LifeStance patients broadly experience clinically meaningful reductions in anxiety (79%) and depression (73%) symptoms. While aggregated results can sometimes hide important differences within the larger group, LifeStance’s study amongst more than 139,000 patients with at least moderate depression or anxiety found that 75% or more improved significantly no matter their age or geographic region.

LifeStance patients broadly experience clinically meaningful reductions in anxiety (79%) and depression (73%) symptoms

A Quick Note on the Numbers

  • Between September 2024 and December 2025, we studied 143,941 patients on the PHQ-9 and 139,798 patients on the GAD-7 that reported at least moderate depression or anxiety severity at baseline (indicated by a score of 10 or higher on the PHQ-9 or GAD-7).
  • PHQ-9 is a 9-question instrument that measures depression. Scores range from 0 to 27. Higher scores mean more depressive symptoms.1
  • GAD-7 is a 7-question instrument that measures anxiety. Scores range from 0 to 21. Higher scores mean more anxiety symptoms.2

Results by Generation

People often ask whether mental healthcare works differently for people of different ages. To investigate potential differences within our dataset, we broke the results down by four major age-related generations (see Table 1 below). Age generations attempt to categorize people born during similar “eras,” or timeframes that share similar historical and cultural experiences. This allows researchers to investigate how these shared factors may influence certain beliefs and behaviors, including response to psychotherapy.3

We found strong similarities in clinical reductions between generations for both depression and anxiety symptoms. The generational order for reductions in depression symptoms from highest percentage to lowest was millennials (77.91%), Generation X (Gen X) (76.54%), baby boomers (76.15%) and Generation Z (Gen Z) (75.65%) and for anxiety symptom reduction it was millennials (83.76%), Gen Z (81.70%), Gen X (80.88%) and baby boomers (79.34%).

This similarity is particularly important related to the findings for those in Gen Z, which includes teenagers and young adults born between 1997 and 2012. Research has routinely found that teenagers, when compared to adults, exhibit lower response rates to psychotherapy4 and some studies have found young adults do not do as well as older adults5. LifeStance data shows that no matter what the generation, our clients experience strong and remarkably similar results.

Table 1. Patients with Clinically Significant Reduction in Symptoms by Generation

Generation Depression (PHQ-9) Clinically Significant Reduction in Symptoms Anxiety (GAD-7) Clinically Significant Reduction in Symptoms
Baby Boomers (ages 62-80) 76.15% 79.34%
Generation X (ages 46-61) 76.54% 80.88%
Millennials (ages 30-45) 77.91% 83.76%
Generation Z (ages 14-29) 75.65% 81.70%
Overall 76.74% 82.24%

Results by Geography (U.S. Census Region)

Mental health resources are not spread evenly across the country. Rural areas often have fewer therapists per person than urban areas, and access to specialty care varies by state.6 There are also important demographic differences by region, which could influence response rates to psychotherapy.

We grouped patients by the four official U.S. Census regions and used the corresponding U.S. Census Bureau’s urban-rural population percentages for each, to compare overall outcomes across regions with variable mixes of rural and urban populations (see Table 2 below). The results of the analysis demonstrate that overall efficacy across regions was comparable despite differences in rural versus urban populations with little variation from the overall response rates for either depression or anxiety. The geographical order for reductions in depression symptoms from highest percentage to lowest was South (77.82%), Northeast (76.87%), Midwest (75.78%) and West (75.53%), and for anxiety symptom reduction it was Northeast (83.32%), South (82.68%), Midwest (81.83%), and West (80.99%). Geographic consistency of outcomes is important and supports that LifeStance can provide high quality care on a national scale.

Table 2. Patients with Clinically Significant Reduction in Symptoms by U.S. Census Region

US Region Depression (PHQ-9) Clinically Significant Reduction in Symptoms Anxiety (GAD-7) Clinically Significant Reduction in Symptoms
Midwest (74.3% Urban) 75.78% 81.83%
Northeast (84.0% Urban) 76.87% 83.32%
South (75.8% Urban) 77.82% 82.68%
West (88.9% Urban) 75.53% 80.99%
Overall 76.74% 82.24%

Summary and Conclusions

Using a very large sample, we analyzed our results by generation and geographic region. There was a remarkable similarity in outcomes for both depression and anxiety across subgroups:

  • A minimum of 75% of individuals from every generation and U.S. Census region experienced clinically significant reductions in depression or anxiety.

Based on these findings, we can confidently report that the strong aggregate results we published previously7 are not due to certain subgroups of patients within these demographic characteristics doing very well in treatment while others struggle. Rather they are due to LifeStance providing strong, consistent care across age groups and across different areas of the U.S. The improvement is broad, and it is consistent.

Appendix: Source Tables

PHQ9 Scores by Demographics

Table 1. PHQ9 Scores by Generation

Characteristic Overall (N = 143,941) Baby Boomers (N = 9,362) Generation X (N = 24,509) Generation Z (N = 52,441) Millennials (N = 57,629) p-value
First PHQ9 Score <0.001
Mean (SD) 14.17 (4.93) 14.38 (4.85) 14.57 (5.09) 14.13 (4.85) 14.01 (4.94)
Median (IQR) 14.00 (8.00) 14.00 (7.00) 14.00 (7.00) 14.00 (6.00) 13.00 (7.00)
Min, Max 5.00, 27.00 5.00, 27.00 5.00, 27.00 5.00, 27.00 5.00, 27.00
PHQ9 Score when MCID achieved <0.001
Mean (SD) 6.78 (4.43) 6.79 (4.45) 7.04 (4.59) 6.86 (4.38) 6.59 (4.40)
Median (IQR) 6.00 (5.00) 6.00 (5.00) 6.00 (6.00) 6.00 (5.00) 6.00 (6.00)
Min, Max 0.00, 27.00 0.00, 27.00 0.00, 27.00 0.00, 27.00 0.00, 27.00
Unknown 33,484 2,233 5,751 12,768 12,732
PHQ9 MCID achieved 110,457 (76.74%) 7,129 (76.15%) 18,758 (76.54%) 39,673 (75.65%) 44,897 (77.91%) <0.001

Table 2. PHQ9 Scores by U.S. Census Region

Characteristic Overall (N = 143,941) Midwest (N = 36,059) Northeast (N = 21,997) South (N = 59,219) West (N = 26,666) p-value
First PHQ9 Score <0.001
Mean (SD) 14.17 (4.93) 14.08 (4.91) 13.67 (4.84) 14.41 (4.95) 14.20 (4.96)
Median (IQR) 14.00 (8.00) 13.00 (7.00) 13.00 (7.00) 14.00 (7.00) 13.00 (8.00)
Min, Max 5.00, 27.00 5.00, 27.00 5.00, 27.00 5.00, 27.00 5.00, 27.00
PHQ9 Score when MCID achieved <0.001
Mean (SD) 6.78 (4.43) 6.72 (4.38) 6.55 (4.38) 6.84 (4.47) 6.91 (4.45)
Median (IQR) 6.00 (5.00) 6.00 (5.00) 6.00 (6.00) 6.00 (5.00) 6.00 (5.00)
Min, Max 0.00, 27.00 0.00, 27.00 0.00, 27.00 0.00, 27.00 0.00, 27.00
Unknown 33,484 8,735 5,089 13,135 6,525
PHQ9 MCID achieved 110,457 (76.74%) 27,324 (75.78%) 16,908 (76.87%) 46,084 (77.82%) 20,141 (75.53%) <0.001

GAD7 Scores by Demographics

Table 3. GAD7 Scores by Generation

Characteristic Overall (N = 139,798) Baby Boomers (N = 8,716) Generation X (N = 23,721) Generation Z (N = 50,971) Millennials (N = 56,390) p-value
First GAD7 Score <0.001
Mean (SD) 13.61 (4.27) 12.81 (4.33) 13.71 (4.36) 13.59 (4.22) 13.71 (4.25)
Median (IQR) 13.00 (7.00) 13.00 (6.00) 14.00 (7.00) 13.00 (7.00) 14.00 (6.00)
Min, Max 5.00, 58.00 5.00, 21.00 5.00, 58.00 5.00, 48.00 5.00, 54.00
GAD7 Score when MCID achieved <0.001
Mean (SD) 6.43 (4.03) 5.89 (3.99) 6.49 (4.10) 6.52 (4.01) 6.41 (4.03)
Median (IQR) 6.00 (5.00) 6.00 (5.00) 6.00 (5.00) 6.00 (5.00) 6.00 (5.00)
Min, Max 0.00, 21.00 0.00, 21.00 0.00, 21.00 0.00, 21.00 0.00, 21.00
Unknown 24,823 1,801 4,535 9,328 9,159
GAD7 MCID achieved 114,975 (82.24%) 6,915 (79.34%) 19,186 (80.88%) 41,643 (81.70%) 47,231 (83.76%) <0.001

Table 4. GAD7 Scores by U.S. Census Region

Characteristic Overall (N = 139,798) Midwest (N = 35,604) Northeast (N = 21,670) South (N = 56,302) West (N = 26,222) p-value
First GAD7 Score <0.001
Mean (SD) 13.61 (4.27) 13.58 (4.27) 13.34 (4.19) 13.78 (4.29) 13.50 (4.27)
Median (IQR) 13.00 (7.00) 13.00 (7.00) 13.00 (7.00) 14.00 (6.00) 13.00 (7.00)
Min, Max 5.00, 58.00 5.00, 58.00 5.00, 21.00 5.00, 21.00 5.00, 21.00
GAD7 Score when MCID achieved <0.001
Mean (SD) 6.43 (4.03) 6.42 (3.96) 6.31 (3.98) 6.44 (4.10) 6.52 (4.02)
Median (IQR) 6.00 (5.00) 6.00 (5.00) 6.00 (5.00) 6.00 (6.00) 6.00 (5.00)
Min, Max 0.00, 21.00 0.00, 21.00 0.00, 21.00 0.00, 21.00 0.00, 21.00
Unknown 24,823 6,470 3,614 9,753 4,986
GAD7 MCID achieved 114,975 (82.24%) 29,134 (81.83%) 18,056 (83.32%) 46,549 (82.68%) 21,236 (80.99%) <0.001

Citations

  1. Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

  2. Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092. https://doi.org/10.1001/archinte.166.10.1092

  3. Pilcher, J. (1994). Mannheim’s Sociology of Generations: An Undervalued Legacy. The British Journal of Sociology, 45(3), 481. https://doi.org/10.2307/591659

  4. Cuijpers, P., Karyotaki, E., Eckshtain, D., Ng, M. Y., Corteselli, K. A., Noma, H., Quero, S., & Weisz, J. R. (2020). Psychotherapy for Depression Across Different Age Groups: A Systematic Review and Meta-analysis. JAMA Psychiatry, 77(7), 694. https://doi.org/10.1001/jamapsychiatry.2020.0164

  5. Saunders, R., Suh, J. W., Buckman, J. E. J., John, A., El Baou, C., Pilling, S., Lewis, G., Stott, J., Krebs, G., & Stringaris, A. (2025). Effectiveness of psychological interventions for young adults versus working age adults: A retrospective cohort study in a national psychological treatment programme in England. The Lancet Psychiatry, 12(9), 650–659. https://doi.org/10.1016/S2215-0366(25)00207-X

  6. Bureau, U. C. (n.d.). Urban and Rural. Census.Gov. Retrieved May 27, 2026, from https://www.census.gov/programs-surveys/geography/guidance/geo-areas/urban-rural.html

  7. Measuring Depression & Anxiety Treatment Outcomes: LifeStance Insights. (n.d.). LifeStance Health. Retrieved June 2, 2026, from https://lifestance.com/insight/depression-anxiety-treatment-outcomes/

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Authored By 

Olga Konovalova, Master’s in Finance
Authored By Bridget Balkaran, MPH
Bridget Balkaran, MPH

A driven biostatistician with strong analytical skills for EMR data. Focuses on translating statistical results into interpretable solutions by identifying and reporting associations. Experience with machine learning and regression models. A unique combination of technical proficiency and clear communication through storytelling with data to discover solutions.

Authored By Matthew Worley, PhD
Matthew Worley, PhD

At LifeStance Health, Matthew leads an Analytics and Insights team focused on business intelligence, performance measurement, clinical quality and outcomes, and delivering insights that inform strategic decision-making, while also overseeing a Community of Analytics that promotes strong data governance and best practices. They bring over 20 years of experience leading data science and business intelligence teams across both startups and large enterprises, with expertise spanning internal analytics and external partnerships. Matthew's background combines quantitative and clinical knowledge, with a focus on statistical modeling, machine learning, and behavior change in health technology and clinical research.

Authored By Stephanie Eken, MD, MBA
Stephanie Eken, MD, MBA

Stephanie Eken, MD, MBA, is a triple board-certified psychiatrist, child and adolescent psychiatrist, and pediatrician with more than 20 years of experience in behavioral health, currently serving as Chief Medical Officer at LifeStance, where she leads clinical strategy and vision to advance outpatient mental healthcare. Prior to joining LifeStance, she served as Chief Medical Officer at Acadia Healthcare and spent 15 years at Rogers Behavioral Health, where she also held the role of Chief Medical Officer. A recognized thought leader in clinical governance, behavioral health innovation, and patient safety, Dr. Eken holds a bachelor’s degree from the University of Richmond, earned her medical degree from the University of Tennessee Health Science Center College of Medicine, completed her residency at the University of Kentucky, and received her MBA from the University of Tennessee.