The Verywell Mind 2021 Year-in-Review

Verywell Mind's 2021 year-in-review is a reflection of all that we’ve faced in 2021. The highs and lows. The hope, the disappointment, and everything in between. This was not the year we started talking about mental health, but it is the year that solidified the topic in our collective consciousness. Mental health is no longer the hidden pandemic or the thing we’re too afraid to talk about, and will continue to do so long after the pandemic is over.

Financial Stress Persisted, Especially for Gen Z

As the pandemic touched every aspect of our lives between personal relationships and work, resilience prevailed and, thanks to the efficacy of vaccines, we were able to adapt and get a glimpse of a sense of normalcy this past summer. Between April and July, some of the biggest stressors of the year diminished 5–6% across the board. According to our ongoing Mental Health Tracker, however, one stressor in particular persisted and continues to linger over our heads: our finances.

Within this timeframe, we found little to no difference in how COVID-19 impacted financial stress amongst American adults. In the spring, 33% of folks reported that COVID had a moderate to extreme impact on financial issues. And in August, practically the same at 32%. Even pausing payments on the nearly $2 trillion in student loan debt owed by Americans since March of 2020 has not been enough to ease this issue.

More recently, we reported that 36% of people rated financial instability as one of their top concerns for the future. And for good reason. Money issues don’t exist in a vacuum. The effects extend far beyond the direct financial component, especially for those who suffered a job loss.

Difficult financial circumstances can put a strain on relationships, living situations, and above all, your health and mental well-being. Mental self-care doesn’t have to be pricey, and while it may not solve a financial crisis, it can better prepare you to face the ongoing stressors of daily life in these difficult times as we keep on with small steps toward recovery.

Doctors and Patients Alike Sought Radical, Outside-the-Box Treatments

Antidepressants don’t work for up to 15% of people who use them, and may only partially work for up to 40%. Others may not be able to cope with certain side effects of SSRIs—the most commonly prescribed antidepressant—such as weight gain, insomnia, and sexual dysfunction. There is an appetite for alternative—but safe—methods for treating mental health concerns. And the list of options is growing by the year.

In the wake of FDA approval of Ketamine for treatment-resistant depression, doctors are increasingly making use of the therapeutic effects of other controlled substances. One example is MDMA, which in 2021 was shown to be a safe and highly effective treatment for severe, chronic PTSD. In a Phase 3 trial 88% of participants reported a reduction in symptoms, and 67% would no longer have qualified for a PTSD diagnosis at all.

Late in 2020, Oregon became the first state to legalize psychedelic mushrooms and their psychoactive compound, psilocybin. In 2021, towns and cities in Massachusetts, Michigan, and Washington have followed suit. Research is ongoing, but the data on using psilocybin as part of treatment for mental health conditions like depression, anxiety, and substance use is promising, and some therapists have begun incorporating it into their therapy practices as the law allows.

Meanwhile, the market for unregulated CBD oils, tinctures, and even beverages has skyrocketed in recent years, with sales expected to grow to over $5.3 billion for 2021, and some projections anticipating over $20 billion in annual sales within a few years.

Further research is sorely needed to show how effective CBD and other substances actually are at easing mental health conditions, helping people sleep, and helping people feel less anxious throughout the day, but there’s no doubt that more and more people are putting their trust in these supplements to traditional therapy.

Our Best Athletes Shared Their Struggles With the World

It’s often said that competition breeds excellence, and given our collective appreciation of athletes performing at the top of their game, excellence seems to be a worthy goal for which to strive. We hold up our best athletes as idols—we chant their name, wear their jerseys, even build statues of them. We treat them more like gods than like real people with internal lives and personal struggles.

More than ever before, however, athletes and other celebrities are speaking out about their mental health in a way that reflects the issues facing all of us on a daily basis. They experience the same daily pressures we all face to perform at work, succeed in life and love, and to be good role models for those around us, except that everything a professional athlete does is under the strongest of microscopes.

• Tennis star Naomi Osaka stepped away from the French Open and Wimbledon Championships, citing anxiety and depression.
• Olympic champion Simone Biles withdrew from multiple gymnastics events in Tokyo when her mind-body connection no longer allowed her to safely perform.
• NFL player Carl Nassib became the first openly gay active player in the league, in the process citing the need to support LGBTQ youths in crisis.

In 2021, these athletes and many others let the world know that they have the same rights to mental health as the rest of us. And while some in the public responded with confusion or even outrage, the world largely applauded. On Verywell Mind, many readers sought empowerment. for themselves, with increased interest in content around your rights at work when dealing with anxiety or depression.

If some of our highest achievers feel self-doubt, anxiety, or depression, any one of us can certainly feel the same. And if they’re willing to fight back against the stigma of mental health issues, we should all be willing to join that fight.

A Brave, Empowered New Workforce Emerged

While many young Americans have been exhausted by long hours and low pay well before the pandemic, COVID-19 only exacerbated these feelings of burnout and job stress.

As video conferencing replaced in-person meetings for over a year, zoom fatigue became an unofficial diagnosis of the physical and mental toll we felt as a result of inundated screen time. Stress loomed as parents juggled pitch presentations with in-home daycare. The line between work and life became increasingly blurred. That's where the so-called "Great Resignation" began

This isn't just about quitting or changing jobs, though. Our very attitudes about work, in general, have shifted to prioritize more flexibility and a greater sense of well-being, and companies responded with partial or full work-from-home arrangements and other considerations to prevent burnout.

This past year, in a survey of 1,000 women aged 13–39 conducted by research and insights company YPulse, we’ve discovered that millennial women particularly aren’t just rethinking their careers but reframing their lives entirely.

Despite still living through a pandemic, many people are beginning to experience what a post-pandemic world could look like. For Millennial and Gen-Z women specifically, the report reveals that moving forward, life and career goals for this group might better align with their values and desires.

Online Therapy Exploded in Popularity, But Did It Work for Everyone?

We saw online therapy skyrocket during the pandemic not purely out of necessity—but because therapists and clients were left with no other option. Though the rise in teletherapy made mental health treatment more accessible for some and allowed us to cast a wider net of therapists outside our immediate area, it also introduced a different set of inequities.

For instance, people who did not have access to computers, smartphones or landlines, steady Wi-Fi connections, and/or are not proficient with technology were at a disadvantage. A study from last winter found that older people (namely those over 55) were among those who reported fewer overall telehealth visits during the COVID-19 pandemic.

Being female, Black or Latinx, and having a lower household income were also all linked to a lower frequency of video calls, according to the JAMA study. As for scheduling fewer appointments of any kind, being Asian, on Medicaid, or not fluent in English were all reported factors.

While physical consultations may still be a reality as we return to normalcy, working together to help older and at-risk groups can ensure more people have access to the therapy they need long after the pandemic continues.

Close Cohabitation Made Many Relationships Worse

As it did for most areas, the pandemic also put our love lives to the test, and Verywell Mind readers wanted as much information as they could get their hands on. We observed significant growth in relationship-related content over the summer, including some of the following topics that cover the full spectrum of romantic relationships:

• Why you should have sex more often
• What to know about the five love languages
• Losing romantic feelings for your partner
• Major red flags in relationships

While many couples thrived as they worked, ate, and adapted together in close quarters, just as many struggled. At the beginning of the year, we surveyed more than 1,200 readers about dating and cohabitating during the pandemic to understand how people approached the season of romance.

Over a year of being cooped up indoors, home wasn’t a safe haven for all. The number of domestic violence incidents in the U.S. increased by 8.1% after lockdown orders, according to analysis released by the National Commission on COVID-19 and Criminal Justice (NCCCJ) in February.

While the dynamics driving the uptick are unclear, stay-at-home orders and pandemic-related economic impacts likely exacerbated factors typically associated with domestic violence, including increased male unemployment, stress associated with childcare, and increased financial insecurity. Poor coping strategies, including the increased substance use and limited access to shelters or safe housing options may have also elevated the risk of abuse.

Substance Use and Suicidal Ideation Presented Major Risks for Young People

In many ways, it feels like the world has stopped for a while. For some, staying safe at home presented an opportunity to step back, slow down a bit, and try to focus more on the things that matter most. For those already in crisis, however, isolation during the pandemic led to significant concerns of deteriorating mental health. People dealing with addictions, for example, may have lost peer support and the ability to safely partake in many of the usual coping mechanisms that helped contain their substance use.

While preliminary data shows that there has not been the significant wave in suicides that many feared during the pandemic, research shows some potential causes for alarm:

• In May, we found that 37% of Gen Z and 34% of Millennials reported thoughts of self-harm over the previous 2 weeks, while over 40% of both populations reported feelings of depression or hopelessness.
• A CDC report showed that suicide rates for males aged 10-14, 15-24, and 25-34 had increased during the pandemic by 13%, 1%, and 5%, respectively. Suicide deaths also increased for black and Hispanic males.
• In July, our Mental Health Tracker survey found that 26% of Americans said they were using more substances than normal over the previous 30 days.

Before COVID, opioids were the epidemic of note, and while our attention has been diverted, the dangers of opioid use have not faded. In fact, overdoses have continued to rise, with CDC provisional data from April showing a 28.5% year-over-year increase in drug overdose deaths.

The personal crises associated with addiction have not stopped, rather they have been looped into the ongoing crises tied to the pandemic, and must not be forgotten. Fortunately, teletherapy, virtual support groups, and other digital options have risen to the challenge of supporting individuals in crisis over the past year.

Extreme Weather Events Provoked Climate Anxiety

While COVID-19 has created a sense of global, existential dread the likes of which many of us have not felt before, climate change persists as an ongoing issue that will continue to affect our lives long after the pandemic is over. On the surface, climate issues appear to create mostly physical experiences—extreme heat and cold, poor air quality, stronger hurricanes, and more frequent floods and wildfires.

That said, the increasingly difficult living conditions, fear for the future, and political discord all commonly associated with climate change have sparked a rise in what can only be described as “climate anxiety.” On several levels, the climate impacts our mental health in a negative way:

• Childhood exposure to air pollution can contribute to mental health issues like depression and substance use down the line.
• High levels of heat may make people more aggressive and depressed, and potentially at higher risk of suicide, with a 0.7% increase in risk for every 1.8-degree increase in the monthly average temperature.
• Should conditions make certain places unlivable, many could face the disastrous effects of homelessness. For example, in a 2021 government report, 69% of homeless youth reported mental health problems.
  
  
• With climate change factors impacting fertility and our feelings about the future, some believe that the issue may be contributing to the decreasing U.S. birth rate.

The climate issue can often spark feelings of distress and even helplessness. It’s a problem so big that it can feel unsolvable. And at a personal level, it’s complicated enough to plan for the future without having to account for unknowable paradigm shifts. That holds particularly true for Gen Z, 71% of whom are concerned about climate change, while 62% of Americans have climate change-related events among their top 3 concerns about the future.

Disparities in Health, Treatment, and Support Affected the LGBTQ+ Community

Isolation can be a struggle for anyone, even the introverts among us. If nothing else, life during the pandemic has proven that. For some, these effects can be even more difficult to bear. People in the LGBTQ+ communities are one example of those who have faced some unique struggles since the start of the pandemic. For LGBTQ+ individuals, restrictions on public activity meant less access to the larger community—an essential outlet for many.

COVID-related difficulties are even more drastic for others, for example, transgender individuals who have been forced to delay gender-affirming surgeries due to a lack of hospital resources or losing their job and health insurance.

Research shows that the LGBTQ+ community, unfortunately, is already at higher risk of mental health issues, and are:

• At least twice as likely to experience severe alcohol or tobacco use as straight individuals
• More likely to be bullied, with 29% of gay or lesbian youth and 31% of bisexual youth having reported being bullied at school, nearly double the rate of straight youth
• More likely to suffer from depression and anxiety
• About 4 times more likely to consider suicide than non-LGBTQ individuals

Additionally, research shows that LGBTQ+ individuals are less likely to receive treatment for issues like substance use or mental health conditions, with as many as 45% receiving no treatment for a mental illness.

On top of that, sexual minorities have higher rates of conditions like cancer, asthma, and heart disease that lead to a higher risk of COVID infection and complications. The disparities that put members of this community at higher risk of physical and mental health issues made them uniquely vulnerable during this time.

When those disparities are cast aside, however, it seems that outcomes improve. An August 2021 survey from the Human Rights Campaign found that 92% of LGBTQ+ adults had received at least one dose of a COVID vaccine—a treatment freely available to all. Without the barriers and biases that put LGBTQ individuals at greater health risks, potentially life-saving treatment was administered to great effect in 2021.

We Turned to Social Media, for Better and Worse

When it comes to social media and our mental health, the first and second years of the pandemic are not created equal. In those early months of lockdown, we united around the collective suffering of quarantine, each one of us doing our part by staying home and learning dances to post on TikTok. We all struggled together and somehow FOMO and self-criticism melted away—but only briefly. 

Once vaccinations were approved and the so-called ‘return to normalcy’ began, the highlight reels were back with a vengeance, along with the anxiety and self-judgment that came with them. What’s more, many people wanted to show that they emerged from a traumatic year looking flawless as ever, with 90% of women reporting the use of a photo filter. When all you see on social media are edited photos, it can promote a vicious culture of unattainable beauty standards—at the inevitable detriment to mental health.

Instagram in particular has been especially hard on teen girls, whose developing body image and sense of self-acceptance are highly vulnerable. This past September, leaked internal documents showed that Facebook (now Meta) knew Instagram was having a consistently negative effect on the mental health of teenage girls—32% of teens said that when they were feeling bad about their bodies, Instagram made them feel worse.

Adults aren't immune from these effects, either. In a November study, social media use was associated with increased levels of depression in 9% of individuals who previously reported no symptoms of depression. Snapchat, Facebook, and TikTok were cited as the biggest offenders.

Social media isn't slowing down, so it's on us to be more intentional about our social media use, and more careful about what we consume on a daily basis.

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A Word From Verywell

Last year at this time, we called 2020 the most difficult year of many people's lives. In many ways, things did get better this year, between widespread vaccine access, better treatments for COVID, more openness around mental health.

And yet, as 2021 closes, researchers are determining the dangers of the variant known as Omicron, travel restrictions are tightening, and people are wondering if it will be necessary to quarantine again. Even as we gather for the holidays, return to some form of in-office work, and re-learn what it means to be social, we aren't out of the woods.

As we always try to do, we at Verywell Mind will do our best to reduce stigma, provide healthy and accessible coping strategies, and present possible next steps for your mental health journey in a friendly, non-judgmental way. As we approach the uncertain future of 2022, the best we can do is take care of ourselves and look out for each other. No matter what you're struggling with, know that you're not alone.