National and state trends in anxiety and depression severity scores among adults during the COVID-19 pandemic

Oct. 8, 2021

The frequency of anxiety and depression symptoms experienced among U.S. adults increased after August 2020 and peaked during December 2020–January 2021. The frequency of symptoms subsequently decreased but in June 2021 remained elevated compared with estimates from the 2019 National Health Interview Survey (NHIS), according to a release from Centers for Disease Control and Prevention (CDC) MMWR data.

Nationwide, average anxiety severity scores increased 13% from August to December 2020 and then decreased 26.8% from December 2020 to June 2021. Similar increases and decreases occurred in depression severity scores.

The relative increases and decreases in frequency of reported symptoms of anxiety and depression at both the national and state levels mirrored the national weekly number of new COVID-19 cases during the same period.

An international group of clinicians and mental health experts recommends that during pandemics, delivery systems for mental health care be adapted to mitigate disparities in the provision of healthcare. Predicting and planning for fluctuations in demand for behavioral health services is often difficult; however, real-time monitoring of mental health symptoms can provide important information for responding to surges in the demand for mental health services during national emergencies. The observed differences in severity score magnitude and peaks across states in this study indicate that these efforts are important at both the national and state levels.

The increased frequency of reported symptoms of anxiety and depression in this study indicates that mental health services and resources, including telehealth behavioral services, are critical during the COVID-19 pandemic, particularly among populations disproportionately affected by COVID-19. National COVID-19 trends demonstrate that certain populations have been disproportionately affected by high COVID-19 incidence, which also suggests that these populations might be more vulnerable to the psychological consequences of COVID-19.

The mental health impact of COVID-19 also might have community-specific effects when morbidity and mortality rates are increasing as a result of COVID-19. Fluctuations in symptoms of anxiety and depression during the pandemic highlight the importance of real-time monitoring of mental health symptoms. Tracking these outcomes, including by demographic characteristics, can provide early indicators of potential increases in the demand for mental health services and for the health care providers needed to treat persons with clinically significant symptoms.

Mental health services and resources, including telehealth behavioral services, are critical during the COVID-19 pandemic.

Recent studies indicate an increase in the percentage of adults who reported clinically relevant symptoms of anxiety and depression during the COVID-19 pandemic. For example, based on U.S. Census Bureau Household Pulse Survey (HPS) data, CDC reported significant increases in symptoms of anxiety and depressive disorders among adults aged ≥18 years during August 19, 2020–February 1, 2021, with the largest increases among adults aged 18–29 years and among those with less than a high school education.

CDC release

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