Updated on April 18, 2022.
While COVID’s toll on people’s physical health is often clear, what may be less obvious is the far-reaching effects the pandemic has had on mental health. Stretching into its third year, the health crisis is slowly shifting from an emergency to a chronic phase, where COVID will fade into the background and become an endemic disease. Left in its wake: a weary nation coping with unprecedented loss, uncertainty, and rising rates of anxiety and depression.
The number of American adults dealing with these mental health issues increased from 36.4 percent to 41.5 percent between August 2020 and February 2021, the Centers for Disease Control and Prevention (CDC) reports. Young adults, in particular, have faced unique challenges.
During the height of the pandemic, mental health experts raised alarms about the consequences that lockdowns, isolation, and economic turmoil were having on college students and those in their 20s who were often less financially stable, experienced, and socially grounded than those in their 30s and beyond. These young adults may have missed out on important milestones and strategic connections as well as academic and work-related experiences.
Pandemic’s toll on young adults
Nearly 63 percent of young adults aged 18 to 24 reported symptoms of anxiety or depression, compared to 40 percent of adults aged 25 to 44, 20 percent of adults aged 45 to 64 and 8 percent of adults aged 65 and older, according to a survey published in August 2020 by the Centers for Disease Control and Prevention (CDC).
Researchers led by Mark Czeisler analyzed the survey responses of 5,412 adults that were collected in June 2020. They found that 1 in 4 of the young adults surveyed reported seriously considering suicide in the previous month. Roughly the same portion reported increased substance use—including alcohol, marijuana, and prescribed drugs—to deal with stress. Overall, nearly 75 percent of the young adults polled acknowledged that they had one or more detrimental mental or behavioral symptom.
In August and September 2020, a follow-up survey of 5,285 adults led by Czeisler, which was published in February 2021 in JAMA Network Open, found similarly stark results, with the brunt of mental distress falling on younger people.
“The impact has been disproportionately worse for younger adults,” Czeisler says.
One explanation for the COVID pandemic’s significant mental health toll: prolonged uncertainty.
“Our brains do not like uncertainty,” says Jud Brewer, MD, PhD, chief medical officer at Sharecare and associate professor of psychiatry at the Warren Alpert Medical School of Brown University. “Uncertainty drives anxiety and when there is too much uncertainty, our brains tend to overheat.”
In other words, because anxiety is unpleasant, “our brains start looking for ways to quickly feel better, such as through stress-eating or using substances, which actually makes it worse,” Dr. Brewer explains.
For younger adults lacking financial stability and life experience, uncertainty may be particularly challenging, notes Czeisler.
“One thing that can be valuable for coping during times like these is having a tolerance for uncertainty and for the feeling of not knowing how long the pandemic and its associated disruptions are going to last or what the outcomes are going to be,” he says. “Older adults generally have more experience with emotional regulation and accepting such uncertainties.”
The effect of economic stress
At the start of the pandemic, one of the biggest blows to the economy was the swift and widespread loss of jobs. The pre-pandemic unemployment rate hovered around 4 percent. But it surged to nearly 15 percent in April 2020, the highest America had seen since the Great Depression, before easing down to 5.4 percent in July 2021.
Unemployment has long been associated with depression, especially for younger adults. A study published by the CDC in 2015 looking at people aged 18 to 25 found that depression was significantly common among those who were unemployed.
During the pandemic, being unemployed, having a household member who was unemployed, or merely expecting to become unemployed were all linked to higher rates of anxiety, worry, loss of interest in activities, and depression among adults aged 18 to 26, according to a November 2020 study published in the Journal of Adolescent Health.
More recently, a CDC study tracking the mental health of American adults, conducted between August 2020 and February 2021, found a continued uptick in symptoms of depression and anxiety among young adults.
By comparison, older adults may have “a more built-out biological stress response and external resources such as social status and financial stability,” Czeisler points out.
Making mental health a priority
Some experts suggest the events that people have endured during the pandemic have placed them at a higher risk for symptoms related to post-traumatic stress disorder (PTSD), such as anxiety, sadness, difficulty sleeping, and having frightening thoughts—a condition being called post-COVID-19 stress disorder. Czeisler says tackling this mental health crisis is of utmost importance.
“As we think about the continued need for pandemic mitigation measures within the U.S. and around the globe, it is important that policy makers, public health officials and communities are aware of and address mental health as a core component of the pandemic response,” he says.
Czeisler is particularly interested in understanding the associations between mental health and lifestyle factors. These include social media exposure, sleep habits and physical activity. By studying these risk factors and their impact on mental health, he hopes to find solutions that can help young adults improve their symptoms without the need for medication.
“Examples of potential modifiable behavioral risk factors for mental health would be prioritizing sleep and sleep regularity—including making sure you’re building out the time to sleep 7 to 9 hours each night and making sure you are going to bed and waking up at similar times each day—and maintaining an overall regular schedule,” Czeisler explains.
While school, work and social lives were interrupted, young adults increasingly turned to their phones for distraction and connection. Social media has fostered some online communities. Ironically, however, several recent studies suggest that spending excessive amounts of time in online spaces can negatively affect mental health by fostering feelings of loneliness.
“Having a routine for exercising, taking breaks from screens, getting outdoors during daylight hours, building out time for social interactions and making time for the little things that make you happy can be difference makers,” Czeisler adds.
When to seek help
Anyone experiencing depression, anxiety or substance abuse should talk to a healthcare provider and receive the support and treatment they need to manage their symptoms and protect their mental and physical health.
People considering suicide can reach out to the Crisis Text Line by texting ‘HELLO’ to 741741. They will be connected to a person who will listen to their concerns without judgment. They can also call the National Suicide Prevention Hotline at 1-800-273-8255 or call, text, or chat 988.
For more information on how to better understand and ease feelings of anxiety, visit Sharecare’s guide to unwinding anxiety.
