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Americans Have Never Been Sicker

Depression, suicide, and obesity are on the rise in America, and not just because of social media and Covid.

Americans have never been sicker. Life expectancy in the United States continues to fall. An increasing number of people are anxious and depressed. And before you blame Covid-19 and lockdowns, it’s important to note that these problems existed long before a deadly pandemic brought the country and the world in general to a screeching halt. Has the pandemic made things considerably worse? Of course. Nevertheless, according to a recent Mental Health America (MHA) report, in 2019, just before the pandemic hit the country, some 50 million American adults were experiencing mental illness.

Worryingly, suicidal ideation is on the rise. In fact, as the MHA authors note, “the national rate of suicidal ideation among adults has increased every year since 2011-2012.” In particular, the country’s youth appear to be struggling, with a growing percentage of young Americans living with major depression. In 2020, according to MHA, more than 15 percent of youth “experienced a major depressive episode.” Today, 2.5 million youth in the U.S. live with severe depression.

Some will read this and blame social media. Again, like Covid, of course social media plays a role. But we simply can’t keep blaming Instagram and TikTok for all of society’s ills. There are bigger issues at play here. As the MHA authors note, more than 60 percent of youth with major depression “do not receive any mental health treatment. Even in states with the greatest access, nearly one in three are going without treatment. In Texas, the bottom-ranked state for this indicator, nearly three-quarters of youth with depression did not receive mental health treatment.” Nationwide, less than a third of youth with severe depression receive regular mental health care. To compound matters, for both youths and adults, rates of substance use are increasing. This worrying trend was evident before the pandemic. In 2020, “7.74% of U.S. adults and 4.08% of youth had a substance use disorder in the past year.”

It is human nature to blame others for our problems, to outsource the point of blame, if you will. It’s our employer’s fault, the government’s, Mark Zuckerberg’s—and maybe it is. Maybe they’re all to blame. Then again, though, maybe they’re not. Maybe it’s our own fault. When it comes to improving ourselves as human beings, the first step starts with self-ownership, a willingness to take responsibility for our own actions. Sure, it helps to have a strong community of friends and family members to help us, guide us, and offer support. But, ultimately, change comes from within. We have agency.

In 2015, the psychotherapist Jonathan Alpert wrote a piece for the Chicago Tribune, asking “Have we become a nation of emotional lightweights?” “As a nation,” wrote Alpert, “we’ve turned toward meds as the solution for emotional pain.” He discussed an alarming rate of antidepressant use by teenagers and adults, and the fact that 10 percent of Americans were using antidepressant medication. “Among women in their 40s and 50s,” he noted, it was closer to 25 percent. Did all of these people really need to be medicated? he asked. The answer then was no.  And the answer is still no. Do some of these people need medication? Of course. But not all. Since Alpert’s article, America’s dependency on antidepressants has grown significantly.

I reached out to Alpert for comment, and the rather colorful psychotherapist was more than willing to assist. In his role as a psychological specialist, Alpert has noticed the perverse ways in which “being depressed, anxious, stressed, and sleep deprived have become a badge of honor for many people and celebrated,” he told me. “How often have you heard people say in a braggadocios way, “I worked 60 hours this week”?  Or, “I’m so stressed”?”

“For me,” he added, “that’s something to be worked on and improved—not celebrated.  It doesn’t make you a better person to be overworked or to be chronically stressed. By changing the way society looks at these things, people can start to aim for being less stressed and anxious and achieving better balance in their lives.”

I offered a little pushback here. Although many Americans still wear the likes of anxiety and stress like badges of honor, plenty don’t. Resilience, which psychologists define as the ability to adapt in the face of adversity, trauma, and tragedy, is sorely lacking. It’s the ability to pick yourself up and dust yourself off after falling off the horse. Sadly, in the U.S., more people appear to be falling off the horse, but fewer appear capable of picking themselves up. If in doubt, let me point you in the direction of college campuses, where safe spaces and trigger warnings have taken precedence over actual learning.

Alpert agreed, then, somewhat rhetorically, asked the following: “What happened to striving for greatness and doing our best?” Good question. “Resilience, perseverance, and performing under pressure were at one time traits worthy of admiration,” he continued. Now, though, “we have world class elite athletes being celebrated, praised, and honored for not showing up and performing in the face of challenges and obstacles.” Alpert was, of course, referring to Simone Biles, an athlete who has spoken openly about her struggles with various mental health issues.

The U.S., it seems, is very much a nation of “emotional lightweights.” At the same time, however, it has become a nation of physical heavyweights. In 2020, the national obesity rate stood at 42.4 percent. This was the first time in history that the national rate passed the 40 percent mark. A new, inglorious milestone. While the pandemic certainly made the obesity crisis worse, this crisis has been years, if not decades, in the making.

It might sound obvious to say the following, but nothing, absolutely nothing, good comes from being obese. In fact, obesity makes everything considerably worse. After all, there is a strong association between obesity and anxiety, obesity and depression, obesity and suicidal ideation, as well as obesity and schizophrenia. Which comes first, obesity or, say, depression? Well, that is up for debate. What’s not up for debate, however, is the role obesity plays in contributing to various mental health issues. But perversely, obesity has become a “badge of honor” for many Americans. Although bullying and fat shaming should not be condoned, fat acceptance (or fat championing) shouldn’t be either. There is a distinct difference between body positivity and delusional thinking. Obesity is not something to be celebrated. But try telling that to a number of highly influential celebrities and publications, many of whom go to great lengths to promote unhealthy lifestyles.

As Alpert puts it, by “accepting all body types, we’ve embraced obesity and being overweight.” Although he is “all for encouraging people to feel good about who they are, and their bodies, there’s a limit to body positivity.” He’s right. “By definition, obesity and being overweight is one’s weight being greater than what is considered healthy for his or her height.  That said, weight should not be celebrated at the cost of one’s physical well-being as it leads people down a path that could potentially be harmful.”

Indeed. An increasing number of Americans are headed down this perilous path. Some 21 percent of the country’s 12-19 year olds are now obese; 20 percent of 6-11 year olds are classified as obese as well.

What we have here is the recipe for an imperfect storm. With less resiliency and ever expanding waistlines, the United States is thinking and eating itself into disaster. The previous line might sound hyperbolic, but it really shouldn’t. Millions of Americans are now too fat to work. And yes, Covid has certainly played a role, and social media has further fueled the atomization of society, but, at some point, we must accept responsibility for our own wayward actions. Then and only then is change possible. The United States is sick, incredibly so, and it appears to be getting sicker.

John Mac Ghlionn is a researcher and essayist. His work has been published by the likes of National ReviewNew York PostSouth China Morning Post, and the Sydney Morning Herald. He can be found on Twitter at @ghlionn.