A third of Americans now show signs of clinical anxiety or depression, Census Bureau finds amid coronavirus pandemic

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A third of Americans now show signs of clinical anxiety or depression, Census Bureau finds amid coronavirus pandemic

Alyssa Fowers

Graphics reporter focusing on data visualization and analysis

William Wan

National correspondent covering health, science and news

For every 100 American adults, 34 show symptoms of anxiety, depression or both

20 have symptoms of both anxiety and depressive disorders

10 show symptoms of anxiety alone

4 show symptoms of depression alone

For every 100 American adults, 34 show symptoms of anxiety, depression or both

20 show symptoms of both anxiety and depression

10 show symptoms of anxiety alone

4 show symptoms of depression alone

For every 100 American adults, 34 show symptoms of anxiety, depression or both

20 show symptoms of both anxiety and depression

10 show symptoms of anxiety alone

4 show symptoms of depression alone

For every 100 American adults, 34 show symptoms of anxiety, depression, or both

20 show symptoms of both anxiety and depression

4 show symptoms of depression alone

10 show symptoms of anxiety alone

A third of Americans are showing signs of clinical anxiety or depression, Census Bureau data shows, the most definitive and alarming sign yet of the psychological toll exacted by the coronavirus pandemic.

When asked questions normally used to screen patients for mental health problems, 24 percent showed clinically significant symptoms of major depressive disorder and 30 percent showed symptoms of generalized anxiety disorder.

The findings suggest a huge jump from before the pandemic. For example, on one question about depressed mood, the percentage reporting such symptoms was double that found in a 2014 national survey.

It’s not normal for this many

Americans to feel depressed

How Americans responded to the question “How often have you been bothered by feeling down, depressed, or hopeless?” Someone who answered “several days” or “more than half the days” would need to show other symptoms to screen positive for clinical depression.

Not at all

At least several days

Nearly every day

More than half the days

4%

10%

4%

10%

17%

30%

76%

50%

2013-2014

May 7-12, 2020

The 2013-2014 study reflects symptoms over a two-week period, while the 2020 survey reflects symptoms over a one-week period.

It’s not normal for this many Americans to feel depressed

How Americans responded to the question “How often have you been bothered by feeling down, depressed, or hopeless?” Someone who answered “several days” or “more than half the days” would need to show other symptoms to screen positive for depression.

Not at all

Several days

More than half the days

Nearly every day

Before the pandemic, 25% of adults in the U.S. experienced depressed mood

During the pandemic, 50% experienced depressed mood

10%

10%

17%

30%

76%

50%

May 7-12, 2020

2013-2014

The 2013-2014 survey reflects symptoms over a two-week period, while the 2020 survey reflects symptoms over a one-week period.

[Have you had trouble accessing mental health services because of the coronavirus pandemic? We want to hear from you.]

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The troubling statistics were released last week in a tranche of data from the Census Bureau. The agency launched an emergency weekly survey of U.S. households at the end of April to measure the pandemic’s effects on employment, housing, finances, education and health. In the most recent data release, 1 million households were contacted between May 7 and 12, and more than 42,000 responded.

Buried within that 20-minute survey, U.S. officials included four questions taken nearly word-for-word from a form used by doctors to screen patients for depression and anxiety. Those answers provide a real-time window into the country’s collective mental health after three months of fear, isolation, soaring unemployment and continuing uncertainty.

coronavirus outbreak in the country, ranked 12th nationwide in terms of share of adults showing symptoms. Nearly half of Mississippians screened positive for anxiety or depression — a staggering number. By contrast, in Iowa, just over a quarter screened positive.

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Anxiety and depression spread

unevenly across states

Percent of adults with symptoms of anxiety or depressive disorders

25%

30%

35%

45%

40%

50%

ME

WI

VT

NH

AK

WA

ID

MT

ND

MN

IL

MI

NY

MA

OR

NV

WY

SD

IA

IN

OH

PA

NJ

CT

RI

CA

UT

CO

NE

MO

KY

WV

VA

MD

DE

AZ

NM

KS

AR

TN

NC

SC

DC

HI

OK

LA

MS

AL

GA

TX

FL

48% of adults in Mississippi showed symptoms of anxiety or depression

Anxiety and depression spread unevenly across states

Percent of adults with symptoms of anxiety or depressive disorders

25%

30%

35%

45%

40%

50%

ME

33%

WI

VT

NH

AK

36%

30%

36%

35%

WA

ID

MT

ND

MN

IL

MI

NY

MA

35%

29%

28%

29%

27%

42%

33%

37%

31%

OR

NV

WY

SD

IA

IN

OH

PA

NJ

CT

RI

30%

38%

28%

30%

26%

35%

33%

32%

40%

36%

34%

CA

UT

CO

NE

MO

KY

WV

VA

MD

DE

34%

30%

32%

33%

41%

38%

39%

31%

35%

32%

AZ

NM

KS

AR

TN

NC

SC

DC

28%

33%

35%

28%

33%

41%

38%

40%

OK

LA

MS

AL

GA

HI

27%

31%

43%

48%

31%

34%

TX

FL

36%

34%

Nearly half of adults in Mississippi showed symptoms of anxiety or depression

Anxiety and depression spread unevenly across states

Percent of adults with symptoms of anxiety or depressive disorders

25%

30%

35%

40%

45%

50%

ME

33%

WI

VT

NH

AK

30%

36%

35%

36%

WA

ID

MT

ND

MN

IL

MI

NY

MA

37%

31%

28%

29%

27%

42%

33%

35%

29%

OR

NV

WY

SD

IA

IN

OH

PA

NJ

CT

RI

30%

38%

28%

30%

26%

35%

33%

32%

40%

36%

34%

CA

UT

CO

NE

MO

KY

WV

VA

MD

DE

34%

30%

32%

33%

41%

38%

39%

31%

35%

32%

AZ

NM

KS

AR

TN

NC

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SC

DC

28%

33%

35%

28%

33%

41%

38%

40%

OK

LA

MS

AL

GA

HI

27%

31%

43%

48%

31%

34%

FL

TX

34%

36%

Nearly half of adults in Mississippi showed symptoms of anxiety or depression

Some groups have been hit harder than others. Rates of anxiety and depression were far higher among younger adults, women and the poor. The worse scores in young adults were especially notable, given that the virus has been more likely to kill the elderly or leave them critically ill.

Those results reflect a deepening of existing trends: rising depression, stress and suicide among young adults. “It’s been a problem many have been studying with no clear answers — whether it’s social media or the way this generation was reared or just a greater willingness to talk about their problems,” said Maria A. Oquendo, a professor psychiatry at the University of Pennsylvania. “What’s worrying is the effect this situation is clearly having on young adults.”

Older people report fewer

symptoms of anxiety or depression

Anxiety symptoms

All adults

30%

18-29

42%

30-39

34%

40-49

32%

31%

50-59

60-69

22%

70-79

16%

80+

11%

Depression symptoms

24%

All adults

18-29

36%

30-39

28%

40-49

26%

50-59

24%

60-69

18%

70-79

12%

80+

9%

Older people are more at risk for the coronavirus, but less likely to report symptoms of anxiety or depression

Anxiety symptoms

Depression symptoms

All adults

30%

24%

18-29

42%

36%

28%

30-39

34%

26%

40-49

32%

31%

24%

50-59

60-69

22%

18%

70-79

16%

12%

80+

11%

9%

As universities and schools look to reopen, they must take mental health into account, said Paul Gionfriddo, president of the advocacy group Mental Health America. “There’s been plenty of talk about spacing desks apart and classroom ratios but not much at all about mental health support,” Gionfriddo said. “For one thing, we have to do much more mental health screening among young people.”

The toll has also hit the poor much harder, according to the Census Bureau data — throwing into even sharper relief mental health disparities that have long existed.

The highest income bracket

worries half as often as the lowest

“Over the last seven days, how often have you been bothered by not being able to control or stop worrying?”

Not at all

32%

68%

36%

$25 − 34K

64%

43%

$35 − 49K

57%

48%

$50 − 74K

51%

47%

$75 − 99K

53%

53%

$100 − 149K

47%

40%

60%

$150K +

The highest income bracket worries half as often as the lowest

“Over the last seven days, how often have you been bothered by not being able to control or stop worrying?”

Several days

Nearly every day

At least half the days

Not at all

At least several days

32%

Less than $25K

68%

64%

36%

$25K − $34K

43%

$35K − $49K

57%

48%

$50K − $74K

51%

47%

$75K − $99K

53%

53%

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$100K − $149K

47%

60%

$150K and up

40%

Only 6% in the highest income bracket worried uncontrollably nearly every day, compared with 23% in the lowest income bracket

When asked, for example, how often they worried uncontrollably in the past week, 60 percent of those making $150,000 or more said they didn’t struggle with it at all. Meanwhile, those numbers were almost inverted among people making less than $25,000 a year — with only 32 percent saying they didn’t struggle with uncontrollable worry and 23 percent saying they worried uncontrollably nearly every day.

Throughout the crisis, lower-income people have struggled more with unemployment, food scarcity and low-wage jobs that don’t allow them to work from home and that offer few financial and physical protections.

growing evidence of accumulating mental harms among Americans. Nearly half of Americans reported the coronavirus crisis is impairing their mental health, according to a Kaiser Family Foundation poll released in April. A survey by the American Foundation for Suicide Prevention found people are experiencing anxiety and sadness more often than before the pandemic and are talking about mental health more frequently. Researchers have projected that without intervention, the country is poised to experience a rise in suicides, substance abuse and overdose deaths.

“It’s understandable given what’s happening. It would be strange if you didn’t feel anxious and depressed,” Oquendo said. “This virus is not like a hurricane or earthquake or even terrorist attack. It’s not something you can see or touch, and yet the fear of it is everywhere.”

The mental health questions were taken from two screening tools called PHQ-2 and GAD-2, used by some primary care doctors to screen patients for depression and anxiety. They were included in the Census Bureau’s emergency coronavirus project — its official name is the 2020 Household Pulse Survey — at the recommendation of the Centers for Disease Control and Prevention’s National Center for Health Statistics, officials said.

Not everyone who screens positive on these tests has clinical depression or anxiety. A Washington Post analysis of research studies on the topic found that about half of those who screen positive on the PHQ-2 in normal times have major depressive disorder. That percentage is lower for the GAD-2.

access, disparities and insurance roadblocks. In the wake of the coronavirus pandemic, Congress appropriated trillions of dollars in emergency funds, but almost none of it has gone toward mental health programs and clinics.

“If you measure a problem, presumably it’s because you want to do something about it,” said Oquendo, former president of the American Psychiatric Association.

Doctors don’t diagnose patients with cancer, for instance, only to send them on their way, she said. “Now that the government knows how widely people are suffering, the question is what are they going to do about it.”

If you or someone you know needs help, call the National Suicide Prevention Lifeline at 800-273-TALK (8255). Crisis Text Line also provides free, 24/7, confidential support via text message to people in crisis when they text to 741741.