Increases in poor mental health, mental distress, and depression symptoms among U.S. adults, 1993-2020

Across three nationally representative surveys (N = 9.2 million), U.S. adults reported increasingly poor mental health between 1993 and 2020. In the Behavioral Risk Factor Surveillance Survey, poor mental health days rose from 3 to 4 days per month, and from 3.55 to 6.02 days per month among young adults ages 18-25. Twice as many young adults spent half or more of their days in poor mental health in 2018-20 compared to 1993-99. Nearly all of the increase occurred before the COVID-19 pandemic began in 2020. In the National Health Interview Survey, 30% more young adults and prime-age adults (ages 26-49) reported moderate to high mental distress in 2017-18 compared to 1997-99. In the National Health and Nutrition Examination Survey, more than twice as many young adults, and 50% more prime-age and older (50 +) adults, fit criteria for moderate to severe depression in 2017-20 compared to 2006-07. The pronounced increase in mood disorder symptoms identified among adolescents has now moved up the age scale to younger adults.