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While our attention is focused on the coronavirus pandemic, another global health issue is flying beneath the radar. Depression and anxiety disorders in teenagers and young adults are so prevalent and severe that the World Health Organization created a Mental Health International College Student Initiative to collect data and implement web-based interventions. The US data is troubling, with the rate of major depressive disorder in teens at 13 percent overall and at a shocking 36.1 percent among adolescent girls. Almost 32 percent of teens experience one of the anxiety disorders, again with higher prevalence among girls. A recent sample of college-age people revealed that now over 40 percent were experiencing depression or anxiety. Clearly, the isolation and disruption caused by COVID-19 will only exacerbate these mental health issues.
Before the pandemic, multiple factors were implicated in the development of depressive and anxiety disorders, including family history (both genetic and environmental), substance misuse, reckless behavior, sleep deprivation, exposure to violence, sexual or physical abuse, and poor nutrition. Learning differences and disabilities present another challenge for teenage life, and if a young person is a member of a minority group—whether racial, religious, or sexual—their lives are more stressful, and mental health issues are far more likely to affect them. Too much social media time, something common among teens, can have a negative effect on mood, sleep, physical activity, and, especially for girls, body image. In addition, many students experience significant pressure to get admitted to a small number of “elite” colleges and focus on resume building, often to the detriment of their emotional growth and mental health.
Because adolescents’ brains are still developing, they’re particularly vulnerable to stress. Other psychiatric disorders, including eating disorders and substance use disorders, also emerge during this time, with half developing by age 14 and three-fourths by age 20. Many young people also lack of access to mental health care, when tragically, research has shown that early intervention into psychological disorders is not only therapeutic but also essential to better adjustment throughout one’s life.
The situation was dire for our young people before the current pandemic. Now, enter the coronavirus.
Amidst COVID-19, the word “stress” has become so common that its effects are often dismissed. To clarify, increased external stress can cause chronic inflammation, a response of the immune system, and that chronic inflammation has been implicated in higher rates of depression. If we turn our attention to the specific types of stress that have resulted from the pandemic, we can see another public health disaster looming.
As of mid-July, over 146, 000 families have been devastated by the loss of a loved one, with no chance to say goodbye. Contrary to what was originally suggested, children can catch and spread COVID-19. For example, as of July 10th in Florida, one-third of children tested were positive. We still do not know what long-term damage might be caused by the coronavirus, even among those with mild or asymptomatic cases, and a constant, low-grade anxiety caused by our fear of the unknown now hangs over everyone.
Not only are American families worried about the fatality rate of COVID-19, but there is also a whole host of other health, safety, and financial concerns associated with the disease. For teenagers, living in close quarters, being socially isolated, and the absence of school are especially difficult. Many children (and their parents) still do not know if schools will re-open this fall.
What can parents and teenagers do to combat the anxiety and depression that is only being aggravated by current circumstances?
If parents are worried about shelter and food, they cannot address mental health issues so financial security must come first. Check to make sure that you are receiving government benefits from the federal stimulus package or state unemployment. There is any number of free programs through which you can seek help and counseling. If you are in a position to help others, consider donating to your local food bank, and if you are one of the millions of parents struggling to put food on the table right now, please don’t be afraid to ask for help.
After all these months of quarantine, it is understandable that family relationships will be tense, and teenagers may be irritable. Two strategies can help. First, try to find times for direct communication, perhaps a family meeting, so that everyone can share problems and feel heard. Second, consider engaging your teenager in a task to distract them and help them feel productive (most people will feel better if they have accomplished a specific goal!). Choose something that matches their interest, whether cooking, repair work, organizing an old photo album, etc.
However, consistent irritability is also a sign of adolescent depression. Try to encourage your teen to share their feelings and listen to their concerns. Notice whether they have had a change in sleep, appetite, activity level, concentration, or are feeling worthless, some of the other symptoms of depression. Do not hesitate to arrange for a professional consultation for a more precise diagnosis.
Depression can be triggered and prolonged by social isolation and teens, who will be missing their friends and activities. Depression can lead to more withdrawal, so they may need encouragement to reach out to their friends by text or video. Let them know that you can help them arrange a socially distanced outside activity with friends. Similar family gatherings can also provide a feeling of connection.
If your teen tends to be anxious, the thought of returning to school amidst the pandemic may increase her fears. Educate yourself and get involved with the parents’ association or school committee so that you can share information and reassure your teen about her safety. Be sure to be available during the initial days of the school year.
Instill hope and reassurance. During this pandemic, uncertainty is the overriding feeling, and the lack of a national leader who can inform us about the challenges ahead and motivate us for a plan for change makes the situation more frightening. Teens are too young and limited in life experience to take the long view, but you can. Things will get better over time but for now, remind them that you are there to help one another as a family.
Finally, remember to take care of yourself! If you take time to replenish, get support from friends, do an activity you enjoy, or even seek counseling for yourself, chances are that your mood will improve, and this long list of to-dos for your teen will feel much more manageable.
