Evolution of Depression and Anxiety During the COVID-19 Pandemic and Across Demographic Groups in a Large Sample of U.S. Adults

Introduction: This study aimed to document the trends of feelings of depression and anxiety over the course of the COVID-19 pandemic within and across age, gender, education, and employment groups.

Methods: Using a large, national, serial cross-sectional sample of adults in the U.S. collected through the COVID-19 Trends and Impact Survey conducted in partnership with Facebook, we examined trends in feelings of depression and anxiety from April 2020 through June 2022 (N=21,359,165).

Results: Over time, differences in feelings of anxiety and depression widened for educational attainment, stayed consistent between employment groups, and narrowed for female versus male and age groups. The odds of frequent feelings of anxiety or depression were significantly lower in the studied final quarter (April-June 2022) than in the studied first quarter (October-December 2020) for the overall population (<0.001). In April-June 2022, younger persons reported 6-7 times the odds (AOR for depression=6.07; 95% CI=5.72, 6.43 and AOR for anxiety=6.69; 95% CI=6.33, 7.07), nonbinary persons reported 5 times the odds (AOR for depression=5.35, 95% CI=4.89, 5.86 and AOR for anxiety=5.35, 95% CI=4.9, 5.85), persons with a high school degree reported 2 times the odds (AOR for depression=2.07, 95% CI=1.92, 2.22 and AOR for anxiety=1.68, 95% CI=1.57, 1.8), and persons who were not employed reported 1.3-1.5 times the odds (AOR for depression=1.46, 95% CI=1.42, 1.51 and AOR for anxiety=1.34, 95% CI=1.3, 1.38) of frequent feelings depression and anxiety, respectively, than counterparts who were older, were male, had graduate degrees, or were employed.

Conclusions: The risk factors most highly associated with poor mental health 2 years into the pandemic were young age, nonbinary gender, and low educational attainment.