Depression and Anxiety Are on the Rise Globally

I recently came across a study published in The Lancet that startled me. The findings on depression and anxiety disorder were grim, and no surprise, COVID-19 was the big culprit.

But COVID wasn’t the whole story, as I will explain. I also have some (hopefully) helpful advice to impart regarding mental illness, and I’ll get to that as well.

First, a quick recap of the study’s key findings.

Key Points From the Global Study

Published in the online version of The Lancet on October 8, 2021, and co-authored by dozens of researchers worldwide, the study looked at the prevalence and burden of depressive and anxiety disorders in 204 countries and territories during 2020, when the pandemic was at its worst. The study authors also discussed historical data on global depression and anxiety prevalence, providing context from the pre-pandemic period.

Study highlights include:

• Among both genders, the prevalence of anxiety disorder went up 25.6 percent worldwide during the pandemic. For depressive disorder, the prevalence increased by 27.6 percent.
• The prevalence increase for both disorders was significantly higher for women versus men. Depression prevalence increased 29.8 percent for women versus 24 percent for men. Anxiety prevalence increased 27.9 percent for women versus 21.7 percent for men. Note: In the pre-pandemic world, the prevalence rates for both disorders were already significantly higher for women than men.
• There was a clear correlation between the severity of the pandemic outbreak and the prevalence increases of the two disorders. For example, the countries and regions hardest hit by COVID showed the highest increases of depression and anxiety among the populace.
• Maybe most interesting, prevalence rates for men and women both before and during COVID were progressively higher for each age group. For example, men and women aged 20-39 had the highest rates, which were significantly higher than the rates of depression and anxiety for men and women aged 40-49. Men and women aged 40-49 have higher rates than those aged 50-59, and so on up to 90 years old.

The Realities Behind the Numbers

The researchers discussed possible social and economic reasons why women experienced greater increases of depressive and anxiety disorders during the pandemic. In some cases, these disparities existed long before COVID.

Possible explanations included:

• Worldwide, women tended to take on a greater share of household responsibilities during COVID due to school closings, caring for sick family members, and the like.
• Women tend to be more financially disadvantaged than men due to lower incomes, less savings, and less secure employment. This reality predates COVID.
• Rates of domestic violence rose during the pandemic, which disproportionately affects women more than men.

As for why younger adults are seeing higher prevalence rates of both disorders than older adults, the researchers point to several possible factors. First, widespread school and college disruptions affected the young far more. Second, younger workers were much more likely to lose their jobs than older workers. And third, the social isolation brought on by COVID hit young people a lot harder than older people.

What This Means, and Some Advice

First point: Research has shown that girls and young women may be especially affected by seeing so-called perfect bodies and perfect lives every day on their social media accounts. This omnipresent influence likely does more harm than we realize regarding body image and self-worth and would logically lead to higher rates of depression and anxiety.

Several studies in the last decade have also shown that the more time young people of both genders spend on social media each day, the higher their risk of having mental health problems, including anxiety and depression.

Second point: Another reason young people 25 and under were so hard hit by depressive and anxiety disorders during COVID was because the human brain is still developing at that age. As such, the brain can be especially prone to things like social isolation, increased drug and alcohol use (both were common during COVID), and even domestic violence and poor nutrition. The brain is resilient and can catch up from certain deficits, but the harmful effects that occur during its development stage can linger for years.

Third point: The researchers discussed the alarming fact that rates of depressive and anxiety disorders have never gone down since accurate measuring began in 1990. Meaning prevalence has either stayed the same year-to-year or gone up, despite the fact that globally there are now more support services, mental health facilities, and other interventions available than ever before.

Here’s My Take

First, there is still far too much stigma around mental illnesses like depression and anxiety disorder, so even though the care has improved for these conditions, and it’s more available in many parts of the world, people still shy away from treatment because of the stigma. That is certainly the case in the U.S.

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Second, it’s one thing to have the care available, but it’s another thing to have access to it. In the U.S., for example, people often don’t have insurance, so they can’t afford mental health care. Or they have insurance, but their plan doesn’t cover mental illness adequately, despite the mental health care parity push of the last decade-plus. Another reason for lack of access is not having a mental health facility nearby, as frequently happens for people who live in rural areas.

Third, the increase in mental illness has gone hand in hand with the drug epidemic that has raged in the U.S. and other countries in the last 20 to 30 years. The one pushes the other upward in terms of prevalence, and vice versa. A person dealing with addiction as well as a co-occurring condition like depression or PTSD is very common in the addiction treatment field where I work.

Fourth point: One reason COVID has had such an outsized impact on our mental health is that so much of our maintenance mental health care slowed or came to a stop because of it. For example, it became more difficult to do things like getting refills on depression or anxiety medications, so compliance rates took a hit. No one wanted to venture out to the pharmacy for their meds! People on medication-assisted treatments with suboxone, methadone, and other helpful drugs suffered the same disruptions.

Same thing with our weekly or monthly therapy sessions. Some of this mental health care could be done remotely, but that didn’t work for a lot of people. Finally, there are all the other non-medical supports many people depend on, like yoga or meditation classes, gym workouts, or the run we do every Wednesday morning with our training partners. Many of these fell by the wayside because of COVID fears.

Fifth point: Here’s some advice. We’re still coming out of the COVID mess, but as of right now, in late October of 2021, the Delta variant finally seems to be ebbing for good here in the U.S. Still, the last year and seven months have been brutal on our mental health, so I urge you or a loved one to seek help if it’s needed.

Hopefully, you have some options for care. If you have a primary care physician, you can always start there. Make an appointment ASAP, and when it’s time for your visit, be honest about how you’re feeling. No need to spin or soft-pedal what’s going on. Ask about the next steps.

If you stopped seeing your therapist during COVID or weren’t seeing one to begin with, be determined to get an appointment on the calendar. Most mental health providers are seeing people in person again and will have safety protocols in place, so you’ll be fine. The risk of COVID infection is extremely low in these settings.

Another great option is a telehealth mental health visit. COVID changed this landscape for good, and you have many remote options now. Mental health professionals are offering telehealth sessions more than ever, in part because they’re getting reimbursed for them by health insurance payers at levels comparable to onsite visits. Take advantage of this newly opened window!

Lastly, if you’re really struggling with your alcohol or drug use or a suspected mental illness, and it’s affecting your life, it may be time to consider inpatient treatment. And you know what? It could end up being the most productive time you’ve ever spent.

If a friend or family can recommend a facility to you, that’s great, make the call. Otherwise, search by “inpatient mental health,” and you’ll likely find a few nearby places to check out. Again, this could be the smartest move you’ll ever make.