Roughly 21 million adults and 5 million adolescents in the United States experience a major depressive episode in a given year. That combined figure of about 26 million people represents one of the most common health conditions in the country, and the numbers have been climbing steadily since at least 2015.
How Depression Rates Have Changed Over Time
Depression is not holding steady in the U.S. The prevalence of past-year depression among all ages rose from 7.3% in 2015 to 8.6% in 2019, then jumped again to 9.2% in 2020. The sharpest increases have hit younger age groups. Among 18- to 25-year-olds, the rate climbed from 10.3% in 2015 to 17.2% in 2020, nearly doubling in just five years. Adolescents aged 12 to 17 saw a similar trend, rising from 12.7% to 16.9% over the same period. Adults aged 26 to 34 also saw a meaningful increase, from 7.5% to about 10%.
By 2021, one in five adolescents (20.1%) had experienced at least one major depressive episode during the year. Of those 5 million teens, about 3.7 million, or 14.7% of all U.S. adolescents, had episodes severe enough to significantly impair their ability to function at school, at home, or in relationships.
Who Is Most Affected
Women are diagnosed with depression at roughly twice the rate of men. In 2020, 11.8% of women reported past-year depression compared to 6.4% of men. That gap has persisted across every year of recent data collection, and it holds across nearly all racial and ethnic groups.
When it comes to race and ethnicity, the differences are smaller than many people assume. CDC data from a large national survey found that non-Hispanic Black adults had a depression prevalence of 9.2%, Hispanic adults 8.2%, and non-Hispanic white adults 7.9%. Those three groups were statistically similar. Non-Hispanic Asian adults had the lowest rate at 3.1%.
States With the Highest Rates
Depression is not evenly distributed across the country. According to the CDC’s Behavioral Risk Factor Surveillance System, the states where the highest percentage of adults have ever been diagnosed with depression are West Virginia (30.2%), Kentucky (28.3%), Oregon (27.3%), Maine (26.7%), and Michigan (26.7%). These figures reflect lifetime diagnoses rather than past-year episodes, so they capture anyone who has ever received a depression diagnosis from a healthcare provider. States in Appalachia and the rural South consistently rank higher, likely reflecting overlapping factors like poverty, limited access to mental health care, and higher rates of chronic pain and disability.
What Counts as Depression in These Numbers
National surveys use criteria based on the standard psychiatric diagnostic manual. To meet the threshold for a major depressive episode, a person needs to have experienced at least five specific symptoms during the same two-week period. At least one of those symptoms must be either a persistently depressed mood or a noticeable loss of interest or pleasure in nearly all activities.
The other qualifying symptoms include significant changes in weight or appetite, sleeping too much or too little, physically feeling slowed down or agitated in ways others can notice, daily fatigue, feelings of worthlessness or excessive guilt, trouble concentrating or making decisions, and recurring thoughts of death or suicide. These symptoms also need to cause real impairment in daily life, whether at work, in relationships, or in other areas. A rough couple of weeks that resolves on its own typically wouldn’t meet the bar.
The Economic Cost
Depression’s financial toll on the U.S. economy reached an estimated $326.2 billion in 2018, up 38% from $236.6 billion in 2010. What changed most over that period was the balance of where costs land. Workplace costs, including lost productivity, now account for 61% of the total burden, up from 48% in 2010. Direct treatment costs (outpatient visits, inpatient stays, medications) make up 35%.
The workplace losses are driven primarily by “presenteeism,” the phenomenon of showing up to work but being unable to perform at full capacity. Presenteeism accounts for 70% of all workplace costs tied to depression. Absenteeism makes up the other 30%, and that category more than doubled between 2010 and 2018, rising by 129%. Pharmacy spending for depression-related medications totaled $20.4 billion in 2018, a relatively small slice of the overall economic picture.
The Treatment Gap
Despite the scale of these numbers, a significant portion of people with depression receive no treatment at all. The gap between how many people have depression and how many get help has actually widened in recent years, even as overall prevalence has risen. Among adolescents, more than a quarter of those with major depressive episodes received no mental health services. For adults, the gap is driven by a combination of cost, stigma, shortage of providers (particularly in rural areas), and the fact that many people don’t recognize their symptoms as depression. The steepest increases in depression rates between 2015 and 2020 occurred in the same young adult age groups that historically face the most barriers to accessing care, including lack of insurance, unfamiliarity with the mental health system, and difficulty finding providers who accept new patients.