Trends in extreme distress in the United States, 1993–2024

Background. We aim to quantify changes in the percentage of US citizens suffering extreme distress since 1993. Methods. Using data on 10.9 million randomly sampled US citizens between 1993 and 2024, we present raw and covariate-adjusted trends in the incidence of extreme distress defined as the percentage who report major mental and emotional problems in all 30 of the last 30 days. We present trends for men and women separately and distinguish between the young and the old, and by work status. Results. Extreme distress has almost doubled since 1993. It rose for men and women, workers and non-workers. But the biggest increases were among young workers – particularly women.