Symptoms of Anxiety & Depression Up 235% During the COVID-19 Pandemic—Here’s Who It’s Impacting the Most

November 17, 2020 Online Therapy Staff

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COVID-19 has negatively impacted the United States, along with the rest of the world, in countless ways.

Hundreds of thousands of people have died, the economy has suffered, and millions of people have lost their jobs.

An often-overlooked aspect of the coronavirus pandemic, however, is its impact on the mental health of our nation’s residents.

Fear of getting the disease and of loved ones dying, anxiety about how to pay the bills after being laid off, and feeling isolated due to restrictions are just some of the emotions millions of Americans are experiencing on a daily basis due to COVID-19 and its far-reaching implications.

To better understand how COVID-19 is impacting the mental health of the United States, we analyzed data from the Household Pulse Survey—an ongoing study by the National Center for Health Statistics (NCHS) and the U.S. Census Bureau designed to better understand the impact of the coronavirus.

We specifically analyzed the 1.3 million+ responses to the questions from Phase 1 (April 23, 2020 to July 21, 2020) and Phase 2 (August 19, 2020 to October 26, 2020) asking if respondents had experienced symptoms of anxiety and depression.

In total, 36.81% of survey respondents reported symptoms of anxiety and depression, an astounding 235% increase from the 11.0% that reported symptoms during the NCHS’ National Health Interview Survey ran from January to June in 2019.

Below you can see how Americans’ mental health has been affected throughout the pandemic as well as what groups are struggling the most including breakdowns by age, state, race/ethnicity, and education level.

Key Findings

  • 36.81% of Americans reported symptoms of anxiety and/or depression—a 235% increase from 2019.
  • Young people are experiencing the most struggles with mental health, with nearly half (49.69%) of those aged 18 to 29 reporting symptoms of anxiety and/or depression.
  • Females have struggled with anxiety and depression (40.63% reporting symptoms)  more than men (32.72%).
  • Those in the “Non-Hispanic, other and multiple races” group reported the most symptoms of anxiety and/or depression (46.00%) while white (34.88%) and Asian (31.60%) respondents reported the least.
  • Those with less than a high school diploma reported the most anxiety and depression symptoms (44.87%) while those with a Bachelor’s degree or higher reported the least symptoms (31.07%).
  • Symptoms vary greatly by state. Respondents in Louisiana reported the most symptoms of anxiety and/or depression (41.04%), while North Dakota reported the least (29.74%).

Symptoms of Anxiety & Depression Over Time During COVID-19

We first took a look at how reported symptoms of anxiety and depression have changed throughout the COVID-19 pandemic.

The following chart shows the national percentage of U.S. citizens reporting symptoms of anxiety and/or depression over time as well as the moving two-week average of new COVID-19 cases.

The chart shows a clear correlation (r = 0.75) between reported symptoms of anxiety and/or depression and the amount of new cases over time. People tend to struggle with their mental health more as cases rise.

Interestingly, people struggled with mental health more once we were around three to four months into the pandemic as opposed to early on. In addition to there being the highest number of new cases during this time, this may also be in part due to people expecting that the virus would have been gone—or at the very least starting to slow down—by this time.

As new cases started to decline towards the middle of August to early September, so did reported symptoms of anxiety and depression. It will be interesting to see how the recently-announced vaccines from Pfizer/Biontech and Moderna factor into Americans’ mental health despite new cases reaching an all-time high as the results of Phase 3 are released in the coming weeks.

States Struggling the Most with Mental Health During the Coronavirus Pandemic

Next, we took a look at the reported symptoms of anxiety and/or depression by state to see which have had the most residents struggling with mental health during the pandemic.

The following table shows the percentage of residents reporting symptoms of anxiety and/or depression throughout the pandemic by state. The numbers reflect the entirety of the survey—from April 23rd to October 26th—not just early or recent responses.

Surprisingly, there was no correlation between the percentage of residents with symptoms of anxiety and/or depression and the cases per 100,000 residents (r = -0.31).

Many Southern states—such as Louisiana, Mississippi, and Texas—and Western states—such as Nevada, Oregon, and California—have the highest reported numbers of mental health struggles.

On the other hand, Midwestern states—such as North Dakota, South Dakota, Minnesota, and Nebraska—have notably lower numbers of reported symptoms of anxiety and depression as compared to the rest of the U.S.

Symptoms of Anxiety & Depression by Age During the Coronavirus Pandemic

We next took a look at which age groups have been struggling the most with mental health during the coronavirus pandemic.

The following chart shows the average percentage of people in different age groups reporting symptoms of anxiety and/or depression through the entire period of the surveys.

As the chart shows, younger people have been struggling much more with their mental health than older populations. Symptoms of anxiety and depression decrease from there with each older age group—especially in the 70 to 79 and 80+ groups.

There may be a few reasons for this.

First, younger people—who tend to experience more anxiety and depression, in general—may also be struggling more with the impacts of the lockdowns and other restrictions.

In a matter of weeks, many young people went from regularly going out with friends, meeting new people, and/or experiencing life on a college campus to being stuck in their apartments or homes with limited or no in-person social interaction.

In addition, this is the first major pandemic that younger people have experienced as adults. Older people have experienced the Asian Flu (H2N2) in 1957 and 1958, the beginning of the AIDS pandemic in 1981, the swine flu (H1N1) pandemic in 2009, and other less deadly pandemics.

Symptoms of Anxiety & Depression by Gender During the Coronavirus Pandemic

Next, we took a look at how anxiety and depression symptoms varied by gender.

As shown in the chart, women are considerably more likely to have experienced anxiety and/or depression symptoms in the last seven months than men.

It’s worth noting that statistics show that women are more likely to suffer from anxiety and depression than men, in general, making it hard to quantify which group has been more impacted by the pandemic.

Symptoms of Anxiety & Depression by Race/Ethnicity During the Coronavirus Pandemic

The Household Pulse Survey data also included information about the race and ethnicity of respondents. The following chart shows the percent of respondents reporting symptoms of anxiety and/or depression by race/ethnicity.

As shown by the graphic, the results vary significantly based on race and ethnicity.

Those in the “Non-Hispanic, other and multiple races” group reported the most symptoms of anxiety and/or depression at an alarming 46.00%. Hispanic or Latino respondents (42.04%) and Black respondents (39.58%) also reported higher levels of mental health struggles than the national average.

White (34.88%) and Asian (31.60%) respondents, on the other hand, reported far fewer symptoms of anxiety and/or depression.

These results are interesting when compared to a 2015 study by the Substance Abuse and Mental Health Services Administration (SAMHSA). The SAMHSA study’s findings are similar to the Household Pulse Survey results in that those identifying as being two or more races faced the most mental illness. The SAMHSA study did find, however, that mental illness was more prevalent among white people than Hispanic and African American people. This seems to suggest that Hispanics and African Americans have had their mental health the most negatively affected by the COVID-19 pandemic compared to previous levels.

Symptoms of Anxiety & Depression by Education Level During the Coronavirus Pandemic

We finally look at how education level has factored into mental health during the COVID-19 pandemic.

As shown in the chart above, those with less than a high school degree have struggled the most during the pandemic.

Those with high school diplomas or GEDs and those with some college or Associate’s degrees experienced slightly higher levels of anxiety and/or depression than the national average, while those with Bachelor’s degrees or higher reported much less mental health struggles.

The employment data from the same Household Pulse Survey for the October 14, 2020 to October 26, 2020 period sheds some light on why this may be.

Respondents without high school diplomas experienced a loss of income since March 13, 2020 the most often (52.75%), followed by some college/Associate’s degree (50.06%), high school or GED (45.75%), and Bachelor’s degree or higher (38.03%).

Respondents without Bachelor’s degrees may have worked in industries that were significantly impacted by the lock downs—such as restaurants, retail, and home services—more often than those with Bachelor’s degrees that were able to work from home.

Resources for Those Dealing With Mental Health Issues

As shown by the data above, Americans’ mental health has been severely impacted during the COVID-19 pandemic. To make matters worse, there has been a large-scale disruption in the availability of mental health services, making it hard for those struggling to find help.

There are a number of resources available for those struggling with mental health during this unprecedented time, however.

Here are some places where you can find help:

  • Those with thoughts of suicide can call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for English or 1-888-628-9454 for Spanish.
  • The Substance Abuse and Mental Health Services Administration (SAMHSA) also offers free, confidential 24/7 treatment referral and information for those struggling with mental health or substance abuse issues. You can SAMHSA’s National Helpline at 1-800-662-HELP (4357).
  • The National Institute of Mental Health provides a number of free resources on how to deal with anxiety and depression, and where you can find help if you are struggling with your mental health.
  • Talking to a licensed therapist online is also a great option for those struggling with their mental health during this pandemic. We can help you find an online therapist that you can visit virtually from the comfort (and safety) of your own home.

There are also countless other resources available for those battling anxiety and depression. Here are some sites that you can visit to find more help:

Methodology

The data used in this report primarily come from the Household Pulse Survey conducted by the United States Census Bureau and National Center for Health Statistics.

The survey was conducted from April 23, 2020 to July 21, 2020 (Phase 1) and August 19, 2020 to October 26, 2020 (Phase 2). Throughout the survey periods, 1,327,657 responses were recorded in total. The 20-minute online survey included questions that were modified from the two-item Patient Health Questionnaire and the two-item Generalized Anxiety Disorder to collect information about symptoms of anxiety and depression in the previous 7 days.

Here are the specific questions asked:

Adapted PHQ-2 questions:

Over the last 7 days, how often have you been bothered by … having little interest or pleasure in doing things? Would you say not at all, several days, more than half the days, or nearly every day?

Over the last 7 days, how often have you been bothered by … feeling down, depressed, or hopeless? Would you say not at all, several days, more than half the days, or nearly every day?

Adapted GAD-2 questions:

Over the last 7 days, how often have you been bothered by the following problems … Feeling nervous, anxious, or on edge? Would you say not at all, several days, more than half the days, or nearly every day?

Over the last 7 days, how often have you been bothered by the following problems … Not being able to stop or control worrying? Would you say not at all, several days, more than half the days, or nearly every day?

Respondents who responded with “more than half the days” and “nearly every day” were considered to be showing signs of Generalized Anxiety Disorder or Major Depressive Disorder.

Note that the questions don’t specifically ask whether the problems were related to COVID-19. Anxiety and depression could have been impacted by other events that occurred during the same time period.

To find the overall percent of people reporting anxiety and depression symptoms in any group for the entire survey period, we weighted the data from each individual survey period by the number of respondents in that same period.

You can learn more about other limitations of the Household Pulse Survey—including measurement error, coverage error, nonresponse error, and processing error—as well as how the survey administrators minimized these limitations here.

Data about the number of new cases over time came from STAT which uses over 15 sources. For this report, we used the two-week rolling average of new cases to better match the survey periods and to account for fluctuations in testing and reporting from day to day.

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