Mental Health Index

U.S. Worker Edition – January 2021 Update

2021 Begins with Workers Getting Some Needed Mental Relief, Stress Drops to Pre-COVID Level for First Time During Pandemic

Mental Health Made Unforeseen Gains in January

Following a gloomy report in December, the Mental Health Index revealed that the mental state of U.S. workers improved drastically in January. In fact, January was possibly the best month for mental health since the pandemic began. Stress and risk of General Anxiety Disorder returned to pre-COVID levels for the first time since February 2020. Multiple other mental capacities improved, particularly for women. These gains, which were largely unexpected after a dismal December, suggest workers may believe their lives and experiences are improving in 2021, and that is lifting their outlook and mental state.

Best Case

Improvements across multiple mental capacities, stress included, may be a sign that workers are beginning to recover from 2020’s challenges, and 2021 will be a year of greater performance and productivity.

Worst Case

January’s positive mental health gains may have simply been a product of workers feeling overly hopeful and optimistic at the prospect of the new year.

Every Case

Regardless of whether the boost workers experienced lasts, January offered at least some reprieve from the intense stress and strain that negatively impacted mental health at the end 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

For Many U.S. Workers, Mental Health Rebounded at the Start of 2021

Many Capacities Including Stress, Risk of General Anxiety Disorder Return to Pre-Pandemic Levels


Risk of General Anxiety Disorder decreased in January, now matches pre-pandemic level


Stress dropped in January, returned to pre-COVID level for first time during pandemic

Major Improvement in Women’s Mental Health Between December and January


Women’s risk of General Anxiety Disorder decreased


Conscious negativity bias lessened among women

Workers Age 40-59 Are Struggling More Than Others


Only age group with Risk of Depressive Disorder higher than before COVID


Anxiety higher than pre-pandemic level only across 40-59 age group

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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.

The Emotional State of Workers Improved in January

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 Was No Worse in January Than When the Pandemic Began

Working Americans’ emotional awareness was the same at the end of January as it was at the start of the pandemic. There was no significant positive or negative change in emotional awareness in working Americans between December and January.

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.

Workers Felt Less Negative During the First Month of 2021

After rising in December, non-conscious negativity bias in U.S. workers dropped back down 8% in January. Overall, working Americans ended January 6% less negative than they were at the beginning of the pandemic.

Both Men and Women Were Less Negative in January

From December to January, non-conscious negativity bias decreased in both men (9%) and women (7%).

Improved Emotional State Shows Workers Felt a Renewed Sense of Optimism in January

At the end of 2020, negativity was up and there was a drop in working Americans’ emotional awareness. However, January was a better month in terms of emotional wellness, thanks to a decline in non-conscious negativity bias among U.S. workers.

January was the twelfth month that we captured Mental Health Index data. Despite some setbacks, if you compare Americans’ emotional state in January 2021 vs. February 2020, the Mental Health Index shows that workers are in a better place emotionally now. In fact, workers were 6% less negative in January 2021 than in February 2020.

A lot of changes occurred in January that may have contributed to increased optimism. The holiday season — which is challenging for many people — ending, the transition to a new government, and the COVID vaccine rollout are possible factors. While it is difficult to predict if negativity will remain lower next month, the takeaway is that January was a good month for emotional wellness.


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

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Stress Subsides, Returns to Level Not Seen Since the Beginning of COVID

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. When external stressors are not resolved, stress becomes chronic and leads to anxiety and depression. Watch to learn more.

Stress Decreased 16% from December to January

January marked a milestone for working Americans in terms of stress. For the first time since the beginning of the pandemic, stress was no longer elevated above the pre-COVID level.

Women Were Significantly Less Stressed in January

The overall drop in stress from December to January was most noticeable among women. During the past month, stress decreased 19% in 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 General Anxiety Disorder. Watch to learn more.

Anxiety Remains Elevated, Despite a Drop in January

Anxiety decreased 19% from December to January. Yet, unlike stress, anxiety is still trending high among U.S. workers. The fact that anxiety has not returned to its pre-pandemic level (and stress has) is not particularly surprising — anxiety often lingers after stressors are resolved.

Anxiety Hit Middle-Aged Workers Hard

Workers in the 40-59 age group appear to be struggling with anxiety most. Anxiety was 37% higher among this group in January than it was at the beginning of the pandemic. For comparison, anxiety was the same for those between the ages of 20-39, and 46% lower for workers 60+ vs. 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. Watch to learn more.

Depressed Mood Lessened Somewhat in January

There was a sharp rise in depressed mood at the end of 2020. But, workers showed some improvement in January when feelings of depressed mood decreased 21%. Still, depressive mood was 22% higher at the end of January vs. at the start of the pandemic.

Depressed Mood Is a Rollercoaster Ride for Youngest Workers

Depressed mood increased dramatically back in December among workers in the 20-39 age group. Then in January, depressed mood decreased in that same age group nearly as much as it had risen the month before, falling by 19%. The rise and fall highlights the volatility of this mental health capacity, and the impact on the youngest workers.

Stress, Anxiety, and Depressed Mood All Improved Some in January

All three of the brain’s feeling capacities improved in January vs. December. Of course, the biggest news in terms of workers’ feelings is the decline in stress that occurred in January. Stress impacts so many aspects of mental health, and American workers have been living and working under a constant state of elevated stress for nearly a year. Now, for the first time since the pandemic began, workers are getting some relief. Overall, stress dropped 16% in January, returning stress to its pre-COVID level.

January’s drop in stress wasn’t the only significant improvement — anxiety decreased 19% and depressed mood improved 21%. These changes reinforced that workers started 2021 feeling optimistic and hopeful, and likely led to other improvements across cognitive and self-control capacities.

Data showed major spikes in stress during the onset of COVID in the U.S. and also during the period around the U.S. elections. With the election and transition of power complete, and more Americans receiving COVID vaccinations, there is a degree of relief from two of the biggest stressors of the past year. This likely fueled some of January’s hope and optimism. We’ll be watching to see if those feelings extended into February, and also if anxiety and depressed mood follow stress and return to pre-COVID levels.

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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Cognitive Capacities Were Either the Same or Better Than December

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 Showed No Significant Change in January

Though workers’ memory capacity did not worsen in January, it remains slightly worse than in February of 2020. In January, memory measured 4% lower than at the start of the pandemic, meaning there were a greater number of memory mistakes in January.

Memory Is Worse Than Pre-COVID Only in Middle Age Group

Memory was 8% worse in January vs. at the beginning of the pandemic across the 40-59 age group. This was the only age group of U.S. workers that made more memory mistakes in January vs. February 2020.

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.

Better Focus and Fewer Mistakes in January vs. December

Focus was extremely low at the end of 2020, but it trended upward in January — improving 21% over December. Workers’ improved focus likely relates to the drop in stress that occurred in January.

Focus Is Another Capacity Where Middle Age Group Is Struggling

Focus (sustained attention) is significantly worse than it was at the beginning of the pandemic for workers in the 40-59 age group. While focus is trending 38% below the pre-COVID level across workers in the middle age group, workers age 20-39 and 60+ are as focused as before the pandemic.


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 Has Slowly Been Improving for Months

Workers’ planning capacity did not change significantly between December and January. However, very small month-over-month changes resulted in a 12% increase in planning between August 2020 and the end of January 2021.

Planning Improved Among Men, No Change in Women’s Planning

After worsening in December, men’s planning capacity reversed in January. An upward trend of 13% in January put men’s ability to plan back at the level where it was prior to the pandemic. Women’s ability to plan was nearly unchanged from December to January.

Drop in Stress Translates to Rebounding Cognition

With stress returning to a pre-COVID level, areas of cognition improved in January. As stress decreased, workers’ ability to plan and complete tasks on time continued to improve, as did their ability to focus. This is consistent with research that has proven the direct relationship between stress and cognition.

There is no doubt that decreasing stress and increasing cognition improves workers’ performance. Workers’ focus improving 21% in January meant that they made fewer mistakes – good news for employers.

One trend to watch in the future is the trailing cognition in workers age 40-59. Both memory and focus are worse than they were in February 2020.

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 – Learn to Change Your Behavior by Closing the Gap Between What You Know and What You Do

Chris Darwin joins Dr. Evian Gordon for another podcast, this time to discuss “Can Small Step Habits Change Your Life?” Chris shares three essentials for real behavior change.

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Workers Were More Resilient and Less Negative in January, a Reversal from December

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.

Workers’ Resilience Increased 5% in One Month

U.S. workers had been showing small signs of decreased resilience for much of the second half of 2020. However, from December to January, resilience quickly climbed back up 5%.

Resilience Improved Across Youngest and Oldest Workers

In line with other January trends, the only age group whose resilience did not improve between December and January was the 40-59 group. In January, resilience improved 6% across workers age 20-39, and 11% for those 60+. There was not a significant increase or decrease in resilience in January among the 40-59 age group.

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 Shifted Their Focus to Be More Positive in January

December’s Mental Health Index reported that conscious negativity was up in working Americans. But conscious negativity decreased in January, improving 12% over the previous month. This large shift suggests that workers may be focusing more on the positive and new opportunities in the new year.

Both Men and Women Less Negative in January

From August to the end of 2020, conscious negativity rose 13% across working men. That five-month increase was nearly wiped out in January when men’s negativity dropped 11%. Working women’s negativity decreased even more last month — 13% just in January.

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. 

U.S. Workers’ Social Connectivity Dipped in January

Working Americans’ social connectivity decreased 4% in January. With this dip, there is no longer a difference between workers’ overall social connectivity now vs. pre-pandemic.

Social Connectivity Remains Above Pre-Pandemic Level in Workers Age 40-59

Younger and older workers have the same level of social connectivity now that they had before the pandemic. It is the middle group of U.S. workers that show a greater desire to maintain social connections. Social connectivity is 5% higher in the 40-59 age group vs. before COVID-19.

Workers’ Resilience and Negativity Took a 180-Degree Turn from December to January

In December, Mental Health Index findings showed resilience was decreasing and conscious negativity was increasing. However, the opposite occurred in January with resilience increasing 5% and negativity decreasing 12%.

January was a much better month vs. December in terms of workers’ self-control capacities. The improvement in conscious negativity offers some perspective on the change. When conscious negativity bias is high, it means individuals are focusing more on problems than on opportunities. The drop in conscious negativity in January suggests workers were focusing on opportunities more. This makes sense given the findings in other capacities that show workers were feeling more optimistic and hopeful in January.

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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January Brought Both Ups and Downs for Workers’ Risk of Mental Disorders

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.

Risk of Addiction Did Not Change in January

The January Mental Health Index’s findings on worker’s risk of addiction were similar to the December findings: there was no significant change in risk of addiction. This was true across all demographic groups measured.

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.

Despite a Sizable Drop in January, Risk of Depression Still Greatly Elevated

The risk of Depressive Disorder was 30% lower in January than in December. Yet, even with January’s drop, working Americans’ risk of Depressive Disorder is 71% higher now than it was in February of 2020.

Depression Risk Is Most Elevated in Men and Workers Age 40-59

Working men’s risk of depression was 100% higher in January 2021 vs. February 2020. Risk of Depressive Disorder is also greatly elevated among U.S. workers age 40-59. While the risk of depression isn’t higher for workers in the 20-39 or 60+ age groups, risk was 124% higher in January 2021 vs. February 2020 for workers between the ages 40-59.

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 General Anxiety Disorder. Watch to learn more.

Risk of Anxiety Disorder Returns to Pre-Pandemic Level

For the first time since the start of the pandemic, U.S. workers’ risk of General Anxiety Disorder is no longer elevated. This milestone is a result of a 37% decrease in workers’ overall risk of General Anxiety Disorder that occurred between December and January.

Decreased Risk of General Anxiety Disorder Driven by Women and 60+ Age Group

Women’s risk of General Anxiety Disorder was high in December, but it dropped 46% in January. Risk of General Anxiety Disorder also fell 82% in January across workers in the 60+ age group.

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.

Social Anxiety Risk Returns to Pre-Pandemic Level

The risk of Social Anxiety Disorder decreased 24% across working Americans in January. As a result, workers’ risk of Social Anxiety Disorder is no longer statistically different than it was prior to the pandemic.

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.

Workers’ Risk of PTSD Decreased Somewhat in January

In December, risk of PTSD was at one of its highest points since the pandemic began. But risk decreased 25% in January. Still, the risk of PTSD for working Americans is 33% higher than it was in February 2020.

Risk of PTSD Continues to Measure Higher in Women than Men

Women’s risk of PTSD decreased 28% in January. However, at the end of January, risk of PTSD was still trending 44% higher among working women vs. working men.

Sleep Apnea

Stress and anxiety may cause sleeping problems. Having a clinical condition 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 Climbed in January

In January, U.S. workers’ risk of sleep apnea increased 40%. This was driven by a sharp rise in risk among women. From December to January, working women’s risk of sleep apnea jumped up 90%. Women’s risk is now 176% above the pre-pandemic level.

Changing Risks of Mental Disorders Highlight Volatility of Workers’ Mental Health

January’s Mental Health Index highlighted some positive changes for mental health in American workers. For example, January was the first month since the beginning of the pandemic in which workers’ risk of General Anxiety Disorder was not elevated. Also, workers’ risk of Depressive Disorder and risk of PTSD decreased in January.

But along with the good news comes some bad. Even after a significant drop in workers’ risk of depression, the overall risk remains well above the pre-COVID level. This is true for PTSD as well.

Ultimately, the mix of some positive and negative changes is a good reminder of the volatility of mental health. On the mental health continuum, we can expect to see more highs and lows in the future — particularly as external stressors such as COVID continue to change and evolve.

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

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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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