19,20,21,22}.

Empirical studies find experiences of awe to be associated with a range of psychological health benefits^1,17,23,24. For example, studies have found that daily experiences of awe were associated with lower reports of stress^17,23. Importantly, these effects remained after controlling for experiences of other positive emotions. In studies in the lab, inductions of awe reduced physiological reactions to stress such as sympathetic autonomic arousal²³. Awe experiences in nature were found to be related to less rumination²⁵ and reduced stress and symptoms of post-traumatic stress disorder in adolescents from under-resourced inner-city schools and combat veterans²⁴.

Particularly germane to the present work, a study examining daily awe during the peak of the COVID-19 pandemic in 2020 found that when community adults and healthcare workers experienced more awe, they reported feeling less stress, less physical health symptoms (e.g., bodily pains), and greater well-being¹⁷. In studies across diverse methodologies—in the lab, daily diaries, and field studies— and across different contexts including the COVID-19 pandemic, awe has robustly predicted improvements in well-being^{17,23,24,26,27}. These findings point to awe as a promising intervention for people living with the long-lasting consequences of the COVID-19 pandemic.