Depression — A Disturbing Trend in Teens
by Lauro Amezcua-Patino, MD, FAPA and Vincent Perez-Mazzola
Being a teenager is tough. Social pressures, sexual pressures, academic pressures, and many other challenges face our teens as they navigate through the labyrinth of adolescence. With the added issues brought on by social media, transgender issues, and even politics, the simple choice of what to wear to school that day can become a significant source of stress. “Will I fit in? How will I do on my test? Am I ready for the big game? What colleges should I apply to?” are just some of the daily pressures our contemporary teens face. It is a much more complicated world than we, as parents, had to navigate.
The COVID years added significant stressors to this already difficult time. Many teens became more isolated and less sociable, while others flourished outside of the classroom. As with all human things, there is no one-size-fits-all. As a psychiatrist specializing in adolescents, the past few years have seen more hospitalizations, suicide attempts, and challenges than in the past. And though there are some positive trends, such as less bullying and early sexual experimentation, the overall picture of teen mental health is bleak.
A recent 10-year study (2011–2021) by the Centers for Disease Control and Prevention (CDC) has shown a downward trend in many areas that significantly affect our teens. Indicators of teen health and well-being — mental health, suicidal ideation, risky sexual behaviors such as reduced condom use and targeted violence — have worsened significantly. Forty percent of high school students report feeling so sad, depressed, or hopeless that they cannot engage in their regular activities such as clubs, sports, and academics. These depressive bouts lasted weeks for some and significantly affected their performance.
Depression in Teens and Adolescents
Depression in teens and adolescents significantly increases the risk of self-harm, risky behaviors, and suicide. Many in the study reported increased thoughts of suicide that went beyond imagining. Many reported seriously considering suicide, planning their death, or even attempting to end their lives at one point or another. Their hopelessness drives them to an existential crisis at a higher rate than at any other time in history. Sadly, the population moving the fastest in a downward direction were female students, who, compared to their male counterparts, were at an even higher risk of substance abuse, violence, and suicidality.
The study found that a lack of connectedness was one of the main culprits, along with poor parental monitoring and unstable housing. Defined as being or feeling socially, emotionally, spiritually, or professionally linked with others or with another, connectedness also refers to the closeness of specific groups and identification with a group or institution such as a school, club, or social organization. Essentially, it is a feeling of belonging, of worth, and knowing one’s place within the framework of society. Some time back, a teacher friend of mine asked his students what their greatest fear was. Some said death, poverty, embarrassment, spiders, and other usual suspects of personal phobias. One student said nothing until prompted by the teacher. That student’s response? His greatest fear was “being irrelevant.”
The lack of feeling relevant in a social framework can lead to feelings of worthlessness. This lack of connectivity makes high school particularly challenging, as many of us have experienced. However, a lack of connectedness can also have a long-lasting impact well into adulthood. It can lead to a pattern of self-isolation that often leads to further depression. Isolation may then become a self-induced coping mechanism. This can significantly affect people socially, psychologically, and even biologically. We know that isolation is a key driver of anxiety and depression. Many of these individuals crave socialization's support and stimulation but can never seem to find it within the existing social fabric of school, work, or relationships.
Kids at Risk
Certain groups of teenagers are at a significantly higher risk of experiencing depression due to various social, environmental, and personal factors. Female students, for instance, are particularly vulnerable, facing higher rates of depression, anxiety, and suicidal ideation compared to their male counterparts. This heightened risk can be attributed to several factors, including societal pressures on body image, academic performance, and social acceptance. Additionally, hormonal changes during puberty can also play a role in increasing susceptibility to depression.
Girls are more likely to experience bullying, both online and offline, and often feel intense pressure to meet unrealistic standards set by social media, contributing to feelings of inadequacy and hopelessness. Students of color and LGBTQ+ students also face disproportionately high risks of depression. These groups often encounter systemic discrimination, racism, and homophobia, both within and outside the school environment. Such experiences can lead to feelings of isolation, marginalization, and fear, which are significant contributors to depression.
Moreover, students from unstable or low-income households face additional stressors such as financial insecurity, lack of access to mental health resources, and unstable living conditions. These compounded challenges create an environment where these teens struggle to find the support and validation they need, making them more susceptible to mental health issues. Addressing the specific needs of these at-risk groups requires targeted interventions and a commitment to creating inclusive, supportive environments.
There are things that we as parents and those in the school system can do:
- Start paying attention to what you say about these groups and individuals
- Strive to avoid generalizations and stereotypes
- Be willing to accept correction
- Be tolerant of tolerance
- Be intolerant of intolerance
- Seek out marginalized voices and perspectives
- Educate your own community
- Banish fear of the unknown and fear of the “other”
By embracing the changes in our social structures and understanding the challenges being faced by these kids, we can make a significant difference. And though many ruffle against pronouns, behaviors unbecoming, and even challenges personal faith, remember that aggressive words and actions rarely unify and seldom help.
As an “old-fashioned” parent, I do not suggest you discard your ethics. I ask that we employ those ethics to be more empathetic and less judgmental. I mean, we settle for love, compassion, and inclusion first. Then, we will work on the other issues at hand. Suppose the lack of connectedness is the most significant reason for the decline of mental health in our teens. In that case, it seems evident that bringing back some connectivity through the community and our behavior may be the start of the solution.
Strategies for Addressing Teen Mental Health Challenges
To further address these disturbing trends in teen mental health, we must adopt a multifaceted approach involving parents, educators, healthcare providers, and community leaders. Here are some additional strategies:
Enhanced Mental Health Education: Integrate mental health education into school curriculums to teach students about mental health, coping mechanisms, and how to seek help. Provide training for teachers and school staff to recognize signs of mental health issues and how to respond appropriately.
Accessible Mental Health Services: Increase the availability of school counselors and psychologists' availability to support students. Offer free or low-cost mental health services in communities, ensuring teens can access the help they need.
Parental Involvement and Education: Educate parents on the importance of mental health and how to support their teens. Encourage open communication between parents and teens about mental health and emotional well-being.
Promote Safe and Inclusive Environments: Foster a school culture that promotes inclusivity, respect, and acceptance of all students, regardless of their background or identity. Implement anti-bullying policies and programs to create a safer school environment.
Encourage Healthy Lifestyle Choices: Promote physical activity, proper nutrition, and adequate sleep as these factors significantly impact mental health. Provide resources and activities that encourage healthy lifestyle choices for teens.
Utilize Technology for Good: Leverage technology to provide mental health resources and support through apps, online counseling, and virtual support groups. Educate teens on the responsible use of social media and the potential impact on their mental health.
Community Engagement: Engage community organizations, local businesses, and religious groups to create a supportive teen network. Organize community events and activities that foster social connections and a sense of belonging.
Getting Help
Finding help with depression is crucial for teenagers to manage their mental health and improve their overall well-being. Friends, family, school counselors, and other mental health practitioners are available to help and should be considered earlier rather than later. Here are several ways kids can seek help:
Talk to a Trusted Adult: Reaching out to a trusted adult, such as a parent, teacher, school counselor, or family member, is often the first step. These individuals can provide support and guidance and help connect the teen with professional resources.
School Resources: Many schools offer mental health services, including school counselors, psychologists, and social workers. These professionals can provide counseling, support groups, and referrals to outside mental health services.
Professional Therapy: Seeking therapy from a licensed mental health professional, such as a psychologist, psychiatrist, or counselor, can be highly beneficial. Therapy can provide a safe space for teens to explore their feelings, develop coping strategies, and receive personalized treatment.
Hotlines and Helplines: Teens can access various hotlines and helplines that offer immediate support and guidance. For example, the National Suicide Prevention Lifeline (1–800–273–8255) and Crisis Text Line (text “HELLO” to 741741) provide 24/7 assistance for those in crisis.
Online Resources and Support Groups: There are numerous online resources and support groups specifically designed for teenagers. Websites like Teen Line, 7 Cups, and ReachOut provide forums, chat services, and articles about mental health. Online support groups can also offer peer support and a sense of community.
Physical Activity and Hobbies: Engaging in physical activities, hobbies, and interests can help alleviate symptoms of depression. Exercise releases endorphins, which can improve mood. Creative activities like art, music, and writing can also provide emotional outlets.
Healthy Lifestyle Choices: Maintaining a healthy lifestyle, including proper nutrition, adequate sleep, and regular physical activity, can positively impact mental health. Teens should be encouraged to develop routines that promote overall well-being.
Medication: In some cases, medication prescribed by a psychiatrist may be necessary to manage depression. Teens and their parents must discuss the benefits and potential side effects of medication with a healthcare professional.
Community Resources: Local community centers, religious organizations, and youth groups often provide support services and programs for depressed teens. These resources can offer additional avenues for finding help and building a support network.
Educating Themselves and Others: Understanding depression and mental health can empower teens to seek help and support others. Educational resources, such as books, articles, and workshops, can provide valuable information and reduce the stigma associated with mental health issues.
Encouraging open conversations about mental health and promoting a supportive environment where teens feel safe to seek help are essential steps in addressing depression. By utilizing these resources and strategies, teens can find the support they need to navigate their mental health challenges.
Final Thoughts
Addressing the mental health crisis among teenagers is not just a matter of urgent concern but a moral imperative. As we witness disturbing trends becoming the norm, we must take collective action to reverse these trajectories and support our youth. Teens today face unprecedented pressures, and the compounded effects of social media, political divisiveness, and the recent pandemic have only exacerbated these challenges. As parents, educators, healthcare providers, and community members, we are responsible for creating environments where they feel safe, valued, and connected.
The data from the CDC study is a sobering reminder of the gravity of the situation. The high rates of depression, suicidal ideation, and risky behaviors among teens, particularly among female students and marginalized groups, are alarming. These statistics are not just numbers; they represent real lives affected by profound pain and isolation. The feeling of being irrelevant, as poignantly expressed by the student mentioned earlier, is a haunting testament to the disconnection many teens experience.
To address this crisis, we need a multifaceted approach prioritizing mental health education, accessible services, and inclusive environments. Schools must become places where mental health is as important as academic achievement. This involves integrating mental health education into curricula, training teachers to recognize and respond to mental health issues, and increasing the availability of school counselors and psychologists.
Parents play a crucial role in this effort. Open communication about mental health, support for emotional well-being, and involvement in their teens’ lives can make a significant difference. Parents should strive to be empathetic listeners and active participants in their children’s journey through adolescence.
Communities must also come together to create supportive networks for teens. This involves engaging local organizations, businesses, and religious groups to foster social connections and a sense of belonging. Community events and activities can allow teens to build relationships and feel valued.
Promoting healthy lifestyle choices, such as physical activity, proper nutrition, and adequate sleep, can positively impact mental health. Schools and communities should provide resources and activities that encourage these healthy habits.
Technology, often seen as a source of stress for teens, can also be a tool for good. By leveraging technology to provide mental health resources and support through apps, online counseling, and virtual support groups, we can reach teens where they are and offer the help they need.
Finally, it is crucial to address the issue of connectedness. Teens need to feel that they belong and that their contributions matter. By fostering inclusive environments in schools and communities, we can help teens build the social connections vital for their mental health and well-being.