Most Young Adults Have "Mental Health Symptoms"

The mental health of millions of Americans has been adversely affected by the coronavirus pandemic. Young adults have been hit the hardest. This makes sense, since young adults are the ones whose lives have been disrupted the most. Their college classes are remote, their career prospects put on hold, their friends and potential romantic partners socially distanced. 

The Census Bureau has been tracking the mental health of the population in its biweekly Household Pulse Survey. A CDC analysis of the survey's mental health data reveals two worrisome facts: the mental health of Americans was not all that great in August, and between August and February it has gotten worse.

Here's what the Household Pulse Survey asks: How often in the past seven days have you felt 1) nervous, anxious, or on edge; 2) unable to stop or control worrying; 3) little interest or pleasure in doing things; 4) down, depressed, or hopeless? Respondents who reported experiencing one or more of these feelings on most of the past seven days were classified as having mental health symptoms. 

In August 2020, a substantial 36.4 percent of adults aged 18 or older were classified as having mental health symptoms, according to the CDC study. By February 2021, the figure had grown to 41.5 percent—a statistically significant increase. 

Symptoms of anxiety/depressive disorder during past 7 days, January 20—February 1, 2021

Total, aged 18-plus: 41.5% 

Aged 18 to 29: 57.0% 

Aged 20 to 39: 45.9% 

Aged 40 to 49: 41.1% 

Aged 50 to 59: 41.2% 

Aged 60 to 69: 33.4% 

Aged 70 to 79: 26.3% 

Aged 80-plus: 22.5% 

Mental health problems are particularly severe among 18-to-29-year-olds. Not only are most young adults experiencing mental health symptoms, but the 18-to-29 age group is also the one whose mental health is eroding the fastest. Between August 2020 and February 2021, the percentage of young adults with mental health symptoms grew by 8 percentage points. While the share of the population with mental health symptoms increased in every age group during those months, the rise was largest among 18-to-29-year-olds. It's well past time to open up vaccination sites to all adults, regardless of age, to give young people some hope. 

Source: CDC, Symptoms of Anxiety or Depressive Disorder and Use of Mental Health Care among Adults during the Covid-19 Pandemic—United States, August 2020—February 2021

Prescription Meds for Mental Health

Twenty-one percent of Americans aged 18 or older have taken a prescription medication in the past four weeks to help with their mental health, according to the Census Bureau's Household Pulse Survey. Ten percent say they have received counseling from a mental health professional in the past four weeks, and another 11 percent say they needed counseling but did not get it. 

Women are far more likely than men to be on medication for mental health issues—26 percent of women reported taking medication in the past four weeks versus 15 percent of men. People who live alone are more likely to be taking medication (25 percent) than those who live with others. Interestingly, the use of medication falls with household income—from 25 percent of those with household incomes below $25,000 to just 15 percent of those with household incomes of $200,000 or more. 

People who have had to borrow money from friends or family in the past 7 days to make ends meet are the ones most likely to be taking prescription medication for mental health. Fully 29 percent of these borrowers are on medication.

Source: Census Bureau, Household Pulse Survey, January 6-18 

Mental Health Problems Common before Coronavirus

The mental health of Americans has taken a beating during the coronavirus pandemic. But mental health wasn't all that great in 2019, either. According to results from the 2019 National Health Interview Survey, a substantial 18.5 percent of adults had experienced symptoms of depression in the past two weeks, and 15.6 percent had experienced symptoms of anxiety. Here are the numbers by age...

Percent with symptoms of depression in past two weeks by age, 2019

Aged 18 to 29: 21.0%

Aged 30 to 44: 16.8%

Aged 45 to 64: 18.4%

Aged 65-plus: 18.4%

Percent with symptoms of anxiety in past two weeks by age, 2019

Aged 18 to 29: 19.5%

Aged 30 to 44: 16.6%

Aged 45 to 64: 15.2%

Aged 65-plus: 11.2%

Millions of Americans are receiving treatment for their mental health problems—either they are taking medication and/or receiving counseling or therapy. Overall, 19.2 percent had received treatment for mental health problems in the past 12 months, according to 2019 survey results. Medication was being taken by 15.8 percent of adults, and 9.5 percent were receiving counseling/therapy. 

Source: National Center for Health Statistics, Symptoms of Depression among Adults: United States, 2019; Symptoms of Generalized Anxiety Disorder among Adults: United States, 2019; Mental Health Treatment among Adults: United States, 2019

More than 1 in 10 Adults Take Antidepressants

The use of antidepressant medications is widespread in the United States, with 13.8 percent of adults taking antidepressants in the past 30 days. Women are more than twice as likely to use antidepressants as men—18.6 percent of women versus 8.7 percent of men took antidepressants in the past month, according to the National Center for Health Statistics' 2017–18 National Health and Nutrition Examination Survey.

The use of antidepressants rises with age. Nearly one in four women aged 60 or older took an antidepressant in the past 30 days...

Percent of men using antidepressants in past 30 days, 2015–18

Aged 18 to 39: 5.5%

Aged 40 to 59: 8.4%

Aged 60-plus: 12.8%

Percent of women using antidepressants in past 30 days, 2015–18

Aged 18 to 39: 10.3%

Aged 40 to 59: 20.1%

Aged 60-plus: 24.3%

The use of antidepressants is highest among non-Hispanic whites, with 16.6 percent taking antidepressants in the past month. The figure is 7.8 percent among Blacks, 6.5 percent among Hispanics, and just 2.8 percent among Asians. 

Source: National Center for Health Statistics, Antidepressant Use among Adults: United States, 2015–2018

"Elevated Levels of Adverse Mental Health Conditions"

The evidence of mental health trauma is piling up. A survey by the CDC found "elevated levels" of mental anguish due to the stress of the coronavirus pandemic. Overall, 41 percent of Americans have experienced one or more adverse mental or behavioral symptoms because of the pandemic.

The CDC fielded the survey June 24-30. The survey's questions assessed symptoms of anxiety, depression, trauma or stress-related disorder, increased substance use, and suicidal thoughts. Here are the findings...

Percent of Americans with adverse mental health conditions, June 24-30
25.5% have an anxiety disorder
24.3% have a depressive disorder
26.3% have trauma or stress related disorder
13.3% had started/increased substance use
10.7% had considered suicide in the past 30 days

These numbers are not normal. "The prevalence of symptoms of anxiety disorder was approximately three times those reported in the second quarter of 2019 (25.5% versus 8.1%)," the CDC reports. "Prevalence of depressive disorder was approximately four times that reported in the second quarter of 2019 (24.3% versus 6.5%)." The percentage of respondents who had seriously considered suicide in the past 30 days climbed from 4.3 percent in the second quarter of 2019 to the 10.7 percent of June 2020.

Younger adults are faring the worst. Among 18-to-24-year-olds, fully 75 percent exhibited at least once adverse mental or behavioral health symptom, as did 52 percent of those aged 25 to 44. The figure was 29.5 percent among 45-to-64-year-olds and 15 percent among people aged 65 or older.

Source: CDC, Morbidity and Mortality Weekly Report, Mental Health, Substance Use, and Suicidal Ideation during the Covid-19 Pandemic—United States, June 24–30, 2020

Covid Stress Is Making Us Sick

The coronavirus is having a negative impact on the mental health of Americans, according to the Kaiser Family Foundation Health Tracking Poll. In July, the 53 percent majority of adults said their mental health was being negatively impacted by the pandemic—the highest share recorded in Kaiser's tracking poll and 14 percentage points higher than in May.

Those most likely to say their mental health is suffering are women (57 percent), young adults aged 18 to 29 (62 percent), Blacks (68 percent), and those who are having financial difficulties because of the pandemic (71 percent).

The worry and stress due to the coronavirus pandemic is also affecting our physical wellbeing. Most Americans have experienced at least one of of these ailments because of the stress...

In the past two months, have you experienced any of the following due to worry or stress related to the coronavirus outbreak?
36% have had trouble falling asleep, staying asleep, or sleeping too much
32% have experienced a poor appetite or overeating
18% have had difficulty controlling their temper
18% have had frequent headaches or stomachaches
12% have increased their alcohol or drug use
12% have had their chronic conditions worsen

Overall, the 52 percent majority of the public has experienced at least one of these health problems in the past two months.

Source: Kaiser Family Foundation, KFF Health Tracking Poll—July 2020

Feeling Nervous, Anxious, on Edge?

How often have you felt nervous, anxious, or on edge during the past week? Chances are, you've felt that way on at least several days, according to the Census Bureau's Household Pulse Survey fielded May 21-26. Only 37 percent of Americans aged 18 or older say they did not feel nervous, anxious, or on edge on any day that week. Another 34 percent said they had been bothered by anxiety on several days, and 28 percent had been bothered on most days or every day. The Census Bureau's Household Pulse Survey is tracking the effect of the coronavirus pandemic on the well-being of the public, including mental health.

Not surprisingly, the demographics of those who are cool as a cucumber differ dramatically from those who are a quivering basket of nerves. One of the biggest differences is by age, with younger adults much more freaked out than their elders—and with good reason since younger adults are the ones being hit harder by job losses. Here are the extremes: the 61 percent majority of people aged 80 or older say they have not suffered from anxiety on even one day in the past week; among people aged 18 to 29, only 28 percent have nerves of steel. Keep in mind, the survey does not include the elderly living in nursing homes, who might be a lot more anxious than their peers in the community.

Days in past week when you felt nervous, anxious, or on edge, May 21-26

	none	several	most or every
Total 18-plus	37.3%	34.4%	28.3%
Aged 18 to 29	27.8	33.8	38.4
Aged 30 to 39	29.4	36.9	33.7
Aged 40 to 49	32.7	37.1	30.1
Aged 50 to 59	36.2	35.8	28.0
Aged 60 to 69	45.5	33.3	21.2
Aged 70 to 70	57.6	28.2	14.2
Aged 80-plus	60.9	23.1	16.1

Note that Wave 4 of the Household Pulse Survey was taken before the murder of George Floyd and the resulting protests and unrest across the country. 

Source: Census Bureau, Household Pulse Survey: May 21-May 26

Who Thinks Their Mental Health Is Excellent?

When asked how mentally healthy they are, 43 percent of Americans aged 18 or older say their mental health is "excellent," according to a 2019 Gallup survey. Feeling good about mental health rises with age...

Percent saying mental health is "excellent"
Aged 18 to 34: 39%
Aged 35 to 54: 43%
Aged 55-plus: 47%

Men are more positive than women about their mental health—49 percent of men and 37 percent of women say they have excellent mental health. Republicans are more likely than any other demographic segment to believe they are at the top of their game. Fully 56 percent of Republicans say they have excellent mental health. Among Democrats, only 30 percent feel that way.

Source: Gallup, 71% of U.S. Adults Rate Mental, Physical Health Positively, Final Topline

Nervous Breakdown?

"Have you ever felt you were going to have a nervous breakdown?" That's one of the mental health questions in the 2016 General Social Survey. A surprisingly large 36 percent of Americans aged 18 or older answered "yes."

Women are more likely than men to have ever felt like they were going to have a nervous breakdown—42 versus 27 percent. By race and Hispanic origin, Asians are most likely to have felt that way (43 percent) and Blacks least likely (28 percent). By generation, nearly half of Millennials have felt on the brink of a breakdown...

Ever felt you were going to have a nervous breakdown?
Millennials: 48%
Gen Xers: 37%
Boomers: 29%
Older: 14%

Source: Demo Memo analysis of the 2016 General Social Survey

How Many Are Lonely?

Nearly 1 in 12 Americans aged 18 or older reported feeling lonely most or all of the time during the past week, according to the 2016 General Social Survey. Several questions in the 2016 survey probed the public's emotional health. The good news is that few of us spent most of the past week feeling bad. The bad news is that some of us did. Five percent felt depressed most or all of the time in the past week, 6 percent felt sad, and 8 percent felt lonely.

Felt lonely most or all of the time in the past week
Aged 18 to 29: 7.4%
Aged 30 to 39: 4.4%
Aged 40 to 49: 9.4%
Aged 50 to 59: 11.9%
Aged 60 to 69: 7.4%
Aged 70-plus: 5.1%

Loneliness peaks among people in their 50s, with 12 percent saying they felt lonely most or all of the time. One factor that may cause loneliness in this age group is the emptying nest. Loneliness is least likely among people in their 30s, the crowded-nest years. The oldest Americans—people aged 70 or older—are one of the age groups least likely to feel lonely.

Source: Demo Memo analysis of the 2016 General Social Survey

Are You Having Trouble Remembering Things?

"During the past 12 months, have you experienced confusion or memory loss that is happening more often or is getting worse?" This question was posed to Americans aged 45 or older in the 2015–16 surveys of the Behavioral Risk Factor Surveillance System.

A substantial 11 percent of people aged 45 or older answered "yes" to the question. They are experiencing what is called "subjective cognitive decline," reports the CDC. Subjective cognitive decline (SCD) can be a symptom of early-stage dementia. Among those who said they were experiencing SCD, the 51 percent majority also reported functional limitations due to their cognitive problems.

Interestingly, the percentage who reported SCD does not vary all that much by age, ranging from 10 percent among 45-to-54-year-olds to 14 percent among people aged 75 or older. By race and Hispanic origin, American Indians are most likely to report SCD (20 percent) and Asians least likely (7 percent). Education has a big impact on the prevalence of SCD, with 18 percent of high school dropouts reporting SCD versus 7 percent of people with a bachelor's degree. By state, the percentage with SCD is highest in Nevada (16.3 percent) and lowest in South Dakota (6.0 percent).

Source: CDC, Subjective Cognitive Decline among Adults Aged ≥ 45 Years—United States, 2015–2016

8% of Americans Experience Depression

Depression is a common condition, according to a National Center for Health Statistics study. Among adults aged 20 or older, 8.1 percent were found to be depressed in a given two-week period of 2013–2016. The NCHS measured depression by administering a nine-item depression screening instrument to a nationally representative sample of the population.

Women are more likely to be depressed (10.4 percent) than men (5.5 percent). Asians are much less likely to be depressed (3.1 percent) than any other race or Hispanic origin group. Interestingly, the prevalence of depression falls as family income increases...

Percent of people aged 20-plus with depression by family income
Less than 100% of poverty level: 15.8%
100% to 199% of poverty level: 10.9%
200% to 399% of poverty level: 7.8%
400% or more of poverty level: 3.5%

Source: National Center for Health Statistics, Prevalence of Depression among Adults Aged 20 and Over: United States, 2013–2016

Poor Mental Health Is Common among Young Adults

On how many days in the past month has your mental health not been good? When asked that question, the 55 percent majority of the public answers "none," according to the General Social Survey—their mental health is just fine, thank you. But a substantial 45 percent of Americans say their mental health has not been good on one or more days in the past month.

There are few differences in the percentage with poor mental health by race and Hispanic origin or education. But there are differences by sex: 49 percent of women versus a smaller 39 percent of men say their mental health has not been good on at least one day in the past month. There are even bigger differences by generation, with Millennials most likely to experience poor mental health...

One or more days of poor mental health in past month
Millennials (22 to 39): 48%
Gen Xers (40 to 51): 46%
Boomers (52 to 70): 41%
Older (71 or older): 36%

Similarly, 48 percent of Millennials admit to having ever felt like they were going to have a nervous breakdown, according to another question on the General Social Survey—a higher percentage than in any other generation. Among the oldest Americans, only 14 percent say they have ever felt like they were on the brink of a breakdown.

Source: Demo Memo analysis of the 2016 General Social Survey

Mental Distress: Where It's the Worst

The CDC regularly monitors health conditions by state and metro area. Its latest analysis examines data collected in 2013—pre Trump, Harvey, and Irma. At that time, these five states had the largest proportion of adults who reported experiencing 14 or more days of mental distress during the past 30 days...

States with highest mental distress
1. West Virginia: 15.2%
2. Alabama: 14.4%
3. Kentucky: 14.3%
4. Oklahoma: 14.3%
5. Mississippi: 14.2%

North and South Dakota had the smallest proportion of residents reporting mental distress (7.7 and 7.9 percent, respectively).

These were the five metropolitan areas with the largest proportion of adults who reported experiencing 14 or more days of mental distress during the past 30 days...

Metros with highest mental distress
1. Akron, OH: 19.4%
2. Kingsport-Bristol, TN-VA: 18.0%
3. Fort Smith, AR-OK: 17.6%
4. Winston-Salem, NC: 16.8%
5. Gulfport-Biloxi-Pascagoula, MS: 16.6%

The metros with the smallest proportions of residents reporting mental distress were Minot, ND (6.3 percent), Grand Forks, ND-MN (6.3 percent), and Sioux Falls, SD (6.5 percent).

Source: CDC, Surveillance for Certain Health Behaviors and Conditions among States and Selected Local Areas—Behavior Risk Factor Surveillance System, United States, 2013 and 2014

Stress is the Norm for New Mothers

In the year before they give birth, 71 percent of new mothers experience what the CDC calls a "stressful life event." The government defines 13 types of stressful life events and categorizes them into four types: financial (moved to a new address, lost job, partner lost job, unable to pay bills); emotional (family member ill and hospitalized, someone close died); partner-associated (separation/divorce, argue more than usual with partner/husband, husband/partner said he did not want pregnancy); and traumatic (homeless, involved in physical fight, partner went to jail, someone close had a problem with drinking/drugs).

The average new mother experiences 1.8 stressful life events in the year before her infants' birth. The 51 percent majority experiences a financial stressor, 30 percent an emotional stressor, 29 percent a partner-associated stressor, and 18 percent a traumatic stressor. Most women are vulnerable to stressful life events, but some are more vulnerable than others. Fully 80 percent of new mothers under age 25, for example, experienced one or more stressors compared with a smaller but still substantial 63 percent of new mothers aged 30 or older. Among the least educated, 76 percent experienced a stressor. Among the best-educated, the figure was 60 percent.

Source: CDC, Stressful Life Events Experienced by Women in the Year Before Their Infants' Births—United States, 2000-2010

Most and Least Depressed

People most and least likely to report moderate to severe depression symptoms in past two weeks...

Most depressed: Women aged 40 to 59 (12.3%)
Least depressed: Men aged 60 or older (3.4%)

Source: National Center for Health Statistics, Depression in the U.S. Household Population, 2009-2012

The Antidepressant Boom

Maybe it was the Great Recession, or pharmaceutical advertising, or the advice of doctors. Whatever the reason, the result is clear: a booming market for antidepressants. The number of Americans who purchased an antidepressant grew by an enormous 65 percent in ten years—rising from 18.5 million in 2000 to 30.6 million in 2010. Overall, nearly 10 percent of Americans purchased a prescribed antidepressant in 2010, up from 7 percent in 2000. Here are the 2010 percentages by age...

Percent purchasing a prescribed antidepressant in 2010
Total people: 9.9%
Under age 18: 1.3%
Aged 18 to 44: 8.8%
Aged 45 to 64: 16.2%
Aged 65-plus: 16.2%

Source: Medical Expenditure Panel Survey, Statistical Brief 430, Trends in Antidepressant Utilization and Expenditures in the U.S. Civilian Noninstitutionalized Population by Age, 2000 and 2010