Mental Health Index

U.S. Worker Edition – November 2020 Update

Risk of Addiction is Steadily Rising Among Working Women, Men’s Resilience Is Down

Rising Risk of Addiction in Women Suggests Working Females Are Coping with the Pandemic in Unhealthy Ways

November marks another month of elevated stress, anxiety, depressed mood, and negativity among American workers. And this month’s Mental Health Index shows that women are finding it difficult to cope with the weight of the pandemic. In fact, they may be turning to substances in an attempt to cope. Between the start of September and November, women’s risk of addiction increased 65%. Depressed mood continues to be elevated in women—it is now 40% higher than before COVID-19. Also, women’s risk of sleep apnea is up 126% vs. February. The result? Physical and mental exhaustion. As these factors combine, it is creating an unhealthy scenario for women as they try to deal with stress, anxiety, and negative feelings brought on by the pandemic.

Men continue to battle mental health issues as well. Making it particularly difficult is the fact that men’s resilience has decreased.

Best Case

There is some indication that mental capacities may begin to show improvement now that the November elections have passed.

Worst Case

Because stress, anxiety, depressed mood, and negativity have been elevated, concerns are high that working Americans may find the strain of the always taxing holiday season harder to cope with this year.

Every Case

In all cases, businesses will see their workers continue to be impacted by COVID-induced stress, anxiety, feelings of depression and negativity in the final month of 2020.

Don’t miss our monthly webinars where industry thought leaders gather to review the latest Mental Health Index data and discuss the mental health of working Americans.

State of Mental Health Among Working Americans

Many Areas of Mental Health Have Worsened During the Pandemic, New Strains Since August

Workers Suffering More from Stress and Negativity During the Past Few Months


Recent wave puts stress up since August, overall 16% increase in stress since February.


Conscious negativity is up since February, with a 6% increase just since August.

Men’s Issues Spiked Around U.S. Election


Increase in men’s anxiety since early September, peaked in early November.


Stress increased among working men from the start of August to the start of November.

Mental Health Challenges Are Driving Up Addiction Risk in Women


Depressed mood has risen among women since February.


Increase in women’s addiction risk from start of September to end of November.

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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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Total Brain measures the 12 brain capacities that define your mental health and screens for your risk of common mental conditions. Contact us to learn how Total Brain can help improve the mental health and wellness of your employees.

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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.

Emotional Capacities Have Improved in Recent Months

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 helps us build relationships and trust. It impacts how well we read emotional cues in others and informs our behavior in uncertain situations.

Emotional Awareness Has Slowly Risen Since June

Unlike many other mental capacities, emotional awareness has not shown dramatic positive or negative changes during the pandemic. Although, recently, there has been a gradual uptick in workers’ ability to perceive others’ emotions accurately. Since June, emotional awareness has increased by 2%.

Working Men Are Showing Improved Emotional Awareness

During the past month, emotional awareness increased 3% among males.

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. Watch to learn more.

Nonconscious Negativity in Workers Is Lower Now vs. February

Nonconscious negativity spiked between February and April. But a 12% drop in negativity since May means that working Americans are now 6% less negative than they were at the beginning of February.

Emotional Awareness Trends Offer Insights into the State of Workers’ Emotions

Some interesting trends have emerged recently related to workers’ emotional capacities. One notable trend is that working Americans’ ability to accurately read others’ emotional cues is increasing.

Since June, working Americans’ emotional awareness has been increasing little by little. Emotional awareness among men bumped up another 3% over the past month.

The increased ability to recognize certain emotions in the faces of other people provides insight into the emotions Americans, themselves, are feeling. Research shows that if a person is experiencing a strong emotional state, their brain can more accurately pick out that emotion in the facial cues of others. This is because the emotion resonates with them. In other words, individuals who are happy are better at identifying happiness, while individuals who are sad can often correctly recognize sadness in others.

The Mental Health Index shows that anger recognition is up 7% in men, while women’s ability to recognize disgust has increased 8%. The takeaway is that men, themselves, are likely experiencing more anger while women are experiencing elevated levels of disgust.

PODCAST – How Emotions and Feelings Drive You

Total Brain’s Founder, Dr. Evian Gordon, is joined by Dr. David Whitehouse for this podcast about the science behind emotions, feelings, and how they impact us all.

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PODCAST – How to Deal with Negativity in the COVID Era

Listen as Total Brain’s Dr. Evian Gordon talks with Christopher Darwin and Dr. David Whitehouse about ways to successfully manage negativity during the pandemic.

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Stress, Anxiety, and Depressive Mood Increased Measurably in Early November

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. COVID-19’s impact on health and the economy is a substantial stressor right now. Also, the November election was a clear stressor. When external stressors are not resolved, stress becomes chronic and leads to anxiety and depression. Watch to learn more.

Stress Increased Steadily Between Early August and Early November

Following a sharp rise at the start of the pandemic, and a subsequent dip, American workers experienced a second wave of increasing stress again recently. From the beginning of August to the beginning of November, stress increased 15%. Currently, U.S. workers are 16% more stressed than they were during the first week of February.

Working Men Continue to Show Elevated Stress

Among working men, stress increased 19% from the start of August to the start of November. Men’s stress made a downward turn in November after the elections in the U.S., yet it remains 13% higher now vs. August. Whether stress will rise or fall in working men in the coming months is something to continue to watch.


Anxiety is the 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. Watch to learn more.

Anxiety Spiked Again in Early November

Anxiety has been elevated since the beginning of the pandemic, and it was particularly high in early November. American workers are 26% more anxious now than they were in February. Workers in the 40-59 age group are 30% more anxious now vs. in February.

Anxiety in Working Men Hit Its Highest Point of the Pandemic in Early November

Among working men, anxiety rose in early November to the highest point of the pandemic. This marked a 39% increase from September to peak. After the apex near the beginning of November, anxiety among working men turned downward.

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. Watch to learn more.

For U.S. Workers, Depressed Mood Is Still Higher Than Before the Pandemic

Depressed mood in working Americans remained about the same between October and November. In other words, depressive mood continues to be substantially elevated. Feelings of depressed mood are 33% higher than they were at the beginning of February.

Depressive Mood Is Up 40% Among Women, Continues to Climb in Men

Since February, depressed mood has risen among women by 40%. Recently, there has been a steady increase in depressed mood among men. Depressed mood increased 29% between the start of August and the beginning of November.

Stress, Anxiety, and Depressed Mood Spiked Amid U.S. Elections

Analysis of workers’ stress, anxiety, and depressed mood shows there was a clear increase around the time of the November elections in the U.S. All three brain capacities were higher during the first part of November than in recent months. The first measure of these three capacities following the election showed they all trended in the direction of improvement post-election.

The rise and fall of stress, anxiety, and depressed mood during and after the election was particularly apparent among working men. This aligns with scientific findings that show men tend to respond to stressors with problem-focused strategies, and therefore stress resolves for men when a problem is “solved.” In this case, the problem was the election, and stress began to fall among men when the election ended.

PODCAST – Modifying Your Reaction to Stress Can Improve Your Mental Health

Listen to Total Brain Founder Dr. Evian Gordon’s podcast “The Role of Stress in Mental Health” with Dr David Whitehouse MD. PhD. Dr. Whitehouse shares how stress damages mental health and how you can reframe your reaction to stress.

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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.

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Workers’ Cognition is Near or At Where it Was Before COVID-19

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. Watch to learn more.

No Significant Changes to Memory in November

Despite stress and anxiety being higher now vs. before COVID, memory is mostly unchanged. Workers’ memory capacity trended slightly higher (4%) for U.S. workers in November. But, overall, working Americans’ memory is not significantly different now vs. at the beginning of the pandemic—meaning workers are able to remember things correctly as well now as they could in February.

Focus: Sustained Attention

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

Workers’ Ability to Focus Returned to Pre-COVID Level

In November, working Americans demonstrated an ability to focus and complete tasks at around the same level as before COVID-19.

After a Large Drop in October, Men’s Focus Improved Somewhat in November

Men’s focus plummeted in October, but reset in November. Between October and November, men’s focus improved by 34%. As a result, focus is not significantly different from where it was in February for either men or women.


Stress can negatively affect your ability to plan and complete tasks on time. When you’re stressed, concentration declines and the amount of time it takes you to complete tasks increases. Watch to learn more.

Planning Capacity Improved in November

Planning, once again, showed some improvement during the past month. Between October and November, planning improved 10%, putting this capacity back in the range of where it was in February.

Overall Improved Planning Influenced by Better Planning in Men

The improvement in planning among American workers was driven by working men. Planning was 14% better for men in November vs. October. The 60+ cohort is the only group to not show an improvement in planning during the past month.

Cognition Has Recalibrated for Now

During the course of the pandemic, cognitive capacities in American workers have fluctuated. Cognitive abilities have certainly been impacted by the mental strain caused by COVID, and by elevated levels of stress, anxiety, and depressed mood. Shifts in these areas and workers’ efforts to adapt have caused cognition to bounce around slightly. So have outside factors such as mindset and behavior changes during the summer, and distractions up to and during the November election.

For now, cognition is at or near where it was in February. However, based on cognition’s tracked movement in 2020, we can expect to see cognition continue to be swayed by new developments related to the pandemic, and by other outside influences.

PODCAST – Learn How Your Brain Works to Improve Your Performance

Listen to Total Brain Founder Dr. Evian Gordon’s podcast “The Brain — From Knowing to Doing,” with Chris Darwin, a great, great grandson of Charles Darwin. They discuss 5 concepts that impact how you process information and your ability to be a peak performer.

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Workers’ Negativity Remains Elevated, Resilience in Men Takes a Dive

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. Watch to learn more.

Resilience Held Steady in November, Has Fallen Among Men

Overall resilience remained unchanged last month. As of November, American workers’ resilience is about the same as it was before the pandemic began. One exception in resilience in working men. Resilience dropped 6% in males since August, and is now 5% lower than it was in February.

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.

No New Change in Conscious Negativity, Workers Remain More Negative than Normal

From October to November there was no change in the conscious negativity level of working Americans as a whole. However, negativity continues to be higher than it was before the pandemic — up 14% over February. Among working men, conscious negativity is 10% higher than it was even at the start of August.

Oldest Cohort of Working Americans Is the Least Negative

The only age group that is not currently showing a significant increase in negativity is workers age 60+. Negativity is up 11% vs. February in workers age 20-39, and is 18% higher among those 40-59. The youngest cohort has the highest conscious negativity level. Negativity among those 20-39 is 16% higher than workers 40-59, and 31% higher than the 60+ group.

Social Connectivity

Social connectivity reflects the extent to which people proactively seek and gain enjoyment from social interaction. Social connection plays a powerful role in supporting our mental and physical health. Watch to learn more. 

While there was no change in social connectivity between October and November, maintaining social connections continues to be a high priority during the pandemic. Social connectivity among U.S. workers remains 6% higher now than it was in February.

Social Connectivity is Higher Among Women than Men

As of November, social connectivity among working women had increased 5% compared to where it was in February. However, there hasn’t been a significant increase in working men since February. When comparing social connectivity between women and men, the Mental Health Index shows that working women have a 10% higher rate of social connectivity vs. working men.

Decreased Resilience in Men and Ongoing Elevated Negativity Are Compounding Mental Health Challenges for Working Americans

In both October and November, the Mental Health Index has highlighted multiple threats to working men’s mental health. Decreased resilience is one example. From the beginning of August to November, resilience has decreased among working men by 6%. As men become less resilient, they are also struggling in other mental capacities. Therefore, it isn’t surprising that men’s stress and conscious negativity have both risen in recent months.

Conscious negativity is also elevated in women. Women are currently 12% more negative now vs. in February. This negativity is likely related to the recent rise in addiction among working women.

The pandemic is far from over, however, positive reports show that a vaccine may become widely available in the near future. In theory, this development may help curb some of the negativity in U.S. workers. This will be something to watch in the coming months.

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.

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Risk of Addiction Surges Among Women, Risk of Other Mental Conditions Remains Higher than Normal

COVID-19 is causing more Americans to screen at risk for certain mental disorders compared to before the pandemic.


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.

Addiction Risk Among Workers Climbed 28% Between September and November

The risk of addiction increased dramatically at the start of the pandemic, but later risk decreased for several months in a row. The risk of addiction began trending upward again in September. That has led to a 28% increase in addiction risk from the start of September to a peak at the beginning of November.

Women’s Risk of Addiction Surged 65% in Three Months

When risk of addiction began climbing in September, men appeared to be most impacted. However, the risk of addiction among women also started to climb during the past few months. There has been a 65% increase in women’s risk of addiction from the start of September to the end of November.

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. Watch to learn more.

Risk of Depression Remains Elevated Among Working Americans

The risk of depression climbed steadily between February and May but has since dropped down considerably. A second smaller spike happened between September and November. Currently, the risk of depression remains 66% higher now vs. in February.

Risk of Depression in Men Rose During the Lead Up to the Election

There was a 69% increase in men’s risk of depression from August to early November. After peaking in early November, the risk of depression in men showed signs of decline. The timing of this peak and downward shift corresponded with the November election, just like many of the other trends related to men’s mental health reported in this month’s Mental Health Index.

General Anxiety Disorder

Persistent and excessive worry are common indicators of general anxiety disorder. People with this condition have an inappropriate triggering of the fight-flight stress system that can make it difficult to control worrying or 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. Watch to learn more.

Risk of General Anxiety Disorder Unchanged Month Over Month

There was not a significant difference in U.S. workers’ risk of general anxiety disorder from October to November. However, there remains a trend level increase of 38% from February to November for general anxiety disorder in working Americans.

Risk Is Highest in Youngest Workers, Risk Has Increased Most in Middle Age Workers

Over the course of the pandemic, risk of general anxiety disorder has risen most among workers age 40-59. Risk increased 103% in this group between February and November. Still, the risk for general anxiety disorder is 57% higher in workers between the ages of 20-39 vs. those 40-59.

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 your ability to socialize and communicate with other people. Watch to learn more.

No Significant Difference in Risk of Social Anxiety

There was no significant change in the risk of social anxiety during the month of November. Also, there is no longer a statistically significant difference in the risk of social anxiety disorder since February for workers in the U.S.

Social Anxiety Disorder Trending Upward in Men

At a trend level, men’s risk of social anxiety disorder is up 68% since February.

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. Watch to learn more.

Risk of PTSD Hit a Peak in Early November

The risk of PTSD has been elevated since the beginning of the pandemic. Currently, workers’ risk of PTSD is 47% higher than it was in February. After some fluctuation, risk of PTSD, like several of the brain capacities, started increasing in September. It followed the pattern of other capacities and peaked in early November. Between late September and early November, risk of PTSD rose 55% among American workers.

Men Have Been Flagging at Risk of PTSD at an Exceptionally High Rate Since September

From the end of September to the early part of November, men’s risk of PTSD increased 124%.

Sleep Apnea

Stress and anxiety may cause sleeping problems. Having an anxiety disorder compounds the problem. Sleep apnea is a condition in which breathing repeatedly stops and starts while sleeping. Watch to learn more.

Risk of Sleep Apnea Decreased Slightly in November

Overall, there was no significant change in the risk of sleep apnea from October to November. However, November marked another month of increased risk of sleep apnea in women.

Risk of Sleep Apnea Remains Elevated in Women

Working women’s risk of sleep apnea was 126% higher in November vs. February. Because sleep is so important to brain health, the rising risk of sleep apnea and poorer quality of sleep women are getting is likely impacting mental and physical health.

Increased Risk of Addiction Part of a Concerning Trend for Women’s Mental Health

Women’s risk of addiction increased 65% from the start of September to the end of November. Alone, this increase is troubling. However, it is even more concerning because women’s increased risk of addiction appears to be interconnected with several other factors that are detrimental to women’s health. For example, the sizable increase in women’s risk of addiction, paired with women’s elevated feelings of depressed mood (40%) indicates that women are struggling to find healthy ways to cope with the strain of the pandemic.

In terms of men’s risk for mental health disorders, next month’s data will be particularly telling. Some of the disorders in which men’s risk had been rising for months, such as depressive disorder and PTSD, appeared higher at the start of November and lower later in the month. This could potentially signal that risk peaked in these areas and is going to begin to decrease. However, it is too early to know for certain which direction these areas of risk will take. We will be keeping a close watch on this next month. Stay tuned.

PODCAST – Genetic Information is a Roadmap that Can Teach Us How to Improve Mental Health

Listen to Total Brain Founder Dr. Evian Gordon’s podcast “How Genetic Brain Information Can Empower You,” with Anu Acharya BSc MSc MS. The podcast touches on how our genes impact our disease disposition, and it explores why understanding our genetics and knowing ourselves better can lead to improved mental health and performance.

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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.

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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.

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