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Mental & Physical Health20266 min read

Your Mental Health Isn't Just About You

Demographic variation in symptoms of depression and anxiety across 22 Global Flourishing Study countries

Notable finding

Substantial depression symptoms range from 14% in Poland to 50% in the Philippines across 22 countries

By
Bradshaw, Matt et al.
Participants
202,898
Countries
22
Journal
Communications Medicine
DOI
10.1038/s43856-025-01366-9
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§1

Key Takeaways

01

Substantial symptoms of depression and anxiety vary widely across 22 countries, with lower-income, non-Western nations tending to report higher proportions of both outcomes compared with higher-income, predominantly Western countries.

02

When pooled across all 22 countries, several demographic factors—including age, gender, marital status, employment status, and education—are associated with symptoms of depression and anxiety, though the strength and direction of these associations often differ across individual nations.

03

The associations between demographic characteristics and mental health symptoms vary considerably across individual countries, suggesting that country-specific cultural, economic, and social contexts play important roles in shaping patterns of depression and anxiety.

§2

Why It Matters

Effective mental health care must be tailored to the real-world pressures people face in their own communities and cultures.

This research matters because it gives us the first real look at mental health symptoms in many countries that have never been studied this way before. Most prior global mental health research focused on clinical diagnoses in wealthier nations. This study broadens the picture by measuring everyday symptoms of depression and anxiety — the kind that may not meet the threshold for a diagnosis but still affect how people live and function. The findings point to vulnerable groups — young adults, unemployed people, those who are separated — who may benefit from targeted screening and support. They also reveal that patterns we often assume are universal, like the mental health benefits of marriage or religious attendance, don't hold everywhere. For policymakers, public health officials, and mental health advocates, this means one-size-fits-all solutions won't work. Each country may need its own approach based on its unique cultural, economic, and social context. As future waves of data arrive, researchers will be able to track how these patterns change over time.

This research matters because it gives us the first real look at mental health symptoms in many countries that have never been studied this way before. Most prior global mental health research focused on clinical diagnoses in wealthier nations. This study broadens the picture by measuring everyday symptoms of depression and anxiety — the kind that may not meet the threshold for a diagnosis but still affect how people live and function. The findings point to vulnerable groups — young adults, unemployed people, those who are separated — who may benefit from targeted screening and support. They also reveal that patterns we often assume are universal, like the mental health benefits of marriage or religious attendance, don't hold everywhere. For policymakers, public health officials, and mental health advocates, this means one-size-fits-all solutions won't work. Each country may need its own approach based on its unique cultural, economic, and social context. As future waves of data arrive, researchers will be able to track how these patterns change over time.

Effective mental health care must be tailored to the real-world pressures people face in their own communities and cultures.

§3

The Story

Imagine asking over 200,000 people in 22 different countries how they've been feeling lately. That's exactly what this study did. Researchers wanted to understand how symptoms of depression and anxiety vary across the globe — not just in wealthy Western nations, but in places that rarely get studied, like Tanzania, Kenya, and Indonesia.

The factors we assume protect our mental health, like marriage or religion, do not work the same way everywhere in the world.

They asked people four simple questions about whether they'd been feeling down, hopeless, nervous, or unable to stop worrying over the past two weeks. The results were striking. In the Philippines, about half of all people surveyed reported substantial symptoms of depression. In Poland, it was only about 14%.

Anxiety followed a similar pattern. Lower-income, non-Western countries tended to have higher proportions of both. But the study also looked at who within each country was struggling most. Younger people reported more symptoms than older people. People who were separated from a partner had higher rates than those who were married.

Unemployed people reported more symptoms than retirees. More education was tied to fewer symptoms in many countries — but not everywhere. And surprisingly, attending religious services more often was tied to better mental health in only two countries: the United States and Israel. In several other nations, the pattern was reversed or simply didn't exist. The big takeaway? Mental health struggles are everywhere, but who is most affected — and what seems to help — depends a lot on where you live.

Figure
50%
Highest National Depression Rate

In the Philippines, 50% of individuals reported substantial symptoms of depression, the highest proportion among the 22 countries studied.

Figure
3.6:1
Cross-National Depression Ratio

The proportion of individuals with substantial depression symptoms in the Philippines (0.50) was approximately 3.6 times that of Poland (0.14), the country with the lowest proportion.

Figure
+18 points
Employment Gap in Depression

When pooled across all 22 countries, the proportion with substantial depression symptoms was 18 percentage points higher among those unemployed and looking for a job (0.42) than among retired individuals (0.24).

Figure
2.5x
Age Gradient in Depression

In the pooled analysis across all 22 countries, the proportion of individuals with substantial depression symptoms among those aged 18–24 (0.40) was about 2.5 times the proportion among those aged 80 or older (0.16).

Figures
50%
Highest National Depression Rate

In the Philippines, 50% of individuals reported substantial symptoms of depression, the highest proportion among the 22 countries studied.

3.6:1
Cross-National Depression Ratio

The proportion of individuals with substantial depression symptoms in the Philippines (0.50) was approximately 3.6 times that of Poland (0.14), the country with the lowest proportion.

+18 points
Employment Gap in Depression

When pooled across all 22 countries, the proportion with substantial depression symptoms was 18 percentage points higher among those unemployed and looking for a job (0.42) than among retired individuals (0.24).

2.5x
Age Gradient in Depression

In the pooled analysis across all 22 countries, the proportion of individuals with substantial depression symptoms among those aged 18–24 (0.40) was about 2.5 times the proportion among those aged 80 or older (0.16).

§4

Reader Questions

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Research Details
& Citation

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Published
2026
Journal
Communications Medicine
Participants
202,898
Countries
22
Cite this paper
Bradshaw, M., Shiba, K., Jang, S. J., Kent, B. V., Bonhag, R., Johnson, B. R., & VanderWeele, T. J. (2026). Demographic variation in symptoms of depression and anxiety across 22 Global Flourishing Study countries. Communications Medicine, 6(1). https://doi.org/10.1038/s43856-025-01366-9
Tags
mental healthdepression-anxietyageincomemarriage
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