Mental Health Index

U.S. Worker Edition – October 2020 Update

The Risk to Men’s Mental Health is on the Rise

Male Mental Health Risks Have Been Rising and are Nearing Levels at the Pandemic’s Onset

As the COVID-19 pandemic enters its ninth month, the U.S. workforce remains at significantly elevated risks for mental conditions, and their brain capacities continue to be negatively affected. Stress and anxiety levels are up 19% and 28% respectively over pre-COVID levels. Feelings of depression are up 32% since February and the ability to focus has decreased by 27% since September. In previous months, we’ve seen that the mental health of those aged 20-39 has been notably worse than older segments of the working population, and we’ve noted that women remained at greater risk than men. This month’s data, however, shows a troubling trend. The negative impact on men’s mental health is rising, and is now, in some cases, on par with or worse than that of women. Since the end of August, men’s risk of general anxiety disorder and depressive disorder is up 55% and 69% respectively. Also of note, men have seen a sharp increase in stress levels by 20% since August.

Best Case

Overall data suggests a continued adaptation to the increased strains brought on by COVID-19, with mental health risks holding steady and even improving slightly among women in some cases.

Worst Case

Worst: A deeper look into the data shows that while women are holding steady or improving, men’s mental health risks are rising and are nearing levels not seen since the onset of the pandemic.

Every Case

Every: In all cases, the risk of mental conditions, and the negative impact on workers’ brain capacities remains significantly elevated.

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

Risk Remains High for Mental Conditions, Men’s Mental Health is Worsening

Despite Stabilizing Overall, Risk for Anxiety and Depression Remains High


Risk for general anxiety disorder is 51% higher than pre-COVID.


Risk for depressive disorder is 65% higher than pre-COVID.

Men’s Mental Health is Increasingly at Risk


Since the end of August, men’s risk of general anxiety disorder has increased 55%.


Men’s risk of depressive disorder has increased 69% since August and is now worse than that of women for the first time since we began monitoring.

Stress and Negativity Rise in Men


Stress levels in men have increased 20% since August.


Males’ conscious negativity bias has increased 12% since August.

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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 Are Nearly Identical to Pre-Covid Levels

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 is Stable

Month after month, American workers have shown that the pandemic has had relatively little impact on their ability to perceive others’ emotions accurately. Emotional awareness is at the same level now as it was in February.*

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.

Negativity Remained Stable

Nonconscious negativity spiked between February and April. However, since May, negativity has been lessening gradually. Between September and October, nonconscious negativity bias showed no change among U.S. workers and remained at a level similar to the beginning of February.*

Emotions Remain Essentially the Same

For most working Americans, the brain capacities that relate to emotions (emotional awareness and nonconscious negativity bias) continue to hold steady. This is in contrast to the other capacities, which have been more volatile during the pandemic.

Among U.S. workers, emotional awareness has shown very little positive or negative swing since February. This is true across workers of different ages and genders. Working women continue to be able to more accurately read emotional cues than working men. Also, workers in the 20-39 and 40-59 age groups continue to rate higher in emotional awareness than workers age 60 and older, though that gap has closed a bit in October.

In recent months’ updates of the Mental Health Index, it was reported that negativity, which had been heightened for a period of time, had improved and was back to the pre-COVID level. This month, non-conscious negativity remained unchanged. This further confirms the previous report that the pandemic hasn’t delivered quite the same shock to Americans’ emotions that it has to other capacities.*

*This data changed directionally but does not reflect a statistically significant difference.

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 Remain Significantly Elevated Over Pre-COVID Levels

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. Stressors ranging from COVID-19’s impact on health and the economy, to clashes about mask mandates, crisis fatigue, and even tension related to the upcoming election are a few of the major stressors affecting us right now. When external stressors are not resolved, stress becomes chronic and leads to anxiety and depression. Watch to learn more.

Eight Consecutive Months of Elevated Stress

Increased stress continues to be the norm. U.S. workers have been experiencing elevated stress levels for eight straight months. Currently, U.S. workers are 19% more stressed than they were during the first week of February.

Stress Trending Upward in Men

Since August, stress among working men has increased 20%, and is now at the same level as that of working women.


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.

Lasting Elevated Anxiety Continues to Affect Workers

Anxiety climbed in the early part of 2020, peaked in April, and then declined for several months between May and August. However, since August, anxiety levels have been on the rise. Overall, American workers are 28% more anxious now than in early February.

Men Now as Anxious as Women

Since the start of September, men’s anxiety levels rose 26%, and are now up 41% over their early February levels. Further, while females had consistently exhibited higher anxiety levels than men, they ended October at the same level.

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.

Depressive Mood Stabilized in Women but Worsened in Men

Overall depressive mood remained unchanged from September to October, still 32% higher now vs. at the beginning of February. However, a closer look at the data shows men’s feelings of depression are trending up.

Feelings of Depressed Mood Are Increasing Among Men

From the beginning of August to the end of October, depressed mood rose 28% in working men and is now worse than it is in working women.

While Women’s Feeling Capacities Held Steady, Men’s Have Worsened

Overall, feeling capacities have remained relatively stable since June. However, a closer look at the data reveals that while working women have reflected the overall trend toward stabilization, men have not. Since August males saw stress increase 20%, anxiety increase 26% and depressed mood increase 28%.

It’s interesting to note that science literature suggests men and women tend toward two different styles of coping strategies. Men tend more towards problem-focused strategies, where they seek to solve the underlying problem causing their stress. Women, by contrast, tend more toward emotion-focused strategies, whereby they change their internal response to the stress. The problem-focused approach is often more successful (which may explain why women normally exhibit worse stress, anxiety and depressed mood scores), except when the source of the stress cannot be removed. In those instances, as with this COVID situation, the problem-focused approach fails. This may very well explain the trend we’ve been seeing among men, whose preferred method of coping may be failing them.

*This data changed directionally but does not reflect a statistically significant difference.

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 Takes Another Hit

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.

Memory Down 5% Month Over Month

Between September and October, memory fell 5% for U.S. workers and is now down 5% from where it was at the beginning of the pandemic.

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.

The Return from Summer Boost to Focus was Not Sustained

Mistakes were up and sustained attention dropped 27% from September to October.

Males and Younger Workers Took the Biggest Hit

From September to October, focus declined 76% among working men and 37% among those aged 20-39.


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 Unchanged Month Over Month

Planning showed no significant difference from September to October. However, planning capacity remains 8% lower than it was in February.

Cognition’s Impact is Something to Watch Going Forward

With stress, anxiety, and depressed mood continuing to weigh heavily on American workers, it’s not surprising that their cognitive capacities have begun to take a hit. There has been some fluctuation in that impact over the last several months, with last month’s moderate improvement in areas like focus likely driven by external factors such as the shift in mindset from a return to work after the summer months.

It will be interesting to see how the election season factors into next month’s data. U.S. worker’s ability to focus is already down 27% from September to October. With so much emphasis being placed on the results of the election, will U.S. workers find themselves even more distracted?

*This data changed directionally but does not reflect a statistically significant difference.

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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Self-Control Capacities Showed Little Movement During the Month of October

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 Remained…Well…Resilient

Resilience showed no significant difference month over month and remains relatively unchanged from its pre-pandemic level.

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.

Workers’ Negativity Remains Elevated

While there was no change month over month, worker’s negativity is up 14% since early February.

Negativity Has Increased in Men and Remains Highest in Younger Cohort

Male negativity increased 12% from the start of August to October, and workers age 20-39 remained significantly more negative than their older counterparts.

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. 

Maintaining Social Connectivity Remains Important to Workers

The Mental Health Index continues to show that maintaining social connections is a higher priority now than it was at the start of the pandemic. Overall, social connectivity among U.S. workers is up 6% since February.

Social Connectivity Bounced Back Among Older Workers in October

Following a decrease in September, social connectivity improved 11% in September among workers 60 and older. This is the only age group that saw social connectivity change significantly during the past month.

Conscious Negativity is on the Rise, Driven by Men

Looking at the self-control capacities, resilience and social connectivity remained relatively steady, showing no material change. Conscious negativity bias, however, has been increasing in men, up 12% from the start of August to October. This now puts men at about the same level as females for the first time since we began measuring.

With the COVID crisis far from over, and spikes in infections and deaths on the rise across the country, it’s likely that chronic stress will continue to drive U.S. workers’ negativity bias in the wrong direction.

*This data changed directionally but does not reflect a statistically significant difference.

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 Mental Conditions Remains Significantly Elevated

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 Creeping Up

After rising early during the pandemic and then eventually falling, the risk of addiction for working Americans was no higher in August than it was in February. That changed in September and October as the risk of addiction ticked upward again. While not yet statistically significant, the risk of addiction is 16% higher in October than it was in early February.*

Working Men Remain More at Risk of Addiction than Working Women

Men’s risk of addiction has been on the rise since August. Currently, men are 38% more at risk of addiction than women.*

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 Still Significantly Elevated Among Working Americans

While risk has decreased 38% since its peak in May, it remains 65% higher than February’s (pre-COVID) level.

Risk of Depression Is Rising for Men

Men’s risk of depression rose 69% from the end of August to October and is 154% higher now than it was in February, putting men at greater risk than women for the first time since we began measuring.

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 Holding Steady

The risk of general anxiety disorder in U.S. workers increased dramatically during the first few months of the pandemic. Since then, the risk has decreased a bit and stabilized. However, the overall risk of anxiety disorder remains 51% higher now compared to February.

Males’ Risk for General Anxiety Disorder Climbing

Risk for general anxiety disorder in men increased 55% from the end of August to October. Men are now tracking at 66% greater risk than they were in February.

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.

Risk of Social Anxiety Trending Up Again in October

For U.S. workers, the risk of social anxiety disorder trended up by 27%* between September and October and is now 40% higher than it was in February.

Younger Workers at Higher Risk of Social Anxiety Disorder

Since we began measuring, younger worker’s risk of social anxiety disorder has measured higher than that of their older counterparts. At the end of October, workers aged 20-39 are at 94% greater risk than those over 40.

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.

October Saw a Significant Increase in Risk of PTSD, Driven by a Spike in Men’s Risk

From September to October, risk of PTSD increased 36% and is now 47% higher than it was in early February before the pandemic began.

Men are Driving the Increased Risk

Between September and October, risk of PTSD rose 68% among working men, while working women showed no significant difference. In fact, men are now at 74% greater risk of PTSD than they were in February.

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.

Working Women Are More at Risk of Sleep Apnea than Before

Overall, while not statistically significant, the risk of sleep apnea is directionally up 17%*, with significant increases in female workers.

The Risk of Sleep Apnea is Rising Among Women

Since February, working women’s risk of sleep apnea has increased 155%. One reason for the greater risk of sleep apnea in women is that body mass index (BMI) has been increasing more in women. Higher BMI is a factor that increases the risk of sleep apnea. Since February, BMI has increased 7% among working women.

Risk for PTSD Increased, Anxiety and Depression Risks Remained Relatively Stable in October

The risk levels for several mental health conditions have followed a similar pattern during the pandemic. Risks rose immediately after the COVID-19 pandemic began and the shock and stress of the situation first set in. Then, a few months into the pandemic, as Americans started to adapt, risks began to fall. After a period of reasonable stability, albeit at elevated levels, we are starting to see the risk of some conditions trend upward again, particularly among men.

At the end of October, risk of depressive disorder was up 65%, risk of general anxiety disorder was up 51%, risk of social anxiety disorder was up 40% and risk of PTSD was up 47% since February. As the election and holiday seasons take hold and COVD-19 cases rise again, it will be interesting to see the impact on mental health metrics.

*This data changed directionally but does not reflect a statistically significant difference.

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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