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 to 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 to 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.