A Difficult December: Increased Depression and Negativity + Drop in Focus

After the hardships and mental toll of this past year, it was a relief to finally move on to a new year and (hopefully) better 2021. But a look back at December reveals that as 2020 was winding down, the possibility of better days ahead didn’t boost the mental state of working Americans. Instead, according to the December Mental Health Index, U.S. workers’ mental health worsened in many ways during the final month of 2020. To close out the year, workers were more anxious, stressed, depressed, and negative. As a result, they struggled with focus and memory.

In December, some mental capacities dipped slightly while others plummeted. A confluence of challenges contributed to declines in mental health at the end of the year.

Spikes in stress and depression are normal around the holidays. But having to make difficult decisions about plans and weigh the risks of holiday travel and celebrations added to the stress of the season in 2020. So, too, did disappointment and loneliness that accompanied cancelled plans and traditions.

For many Americans, life changed drastically in 2020. That meant some were facing the pain of their first holiday season without loved ones lost to COVID-19. Others were trying to navigate financial hardships caused by the pandemic.

Even fallout from the November election triggered mental strain in December. Tensions remained high while some Americans questioned the election’s outcome and the future leadership of the United States seemed uncertain.

For U.S. workers, bearing the weight of these and other stressors was a lot to deal with. The following is a closer look at some of the key findings from the December Mental Health Index that show how these adversities impacted mental health.


Anxiety, which has been increasing for several months, was 26% higher at the end of December than it was a few months ago in August. Overall, American workers are now 45% more anxious than they were in February 2020.

Beyond simply feeling more anxious, the risk of General Anxiety Disorder increased in December, particularly among women. The December Mental Health Index found that women’s risk of General Anxiety Disorder was 98% higher at the end of 2020 vs. where it was prior to the onset of the pandemic. Also, from November to December, the risk of General Anxiety Disorder among working women trended upward 46%.

One aspect of General Anxiety Disorder involves persistent and excessive worrying. Unfortunately, in the last few months of 2020, a barrage of triggers gave Americans plenty of opportunities to worry.


Both non-conscious and conscious negativity were up in December.

Non-conscious negativity increased 9% from November to December. The most noticeable rise was in men and workers between the ages of 20-39. Non-conscious negativity is driven by our natural intuition and formed by our experiences. The one-month jump in non-conscious negativity tells us that challenging experiences involving COVID illness, lockdowns, and other stressors in December may have been partially responsible for driving up negativity. 

It’s noteworthy that conscious negativity bias was also elevated in December, because conscious negativity has been shown to rise in times of uncertainty. Elevated conscious negativity suggests that working Americans may have been feeling apprehensive in December. Conscious negativity actually began rising in August. From August to December, it increased 13%. Considering the events that occurred over the course of those months, it is probable that the uncertainty of going back to school during the pandemic, followed by an intense lead into the U.S. elections, and then having to navigate a very unusual holiday season led to heightened conscious negativity during the last part of 2020.


Stress has been a chronic issue since the pandemic began. Every month, workers have been battling heightened stress, and December was no different. Stress was 22% higher among U.S. workers in December vs. February 2020. Overall, workers’ stress increased 13% between the start of August and the end of December.

An obvious connection emerged between stress in working men and the U.S. elections. Stress rose sharply among men just prior to the November elections, and subsided immediately after. However, stress was up slightly again for men in December — possibly because there was additional election-related turmoil throughout the month that created additional uncertainty.

Better stress management is a critical need for U.S. workers. Long-term elevated stress can negatively impact everything from workers’ physical and mental health to workplace productivity. In fact, prolonged stress is a common culprit behind depression — another area of concern on the December Mental Health Index.


Working Americans have been struggling with elevated feelings of depressed mood throughout the pandemic. Depressed mood is now 55% higher than it was in February 2020. Depressed mood first peaked a few months into the pandemic. Depressed mood again reached that same peak point in December.

Depressed mood is characterized by feelings of sadness, frustration, anger, loneliness, or grief that eventually lift after a few days or weeks. If the feelings persist over time, depressed mood can turn into clinical depression.

In December, U.S. workers’ risk of depression — which was already elevated — climbed further. This time it increased 48%. As a result, risk of depression was 145% higher in December than before the pandemic.

The Business Impact + A Look Ahead

For businesses, the findings from the December Mental Health Index are concerning on a couple of levels. For starters, workers’ wellbeing is a priority and businesses know their employees are struggling. Also, stress, anxiety, depression, and other mental health threats are impacting worker’s ability to perform. 

According to the Mental Health Index, working Americans struggled with memory and focus in December. This shouldn’t be surprising at all — stress and anxiety can hinder how we form and retrieve memories, making us more forgetful. And, depressed mood can make it much more difficult to focus, and lead to mistakes.

From November to December, workers’ ability to focus decreased 62%. Memory slipped 8%. Part of the decline may have been due to December being a month with a lot of distractions, and workers attempting to multitask more at the end of the year. However, high stress, anxiety, and feelings of depressed mood were also likely factors. Either way, a drop in memory and focus is problematic because it hampers workplace performance and productivity.

So, what is next? What is the outlook for the future? Will things get easier during year two of dealing with the pandemic? And, when?

It is hard to predict exactly what lies ahead, and what the impact will be on mental health. Several major events occurred in January, such as the Capitol riots, the swearing in of a new president and wider rollout of COVID vaccines. Our Total Brain team will continue to study mental health trends and share our findings. Watch for the next Mental Health Index to see an updated report.

Also, you’re invited to check out our monthly webinars where industry thought leaders gather to review the latest Mental Health Index data and discuss the mental health of working Americans. You can register here.

If you’re an HR or benefits professional charged with improving employee mental health, schedule a meeting to discuss how Total Brain can help.

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