The national public health emergency around Covid-19 officially ended on May 11, 2023, and while the return to “normal” has been celebrated by many, results from the most recent Stress in America™ survey paint a different picture. Psychologists with APA say a superficial characterization of day-to-day life being more normal is obscuring the posttraumatic effects that have altered our mental and physical health.
When reviewing this year’s survey data, APA psychologists widely agreed there is mounting evidence that our society is experiencing the psychological impacts of a collective trauma.
“The Covid-19 pandemic created a collective experience among Americans. While the early-pandemic lockdowns may seem like the distant past, the aftermath remains,” said Arthur C. Evans Jr., PhD, APA’s chief executive officer.
Further, widespread trauma has not been limited to the pandemic. Global conflict, racism and racial injustice, inflation, and climate-related disasters are all weighing on the collective consciousness of Americans.
Stress in America 2023: A Nation Recovering from Collective Trauma examines the lasting psychological impacts of this combination of era-defining crises. An inspection of pre- and post-pandemic mental and physical health reveals signs of collective trauma among all age cohorts.
The data suggests the long-term stress sustained since the Covid-19 pandemic began has had a significant impact on well-being, evidenced by an increase in chronic illnesses—especially among those between the ages of 35 and 44, which increased from 48% reported in 2019 to 58% in 2023. Adults ages 35 to 44 also experienced the highest increase in mental health diagnoses—from 31% reported in 2019 to 45% in 2023—though adults ages 18 to 34 still reported the highest rate of mental illnesses at 50% in 2023.
Psychological science has revealed that long-term stress creates risks for a variety of mental health challenges, may make us feel more sensitive even to daily hassles, can have broader impacts on our general life outlook and goals, and affects the body’s physiological response to stressors in ways that have notable implications for our physical health. Coping with long-term stress requires a different set of skills than adjusting to temporary stressors.
Stress puts the body on high alert and ongoing stress can accumulate, causing inflammation, wearing on the immune system, and increasing the risk of a host of ailments, including digestive issues, heart disease, weight gain, and stroke.
“We cannot ignore the fact that we have been significantly changed by the loss of more than one million Americans, as well as the shift in our workplaces, school systems, and culture at large. To move toward posttraumatic growth, we must first identify and understand the psychological wounds that remain,” said Evans.
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The collective trauma of a confluence of crises leaves lasting impact
When examining this year’s survey data, APA psychologists noted many people had generally positive perceptions of their physical health even when they also reported being diagnosed with a chronic condition. For example, despite high ratings of physical health (81% rated their physical health as good or better), two-thirds of adults (66%) said they have been told by a health care provider that they have a chronic illness—including high blood pressure (28%), high cholesterol (24%), or arthritis (17%).
Further, 81% of adults reported their mental health as good or better, while more than one-third (37%) said they have a diagnosed mental health condition—a 5 percentage point increase from prepandemic levels (32% in 2019). Most cited anxiety disorder (24%) or depression (23%).
The data also shows a tendency among respondents to downplay stress; around two-thirds of adults (67%) reported feeling like their problems are not “bad enough” to be stressed about, because they know others have it worse. Other top reasons adults reported they or a family member may give for not seeking treatment included the belief that therapy doesn’t work (40%), lack of time (39%), or lack of insurance (37%).
When it comes to stress management, many are struggling to cope and are bearing the burden alone. Around three in five adults (62%) said they don’t talk about their stress overall because they don’t want to burden others. Although finances are a top stressor, talking about them is off the table. In fact, only 52% of adults said they are comfortable talking with others about money/finances, and more than two in five adults (45%) said they feel embarrassed talking about money or their financial situation with others.
Around three in five adults (61%) said people around them just expect them to get over their stress. Nearly half (47%) said they wish they had someone to help them manage their stress. Some adults (36%) said they don’t know where to start when it comes to managing their stress, and a third (33%) said they feel completely stressed out no matter what they do to manage their stress. In fact, two-thirds of adults (66%) said that, in the last 12 months, they could have used more emotional support than they received, and around a quarter (26%) cited the need for a lot more support. More than two in five adults (44%) said they don’t feel anyone understands what they are going through, and more than half (52%) said they wish they had someone to turn to for advice and/or support.
Another consequence of a society under stress is that nearly three in 10 adults (28%) said they have struggled with or had difficulty planning for their future in the past month because of stress. Additionally, a third of adults (33%) said they have too much stress in their day-to-day lives to think about the future.
A widespread feeling of discontent from what they are seeing in the media also serves as a prominent source of stress. Half of adults (50%) said it stresses them that the news is not focusing on what is most important to them on a day-to-day basis and three in five (59%) said it stresses them that politicians aren’t talking about things that are most important to them. On top of it all, few reported confidence about the direction our country is going (34%) or said they feel that their government representatives have their best interests in mind (31%).
Psychological impacts of pandemic-era stress felt across age cohorts and lifestyles
When asked to quantify their average level of stress, adults in the U.S. said it’s a five out of 10 (on a scale of 1–10 where 1 is “little to no stress” and 10 is a “great deal of stress”). This remains unchanged since last year. Still, a quarter of adults (24%) rated their average stress between eight and 10. This is up from 19% in 2019, before the pandemic. This increase is mirrored across all age groups except those 65+.
The increase among those who ranked their average stress level between eight and 10 is also up among parents and single adult households, while there has been little change among the retired population.
A closer look at age-based stress also revealed that though the stress level for the general population has remained relatively steady, the increase is significantly higher for the 35 to 44 age cohort:
- 18 to 34, 2023 vs. 2019 was 6 vs. 5.7
- 35 to 44, 2023 vs. 2019 was 5.7 vs. 5.2
- 45 to 64, 2023 vs. 2019 was 5 vs. 4.9
- 65+, 2023 vs. 2019 was 3.4 vs. 3.6
The future of our nation (68%) and violence and crime (61%) were reported as significant sources of stress in adults’ lives. These were followed by the U.S. debt (57%), mass shootings (56%), social divisiveness (55%), and health care (54%).
Among the day-to-day stress categories, health-related stressors (65%), money (63%), and the economy (64%) were reported among the top significant sources of stress in adults’ lives. Those ages 35 to 44 reported having the most factors that cause them significantly more stress today than in 2019, which include money, the economy, family responsibilities, personal safety, and discrimination. Those ages 65+ were the only age group to cite multiple sources as less stressful today than in 2019.
[Related: Gen Z adults and younger millennials are “completely overwhelmed” by stress]
A closer look at ages 18 to 34
The top significant sources of stress reported among the 18 to 34 age cohort in 2023 were health-related and money (both 82%). Of the three categories covered under health-related (family-related, physical health, or mental health), mental health as a stressor was the highest at 72%, which also was the highest among all age cohorts. The largest increases in major stressors reported since 2019 for the 18–34 age group were due to the economy (from 52% in 2019 to 72% in 2023) and housing costs (from 57% in 2019 to 70% in 2023).
The 2023 survey data showed that this age cohort was more likely than their older counterparts to report many effects of stress. They also were more likely to report not wanting to talk about their stress overall because they don’t want to burden others.
A closer look at ages 35 to 44
The top significant sources of stress reported in 2023 among the 35 to 44 age cohort were money (77%) and the economy (74%). Adults ages 35 to 44 who reported money as a significant source of stress were more likely than those 18 to 34 and 65+ to say paying for essentials causes them stress (67% vs. 58% and 53%).
The largest increases in major stressors reported since 2019 by the 35 to 44 age cohort were due to the economy (from 51% to 74%), personal safety (from 36% to 49%), and family responsibilities (from 59% to 71%).
Further, there was a significant increase in chronic conditions in 2023 compared with 2019 for those ages 35 to 44 (58% vs. 48%). Similar to chronic health conditions, this age cohort saw a significant increase in mental health diagnoses reported in 2023 compared with 2019 (45% vs. 31%).
A closer look at ages 45 to 64
Adults ages 45 to 64 were most likely to report money and the economy (both 63%) and health-related (62%) as top significant stressors in 2023. The biggest increase in stressors from 2019 was the economy (up from 45%).
Similar to the trends among those ages 35 to 44, those ages 45 to 64 were more likely to say they have a chronic illness in 2023 compared with 2019 (73% vs. 68%). This age cohort also saw a significant increase in mental health diagnoses reported in 2023 compared with 2019 (36% vs. 26%).
A closer look at ages 65+
The top significant sources of stress reported in 2023 among adults 65+ were the economy (47%) and health-related (45%). The only major stressor that increased in recent years was the economy (from 36% in 2019 to 47% in 2023).
This age cohort was more likely than those ages 18 to 34 and 35 to 44 to report the ability to get things done even when they are feeling stressed (78% vs. 71%, each). They were also more likely than those ages 18 to 34, 35 to 44, and 45 to 64 to say that when they feel stressed, they can get over it quickly (71% vs. 51%, 59%, and 59%).
Further, this tendency to push through stress may be a result of downplaying their stress; adults ages 65+ were more likely than their younger counterparts to feel like their problems are not “bad enough” to be stressed about because they know others have it worse (74% vs. 65% of ages 18 to 34, 63% of ages 35 to 44, and 67% of ages 45 to 64). This “tough it out” mentality may be deterring those in need from seeking help.
A closer look at life stages
In addition to the age-based stress analysis, the survey findings revealed stress trends among varying life stages and lifestyles, including parents, single adult households, and retired adults. For example, in 2023, parents of children under age 18 were more likely than other adults to report a variety of stressors and effects of stress.
When comparing pre- and post-pandemic survey results, parents were more likely to report having a chronic illness today than in 2019 (63% vs. 56%) and were more likely to say many stressors cause them significant stress—including money (79% vs. 71%), family responsibilities (77% vs. 71%), the economy (75% vs. 56%), and health problems affecting their family (59% vs. 51%)—today than in 2019. Single adult households with or without children were more likely to cite many significant sources of stress—including money (68% vs. 57%), the economy (63% vs. 47%), housing costs (57% vs. 49%), and personal safety (44% vs. 33%)—today than in 2019. And retirees were more likely to cite the economy as a significant source of stress today than in 2019 (51% vs. 38%).
Women say they’re stressed, misunderstood, and alone
This year’s survey found that women continue to report higher stress levels than men and could have used more support. Women reported a higher average level of stress than men (5.3 vs. 4.8 out of 10) and were more likely to rate their stress levels between an eight and 10 than men (27% vs. 21%). Women also were more likely than men to report that they could have used more emotional support than they received in the last 12 months (68% vs. 63%).
[Related: Women in America are stressed—and psychologists aren’t surprised]
This year, people of all genders reported that health and finances were among the top sources of stress. But women were more likely than men to report feeling “consumed” by their worries about money (50% vs. 44%). Among those who cite money as a significant source of stress, women were more likely than men to report both paying for essentials (66% vs. 55%) and unexpected expenses (60% vs. 49%) cause them stress. Women were also more likely than men to cite family responsibilities (58% vs. 52%) and relationships (49% vs. 44%) as key stressors in their lives.
What’s more, women were more likely than men to say they “strongly agree” that no one understands how stressed they are (22% vs. 17%) and were less likely to report that they can quickly get over stress (54% vs. 65%).
Discrimination and disparities in stress pervade
Discrimination is not only a stressor in some adults’ minds, but perhaps a very real presence in their everyday life and potentially a harm to their personal safety. Although financial and health-related stress are top of mind for adults in the U.S., discrimination and personal safety also are concerns. Nearly two in five (39%) said that personal safety is a significant source of stress in their lives, in congruence with more than a quarter (27%) who said discrimination is as well. For those who have experienced at least one act of discrimination, many attributed it to their age (36%), their race (28%), or their gender (22%).
Everyday discrimination is significant for LGBTQIA+ adults. For example, LGBTQIA+ adults were more likely than those who do not identify as LGBTQIA+ to:
- Cite discrimination as a significant stressor (45% vs. 24%).
- Say they don’t feel comfortable voicing their experiences around others for fear of how they would react (57% vs. 44%).
- Not feel accepted in their community (43% vs. 25%).
Similar trends are seen among adults with disabilities. Adults with a disability were more likely than adults without a disability to:
- Cite discrimination as a significant stressor (34% vs. 22%).
- Say they don’t feel comfortable voicing their experiences around others for fear of how they would react (57% vs. 40%).
- Not feel accepted in their community (40% vs. 21%).
When looking across racial/ethnic identities, Black and Latino/a/e adults were more likely than Asian and White adults to cite discrimination as a significant stressor (43% and 40% vs. 31% and 19%). Black adults were more likely than White adults to have ever experienced a range of acts of discrimination.
Latino/a/e adults were more likely to have experienced various forms of everyday discrimination than White adults. They also were more likely than White and Black adults to say they don’t feel comfortable voicing their experiences around others for fear of how they would react (53% vs. 45% and 42%). In addition, this population was more likely than White adults to not feel accepted in their community (33% vs. 27%).
Though adults reported being open to talking about various topics, some are off limits; many reported they never talk with others about their stress related to discrimination (58%). White, older, adults without children under 18, and non-LGBTQIA+ adults were significantly more likely to say they never talk about discrimination, personal safety, or mental health compared with Latino/a/e, Black, Asian, younger adults, parents, and LGBTQIA+ adults.
Additionally, while adults may want to get involved in bettering their community, stress may play a role in their drive to act—and this disproportionately impacts marginalized communities. More than two in five adults (46%) said they care about what happens in their community, but their day-to-day stress distracts them from acting.
Understanding the impacts of stress—what researchers want you to know
The continued prevalence and severity of stress has made it a critical area of research for psychologists, who have conducted hundreds of investigations on the topic over the years. Their work has helped uncover the wide-ranging sources and consequences of stress—and identify buffers and solutions to this universal, but unequal, experience.
These are some of the important things they have found.
- Stress can manifest in the body.
- Physical effects of stress can be damaging even when you appear “fine” on the outside.
- Effects don’t end when the stressful experience ends.
- Social support is good for everyone.
- Some coping mechanisms don’t suffice in unbearable situations.
- You need stress—and often grow from it.
Read 6 things researchers want you to know about stress for more details
Methodology
The 2023 Stress in America™ survey was conducted online within the United States by The Harris Poll on behalf of APA between August 4–26, 2023, among 3,185 adults ages 18+ who reside in the U.S. that serve as a nationally representative sample. In addition, oversamples were collected in addition to the national sample to allow for increased totals by race/ethnicity: 805 Black, 811 Latino/a/e, and 800 Asian individuals. Interviews were conducted in English and Spanish.
Data is weighted where necessary to reflect their proportions in the population based on the 2022 Current Population Survey by the U.S. Census Bureau and PEW NPORS 2022 (for frequency of internet use). Weighting variables included age by gender, race/ethnicity, education, region, household income, size of household, and frequency of internet use. Latino/a/e adults also were weighted for acculturation, taking into account respondents’ household language as well as their ability to read and speak in English and Spanish. Country of origin (U.S./non-U.S.) also was included for Latino/a/e and Asian subgroups. Propensity score weighting was used to adjust for respondents’ tendency to be online. A propensity score allows researchers to adjust for attitudinal and behavioral differences between those who are online vs. those who are not, those who join online panels vs. those who do not, and those who responded to this survey vs. those who did not.
Respondents for this survey were selected from among those who have agreed to participate in our surveys. The sampling precision of Harris online polls is measured by using a Bayesian credible interval. For this study, the sample data for the “national sample” is accurate to within ± 2.5 percentage points using a 95% confidence level. This credible interval will be wider among subsets of the surveyed population of interest.
- The sample data for the Black sample (national sample and oversample) is accurate to within ± 4.8 percentage points using a 95% confidence level.
- The sample data for the Latino/a/e sample (national sample and oversample) is accurate to within ± 5.5 percentage points using a 95% confidence level.
- The sample data for the Asian sample (national sample and oversample) is accurate to within ± 4.8 percentage points using a 95% confidence level.
All sample surveys and polls, whether or not they use probability sampling, are subject to other multiple sources of error which are most often not possible to quantify or estimate, including, but not limited to coverage error, error associated with nonresponse, error associated with question wording and response options, and postsurvey weighting and adjustments.