Mental Health Index

U.S. Worker Edition – May 2020 Update

Pandemic Continues to Impact the Mental Health of Working Americans

State of Mental Health Among Working Americans

Stress and Anxiety Remain Elevated, Risk for Depression Nearly Doubles

High Stress Levels


The average working American is experiencing a 28% increase in stress since the beginning of February.


U.S. workers aged 40-59 are being hit the hardest with stress levels increasing 39%.

Anxiety Remains Elevated


 Working adults continue to suffer from high anxiety, with levels up 47% across the board. 


U.S. workers aged 40-59 are most severely affected with anxiety levels up a whopping 75%.

Startling Increase in Depression Risk


The number of working Americans at risk of depressive disorders has nearly doubled since February.


Even more alarming — depression risk has more than doubled for working Americans aged 40-59.

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Your Total Brain

Your brain’s 85 billion highly interconnected neurons self-organize into four core systems — emotion, feeling, cognition and self-control. Each of these systems is measured by 12 key capacities, and they fluctuate continuously along a performance continuum from well-being to risk of a mental health condition such as depression, addiction, and ADHD.

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Listen to Total Brain Founder Dr. Evian Gordan and Professor Anthony Hannan, PhD, discuss how to rewire your brain to better manage emotions, stress and anxiety. Listen to Learn More.

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Mental Health Index

The Mental Health Index data is updated monthly so our workers’ mental health and capacity can be monitored as we muddle through these uncertain times. Explore this month’s findings by clicking through the key findings tabs. Learn more about our methodology.

American’s Emotions Continue to Trend Negative

Our emotions greatly influence all other brain capacities, which can also be impaired by mental conditions like depression, anxiety, and ADHD. Watch to Learn More

Emotional Awareness

Emotional awareness is key to building relationships and trust because it impacts how well we read emotional cues in others and helps determine how we act in uncertain situations.

Emotional Awareness Remains Intact

There has been no change in how well working Americans accurately perceive others’ emotions.

Nonconscious Negativity Bias

Nonconscious negativity bias is our natural intuition formed by life experiences. It strongly influences our feelings, motives and decisions. And, it determines how effectively we communicate and collaborate with others.

Subconscious Negativity is Worsening

Working Americans are 7% more negative under the surface. This equates to more snap judgements and an increase in gut instincts that “things are not quite right.”

Working Americans Experiencing Continuous Negative Thoughts and Feelings

At a subconscious level, working Americans’ feelings and perceptions are trending more negative since February.

If you consider how our brains work, an increase in nonconscious negativity during this pandemic makes sense. When the brain detects a threat, it triggers a response to keep us safe. Until the threat is resolved, we experience a heightened sense of fear and alarm.

We are currently stuck in a state of sustained threat response — our brains can’t resolve the COVID-19 threat, so our brains continuously fire threat response impulses that keep us feeling chronically alert and on edge. As a result, we experience ongoing negative thoughts and feelings.

PODCAST – How To Master Your Emotions

Listen to Total Brain Founder Dr. Evian Gordon’s podcast “How to Master Your Mind and Emotions During This Crazy Time,” where he talks about emotions with John Assaraf. Assaraf is one of the world’s leading behavioral experts. He has written two New York Times bestselling books and appeared on Larry King Live, Anderson Cooper and The Ellen DeGeneres Show.

Listen Now

Heightened Levels of Stress, Anxiety, Depressive Mood

Feelings are your conscious awareness of, and body’s response to, your unconscious emotions. For example, when you’re feeling stressed or anxious, your body will respond with changes in heart rate, breathing, muscle tension, and sweating. Feelings are triggered by emotions, and emotions are triggered by cues of threat or reward. Watch to Learn More


Stress is a response to an external “stressor” such as a work deadline, an argument with a loved one, the loss of a job, or a major life change. Right now two major stressors are affecting all of us: COVID-19 and its negative impact on the economy. When external stressors aren’t resolved, stress becomes chronic and leads to anxiety and depression.

Working Americans 28% More Stressed

Stress levels of working Americans have increased 28% since the first week of February, peaking at a 38% increase in early April 2020

Middle Aged Working Americans Hit Hardest

Stress levels of U.S. workers aged 40-59 have increased 39% since February, peaking at a 52% increase in early April 2020.


Anxiety is your internal reaction to stress. It is often accompanied by persistent worrying and fearing something bad will happen. Unlike stress, anxiety persists even after the stressor has been resolved. In severe cases, anxiety can lead to an anxiety disorder.

Anxiety Levels Up 47%

Anxiety levels among working Americans have increased 47% since February, peaking at a 54% increase in early April 2020.

Anxiety Hitting Working Women Harder than Working Men

Anxiety levels have increased 52% among working women, and 29% for working men since February 2020.

Depressive Mood Level

Feeling sadness, frustration, anger, loneliness, or grief often make up what is considered “depressive mood.”  These feelings, however, lift after a few days or weeks. When these feelings persist over time, you can become clinically depressed.

U.S. Workers Feeling Increasingly Gloomy  

Feelings of depressive mood increased 64% between February and May, showing a steady increase.

Working Women More Weary Than Working Men

Feelings of depressive mood increased 78% among working Americans aged 40-59.

Middle Aged Working Americans in Greatest Despair

Feelings of depressive mood continue to increase, with a peak 86% among working Americans aged 40-59 in May 2020.

Working Americans Experience Startling Levels of  Stress and Anxiety, Depressive Mood Continues to Rise

At the peak of the COVID-19 pandemic in mid-April, the Mental Health Index measured an overall 38 percent increase in feelings of stress and a 54 percent increase in anxiety. By the end of May, both had decreased slightly but still remained substantially elevated compared to the baseline, with a 28 percent increase in stress and 47 percent increase in anxiety.

Feelings of depressive mood increased 64% between February and May, showing a steady increase. 

All three capacities — stress, anxiety and depressive mood — increased from February through May for both males and females, but this increase has been significantly greater in females. 

In our results, we see a complete hijacking of the non-conscious brain by stress, fear and uncertainty. All of us live in two states of the brain all the time: fight-or-flight (the stress response) versus the ‘calm-flexible’ part of the brain driven by the vagus nerve. The fight-or-flight response is wired into us to keep us safe and is useful in getting us out of danger. It pumps adrenaline, increases our blood pressure and quickens our breathing. But if it stays on for too long, it has enormously damaging effects.

Not surprisingly many of those effects take a direct hit on employee performance, as documented over decades of research on stress and anxiety in the workplace.

PODCAST – Anxiety: It’s Trying to Teach Us Something

Listen to Total Brain Founder Dr. Evian Gordon’s podcast “What Can People with Anxiety Teach Us?” with Dr. Heidi Hanna PhD. They discuss how feeling anxious is a normal part of a healthy life and how to practice stillness.

Listen Now

U.S. Workers Aged 40+ Beginning to Lose Focus, Make More Mistakes

Your cognitive capacity determines how well you learn, remember, pay attention and solve problems. It impacts how quickly you can complete tasks and how many mistakes you make while doing so. Chronic stress and anxiety can result in cognitive decline over time. Watch to Learn More


Stress and anxiety can hinder the way we form and retrieve memories. It can make you more forgetful. For example, you may find yourself forgetting where you left your phone, or have a hard time recalling names.

Middle-Aged Working Americans More Forgetful in Wake of COVID-19

Overall, there has been no memory change in U.S. workers since February 2020. However, for working Americans aged 40-59, the ability to recall information has worsened by 7%.

Focus: Controlled Attention

Increased levels of stress not only cause us to become more irritable, but also impact our ability to focus. For example, it’s common for stress to cause people to make more mistakes.

Highly Stressed Middle-Aged Workers Making 42% More Mistakes

Focus is down 32% overall, and middle-aged adults aged 40-59 are making 42% more mistakes in the wake of COVID-19.


Stress negatively affects your ability to plan and complete tasks on time.  When you’re stressed, your concentration levels decline and the amount of time it takes you to complete tasks increases.

Dramatic Drop in Productivity Across the Nation

Heightened levels of stress take a toll on productivity. Overall, it’s taking U.S. workers 8% longer to complete tasks, with a peak of 15% in early April 2020. Younger adults (aged 20-39) are most challenged in this area — requiring 20% more time to complete tasks.

Stress, Anxiety Have Cascading Impacts on Cognition

Chronic stress and anxiety have a downstream impact on cognition.  We’re already beginning to see slight cognitive decline. The longer U.S. workers endure higher than usual levels of stress and anxiety, the more likely cognition will continue to decline. 

When the brain gets stuck in fight-or-flight mode, with high levels of stress and anxiety, its energy goes toward short-term, survivalist thinking. That compromises the brain’s capacity for higher-level, intense reasoning, planning and innovating. 

That outcome was verified in the Mental Health Index data, which showed drops in cognitive factors like memory and focus, which causes people to make more mistakes. In both these areas, middle-aged respondents performed the poorest: a 7 percent drop in memory (i.e., fewer correct responses) and a 42 percent drop in focus (i.e., more false miss errors).

We anticipate cascading impacts to include further negative impacts on memory and reduced focus and sustained attention. When we’re anxious and afraid, we experience difficulty completing complex tasks. 

As a result, companies across the nation may continue to see a decrease in productivity. Employees may have difficulty concentrating; take longer to complete tasks; have difficulty thinking, reasoning, and deciding; put off challenging work and have difficulty juggling tasks or responsibilities.

PODCAST – Change Your Life with Darwin’s Thinking System

Listen to Total Brain Founder Dr. Evian Gordon’s podcast “Charles Darwin’s Golden Rule,” with Chris Darwin, a great, great grandson of Charles Darwin. They discuss the importance of challenging your biases and considering various options to the problems you’re facing.

Listen Now

Working Americans’ Negativity Spikes, Resilience on the Decline

Our ability to control our behavior enables us to achieve goals, resist temptation, avoid acting on impulse, and maintain our mental and physical health. When under high levels of stress, people tend to become more negative and less resilient.  As a result, they may lose the ability to self-regulate their behavior, which leads to a myriad of problems, including obesity, addiction, poor financial decisions, sexual infidelity, and more. Watch to Learn More


Resilience allows us to bounce back when something bad happens. It’s the ability to adapt in the face of adversity, trauma, tragedy, or other significant sources of stress. Resilience can drop quickly after an emotionally distressing event or a particularly stressful period in life.

U.S. Workers’ Resilience is Declining

U.S. workers’ resilience has declined 4% since February 2020, a percentage point better since our last report, which was at a 5% decline in resilience.

Conscious Negativity Bias

Conscious negativity bias – the tendency to see the “cup half empty” rather than the “cup half full” – can rise in times of uncertainty and discouragement. It’s a disproportionate focus on problems rather than opportunity. And, it’s highly contagious. That’s why one very negative person can disrupt an entire group or team.

Working Americans’ 23% More Negative in Wake of COVID-19

U.S. workers’ outlook trends negative. Across the nation, negativity has increased 23% since February 2020.

Working Women Exhibiting Significantly More Negativity than Working Men

Working women are 27% more negative and working men are 14% more negative since February 2020.

Social Connectivity

Social connectivity reflects the extent to which people proactively seek and gain enjoyment from social interaction.

The Desire to Connect with Others Increases During Pandemic

Social connectivity scores have increased 3% since February 2020, with a peak 6% increase in March and through April. 

U.S. Workers’ Resilience Dwindling, Negativity on the Rise

Because the current crisis has removed many of our coping strategies and interfered with positive self-talk, resilience has already declined by four percent. We may see resilience continue to decline in the coming months as the pandemic continues to take its toll.

Conscious negativity bias is rising dramatically, leaving U.S. workers feeling a sense of despair. This may become more pronounced for those whose “input,” such as the media and messages they see, hear, and absorb each day, leans more negative than positive. As a result, working Americans are becoming more irritable, less patient and not as cooperative.   

As our relationships with family members, neighbors and even fellow citizens experience unusual pressures, we can expect to see Americans’ outlook continue to trend to the negative. 

So far, social connectivity scores have increased slightly. This increase may reflect a growing appreciation of social connection, at a time when many are still physically isolated. Currently, individuals seem to be initiating remote social contact with their friends and colleagues. However, social isolation can contribute substantially to depressive feelings, sadness and hopelessness, having a detrimental impact on mental well-being. Social connectivity scores could possibly take a turn for the worse over time. This is one to watch. 

PODCAST – COVID-19 Captivity: Social Connectivity During Pandemic

Listen to Total Brain Founder Dr. Evian Gordon’s podcast “Social Connectivity in the COVID-19 Era,” with Dr. Shelley Carson PhD, a Harvard-trained psychologist. They discuss why social connectivity and social support is important for stress mastery, especially during these uncertain times.

Listen Now

Risk of Mental Disorders Doubles During Pandemic

Significantly more working Americans are screening positive for risk of mental disorders during this time of fear and uncertainty.


When chemicals from drugs or alcohol hit the brain’s reward receptors in bursts, it triggers a response similar to a highly pleasurable event. As the person repeats and increases substance use, the receptors degrade to the point that they cannot respond to un-intoxicated pleasure in the same way as they once did. The brain gets re-mapped to seek pleasure through intoxication rather than healthier activities, and as this new mapping takes hold, addiction is born. Watch to Learn More

Risk for Addiction Tripled for U.S. Workers Age 60+

Risk of addiction is up 25% across age groups, and has more than tripled for working Americans aged 60 and older (208% increase).

Depressive Disorder

Depression is more than a bout with the blues. When feelings of sadness and hopelessness persist and worsen, you may be clinically depressed. Some people are predisposed to depression based on genetics and the brain’s chemical makeup.Chronic stressful life situations can also increase the risk of developing depression if you aren’t coping well.

Risk for Depression Increases at Alarming Rates

The risk for depression more than doubled among U.S. workers aged 20-39 (113% increase) and aged 60 and older (179% increase) and more than tripled for those aged 40-59 (212% increase).

Working Women’s Depression Risk Outpaces Working Men’s Risk

Working women’s risk for depression has increased 177%, while working men’s risk increased 134% since February 2020. 

General Anxiety Disorder

Persistent and excessive worry are common indicators of general anxiety disorder. People with this condition find it difficult to control their worry and don’t know how to stop the worry cycle.  As a result, they overthink, lose sleep, and agonize more than seems warranted for the situation. Stress is a common trigger for anxiety and if it becomes chronic it can lead to an anxiety disorder.

General Anxiety Disorder Rising a Disconcerting Rates

Working Americans’ risk for general anxiety disorder has nearly doubled (91% increase). Middle-aged U.S. workers aged 40-59 have been hit the hardest with risk increasing 153% from February through May, with a peak 207% increase in April. 

Working Women Currently at Greater Risk for General Anxiety Disorder

Working women are most severely affected, with risk for general anxiety disorder increasing 98%, while working men’s risk increased 67% since February 2020.


Social Anxiety Disorder

People who have social anxiety disorder have intense fear of being judged negatively or rejected in social situations. They often worry about being perceived as stupid, awkward, or boring. It can significantly impact their ability to socialize and communicate with other people.

Risk for Social Anxiety Disorder Heightened Among U.S. Workers

The number of working Americans screening positive for social anxiety disorder has increased 55% between February and May 2020, with a peak 80% increase in late April.

Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a traumatic event. Most people who experience a distressing event may temporarily have trouble coping. However, they get through it with time and self-care. When symptoms persist for months and years, interfering with daily life, you may have PTSD.

Risk for PTSD Alarmingly High During Pandemic

The number of American adults flagging positive for PTSD has increased 73% from February through May, peaking at 86% in early April 2020. Adults aged 40-59 are being hit the hardest with an 83% increase in risk for PTSD.

 Working Men at Greater Risk for PTSD

Working men are most severely affected, with risk for PTSD increasing 89%, while working women’s risk increased 47% since February 2020.

Sleep Apnea

Stress and anxiety may cause sleeping problems. And, having an anxiety disorder compounds the problem. Sleep apnea is a condition in which breathing repeatedly stops and starts while sleeping.

Sleep Apnea Remains Unchanged

There has been no change in the percent of working Americans screening positive for sleep apnea since February 2020.

Mental Health Conditions Increase at Disconcerting Rates During Pandemic

Stress levels among Americans have risen dramatically in the months since the onset of the COVID-19 pandemic. Not only are people isolated from loved ones and fearful of getting sick, but many are trying to adapt to working from home – or not working at all — homeschooling their children and caring for elderly loved ones from afar. Recently, these emotions were compounded by the news and protests stemming from George Floyd’s tragic death, along with other race-related incidents. We are a nation in crisis in many ways, and our mental health is suffering the consequences.


These factors, in turn, appear to be contributing to a higher risk for mental disorders. 


Depression rates have more than doubled for working Americans. Middle-aged adults (aged 40-59) are particularly at-risk for depression. Shelter in place mandates are compounding the problem — people become isolated and interactions with caregivers and loved ones are limited, which can lead to increased feelings of loneliness, fear and uncertainty. 


U.S. workers are also suffering from high levels of chronic anxiety, with risk for general anxiety disorder nearly doubling since February.  


Substance abuse and addiction are also on the rise, particularly among U.S. workers age 60 and older. For those who struggle with addiction, COVID-19 has produced the perfect storm of dangerous conditions. Stress and anxiety, combined with isolation and an interruption of healthy coping strategies, together have created a trigger-rich environment for overuse and relapse.


Additionally, working Americans have not been able to rely on their usual strategies or methods to cope with temptations, such as in-person support groups, exercise clubs or even accountability networks like friends and co-workers. Working from home week after week, unsupervised and loosely managed, people have more opportunities to overindulge. These factors make recovering addicts and other substance abusers extremely vulnerable to problematic substance use.


While the risk for PTSD is high right now, the numbers are potentially indicative of past traumas. The fear and anxiety people are feeling in the midst of the pandemic is likely surfacing unresolved feelings from previous distressing events.  It’s too soon for anyone to have been diagnosed with PTSD as a result of the pandemic. However, it’s possible we will see PTSD diagnoses in the future. This is one to watch. 

PODCAST – Depression Prevalent and Growing in America

Listen to Total Brain Founder Dr. Evian Gordon’s podcast “What Can People with Depression Teach Us?” with Dr. David Whitehouse MD, PhD. Depression is excessively prevalent and growing in our society. They discuss how to maximize the functioning of our brain and minimize the threat of depression.

Listen Now

PODCAST – Addiction During the Pandemic

Listen to Total Brain Founder Dr. Evian Gordon’s podcast “The Hurricane of Addiction,” with Dr. David Whitehouse MD, PhD. They discuss how easy it is to fall under the power of addiction — especially during these uncertain times — while addressing how to restore and reconnect your brain pathways to survive.

Listen Now