Mental health state in activists during political turmoil

Abstract

Background

Mental health issues, including anxiety and depression, are widespread globally, with various stressors influencing their prevalence. While activism can be empowering, it may also contribute to mental health challenges. This study assesses the mental health of activists in the Republic of Georgia before a major political election, a period marked by significant political tension. We explore the relationship between personal factors (e.g., income, time spent on activism) and mental health outcomes.

Materials and methods

Between October 19 and October 25, 2024, we collected data from 73 activists (30 males, 43 females), assessing anxiety and depression using the GAD-7 and PHQ-9 tools. Participants were over 18 years old, without diagnosed psychiatric disorders, and actively involved in anti-government activism.

Results

Nearly 80% of participants exhibited moderate to severe anxiety and depression levels. No statistically significant correlations were found between anxiety and depression scores and personal factors such as income, education, time spent on activism, or relationship status.

Conclusion

This study reveals high levels of anxiety and depression among political activists in Georgia, likely exacerbated by political unrest. Although personal factors did not show significant correlations with mental health outcomes, ongoing political turmoil and government tactics may contribute to these challenges. Further research is needed to explore additional risk factors and develop targeted mental health interventions for activists.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-025-03441-1.

Introduction

Mental health issues are increasingly prevalent worldwide, with numerous factors potentially triggering, causing, or exacerbating these conditions [1]. It is well established that mental health is shaped by a constellation of contextual and personal factors. Individuals may be disproportionately vulnerable due to confounders such as geographic isolation, socioeconomic disadvantage, educational inequities, family dynamics, and broader societal stressors. Political unrest, active conflict, or even the looming threat of warfare can exert especially profound psychological burdens on entire communities [2–8]. Although there has been substantial progress in recent years in the areas of prevention, early intervention, and mental health screening, relatively little attention has been directed toward the mental health of activists [9]. This study assessed anxiety and depression levels among political activists in the Republic of Georgia during the week preceding a major election—following six months of escalating political tension. We also gathered data on personal variables (e.g., income, hours devoted to activism, and educational attainment) to determine whether these potential confounders significantly influenced participants’ mental-health outcomes.

Materials and methods

Data collection took place between October 19 and October 25, 2024, preceding the 2024 election in Georgia, a period marked by high political tension. Although data collection was scheduled before the election, it is important to note that political tensions had already been escalating since the re-introduction of the so-called “Russian Law” in Georgia’s Parliament. As with the previous year—when the bill was withdrawn after three days of mass protests—its revival triggered large-scale demonstrations, which were met with police brutality, incidents of violence via criminal proxies (beating up people near their homes or work places), and the unlawful persecution and detention of protesters. Before data collection began, approximately 250 individuals met the study’s eligibility criteria; however, only 73 ultimately chose to participate. The study was designed as an observational cohort study. Inclusion criteria were as follows: (1) age over 18 years, (2) absence of diagnosed psychiatric disorders, and (3) active involvement in anti-governmental activism. Control group comprised of 89 individuals.

This survey-based study gathered personal data, including age, biological sex, time spent on activism, and average monthly income. Additionally, the GAD-7 (Cronbach’s alpha = 0.93) tool [10] (Supplemental file 1) was used to assess anxiety levels, and the PHQ-9 (Cronbach’s alpha = 0.84) tool [11] (Supplemental file 2) was employed for depression assessment.

Statistical analysis

Statistical analyses were conducted using SPSS 26. Linear regression was employed to examine correlations between scale variables, while eta coefficients were used to assess relationships between categorical and scale variables. Mean values and overall statistics were calculated, and p-values less than 0.05 were considered statistically significant.

Results

Hypothesis

The study hypothesised that: (1) average monthly income would be inversely associated with GAD-7 and PHQ-9 scores; (2) weekly hours devoted to activism would be positively associated with both scales; and (3) other demographic and contextual variables—educational attainment, employment sector, biological sex, relationship status, and parenthood—would each show significant associations with GAD-7 and PHQ-9 outcomes.

General information

Seventy-three activists were enrolled in the study, including 30 males and 43 females (Tables 1 and 2). Of these participants, 56 (76.7%) scored 10 or above on the GAD-7 anxiety screening test, indicating moderate to severe anxiety levels. Compared with the control group, the acitivist group showed a significantly higher proportion of cases that score above 10 —76.7% (56/73) versus 46.1% (41/89) (χ²(1) = 15.57, p = 0.0001)(Table 2). Among females, 35 out of 43 (81.4%) scored at this level, compared to 21 out of 30 males (70.0%). However, the difference in proportions between males and females was not statistically significant (χ²(1) = 1.26, p = 0.26).

Table 1.

This table contains all the data that was accumulated over the course of the study

ID #	Biologic Sex	Level of Education	Employment Sphere	Is the hiring organization local or international?	Do you have a spouse/partner?	Do you have child (ren)?	Average Monthly Salary? (GEL)	How much time do you spend in activism a week? (hours)	Total Score – GAD-7	Total Score – PHQ-9
1	Female	Master’s Degree	Civil Society	Local	No	No	1000	20	19	20
2	Male	Master’s Degree	Academia	Local	Yes	Yes	3000	25	10	9
3	Male	high school diploma	Freelancer	International	No	No	800	40	10	16
4	Female	Bachelor’s Degree	Not-employed/Student	International	No	No	1100	15	20	24
5	Female	Master’s Degree	Self-employed	Local	Yes	No	1000	11	6	14
6	Male	Master’s Degree	Academia	Local	No	No	1500	16	9	9
8	Female	high school diploma	Sales	Local	No	No	600	40	14	13
9	Male	Master’s Degree	Civil Society	Local	No	No	2300	40	12	14
10	Female	Master’s Degree	International Organization	International	Yes	Yes	5000	10	12	11
11	Female	Bachelor’s Degree	Medical Field	Local	Yes	Yes	3500	40	18	13
12	Male	Bachelor’s Degree	Sales	Local	Yes	No	1500	20+	14	13
13	Male	Bachelor’s Degree	Civil Society	Local	Yes	No	2500	10	4	2
14	Male	Master’s Degree	Civil Society	International	No	No	3500	10	5	11
15	Female	high school diploma	Sales	Local	No	No	1500	10	15	19
16	Female	Bachelor’s Degree	Not-employed/Student	Local	No	No	0	3	16	18
17	Female	Master’s Degree	Civil Society	Local	Yes	Yes	2000	30	10	20
18	Female	high school diploma	Not-employed/Student	Local	No	No	1250	60	15	19
19	Female	high school diploma	Service	International	No	No	700	7	15	16
20	Female	Bachelor’s Degree	Civil Society	Local	No	No	800	15	9	11
21	Male	high school diploma	Not-employed/Student	International	No	No	0	21	16	13
22	Male	Bachelor’s Degree	Civil Society	Local	No	No	500	10	14	9
23	Female	high school diploma	Student	International	No	No	600	3	12	10
24	Male	Bachelor’s Degree	Civil Society	Local	Yes	No	1000	10	12	4
25	Female	Bachelor’s Degree	Not-employed/Student	International	No	No	1000	10	18	21
26	Female	Bachelor’s Degree	Civil Society	International	No	Yes	3000	40	17	14
27	Female	Bachelor’s Degree	Medical Field	International	No	No	500	4	8	10
28	Male	Bachelor’s Degree	Not Employed	Local	No	No	0	28	9	17
29	Female	high school diploma	Education	Local	No	No	300	8	14	21
30	Female	high school diploma	Not-employed/Student	Local	No	No	500	5	5	5
31	Female	high school diploma	Not-employed/Student	Local	Yes	No	750	6	7	5
32	Female	Bachelor’s Degree	Civil Society	International	No	No	1000	60	20	18
33	Female	Master’s Degree	Academia	Local	Yes	No	500	10	15	18
34	Female	Bachelor’s Degree	Sales	International	No	No	1150	32	10	11
35	Male	Master’s Degree	Civil Society	Local	No	No	4500	5	12	16
36	Female	Master’s Degree	Medical Field	Local	No	No	1500	80	16	19
37	Male	Bachelor’s Degree	Civil Society	Local	No	No	0.00	3	19	14
38	Female	Master’s Degree	Academia	Local	No	No	1500	20	19	9
39	Male	high school diploma	HORECA	Local	No	No	1300	20	16	12
40	Male	Master’s Degree	Civil Society	Local	No	No	1000	37	12	20
41	Female	high school diploma	Not-employed/Student	International	No	No	700	10	14	13
42	Male	Master’s Degree	Civil Society	International	Yes	No	4000	40	19	20
43	Female	high school diploma	Civil Society	Local	No	No	2000	40	9	18
44	Female	high school diploma	Sales	Local	Yes	No	5000	15	12	17
45	Male	Master’s Degree	Academia	Local	No	No	2000	30	9	2
46	Female	high school diploma	Sales	Local	No	No	800	40	7	3
47	Male	high school diploma	Student	Local	Yes	No	0	48	6	10
48	Female	Master’s Degree	Coding/IT/AI	International	No	Yes	5000	5	5	6
49	Female	Master’s Degree	Civil Society	Local	No	No	3000	40	19	20
50	Male	Bachelor’s Degree	Not-employed/Student	International	No	No	3000	5	7	13
51	Female	Bachelor’s Degree	Public Sector	Local	No	No	800	40	10	11
52	Male	Bachelor’s Degree	Services	Local	No	No	1000	40	12	15
53	Male	high school diploma	Public Sector	Local	No	No	1500	10	4	4
54	Female	high school diploma	Not Employed	Local	No	No	600	80	15	11
55	Female	Master’s Degree	International Organization	International	No	Yes	5000	5	12	15
56	Male	Bachelor’s Degree	Sales	International	No	No	1300	2	9	7
57	Male	high school diploma	Sales	Local	No	No	1200	15	20	21
58	Male	Bachelor’s Degree	Civil Society	Local	Yes	No	1400	70	12	9
59	Male	Bachelor’s Degree	International Organization	International	No	No	2300	8	16	14
60	Male	Bachelor’s Degree	Medical Field	Local	No	No	500	20	14	13
61	Male	high school diploma	Sales	Local	Yes	No	1500	5	17	13
62	Female	Bachelor’s Degree	Civil Society	Local	Yes	No	1200	15	21	15
63	Female	Bachelor’s Degree	Not-employed/Student	Local	No	No	1000	15	13	11
64	Female	high school diploma	Education	Local	Yes	No	1000	5	21	18
65	Female	Master’s Degree	Civil Society	Local	Yes	Yes	1500	22	11	12
66	Male	Bachelor’s Degree	Banking	International	Yes	No	3000	20	17	17
67	Female	Bachelor’s Degree	Public Sector	Local	No	No	1000	4	21	22
68	Female	Bachelor’s Degree	Civil Society	Local	Yes	Yes	2500	30	15	13
69	Female	Bachelor’s Degree	Not-employed/Student	Local	No	No	500	20	14	19
70	Female	Master’s Degree	Freelancer	International	Yes	No	7000	20	12	7
71	Female	Master’s Degree	Civil Society	Local	Yes	No	1500	10	20	22
72	Male	Master’s Degree	Public Sector	Local	No	No	2000	5	13	14
73	Female	Master’s Degree	Public Sector	Local	Yes	Yes	500	10	13	15
74	Male	Master’s Degree	Civil Society	Local	Yes	No	30,000	7	18	20

Table 2.

This table depicts the descriptive data collected throughout the study

Descriptive Statistics	N	Minimum	Maximum	Mean	Std. Deviation
Average Monthly Salary (GEL)	73	0	30,000	2047.26	3608.35
How much time do you spend in activism a week? (Hours)	72	2	80	21.74	18.56
Activists - GAD7	73	4	21	13.16	4.57
Activists - PHQ9	73	2	24	13.67	5.26
Control – GAD7	89	0	20	9.06	5.37
Control – PHQ9	72	0	27	10.03	5.98

Similarly, on the PHQ-9 depression screening test, 58 participants (79.8%) scored 10 or above, suggesting moderate to severe depression levels. Similarly to anxiety screening test the activist group group showed a significantly higher proportion of cases when compared with control—76.7% (56/73) versus 47.19% (42/89) (χ²(1) = 14.52, p = 0.0001) (Table 2). By sex, 37 out of 43 females (86.0%) and 21 out of 30 males (70.0%) met this threshold, but this difference was also not statistically significant (χ²(1) = 2.89, p = 0.09).

Average monthly income versus GAD7 and PHQ9 scores

We found no statistically significant correlation between average monthly salary (in GEL) and either GAD-7 scores or PHQ-9 scores (Figs. 1 and 2; Table 3).

Fig. 1.

The figure depicts linear relationship between average monthly income and GAD-7 score

Fig. 2.

The figure depicts linear relationship between average monthly income and PHQ-9 score

Table 3.

This table contains statistical data explaining correlation between variables and GAD-7 and PHQ-9

	Average monthly income	Average weekly time spent on activism	Level of Education	Employment sphere	International or local employer	Biologic Sex	Relationship status	Having children
GAD-7	R(71) = 0.08 R² = 0.01 F = 0.44 β = 0.00 95% CI [0.00, 0.00] p = 0.51	R (71) = 0.07 R² = 0.01 F = 0.35 β = 0.02, 95% CI [-0.04, 0.08] p = 0.55	η(71) = 0.13 η2  = 0.02 p = 0.88	η(71) = 0.39 η2 = 0.15 p = 0.65	η(71) = 0.02 η2 = 0.00 p = 0.89	η(71) = 0.17 η2 = 0.03 p = 0.15	η (71) = 0.04 η² = 0.00 p = 0.74	η²(71) = 0.08 η² = 0.00 p = 0.52)
PHQ-9	R(71) = 0.09 R² = 0.01 F = 0.65 β = 0.00, 95% CI [0.00, 0.00] p = 0.42	R(71) = 0.08 R² = 0.01 F = 0.40 β = 0.02, 95% CI [-0.05, 0.09] p = 0.53	η (71) = 0.09 η2  = 0.00 p = 0.48	η(71) = 0.37 η2 = 0.14 p = 0.34	η(71) = 0.00 η2 = 0.00 p = 0.99	η(71) = 0.21 η2 = 0.04 p = 0.08	η²(71) = 0.06 η² = 0.00 p = 0.60	η²(71) = 0.07 η² = 0.00 p = 0.57

Average weekly time spent on activism versus GAD7 and PHQ9 scores

We found no statistically significant correlation between average weekly time spent on activism (in hours) and either GAD-7 scores or PHQ-9 scores (Figs. 3 and 4; Table 3).

Fig. 3.

The figure depicts linear relationship between average time spent on activism a week in hours and GAD-7 score

Fig. 4.

The figure depicts linear relationship between average time spent on activism a week in hours and PHQ-9 score

Level of education versus GAD7 and PHQ9 scores

We found no statistically significant correlation between levels of education and either GAD-7 scores or PHQ-9 scores (Figs. 5 and 6; Table 3).

Fig. 5.

The boxplot compares average GAD-7 scores in relation to an academic degree

Fig. 6.

The boxplot compares average PHQ-9 scores in relation to an academic degree

Employment sphere versus GAD7 and PHQ9 scores

There was no statistically significant correlation between employment sphere and GAD-7 scores or between whether the organization was local or international and GAD-7 scores (Fig. 7; Table 3).

Fig. 7.

The boxplot compares average GAD-7 scores in relation to employment sphere

Similarly, there was no statistically significant correlation between employment sphere and PHQ-9 scores or between whether the organization was local or international and PHQ-9 scores (Fig. 8; Table 3).

Fig. 8.

The boxplot compares average PHQ-9 scores in relation to an employment sphere

Biologic sex versus GAD7 and PHQ9 scores

There was no statistically significant correlation between biological sex and either GAD-7 scores or PHQ-9 scores (Figs. 9 and 10; Table 3).

Fig. 9.

The boxplot compares average GAD-7 scores in males and females

Fig. 10.

The boxplot compares average PHQ-9 scores in males and females

Relationship status, having children versus GAD7 and PHQ9 scores

There was no statistically significant correlation between having a partner or spouse and either the GAD-7 or PHQ-9 scores (Figs. 11 and 12; Table 3). Similarly, no significant correlation was found between having children and either the GAD-7 or PHQ-9 scores (Figs. 13 and Supplementary File 3; Table 3).

Fig. 11.

The boxplot compares average GAD-7 scores in people with and without partners/spouses

Fig. 12.

The boxplot compares average PHQ-9 scores in people with and without partners/spouses

Fig. 13.

The boxplot compares average GAD-7 scores in people with and without children

Supplementary File 3. The boxplot compares average PHQ-9 scores in people with and without children

Discussion

Research on the mental health impacts of political activism has found diverse effects. For example, Hope et al. highlight that while political activism can reduce the negative impacts of racial and ethnic discrimination for Latino students, it exacerbates anxiety and depression for African American students [12]. In Israel, participation in protests is associated with both heightened anxiety and a sense of empowerment [13]. Similarly, Lau et al. reported that the Occupy Central movement in Hong Kong caused political distress that affected both activists and the general public [14]. In Argentina, Gal et al. documented both the resilience and PTSD experienced by individuals involved in activism under dictatorship, showing a mix of positive and negative mental health outcomes [15].

Chen et al. pointed out that addressing burnout is crucial to maintaining both personal balance and long-term activism effectiveness [16]. However, in the United States, some studies suggest that activists may lead more fulfilling lives than non-activists, experiencing a greater sense of accomplishment [17]. A study in Israel found that exposure to war and terror negatively affected teenagers’ political attitudes, with those holding more rigid political views experiencing higher stress and lower life satisfaction [18].

Activism also appears to mitigate feelings of helplessness associated with media-based bullying in adolescents, offering a potential coping mechanism for vulnerable youth [19]. A study of LGBTQ activists in Southeast Asia revealed how these individuals manage backstage emotional labor, balancing public positivity with private vulnerability. These activists engage in both individual and collective strategies to cope with the emotional toll of their work [20]. Furthermore, youth activists challenge the perception of widespread apathy, advocating for the legitimacy of alternative, peer-based political engagement [21].

A research into race-based prejudice and cognitive functioning shows that while Black individuals are better equipped to handle blatant discrimination, they are more vulnerable to the cognitive impairments caused by subtle, ambiguous forms of prejudice. This underscores the importance of addressing subtle discrimination and developing strategies to mitigate its impact on activists and other marginalized groups [22].

A study of Belarusians who were forced to flee the country following the 2020 election protests found profound ontological insecurity and uncertainty about whether they were “deserving” of support, while facing numerous challenges such as limited access to care, difficulty adjusting to stress, and persistent fear of persecution [23]. To address these issues, the Samopomoch platform—an encrypted digital system—was developed to provide activists with self-screening tools, psychoeducational resources, and counseling. Findings suggest that secure online services can be effective for delivering trauma support to individuals who are wary of using official channels [24].

In Ukraine, a study conducted after the Maidan Revolution and the first Russian invasion, which displaced approximately 2 million people, reported that 27% met criteria for post-traumatic stress disorder (PTSD), 20% for major depression, and 16.1% for generalized anxiety disorder. Although these findings are not directly tied to protest participation alone, they illustrate the significant mental health burden associated with political turmoil [25]. More recent studies reinforce this trend, indicating that at least one-third of the population is currently experiencing some form of mental disorder [26].

Similarly, a study from Kazakhstan reported that 14.8% of respondents exhibited significant PTSD symptoms, with this figure rising to 30% in Almaty, the epicenter of unrest; additionally, approximately 10% reported moderate-to-severe anxiety (GAD-7 score > 10) [27]. It is important to note that the studies from Ukraine and Kazakhstan were conducted among the general population, not exclusively activists, which should be considered when interpreting these results.

A systematic review found that PTSD prevalence ranged from 4 to 41% in riot-affected areas and that the overall prevalence of major depression increased by approximately 7% following such events [28].

In this study, we aimed to examine various factors that might correlate positively or negatively with elevated GAD-7 and PHQ-9 scores. Identifying such correlations could highlight areas to target in efforts to reduce or mitigate risk factors associated with anxiety and depression.

Our analysis did not reveal significant associations between mental health outcomes and personal factors such as income, education, or time spent on activism, which contrasts with previous literature linking these variables to mental health. Several explanations are possible. First, the limited sample size reduced statistical power, making smaller effects harder to detect. Second, the timing of data collection—during a peak of political turmoil—may have created a pervasive stressor that overshadowed individual differences, rendering typical protective factors less influential. Third, the relative homogeneity of our sample, which comprised highly active activists with similar socio-political profiles, likely restricted variability in key predictors. Finally, although GAD-7 and PHQ-9 are validated tools, they may not fully capture activism-specific stressors such as surveillance, harassment, and digital intimidation, which could explain the null findings. It should also be noted that was self-selected, which may introduce self-selection bias. Individuals with higher levels of anxiety or depression might have been more motivated to participate, potentially inflating prevalence estimates; The data collection relied exclusively on self-reported measures. Although validated tools such as the GAD-7 and PHQ-9 were used, self-reporting is inherently subject to recall bias and social desirability bias. The study design was cross-sectional; therefore, it cannot establish causality or capture changes in mental health status over time. Future research using longitudinal designs is needed to track mental health trajectories in activist populations and better understand the temporal relationships between activism and psychological outcomes.

Notably, nearly 80% of participants in our study had scores indicative of moderate to severe anxiety and depression—a concerning statistic especially when compared to the control. However, it is important to acknowledge that our sample comprised highly active participants opposing the established political order, which may limit the generalizability of these findings to the broader population.

Despite hypothesizing that the amount of time dedicated to political activism might correlate positively with higher screening scores, no such association was identified. Similarly, no statistically significant correlations were found between screening scores and average monthly income, educational level, or relationships status and having kids.

In summary, our findings suggest the need to explore additional factors underlying the high prevalence of anxiety and depression among political activists. Since none of our initial hypotheses held true, one possible explanation could be the ongoing political turmoil, which may disrupt the lives and routines of these individuals, thereby contributing to elevated anxiety and depression levels. It is important to note that the current government extensively uses state media and fake social media accounts to discredit and intimidate activists, spread false rumors, and create misleading narratives about the resistance. This strategy may be a key factor contributing to the elevated levels of anxiety and depression observed among activists. Across Eastern Europe, authoritarian-leaning governments deploy disinformation and intimidation to silence critics. Smear campaigns brand activists as “traitors” or “foreign agents,” while intrusive surveillance, anonymous threats, and orchestrated violence reinforce fear. In Georgia, ruling-party media routinely label civil-society leaders “enemies of the state,” echoing Soviet-era propaganda meant to break their spirit. Protesters against laws such as the proposed “foreign agent” bill report threatening calls, doxxing, stalking, and beatings, creating a pervasive “environment of intimidation and retaliation.” Kremlin-aligned trolls run parallel online assaults, amplifying defamation and death threats. These sustained stressors foster chronic anxiety, depression, and burnout among activists [29–32]. Although studying this was not within the scope of the current study, we plan to conduct research on this topic in the future. Additionally, an area that warrants further exploration is the potential difference in the prevalence of mental health disorders between democratic and non-democratic countries.

Further studies and interventions are crucial to address these mental health challenges faced by political activists. Involving more mental health professionals and civil society organizations could be instrumental in this effort. For instance, civil society organizations might consider offering free and accessible online psychiatric or psychological evaluations for activists, which could encourage timely action to mitigate these risks.

Our findings, indicating that nearly 80% of participants screened in the moderate-to-severe range for both anxiety and depression, provide strong evidence that mental health interventions should be prioritized for activist populations during periods of political turmoil. Evidence-based measures include systematic mental health screening, early detection, and referral to professional services.

Beyond these immediate implications, CSOs and advocacy groups may consider additional strategies aimed at resilience and long-term sustainability of activist communities. These may include integrating accessible tele-counseling, offering peer support systems, promoting digital security practices to reduce psychological strain from surveillance threats, and developing structured role-rotation plans to prevent burnout. While these suggestions extend beyond the scope of our data, they align with best practices identified in prior research and can inform future programmatic initiatives. Activists can reduce personal risk by adopting boundary-based self-care and collective resilience practices. Recommended steps include: maintaining fixed sleep schedules and scheduled “digital curfews,” forming micro peer-support pods that meet weekly for debriefing, and creating individual “psychological safety plans” that list early-warning signs and pre-agreed referral pathways. Early engagement with professional help—via CSO-sponsored vouchers or free tele-consultations—should be normalised, while improved digital hygiene (two-factor authentication, separate activist devices, encrypted incident logs) can lessen hyper-vigilance and anxiety. Recognising the need for temporary withdrawal or role rotation is essential to prevent burnout and sustain the movement’s long-term effectiveness.

Conclusion

This study highlights a critical mental health challenge among political activists in the Republic of Georgia, with nearly 80% of participants showing moderate to severe levels of anxiety and depression. Despite our efforts to examine potential correlations between these mental health outcomes and factors such as income, time spent on activism, educational level, and relationship status, no statistically significant associations were found. This suggests that either the mental health struggles of activists may not be readily explained by these personal characteristics alone or the sample size could not detect smaller effect size. One plausible explanation for the high anxiety and depression rates observed could be the pervasive political tension and government tactics may contribute to these challenges. Activists in politically charged environments may experience unique stressors that disrupt daily life, create a sense of uncertainty, and heighten psychological vulnerability. Our findings underscore the need for targeted mental health interventions within activist communities, particularly during periods of heightened political stress. Collaborative efforts involving mental health professionals, civil society organizations, and policymakers are essential to develop and implement support mechanisms for activists. Programs providing free and easily accessible online psychological assessments and counseling could encourage early intervention, helping activists manage stress more effectively and reduce the long-term risk of anxiety and depression. Several factors constrain the generalizability of these findings. First, the sample was self-selected and relatively small, which may introduce selection bias and limit statistical power. Second, the reliance on self-reported data raises the possibility of recall and social desirability bias. Third, the cross-sectional design precludes causal inference and does not capture changes over time. Finally, participants represented highly active individuals within a politically engaged subgroup, which may not reflect the experiences of the broader activist community. Future research should explore other potential risk factors in this population in a longitudinal setting and in a larger sample, aiming to better understand and mitigate the mental health burdens that activists bear.

Supplementary Information

Below is the link to the electronic supplementary material.

Author contributions

All authors are responsible for the work described in this paper. All authors were involved in at least one of the following: [conception, design of work or acquisition, analysis, interpretation of data] and [drafting the manuscript and/or revising/reviewing the manuscript for important intellectual content]. All authors provided final approval of the version to be published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Funding

No financial assistance was received to support the study.

Data availability

All data generated or analyzed during this study are included in this published article.

Declarations

Ethics approval and consent to participate

The study was approved by the Ethical Committee of The University of Georgia (Study code: UGREC-01-25) and is in accordance with Declaration of Helsinki. Informed consent was obtained from each respondent. Clinical trial number not applicable. No direct identifiers were collected from the participants and communication was conducted through Signal which is believed to be the most secure communcation channel.

Consent for publication

N/A.

Competing interests

The authors declare no competing interests.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.