High Anxiety in America: APA Poll Highlights Nationwide Worries

Megan Brooks

May 07, 2018

NEW YORK — Americans are much more anxious today than a year ago, and baby boomers have seen the largest increase in anxiety levels, according to a new poll released today by the American Psychiatric Association (APA).

"This poll shows US adults are increasingly anxious, particularly about health, safety, and finances. That increased stress and anxiety can significantly impact many aspects of people's lives, including their mental health, and it can affect families," APA President Anita Everett, MD, said in a statement. "It highlights the need to help reduce the effects of stress with regular exercise, relaxation, healthy eating, and time with friends and family."

The APA assessed anxiety levels from a nationally representative sample of 1004 adults during the period March 22-25, 2018, and compared those results with results from a similar poll of 1019 adults conducted roughly a year early. Respondents were asked to rate their anxiety in five different areas — health, safety, finances, relationships, and politics.

This year's national anxiety score, determined on the basis of mean scores on a 0 to 100-point scale, is 51, a 5-point jump over 2017, the APA reports.

Paying the Bills

Increases in anxiety scores were seen across age groups, across people of different races and ethnicities, and among men and women. Millennials continue to have the highest levels of anxiety among all age groups, but baby boomers had the biggest jump in anxiety from 2017 to 2018 (up 7 points).

Although more Americans are anxious than last year in all five areas (health, safety, finances, relationships, and politics), the greatest increase was in anxiety about paying bills, particularly among millennials. Nearly three quarters of young adults aged 18 to 34 years, nearly three quarters of women, and nearly 4 of 5 Hispanic adults report being somewhat or extremely anxious about paying their bills.

Women are more anxious than men. Women also experienced a greater increase in anxiety than men from 2017 to 2018. When asked to compare their current anxiety to that of the previous year, more than half (57%) of women aged 18 to 49 reported being more anxious, compared to 38% of men the same age.

This gap between the sexes is also evident in older Americans, with 39% of women aged 50 or older saying they are more anxious now than they were this time last year, vs 24% of men 50 or older. Overall, nearly 4 in 10 people (39%) say they are more anxious than they were last year.

Other key findings from the poll:

  • People of color are more anxious than whites (11 points higher on the anxiety index).

  • Americans expressed nearly equal concerns about health, safety, and paying bills. They were somewhat less concerned about politics and relationships.

  • People with Medicaid are more anxious than people with private insurance.

The poll also assessed attitudes and perceptions about mental health and treatment. Results show that most Americans believe a person's mental health affects their physical health (86%, up from 80% in 2017). Three quarters of Americans think untreated mental illness has a significant effect on the US economy.

About half of Americans say there is less stigma against people with mental illness than there was 10 years ago. However, more than one third say they would not vote for a candidate for public office who had been diagnosed with a mental illness, even if the candidate had received treatment.

Anxiety Crisis

Reached for comment, Drew Ramsey, MD, assistant clinical professor of psychiatry at Columbia University, in New York City, thinks that it may be that "our behavior has made us more anxious. We've become more polarized, people are more vocal about their complaints, and we've grown less civilized in how we care for one another. So we could blame this on certain people, but mental health is all about taking ownership."

Our behavior has made us more anxious. Dr Drew Ramsey

As a psychiatrist, Ramsey said he's "very concerned" that anxiety levels are up. "This has been happening year after year, and it's a real crisis. Anxiety disorders are the most diagnosed mental health disorders in the world, and in America, over 40 million Americans have an anxiety disorder," said Ramsey.

It is also "very concerning," said Ramsey, to see that the majority of women, 57%, are reporting more stress and more anxiety compared to last year and that more people are concerned about paying their bills. "We hear a lot of news about how the economy is on fire, but that's not translating to a lot of Americans," he said.

As for anxiety levels among millennials, Ramsey said it's a "very hard time to be in your 20s, and we have not, in many ways, focused our attention to nurturing our youth.

"In many ways, a poll like this should give us our marching orders — that we really need to look inwardly and ask, What are we really actively doing to reduce our anxiety? There are lots of very effective treatments for anxiety, including psychotherapy, medication, mindfulness, sleep hygiene, and better diet. It's probably one of the mental health disorders that we are most effective in treating," said Ramsey.

Prameet Singh, MD, associate dean for graduate medical education at the Icahn School of Medicine at Mount Sinai in New York City, said it's important to note that even though the poll included a "so-called representative sample, it was still only about 1000 people, which is relatively small for a population study like this."

That said, Singh noted it is not surprising that women are more anxious than men. "Women have higher depression rates as well as anxiety. That's always been the case," he said.

"That people of color and Hispanics were more anxious is also not surprising. It doesn't take much to figure out that that may have some correlation with the current political climate that we live in," said Singh.

Regarding anxiety among millennials, Singh said that the physicians-in-training with whom he works are "representatives of millennials" and that "they do seem more anxious and seemingly less able to tolerate changes in their environment or in their schedule. They are less likely to take things in stride."

American Psychiatric Association (APA) 2018. Presented May 7, 2018.

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