Mental Health Index

U.S. Worker Edition – August 2020 Update

The Sustained Negative Impact of COVID-19 on Mental Health Is Now Causing Chronic Issues for Working Americans

Updated Mental Health Data Reveals Issues Shifting from Acute to Chronic

The mental strain on working Americans rose sharply when the pandemic began. Now, mental health data is raising new concerns about the prolonged elevated levels of mental stress Americans have been experiencing. August marked six consecutive months of higher than normal mental health issues for workers in the U.S. The extreme increase in stress, anxiety, and feelings of depression that occurred early in the pandemic has receded somewhat during the past few months. Still, it remains significantly higher than pre-COVID. The fact that so many workers across the country are struggling with mental health issues that are now chronic vs. acute is raising alarms for businesses.

Best Case

Workers are gradually adapting to living and working under the strain of COVID-19.

Worst Case

Business performance is threatened due to widescale mental health issues across the American workforce moving from acute to chronic.

Every Case

In all cases, the burden of prolonged stress, anxiety, and feelings of depression is directly impacting workers’ productivity.

State of Mental Health Among Working Americans

Slight Improvements in Recent Months Haven’t Offered Reprieve from Chronic Mental Strain

Feeling Capacities Show Marginal Improvements


Anxiety decreased 16% in total between May and August.


Workers are experiencing 21% fewer depressive feelings since May.

Initial Mental Shock Subsides but Feelings Remain Chronically Impacted


Anxiety remains 23% higher than the February (pre-COVID) levels.


Despite an improvement in mood, feelings of depression remain 30% higher now vs. February.

Cognitive Areas Worsening Among Workers


Planning performance worsened 7% between June and August.


Focus is 31% worse today than February (pre-COVID) levels.

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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 core 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.

You Can Rewire Your Brain

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.

Learn How Total Brain Can Help

Total Brain measures the 12 brain capacities that define your mental health and screen 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.

Emotions Are Stable, Gradually Becoming Less 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 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 Unchanged Except in Workers Aged 40–59

Overall, since February, there has not been a change in how well American workers accurately perceive others’ emotions. From July to August, emotional awareness decreased very slightly (2%) in adults aged 40–59. Emotional awareness in this middle age group of workers is now just below where 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 Has Lessened Slightly in Workers Recently

After a period of heightened negativity, nonconscious negativity bias in American workers decreased 6% between May and August.

Youngest Workers Currently Less Negative

Nonconscious negativity improved 4% in younger adults (aged 20-39) between July and August. This was the first time an improvement was seen in this age group independent of other age groups. Workers aged 20–39 are 8% less negative vs. workers aged 40–59, and 20% less negative vs. workers aged 60+.

Working Americans’ Emotions Are Relatively Stable

Unlike some of the other brain capacities, the capacities that relate to emotions (emotional awareness and nonconscious negativity bias) are relatively stable for most working Americans.

For the average U.S. worker, neither emotional awareness nor nonconscious negativity is worse than it was before the pandemic began. One exception is among adults aged 40–59 — emotional awareness dipped very slightly last month in this group.

In some of the other capacities that are currently at or near the pre-COVID level, there was a greater range of upward or downward movement that eventually trended back to center. Negativity was heightened for a period; however, the pandemic hasn’t delivered quite the same shock to Americans’ emotions that it has to other capacities.

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.

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Despite Some Improvement, Workers Are Experiencing Chronic Stress, Anxiety, and 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. Stressors ranging from COVID-19’s impact on health and the economy, to clashes about mask mandates, and even crisis fatigue, are just 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.

Chronically Stressed Workers Showed Small Improvements Over Several Months

Stress has been improving little by little for the past few months. Between May and August, stress improved a total of 12%. However, American workers are still 13% more stressed now than they were during the first week of February.

Women Are Experiencing Greater Stress

While working men are experiencing about the same stress levels now as they were pre-COVD, working women continue to have elevated levels of stress. Women’s stress levels are currently 14% higher now than in February (pre-COVID).


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. Watch to learn more.

Anxiety Has Improved Incrementally, Still Up 23%

Between May and August, anxiety in working Americans decreased 16%. However, workers remain 23% more anxious now vs. in February.

Anxiety Is Highest in Women

Anxiety significantly decreased 20% in women but only 10% in men, whose COVID-related spike was also much smaller to begin with. Like with stress, women continue to have a higher anxiety level than men – compared to February, only women’s anxiety levels remain elevated with 23% more anxiety today than February.

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 Has Been Lifting Slightly in Recent Months

Depressive mood rose sharply from February through April. Then, depressive feelings began decreasing slightly each month for a total drop of 21% since May. Even with this improvement in mood, feelings of depression remain 30% higher now vs. in February.

Youngest and Middle-Aged Workers Are Most Down

Younger and middle-aged workers are the most chronically impacted: feelings of depressive mood are 31% higher since February in workers between 20-39, and 33% higher among those 40-59. Feelings of depressed mood in working adults age 60 has returned to pre-COVID levels.

August Marked a Milestone: Six Months of Elevated Mental Stress for Workers

When it comes to stress, anxiety, and depressed mood, the impact of COVID-19 is apparent. Yet, the news isn’t all doom and gloom. There have been small improvements in each of these areas in recent months. The gradual changes have led to 12% less stress, 16% less anxiety, and 21% fewer depressed feelings since May. Still, because these brain capacities were impacted so negatively at the start of the pandemic, workers continue to be struggling in all three of these areas more than they were pre-COVID.

Right now, one of the biggest concerns in terms of feeling capacities is that they may be leveling off, but at a much higher place than before. For example, depressive feelings skyrocketed, then fell again. Now they are sitting well above where they were in February. If feelings of depressed mood hover, and they don’t return to normal, these chronic issues will impact workers’ performance even more than they have.

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.

Listen Now

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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Chronic Mental Health Challenges Are Chipping Away at Cognition

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 Hasn’t Changed Significantly During the Pandemic

From July to August — there was no significant change in memory among all workers. Overall, memory is at virtually the same level as it was before the pandemic.

Memory Slipped Recently Among Older Workers

The 60+ age group is the exception when it comes to memory. In this age group, memory decreased 11% from July to August.

Focus: Sustained 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. Watch to learn more.

Poor Focus and Increased Mistakes Now a Chronic Problem

Focus decreased early during the pandemic with a sharp drop in February. Since then, there have been some short bursts of recovery, but workers’ focus has yet to return to its pre-pandemic level. Focus remains 31% lower than it was at the beginning of February.

Workers Age 20-39 Making Significantly More Mistakes

Focus is down most among workers 20-39 since February. This group is making 39% more mistakes since the beginning of February.

Working Men Making More Mistakes Than Working Women

While focus for working women has had no significant change since February, it’s a different story for working men.  Focus is down for men, who are making 51% more mistakes since the beginning of February.


Stress negatively affects 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 Is Still Dropping

Since June, planning has worsened by 7%, and it is currently 15% below where it was in February.

Planning Worsened Most in Youngest and Oldest Workers Recently

Since June, the ability to plan has been declining among working Americans.  Overall, panning performance decreased 7% from June to August. Since February, workers aged 20-39 have had a 30% decrease in planning performance, the largest decline out of all age groups. Despite this, planning remains 24% higher in those 20-39 vs. 40-59, and 51% higher in those 20-39 vs. 60+.

Sustained Stress and Anxiety Impacting Cognition

The negative impact of diminished cognition is fairly easy for businesses to quantify. Less focused employees, more mistakes, and reduced efficiency are a few of the side effects.

A snapshot of America’s workforce shows that two important areas of cognition continue to be reduced due to the pandemic: planning and sustained attention.

Overall, planning is 15% worse than it was in February. Focus, as measured by sustained attention, is 31% worse than it was in February.

Even a month or two of decreased cognition across a group of employees is both noticeable and disruptive to business. But COVID-19 is not shaping up to be a short-term distraction. Cognitive issues are a chronic problem among working Americans at this point.

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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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.

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Growing Resilience and Social Connectivity Pair with Lessening Negativity for Slight Self-Control Improvements

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.

U.S. Workers Are Maintaining Resilience

Resilience, which worsened some in March and April, has been improving in recent months. Overall, resilience increased 5% from May to August.

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 Lessened in Recent Months

From May to August, workers were 10% less negative. Conscious negativity does, however, remain 11% higher than February (pre-COVID) level.

Negativity Is Highest in Youngest Workers

At the end of August, conscious negativity was 25% higher in workers aged 20-39 vs. 40-59, and 30% higher in those aged 20-39 vs. 60+.

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. 

Workers’ Desire to Connect with Others Is Still Increasing

Maintaining connections with others has become more important during the pandemic as evidenced by the fact that social connectivity keeps rising. Social connectivity has risen 4% since May, and is up a total of 7% since February.

Recent Rise in Social Connectivity Among Older Workers

The biggest increase in social connectivity from July to August was in workers 60 and older. Social connectivity increased 7% among this group of workers during that time period.

Self Control Emerges as an Area of Strength

Data related to workers’ self control capacities reveals that resilience, conscious negativity, and social connectivity all trended toward improvement between May and August. While changes may have seemed insignificant from one month to the next, over several months the improvements were measurable. Resilience’s 5% increase, negativity’s 10% improvement, and social connectivity’s 4% rise since May serve as a positive sign for working Americans.

Most importantly, this movement means that both resilience has risen back to the same level and social connectivity are is slightly better now than at the start of the pandemic.

Negativity, however, is still higher than it was in February. The next few months should reveal whether negativity returns to its pre-COVID level, or settles into a higher-than-normal state like some other mental capacities.

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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Chronically Elevated Risk of Mental Disorder Persists, Lessens Somewhat

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 Back to Pre-COVID Level

The risk of addiction dropped 20% between May and August. Currently, the risk of addiction for workers is no higher than it was in February.

Risk of Addiction Higher for Workers Age 20-39

Younger people are at greater risk of addiction problems. Workers age 20-39 are 41% more at risk than 40-59 year-old workers, and have a 132% higher risk than 60+ workers.

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 Dropped 41% from May to August

The risk of depressive disorder among U.S. workers was reduced 41% between May and August. Still, risk of depression is 56% higher than February (pre-COVID) level.

Women Have a Higher Risk of Depression

At the end of August, risk of depression was 55% higher for women vs. men.

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. Watch to learn more.

Risk of General Anxiety Disorder Decreased 24% from May to August

The risk of general anxiety disorder in U.S. workers is not as high as it was earlier in the pandemic, but it also isn’t as low as it was pre-COVID. From May to August, risk of general anxiety disorder decreased 24% in total. Overall, risk is 45% higher than it was in February.

Anxiety Disorder Risk Is Consistently Higher in Women

Working women’s risk for general anxiety disorder is now 81% higher than working men’s risk.

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. Watch to learn more.

Workers Age 60+ See 603% Increase in Social Anxiety Disorder Since May

The number of workers in the 60 and older age group who flagged at risk for social anxiety disorder increased 603% from May to August.

Youngest Workers Most Susceptible to Social Anxiety Disorder

Workers in the 20-39 age group have a higher risk of social anxiety. Compared to workers 60+, adults who are 20-39 have a 110% greater risk of social anxiety. Also, workers aged 20-39 have a 196% higher risk of social anxiety disorder vs. workers aged 40-59.

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.

Number of Workers Screening At Risk of PTSD Is Declining

Risk of PTSD has fallen 20% since May. Still, the number of working Americans flagging at risk of PTSD remains 39% higher now vs. February.

More Women Flag At Risk of PTSD than Men

At the end of August, risk of PTSD was 62% higher for women vs. men.

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. Watch to learn more.

Sleep Apnea Risk Continues to Rise in Women

Women are showing significantly increased risks of sleep apnea. The risk of sleep apnea is 125% higher in women since February due to a corresponding significant increase in BMI, which is greatly increasing the risk of sleep apnea.

Risk for General Anxiety Disorder, Depressive Disorder, PTSD, and Addiction Dropped in August

Increased risks of mental health disorders have been reported since the COVID-19 pandemic began. After months of elevated risk, the worry is that COVID has made U.S. workers much more susceptible to mental disorders. The most recent mental health data indicates there are reasons to be both hopeful about improvements and concerned about current trends.

The risk of general anxiety disorder remains 45% higher, risk of depressive disorder is 56% higher, PTSD risk is 39% higher, and sleep apnea risk 125% for working women than in February.

The pandemic is going to continue for the foreseeable future. For now, it seems likely that August’s decrease in risk for some of the mental health disorders indicates that working Americans are adapting to the longevity of this unique situation. However, that doesn’t necessarily mean risks will continue to decrease. This is something we will need to watch and learn more about in the coming months.

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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