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Are Mental Health Issues On the Rise?

Why it's important stories about generational differences look at the research

“I’m a member of Generation Y, or the millennial generation,” said Maanvi Singh on NPR’s Morning Edition today. “Journalists and commentators love ragging on us.” The idea that Millennials (those born in the 1980s and early 1990s) are more likely to struggle with anxiety and depression, she concludes, is just a rumor with little basis in fact. “Researchers weren't very good at collecting data on mental illness back in the '60s and '70s, when the baby boomers were in their late teens and 20s,” she says.

That’s completely untrue. A raft of research studies do just that, comparing Boomers (or even earlier generations’) responses to measures of anxiety, depression, and other mental health scales in the ‘60s and ‘70s (or other decades) to the responses of GenX’ers and Millennials at the same age. Just a sampling of the studies:

Cohen, S., & Janicki-Deverts, D. (2012). Who’s stressed? Distributions of psychological stress in the United States in probability samples from 1983, 2006, and 2009. Journal of Applied Social Psychology, 42, 1320-1334.

Herbst, C. M. (2011). ‘Paradoxical’ decline? Another look at the relative reduction in female happiness. Journal of Economic Psychology, 32, 773-788.

Klerman, G. L., & Weissman, M. M. (1989). Increasing rates of depression. Journal of the American Medical Association, 261, 2229–2235.

Lester, D. (2013). Hopelessness in undergraduate students around the world: A review. Journal of Affective Disorders, 150, 1204–1208.

Olfson, M., Druss, B. G., Marcus, S. C. (2015). Trends in mental health care among children and adolescents. New England Journal of Medicine, 372, 2029-2038.

Twenge, J. M. (2015). Time period and birth cohort differences in depressive symptoms in the U.S., 1982-2013. Social Indicators Research, 121, 437-454.

Twenge, J. M., Gentile, B., DeWall, C. N., Ma, D. S., Lacefield, K., & Schurtz, D. R. (2010). Birth cohort increases in psychopathology among young Americans, 1938-2007: A cross-temporal meta-analysis of the MMPI. Clinical Psychology Review, 30, 145-154.

These studies conclude that anxiety and depression are markedly higher than they were in earlier eras. They examine age groups from children to middle-aged adults and span the medical and psychological literature. Many are nationally representative samples. Most employ anonymous questionnaires asking about symptoms, which means the increases cannot be due to over-diagnosis – these are people filling out surveys for research studies, not people seeking treatment. Yet they still report more issues. And it’s not just because they think it’s more acceptable to do so – the MMPI includes two measures of this type of response bias, and it still showed increases in mental health issues among high school and college students after these scales were included in the model.

The increase in mental health issues is most consistent between the 1930s and the early 1990s. There is little doubt that anxiety and depression increased between these decades. After that, trend shows an inconsistent pattern, with some measures leveling off at historically high levels, some continuing to increase, and others declining. For example, Singh correctly points out that the youth suicide rate declined after the early 1990s. However, most other measures of mental health have not improved in the last 20 years. For example, in a nationally representative sample of high school seniors, more in the 2010s reported psychosomatic symptoms of depression such as having trouble sleeping and concentrating.

Why would suicide rates go down? Probably because the people with the most severe depression – also those at the highest risk for suicide – are now more likely to take anti-depressants. Modern anti-depressants were introduced in the early 1990s, right before the suicide rate started to decline. The decline in the suicide rate is not a very good gauge of the overall state of young people’s mental health.

How did this NPR commentary get things so wrong? It appears that Singh did not try very hard to find the actual data on generational differences. This is a systematic problem: Many journalistic stories on generational differences don’t bother to find actual evidence for their conclusions. (For example, the New York Times article last year on Millennials being “Generation Nice.”) Journalists often talk to a few experts, but that’s a far cry from searching out the research that has looked carefully at these issues. Singh interviewed Mitch Prinstein, a psychologist from UNC Chapel Hill who researches adolescent mental health. However, as far as I know, Prinstein has not done research on generational differences in mental health (or any studies on cultural change). That might be why Prinstein was apparently unaware of the extensive literature on this topic. Oddly, Singh mentions my book Generation Me and even quotes from it, but clearly did not read the chapter describing the evidence I just laid out above – or the writings of the many other researchers who have reviewed the evidence for increases in anxiety and depression.

Singh complains that “Journalists and commentators love ragging on us,” but seems not to understand that data is not the same as “ragging” and that pointing out mental health issues is the first step to making sure young people (and everyone else) get the help they need. Finding as much data as possible on generational trends allows us to see the scope of the problem and how to solve it. Defensiveness and ignoring the scientific literature doesn’t help – and if it spreads misinformation about the need for mental health services, it can even hurt.

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