Teen depression: Why is anxiety rising in teens during the COVID pandemic?

A mother finds a drawing of a tombstone among her son’s schoolwork. “Rest in peace,” the caption read. “Maybe I better die.”

The boy is 10 years old.

Terrorized, she turns to marriage and family therapist Laurie Singer. That a child so young has mental health issues comes as no surprise to Singer — or to teachers, other mental health experts, doctors, or a troubling share of parents who see the cauldron of anxiety and of depression boiling in America.

The crisis has been bubbling for decades, and in 2019 a third of secondary school students – half of girls – reported feeling lingering sadness or despair, a huge increase from 2009. The pandemic has thrown grief and fear in the jar.

The mental health of millions of young Americans has become so fragile that US Surgeon General Dr. Vivek H. Murthy issued an urgent public health advisory in December. “The unfathomable pandemic-era death toll, pervasive sense of fear, economic instability and forced physical distancing from loved ones, friends and communities have exacerbated the unprecedented stress young people were already facing.” , wrote Murthy. Amid the COVID-19 pandemic, cases of depression and anxiety have doubled among young people. ER visits for suspected suicide attempts were 51% higher for teenage girls and 4% higher for teenage boys compared to early 2019.

Then, just when some children got a little used to going to school and living while confined to their homes, the doors opened and they were ordered back into a world that doesn’t really seem more sure.

The mental health crisis in the United States is not ageist. At his practice in Camarillo, Calif., Singer treats patients as young as 5 and as old as 80 who suffer from anxiety, depression, or both. But teenagers have been particularly affected.

Sam Goldstein, a psychologist and assistant professor of psychiatry at the University of Utah, specializes in treating young people with multiple and complex mental health issues. He saw the numbers swell.

In 2020, the National Survey on Drug Use and Health found that 21% of 16-17 year olds experienced a major depressive episode. Anxiety, depression, somatic disorders and suicide in adolescents are known as “internalizing disorders” – conditions that are often almost invisible to others, but cause great pain to those who experience them. are tormented.

One of the toughest challenges with these disorders is that they tend to come back, warned Goldstein, author of “Tenacity in Children.” “Once your body turns on that kind of extreme response, under stress, the body regresses again. So about 50-70% of teenagers who have a depressive episode before age 18 will have another one before age 18.

“And if you have two, then you are in the club. You may not always be in the building, but you have a membership card. You’re going to go in and out of depressive episodes,” he said.

Why the increase in serious mental health problems among young people? Maybe there is less stigma now, so more people are seeking help. Or maybe the mental health is really getting worse.

Unquestionably, experts say, young America faces serious mental health issues, growing up in a melting pot of digital media, academic pressure, financial uncertainty, racism, gun violence, inequality societal and lest the planet itself die.

The pain is also not evenly distributed. Children in rural areas, LGBTQ children, immigrants and people living in poverty are among those facing the most difficult path. Girls are more likely to be diagnosed with anxiety, depression or an eating disorder, while boys may exhibit behavioral problems and are more likely to die by suicide.

COVID-19 has definitely increased stress and that impact is not theoretical, Goldstein said. Levels of cortisol – the main hormone produced by stress – have increased measurably as children and adults struggle to make sense of what they see, feel and hear. Cortisol spikes can also cause depression and harm physical health.

When Presidents Donald Trump and later Joe Biden assembled advisers for their responses to the pandemic, Goldstein wished they had taken a more holistic approach, incorporating educators and experts in the fight against addiction and domestic violence. . The virus has exacerbated these problems as surely as it has filled hospitals and clinics. “We may have significantly increased numbers and vulnerability in several other areas downstream,” he said.

Goldstein thinks America needs to radically change its approach to mental illness. “In light of the heightened vulnerability we all have – not just to being unhappy, but unhappiness that causes impairment – perhaps we need to think about system-wide intervention like we do when it comes to physical health,” he told Deseret.

Just as kindergartners are screened for their readiness for school, children should be screened for their mental health, Goldstein says. He gives the example of a school district in Austin, Texas, where all students were selected for a study 30 years ago. Students who answered yes to a question were given further consideration. Of three questions, one – “Are you worried about school?” – was particularly correlated with mental health problems, usually depression.

The next logical step is to teach children about depression and to detect it in themselves, with more information and resources depending on the level of risk identified. “I’m not trying to pathologize and I’m certainly not trying to create business, because right now there aren’t enough professionals for everyone,” he adds.

Parents can also do some screening by examining whether their child seems more preoccupied with their abilities than is warranted. Do they see the world through mud-colored glasses? Children could also think about it. Self-diagnosis is fine as long as it’s not where people stop.

Goldstein breaks down the action into big and small things. Being proactive is important. The threshold leading to action must be low. If you’re worried, do something, he says.

Pediatricians and family physicians offer a starting point, experts say. Many insurance companies have access to an employee assistance program with mental health professionals who can help people get care. Groups like the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and mental health-focused nonprofits are some of the groups with reputable online screening tools.

Health systems and academic institutions are also involved. In New York, for example, the Montefiore Health System’s Pediatric Behavioral Health Integration Program uses telehealth technology to convene group therapy for adolescents with anxiety and depression. Psychologists and psychiatrists are based in primary care offices and refer children if mental health screening reveals a cause for concern, said psychologist Teresa Hsu-Walklet, deputy director of the program. The program aims to help young people understand mental disorders and learn coping strategies, in part by telling themselves what has worked for them.

Telehealth is a growing resource for mental health treatment that will likely persist beyond the pandemic, though capacity is limited and requires a good Wi-Fi connection, Hsu-Walklet said. But technology enables essential help when two people cannot be in the same place.

Harvard Medical School and Boston Children’s Hospital created “Mightier” in 2016, an emotional health program for children ages 6 to 12 that combines video games with evidence-based strategies to help children learn to regulate their emotions and develop coping skills at home. Available by subscription on Mightier.com, it combines biofeedback with curated video games that kids are already playing. When biofeedback shows the player becoming anxious or frustrated, the player needs to calm down or the game becomes even more difficult. Emotional regulation becomes instinctive over time and children learn that they can overcome stress.

Jason Kahn, behavioral health researcher and scientific director of Mightier, said children need to be resilient, often without the tools to do so. “It’s a very big demand and we need to prioritize developing the kinds of skills that will help them.”

Singer, therapist and author of “You’re Not Crazy: Living With Anxiety, Obsessions and Fetishes,” combines cognitive behavioral therapy with behavior modification to help children temper depression and anxiety using coping strategies. color-coded “signage” and other tools. Although communities often lack enough professionals to meet local needs, she said families should not give up. Doctors, teachers and friends may know someone who can help you.

The walls aren’t tall enough or the locks strong enough to keep the world away from children, so Goldstein tells parents to have candid, age-appropriate discussions about anything that might confuse them, like why schools and businesses open and close and what is risky and what is not. ‘t. “If adults are confused, imagine how confused children are,” he said.

Murthy’s suggestions are more prosaic: he said it’s important to ask for help, to work on having healthy relationships, to find ways to serve others, to manage stress, to sleep, to feed body and mind and to be “intentional” when using social media and technology.

He emphasizes that news is never all bad. Some kids have thrived during the pandemic: more sleep, more quality family time, less school stress, less bullying, more flexible hours. But the call to action on mental health is clearly urgent. Communities must ensure access to good, affordable and culturally appropriate mental health care, he said. “It would be a tragedy if we postpone one public health crisis only to allow another to develop in its place.”

This story appears in the March issue of Desert Magazine. Learn more about how to subscribe.

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