Marriage, Family, and the Mental Health Crisis

As of 2022, 15% of U.S. teens reported a major depressive episode¹(up from 8% in 2007).² The suicide rate has increased by 38% in the last 20 years, an all-time high.³ The vast majority of Americans agree that we are facing a mental health crisis. It’s worth considering, how did we get here? What is driving the huge increase in mental health problems facing our nation? 

There are many factors at play. The pandemic certainly exacerbated our mental health crisis, but trouble was brewing long before COVID-19. The increasing amount of time Americans spend glued to screens has also been problematic. But underlying many of the developments that have contributed to our failing collective mental health is a growing social disconnectedness. In fact, loneliness has been found to be as harmful to health as obesity or even cigarette smoking.⁴

At the heart of this loneliness epidemic is the breakdown of marriage and family that has occurred during the last five decades. Admitting this is somewhat taboo in many circles. But, as University of Maryland economist Melissa Kearney has noted in her recent book, The Two Parent Privilege, the data are overwhelming at this point. People are more likely to thrive when they find themselves in the context of stable, loving marriages and families. Unfortunately, these trends have impacted the most vulnerable among us, those from the poor and working class. 

Children, in particular, are more likely to experience mental health problems when they experience family breakdown. In one study of several thousand families, children from divorced or single-parent families were 3.2 times more likely to experience an anxiety disorder, 2.8 times more likely to experience depression, and 1.9 times more likely to suffer from ADHD compared to children from intact families.⁵ Another study found that girls whose parents divorced were 50% more likely to attempt suicide when they grew up compared to girls from intact families.⁶ In terms of academic performance, children from intact families are less likely to drop out of high school, less likely to be expelled or have to repeat a grade, and less likely to be without a job or school in early adulthood.⁷

But don’t just keep mom and dad together for the kids’ sake. There are lots of reasons to keep couples together for their own well-being. Marriage seems to have unique benefits for both men and women, including substantially increased chances of happiness, better physical and mental health, and increased longevity.⁸

Some argue that family breakdown has nothing to do with our increase in isolation, or that we can somehow alleviate our loneliness by strengthening communal ties while ignoring family ties. A recent report⁹ on the loneliness epidemic by the Surgeon General omitted any consideration of strengthening marriage and family relationships in its recommendations, even though Dr. Murthy recounted his own transformative experience with family that was integral to bringing him back from the brink of despair (curiously, the word ‘family’ doesn’t even appear in the report’s recommendations).¹⁰ This somewhat naïve approach ignores an important connection between the root of relationships and biology. Why is social connectedness so important? Why are our personal relationships the most important determinant of health, happiness, and well-being? If you believe in scientific explanations, a big part of the answer must come from our evolution.

From a scientific standpoint, the importance of relationships is most likely related to the necessarily deep and loving relationships that human parents had to develop with their young children to ensure their survival. Human infants are utterly helpless when they are born. In fact, some experts call the first few months of life the “fourth trimester” because our babies are born half baked. They are totally dependent on their parents for survival. As a result, human parents have developed an incredibly deep feeling of love and attachment toward their children. Family relationships represent the most powerful forms of affection that nature has created. 

Some might think this is a cynical perspective—that we only love our children because they share our genes. I would frame it as follows: this is how nature created within us the most powerful forms of love and affection. This is the way we were created. 

Another reason relationships are so important is that strong social connections have always served us so well. During the Pleistocene era, our ancestors likely faced many unpredictable challenges, ranging from rapidly changing weather to attacks from wild animals. Those families that formed strong social connections were more likely to survive. As a consequence, deep relationships became extremely rewarding.

If we are going to tackle the problem of waning social connectedness, the most logical place to start is with our family relationships, those with whom we share genetic relatedness. This is a function of how we were created. 

Dr. Samuel Wilkinson is Associate Professor of Psychiatry at the Yale School of Medicine and Associate Director of the Yale Depression Research Program. This essay is adapted from his new book, Purpose: What Evolution and Human Nature Imply About the Meaning of Our Existence. 

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1. Reinert, M, Fritze, D. & Nguyen, T. (October 2021). “The State of Mental Health in America 2022,” Mental Health America, Alexandria VA. 

2. A. W. Geiger and Leslie Davis, “A Growing Number of American Teenagers – Particularly Girls – Are Facing Depression,” Pew Research Center, July 12, 2019.

3. Haley Weiss, “U.S. Suicide Rates Reached an All-Time High in 2022,” TIME, November 29, 2023.

4. Julianna Holt-Lunstad, Timothy B. Smith, Mark Baker, Tyler Harris, and David Stephenson, “Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review,” Perspectives on Psychological Science 10, No. 2 (March 11, 2015), 227–237.

5. Francisco Perales, Sarah E. Johnson, Janeen Baxter, David Lawrence, and Stephen R. Zubrick, “Family Structure and Childhood Mental Disorders: New Findings from Australia,” Social Psychiatry and Psychiatric Epidemiology 52 (2017), 423–433.

6. Dana Lizardi, Ronald G. Thompson, Katherine Keyes, and Deborah Hasin, “Parental Divorce, Parental Depression, and Gender Differences in Adult Offspring Suicide Attempt,” Journal of Nervous and Mental Disease 197, No. 12 (Dec. 2009), 899–904.

7. Samuel T. Wilkinson, Purpose: What Evolution and Human Nature Imply About the Meaning of Our Existence (New York: Pegasus Books), 2024. 

8. The Effect of Marriage on Health: A Synthesis of Recent Research Evidence. Research Brief, Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, June 30, 2007.

9. Our Epidemic of Loneliness and Isolation: The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community, 2023.

10. Vivek Murthy, “Surgeon General: We Have Become a Lonely Nation. It’s Time to Fix That.” The New York Times, April 30, 2023.