tag:theconversation.com,2011:/uk/topics/teen-depression-22691/articlesTeen depression – The Conversation2024-01-04T13:44:51Ztag:theconversation.com,2011:article/2196992024-01-04T13:44:51Z2024-01-04T13:44:51ZStories about war, violence and hate crime can cause anxiety, anger and depression in kids – here’s how to discuss bad news with your children<figure><img src="https://images.theconversation.com/files/565047/original/file-20231212-27-4c2nj0.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C7348%2C4912&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">For younger children in particular, checking in on what they're seeing on social media is critical.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/looking-for-some-entertainment-online-royalty-free-image/1049816596?phrase=kids+watching+violent+images+on+social+media&searchscope=image%2Cfilm&adppopup=true">Tassii/E+ via Getty Images</a></span></figcaption></figure><p><em>Violent photos and videos – whether from conflicts abroad or shootings near home – are commonplace, even ubiquitous, on television and social media today. The impact on children can be debilitating.</em></p>
<p><em>SciLine interviewed <a href="https://psychiatry.duke.edu/profile/robin-gurwitch">Dr. Robin Gurwitch</a>, a psychologist and professor in the department of psychiatry and behavioral sciences at Duke University Medical Center, who discussed how these images and stories affect a child’s mental and emotional health; how the conversation about war and violence differs with young children, tweens and teens; and how to recognize signs that children are struggling with recent events.</em></p>
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<figcaption><span class="caption">Robin Gurwitch discusses how children react to scenes and stories of war, violence and hate.</span></figcaption>
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<p><em>Below are some highlights from the discussion. Answers have been edited for brevity and clarity.</em></p>
<p><strong>How do images and stories about war and violence affect children’s mental and emotional health?</strong></p>
<p><strong>Robin Gurwitch:</strong> The very short answer is, it’s not good. These events take a toll on our youth. We know from much academic <a href="https://doi.org/10.3389/fped.2016.00026">work in this area</a> that we see an increase in anxiety, in worries, in fears, in depression and, sometimes, an increase in anger. We see an increased sense of hopelessness, and then, at the extreme, an increase in risk for suicide. </p>
<p><strong>How should parents prepare for a conversation with their children about hate and hate crimes, war and violence?</strong></p>
<p><strong>Robin Gurwitch:</strong> Before we even begin to talk to our children, as adults we have to put in place our thoughts and feelings. What are the values and beliefs that we hold in the face of these types of events? Talk to friends and other trusted relatives to make sure that you have a handle on your emotions. </p>
<p><strong>What specific advice do you have for talking to very young children – and to older children?</strong></p>
<p><strong>Robin Gurwitch:</strong> With really young children, under preschool age and younger, they probably don’t know and won’t understand what’s going on. Yet they <a href="https://www.pbs.org/parents/thrive/helping-children-with-tragic-events-in-the-news">can sense your distress</a>. So making sure you keep their routines as consistent as possible will be helpful. </p>
<p>When we start talking about school-age children – assume they know. They’ve heard about it on the school bus. They’ve heard about it from friends. They’ve <a href="https://www.nytimes.com/2020/04/18/parenting/kids-current-events.html">seen it on TV</a> when they’ve walked through the living room. </p>
<p>With them, I think you start the conversation saying, “There’s been …” And then fill in the event you’re going to talk about. “There’s been a shooting in Maine.” “There’s been a hurricane in Mexico.” “There’s been a terrorist attack in Israel and now there’s a war, and that’s really hard, but I want to talk to you about it. Tell me what you’ve heard about it.” </p>
<p>Allow them to have that ability to tell you what they’ve heard. Listen for and gently correct misinformation, rumors and misinterpretations. And then follow that up with, “How is that making you feel?” As they share their feelings with you, accept those rather than try to talk them out of them. It doesn’t work for adults, and it won’t work for children.</p>
<p><strong>What specific advice do you have for talking to tweens and teens?</strong></p>
<p><strong>Robin Gurwitch:</strong> Sometimes when we talk or try to talk to our tweens and teens, they give us the shoulder shrug, or they say, “I’m fine,” or nothing, or “Why do I need to tell you what I think?” So sometimes we may <a href="https://parentandteen.com/tragic-events/">take a different approach with them</a>. </p>
<p>Instead of saying, “Tell me what you know about the war happening between Israel and Hamas,” you may phrase it a little differently and say, “You know, the war between Israel and Hamas has been going on for several weeks. Tell me what your friends are saying about that,” or “What are you seeing on social media about the war?” </p>
<p>This approach gives them a little bit of distance from you. That is, they may be more willing to share about their friends and social media. And it gives you some insight on what they understand, what they believe, and gives you an opportunity to check in about any misperceptions or misinformation that they may have.</p>
<p><strong>What specific advice do you have for talking to college students?</strong></p>
<p><strong>Robin Gurwitch:</strong> There’s still a tether that binds the two of you as they’re continuing to grow into their own person. So, it is important to reach out. “Tell me what’s happening on campus related to the war in Israel and Gaza. What are professors saying? What are your classmates saying?” Check in to make sure that they feel safe and supported. And to let them know that you are there if they have any concerns, or any worries about anything, to give you a call and you’ll talk it through with them. </p>
<p><strong>How can parents monitor their children’s media diet and social media use while respecting their privacy?</strong></p>
<p><strong>Robin Gurwitch:</strong> When we’re talking about school-age children, parents and caregivers truly need to know what their social media is all about. They need to look at it. They need to make sure that it’s appropriate. </p>
<p>As children get older, they do <a href="https://www.pewresearch.org/internet/2016/01/07/how-parents-monitor-their-teens-digital-behavior/">expect a little bit more privacy</a>. But I think it’s important for parents to say, “You know, I’ve heard from other parents” – you can throw other parents under the bus – “I’ve heard from other parents that there’s a lot of things on social media about the war in Israel,” or whatever the topic is. And let them know that oftentimes there are things on social media that just aren’t true. And to come to you if they have any questions about what they’re seeing or hearing, and you’ll tell them what you know to be true. </p>
<p>Also tell them that sometimes there are images that no one should see. If they see them, tell them to come to you so you can talk it through with them. Acknowledge that while their friends are seeing it, and they may be drawn to it, this can interfere with their sleep and their focus, because those images are hard to get out of our minds. </p>
<p><strong>What are some signs and symptoms that children or teens may be struggling with recent events?</strong></p>
<p><strong>Robin Gurwitch:</strong> We may see <a href="https://www.healthday.com/mental-health-information-25/behavior-health-news-56/violent-tv-shows-keep-young-kids-awake-study-667375.html">sleep problems</a>. Either problems falling asleep or staying asleep, so they may be more tired. Because of that and because of <a href="https://theconversation.com/disaster-news-on-tv-and-social-media-can-trigger-post-traumatic-stress-in-kids-thousands-of-miles-away-heres-why-some-are-more-vulnerable-173627">other reactions to stress</a>, children may be more irritable. </p>
<p>Younger children may have more meltdowns and temper tantrums, and even our tweens and teens – where we expect some of it – it’ll be above and beyond. We may see more conflict between you and your children, but also between your children and their peers. </p>
<p>We may see a lack of enjoyment with the things that they used to really look forward to or want to do. Sometimes we see problems with attention and focus and concentration. That can lead to difficulties with schoolwork. It’s not that they’re not studying hard. It’s not that they’re not trying their best. But being able to process and retain new information becomes really hard. </p>
<p>So a little bit of extra patience, maybe a little bit more help, attention and love really will go a long way these days.</p>
<p><em>Watch the <a href="https://vimeo.com/881835248">full interview</a> to hear more.</em></p>
<p><em><a href="https://www.sciline.org/">SciLine</a> is a free service based at the nonprofit American Association for the Advancement of Science that helps journalists include scientific evidence and experts in their news stories.</em></p><img src="https://counter.theconversation.com/content/219699/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Robin Gurwitch receives funding from SAMHSA. Some of my efforts are funded as part of the National Child Traumatic Stress Network, which is funded by SAMHSA. All work is non-profit. All funds for salary support go through my employer, not directly to me. </span></em></p>Talking about violence with teens and tweens is very different from the conversation you’ll have with younger children.Robin Gurwitch, Professor of Psychiatry and Behavioral Sciences, Duke UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2101182023-10-23T12:24:57Z2023-10-23T12:24:57ZHow much time do kids spend on devices – playing games, watching videos, texting and using the phone?<figure><img src="https://images.theconversation.com/files/544091/original/file-20230822-5267-868e99.jpg?ixlib=rb-1.1.0&rect=10%2C10%2C6699%2C4456&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Today, nearly all U.S. teens have a smartphone.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/teenage-boy-using-smartphone-at-home-royalty-free-image/1218225082?phrase=teen+on+social+media+looking+unhappy&adppopup=true">MoMo Productions/Digital Vision via Getty Images</a></span></figcaption></figure><figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=293&fit=crop&dpr=1 600w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=293&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=293&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=368&fit=crop&dpr=1 754w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=368&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/281719/original/file-20190628-76743-26slbc.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=368&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em><a href="https://theconversation.com/us/topics/curious-kids-us-74795">Curious Kids</a> is a series for children of all ages. If you have a question you’d like an expert to answer, send it to <a href="mailto:curiouskidsus@theconversation.com">curiouskidsus@theconversation.com</a>.</em></p>
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<p><strong>How many hours does the average American spend on devices each year? – Maxwell P., age 10</strong></p>
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<p>Think about your favorite devices – your smartphone, laptop, tablet, computer or console – the things you use to play cool games, watch hilarious videos and connect and chat with friends. </p>
<p>Many young people spend a lot of free time looking at them. Turns out that teens spend an average of <a href="https://www.commonsensemedia.org/research/the-common-sense-census-media-use-by-tweens-and-teens-2021">8½ hours on screens per day</a>, and tweens – that’s ages 8 to 12 – are not far behind, at 5½ hours daily.</p>
<p>Keep in mind those numbers are for only social media, gaming and texting. They do not include the time that kids <a href="https://www.apa.org/monitor/2020/04/cover-kids-screens">used screens for schoolwork or homework</a>.</p>
<p>What’s more, much of the time taken up by social media and texting is apparently not even enjoyable, much less productive. A 2017 study of teens ages 13 to 18 suggests they spend most of those hours on the phone <a href="https://www.theatlantic.com/magazine/archive/2017/09/has-the-smartphone-destroyed-a-generation/534198/">in their bedroom, alone and distressed</a>. </p>
<p>These lonely feelings correlate with the <a href="https://doi.org/10.1177/0265407519836170">rise in the use of digital media</a>. In 2022, <a href="https://www.pewresearch.org/internet/2022/08/10/teens-social-media-and-technology-2022/">95% of teens had smartphones</a> compared with only 23% in 2011. And 46% of today’s teens say they use the internet almost constantly, compared with 24% of teenagers who said the same in 2014 and 2015. </p>
<p><a href="https://www.med.wayne.edu/profile/aa3409">Our team of psychiatrists</a> who treat young people with digital addiction have many patients who spend over 40 hours per week on screens – and some, up to 80 hours. </p>
<p>Think about it: If you spend “just” an average of 50 hours per week on devices from ages 13 to 18 – the total time you will spend on screens equates to more than 12 years of school!</p>
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<figcaption><span class="caption">The U.S. surgeon general says too much screen time can increase anxiety and depression in teens and tweens.</span></figcaption>
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<h2>Find the right balance</h2>
<p>All this is not to say that everything about devices is bad. In this digital age, people embark on exciting journeys through the screens of their devices. Sometimes, screens are the windows to a magical adventure. </p>
<p>But too much screen time can lead to problems. As human beings, we function best when we’re in a state of balance. That happens when we eat well, exercise regularly and get enough sleep.</p>
<p>But spending too much time using digital devices can cause changes in the way you think and behave. Many teens and tweens developed the “fear of missing out” – <a href="https://saferkidsonline.eset.com/sg/article/5-tips-for-combating-fomo">known as FOMO</a>. And one study shows <a href="https://doi.org/10.3390/ijerph17020580">some people develop nomophobia</a>, which is the fear of being without your phone, or feeling anxious when you can’t use it. </p>
<p>Moreover, digital addiction in high school may predict serious <a href="https://doi.org/10.3390/children10010086">depression, anxiety and sleep disruption</a> in college. </p>
<p>Rates of depression and anxiety <a href="https://doi.org/10.1016/j.jpsychires.2012.11.015">are skyrocketing among college students</a>. The fear of missing out is pervasive, resulting in sleep disruption; too many college students <a href="https://doi.org/10.3390/ijerph19159693">sleep with smartphones turned on</a> and near their bed – and wake up to respond to texts and notifications during the night. Sleep disruption itself is a core symptom of <a href="https://doi.org/10.31887/DCNS.2008.10.3/dnutt">both depression and anxiety</a>. </p>
<h2>How to avoid device addiction</h2>
<p>A 2016 poll indicated that half of teens felt they were <a href="https://www.commonsensemedia.org/press-releases/new-report-finds-teens-feel-addicted-to-their-phones-causing-tension-at-home">addicted to their mobile devices</a>. </p>
<p>Getting hooked on screens means missing out on healthy activities. To achieve a better balance, <a href="https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-And-Watching-TV-054.aspx">some experts recommend the following</a>: Turn off all screens during family meals and outings. Don’t complain when your parents use parental controls. And turn off all the screens in your bedroom 30 to 60 minutes before bedtime – this step will improve sleep. </p>
<p>You may be a “<a href="https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/are-video-games-and-screens-another-addiction#:%7E">screen addict</a>” if you: </p>
<ul>
<li>Feel uneasy or grumpy when you can’t use your device.</li>
<li>Don’t take breaks while spending hours on your device.</li>
<li>Ignore other fun activities you enjoy, like going outside or reading a book.</li>
<li>Have trouble sleeping, or falling asleep, because your screen time is too close to bedtime.</li>
<li>Experience eye, lower back and neck strain.</li>
<li>Struggle with weight gain or obesity because you’re inactive.</li>
<li>Have difficulty with real-life, face-to-face social interactions.</li>
</ul>
<p>If you notice these signs, do not dismiss them. But also realize you’re not alone and help is out there. You can find balance again.</p>
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<figcaption><span class="caption">A kid breaks his addiction to gaming and social media.</span></figcaption>
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<h2>A healthy approach</h2>
<p>Exercise – riding a bike, playing sports, lifting weights or going for a jog or walk – <a href="https://theconversation.com/the-exercise-pill-how-exercise-keeps-your-brain-healthy-%20and-protects-it-against-depression-and-anxiety-155848">keeps your brain healthy</a> and protects it against depression and anxiety, as well as limiting your screen time.</p>
<p>Another way to be happier and healthier is to spend time with people – face to face, not via a screen. Seeing people live and in person is the <a href="https://news.harvard.edu/gazette/story/2017/04/over-nearly-80-years-harvard-study-has-been-showing-how-to-live-a-healthy-and-happy-life/">best way to bond with others</a>, and it may be even better for life span than exercise. </p>
<p>Creative hobbies are good, too. Cooking, playing an instrument, dancing, any arts and crafts, and thousands of other fun things make people happier and more creative. What’s more, hobbies make you well rounded <a href="https://fordhamram.com/2023/04/19/learn-how-to-meet-people-with-social-hobbies#:%7E">and more attractive to others</a> – which leads to more face-to-face interactions. </p>
<p>It’s also critical for parents to practice healthy screen habits. But about one-third of adults <a href="https://www.pewresearch.org/short-reads/2021/03/26/about-three-in-ten-u-s-adults-say-they-are-almost-constantly-online/">say they use screens “constantly</a>.” This is not exactly a great example for kids; when adults take responsibility to minimize their own screen time, the whole family gets better.</p>
<p>Our research team used magnetic resonance imaging, <a href="https://kidshealth.org/en/parents/mri.html#:%7E">also known as MRI</a>, to scan the brains of teens who had digital addiction. We found impairment in the brain’s decision-making, processing and reward centers. But after a digital fast – meaning the addicted teens unplugged for two weeks – those brain abnormalities reversed, and the damage was undone. </p>
<p>Our findings also showed that kids with a desire to overcome digital addiction did better with a digital fast than those who were less willing or who denied their addiction. </p>
<p>A balanced lifestyle in the digital age is all about finding joy in screenless activities – being active, connecting with others and exploring your offline interests.</p>
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<p><em>Hello, curious kids! Do you have a question you’d like an expert to answer? Ask an adult to send your question to <a href="mailto:curiouskidsus@theconversation.com">CuriousKidsUS@theconversation.com</a>. Please tell us your name, age and the city where you live.</em></p>
<p><em>And since curiosity has no age limit – adults, let us know what you’re wondering, too. We won’t be able to answer every question, but we will do our best.</em></p><img src="https://counter.theconversation.com/content/210118/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David Rosenberg receives funding from the Children’s Hospital of Michigan Foundation, Detroit, MI, and a grant from the National Institute of Mental Health (R01MH59299). This work was also supported in part by the State of Michigan Lycaki Young Fund and the Detroit Wayne Integrated Health Network.</span></em></p><p class="fine-print"><em><span>Natalia Szura does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Up to 50% of US teens feel they are addicted to their devices. But help is out there.David Rosenberg, Professor of Psychiatry and Neuroscience, Wayne State UniversityNatalia Szura, Research Assistant in Psychiatry, Wayne State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2067022023-10-04T19:04:49Z2023-10-04T19:04:49ZI think my teen is depressed. How can I get them help and what are the treatment options?<figure><img src="https://images.theconversation.com/files/544471/original/file-20230824-29-js41sa.jpg?ixlib=rb-1.1.0&rect=29%2C0%2C4891%2C3260&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Unsplash</span></span></figcaption></figure><p>Moody, withdrawn, down. These words are often used by parents of teens. And young people may say they feel so “depressed” about upcoming exams, or that the world is “just so depressing” these days.</p>
<p>But how do you know if your teen is experiencing what health professionals call “major depression”? And when should you seek help? </p>
<p>First, let’s understand what is meant by this term. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228578/">Major depression</a> is characterised by persistent low mood and/or irritability and loss of interest or pleasure in usual activities for at least two weeks. It also includes physical symptoms, such as sleep disturbance and fatigue, and cognitive symptoms, such as negative thoughts about themselves and the future, difficulty concentrating or making decisions. </p>
<p>Major depression is more than brief sadness, or an expected reaction to loss or a stressful event. </p>
<p>While the diagnosis is the same for adolescents and adults, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228578/">teens may be more likely</a> to present with irritability and mood changes rather than the low mood typical of adults. </p>
<h2>Increasing over time</h2>
<p>There is evidence depression is increasing among young people, with an <a href="https://jamanetwork.com/journals/jamapediatrics/fullarticle/2782796">international study in 2021</a> estimating 25% of children and adolescents experienced elevated depression symptoms – double pre-pandemic levels. While Australia was not included in this study, a recent Australian study showed psychological distress have <a href="https://doi.org/10.1016/j.psychres.2023.115356">spiked</a> in Australian millennials (born between the early 1980s and late 1990s) and Gen-Z Australians (born late 1990s to early 2010s). </p>
<p>While the cause of this increase is unclear, it is likely due to <a href="https://mentalhealththinktank.org.au/wp-content/uploads/2023/08/Mental_Health_Recovery_Package_Australias-Mental-Health-Think-Tank.pdf">multiple factors</a>, such as financial pressures, social isolation, and climate change, and made worse by the <a href="https://pubmed.ncbi.nlm.nih.gov/36970258/">COVID pandemic</a>. </p>
<p>Given the understandable distress experienced by many young people, how can parents or carers know when to seek help? </p>
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Read more:
<a href="https://theconversation.com/how-parents-can-play-a-key-role-in-the-prevention-and-treatment-of-teen-mental-health-problems-192927">How parents can play a key role in the prevention and treatment of teen mental health problems</a>
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<h2>Listen up</h2>
<p>Begin by talking to your child. Let them know you have noticed some changes and you are concerned about them. If your child opens up about their difficulties, listen carefully and validate their feelings. Being able to talk about difficulties, and knowing support is there if they need may be enough for some teens. </p>
<p><a href="https://parents.au.reachout.com/common-concerns/mental-health/depression-and-teenagers">Read up on depression</a> from <a href="https://headspace.org.au/explore-topics/supporting-a-young-person/depression/">reputable sources</a>, so you are better equipped to understand and support a young person. </p>
<p>Try not to dismiss a teen’s feelings or punish irritable behaviour. It can be tempting to remind them of positives or offer solutions – but this can often backfire, leaving them feeling misunderstood. While it might be difficult or uncomfortable to talk openly with your teen about their mental health, it is often a <a href="https://aifs.gov.au/media/most-teenagers-turn-parents-and-friends-help">huge relief</a> for them. </p>
<p>Professional help may be needed if they are highly distressed, or if their difficulties are having a significant impact on their usual activities and relationships (this may include withdrawing from many activities, avoiding school, or avoiding friends and family most of the time). </p>
<p><div data-react-class="InstagramEmbed" data-react-props="{"url":"https://www.instagram.com/p/CpMfprROau0/?img_index=1","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"></div></p>
<h2>Start with a GP</h2>
<p>The good news is, effective treatments are available. </p>
<p>The first step to finding appropriate treatment will likely be supporting your teen to see a GP. Again, simply talking through their concerns with the doctor may be very helpful. Your young person might prefer to discuss this with the GP without you.</p>
<p>The GP may <a href="https://www.health.gov.au/our-work/better-access-initiative">refer them to a mental health professional</a>, such as a <a href="https://psychology.org.au/psychology/about-psychology/seeing-a-psychologist-faqs">psychologist</a> or <a href="https://www.healthdirect.gov.au/psychiatrists-and-psychologists">psychiatrist</a>. </p>
<p>Teens can also go directly to an organisation like <a href="https://headspace.org.au">Headspace</a>, which provides information, support and services to young people aged 12 to 25 and their families and friends via centres across Australia.</p>
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<strong>
Read more:
<a href="https://theconversation.com/the-first-sleep-health-program-for-first-nations-adolescents-could-change-lives-206286">The first sleep health program for First Nations adolescents could change lives</a>
</strong>
</em>
</p>
<hr>
<h2>What does depression treatment look like?</h2>
<p>A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228578/">recent review</a> on recognising and managing teen depression examined clinical practice guidelines from Canada, Australia, the United Kingdom, the United States and New Zealand found a comprehensive treatment approach is typically used. </p>
<p>Treatment can include:</p>
<ul>
<li><p>education about depression and its treatment</p></li>
<li><p>lifestyle interventions (such as improving sleep, diet and exercise)</p></li>
<li><p>psychological therapy (often focused on understanding and changing unhelpful thinking patterns)</p></li>
<li><p>prescription of antidepressants when needed. </p></li>
</ul>
<p>Whether to start a teen on <a href="https://australianprescriber.tg.org.au/articles/antidepressants-in-adolescence.html">antidepressant medication</a> can be a difficult decision. It should be a collaborative decision involving the teen, their parents and health professionals. </p>
<p>Like all medication, antidepressants have side effects and potential risks. They are typically used in cases of severe depression, or if psychological treatments have been unsuccessful. Suicidal thoughts or behaviour are a <a href="https://www.aacap.org/aacap/medical_students_and_residents/mentorship_matters/developmentor/Do_Antidepressants_Increase_the_Risk_of_Suicide_in_Children_and_Adolescents.aspx">possible side effect of antidepressants</a> for a small proportion of adolescents and should be carefully monitored. However, untreated depression is also a risk factor for suicide, so the potential benefits and risks of antidepressant use by teens needs to be carefully considered. </p>
<p><div data-react-class="InstagramEmbed" data-react-props="{"url":"https://www.instagram.com/p/CxAZ5ZTBrhe/?img_index=1","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"></div></p>
<h2>Assessing risk</h2>
<p>Suicidal thoughts and self-harm are common in depression but can be effectively treated. </p>
<p>Suicide risk assessment is a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228578/">critical part</a> of any treatment for depression, and should include the development of a <a href="https://au.reachout.com/articles/how-to-make-a-safety-plan">safety plan</a> with the teen and their parents or carers. Safety plans can be very helpful in times of distress, listing helpful coping strategies and contact details for family, friends and health professionals.</p>
<p>If you are concerned your teen <a href="https://parents.au.reachout.com/common-concerns/mental-health/suicide-and-teenagers">might be at risk of suicide</a>, take it seriously. Ask them direct questions, such as “Are you thinking about suicide?”. Get professional support as soon as possible and take the young person to the nearest emergency department or call 000 if you are worried about their immediate safety. You can also contact Kids Helpline 24 hours a day 1800 55 1800.</p>
<p>Importantly, look after yourself. Supporting a teen with depression can take a toll and lead to significant tension in a household. </p>
<p>Find someone (other than your child) you can confide in. Make sure you’re getting rest, nutrition and exercise. Seek professional support if you find yourself struggling. Taking care of yourself means you are better equipped to support your child. </p>
<hr>
<p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call <a href="https://www.lifeline.org.au/">Lifeline</a> on 13 11 14 or <a href="https://kidshelpline.com.au/">Kids Helpline</a> on 1800 55 1800.</em></p><img src="https://counter.theconversation.com/content/206702/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Louise Birrell receives funding from the National Health and Medical Research Council, the Australian government and Australian Rotary Health. </span></em></p><p class="fine-print"><em><span>Andrew Baillie is employed by the University of Sydney in a position half funded by Sydney Local Health District and he receives funding from the National Health and Medical Research Council and the Medical Research Future Fund. </span></em></p><p class="fine-print"><em><span>Maree Teesson is Chair of Australia's Mental Health Think Tank which is funded by the BHP Foundation. She is Director of The Matilda Centre, The University of Sydney. She is chair of the Million Minds Mission. She receives funding from the National Health and Medical Research Council, the Australian Government, BHP Foundation, Paul Ramsay Foundation and other research organisations. She is co-director of OurFutures Institute a not-for-profit company established to distribute evidence resources to education organisations. </span></em></p><p class="fine-print"><em><span>Erin Kelly does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Teen depression is on the rise but effective help is available. We look at what parents can do to support their teen.Louise Birrell, Researcher at The Matilda Centre for Research in Mental Health and Substance Use, University of SydneyAndrew Baillie, Professor of Allied Health, University of SydneyErin Kelly, Research Fellow and Clinical psychologistMaree Teesson, Professor & Director of The Matilda Centre. Chair, Australia's Mental Health Think Tank, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2074762023-08-16T12:28:50Z2023-08-16T12:28:50ZAs the mental health crisis in children and teens worsens, the dire shortage of mental health providers is preventing young people from getting the help they need<figure><img src="https://images.theconversation.com/files/534699/original/file-20230628-23-9wa1lm.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5584%2C3731&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Anxiety, depression and suicide among U.S. teens continue to increase. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/young-girl-in-trouble-feeling-sad-and-depressed-royalty-free-image/1135281941?phrase=distressed+teenager&adppopup=true">Paolo Cordoni/iStock via Getty Images Plus</a></span></figcaption></figure><p>The hospital where I practice recently admitted a 14-year-old girl with <a href="https://www.samhsa.gov/mental-health/post-traumatic-stress-disorder#">post-traumatic stress disorder</a>, or PTSD, to our outpatient program. She was referred to us six months earlier, in October 2022, but at the time we were at capacity. Although we tried to refer her to several other hospitals, they too were full. During that six-month wait, she attempted suicide. </p>
<p>Unfortunately, this is an all-too-common story for young people with mental health issues. A 2021 survey of 88 children’s hospitals reported that they <a href="https://www.cdc.gov/nchs/products/databriefs/db471.htm">admit, on average, four teens per day</a> to inpatient programs. At many of these hospitals, more children await help, but there are simply not enough services or psychiatric beds for them. </p>
<p>So these children languish, sometimes for days or even a week, in hospital emergency departments. This is not a good place for a young person coping with grave mental health issues and perhaps considering suicide. Waiting at home is not a good option either – the family is often unable or unwilling to deal with a child who is distraught or violent. </p>
<p>I am a <a href="https://som.cuanschutz.edu/Profiles/Faculty/Profile/28534">professor of psychiatry and pediatrics</a> at the University of Colorado, where I founded and direct the <a href="https://medschool.cuanschutz.edu/psychiatry/PatientCare/STARTcenter">Stress, Trauma, Adversity Research and Treatment Center</a>. For 30 years, my practice has focused on youth stress and trauma. </p>
<p>Over those years, I have noticed that these young patients have become more aggressive and suicidal. They are sicker when compared to years past. And the <a href="https://blogs.cdc.gov/nchs/2023/06/15/7396/#">data backs up my observation</a>: From 2007 through 2021, suicide rates among young people ages 10 to 24 increased by 62%. From 2014 to 2021, homicide rates rose by 60%. The situation is so grim that in October 2021, health care professionals <a href="https://www.aap.org/en/advocacy/child-and-adolescent-healthy-mental-development/aap-aacap-cha-declaration-of-a-national-emergency-in-child-and-adolescent-mental-health/">declared a national emergency</a> in child mental health. </p>
<p>Since then, the crisis has not abated; it’s only gotten worse.
But there are <a href="https://www.commonwealthfund.org/publications/explainer/2023/may/understanding-us-behavioral-health-workforce-shortage#">not enough mental health professionals</a> to meet the need. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/tuCuFddCaqM?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">How school bullying led to tragedy.</span></figcaption>
</figure>
<h2>The numbers behind the suffering</h2>
<p>The American Academy of Child and Adolescent Psychiatry reported in May 2023 that there is a <a href="https://www.aacap.org/aacap/zLatest_News/Severe_Shortage_Child_Adolescent_Psychiatrists_Illustrated_AACAP_Workforce_Maps.aspx">drastic shortage of child and adolescent psychiatrists</a> across the U.S. </p>
<p>For every 100,000 children in the U.S. – with 1 in 5 of those children having a mental, emotional or behavioral disorder in a given year – there are only 14 child and adolescent psychiatrists available to treat them, <a href="https://www.aacap.org/aacap/Advocacy/Federal_and_State_Initiatives/Workforce_Maps/Home.aspx">according to the American Academy of Child and Adolescent Psychiatry</a>. At least three times as many are needed. </p>
<p>There is also a significant shortage of child therapists – social workers, psychologists, licensed professional counselors – as well. This is particularly the case in <a href="https://doi.org/10.1001/jamapediatrics.2018.5399">rural areas across the country</a>. </p>
<p>Studies show that young people in the U.S. are <a href="https://www.pewresearch.org/social-trends/2019/02/20/most-u-s-teens-see-anxiety-and-depression-as-a-major-problem-among-their-peers/">increasingly stressed and traumatized</a>. The <a href="https://www.mayoclinic.org/healthy-lifestyle/tween-and-teen-health/in-depth/teens-and-social-media-use/art-20474437#">constant barrage of information</a> via social media and the demand to participate in it is complex, and interactions can be harmful to a child’s mental health. </p>
<p>Young people deal with <a href="https://cyberbullying.org/cyberbullying-statistics-age-gender-sexual-orientation-race">cyberbullying</a> and endless exposure to social media content <a href="https://theconversation.com/mounting-research-documents-the-harmful-effects-of-social-media-use-on-mental-health-including-body-image-and-development-of-eating-disorders-206170">focused on body image</a>.</p>
<p>But what children and adolescents see online is not the only problem. Much of life still happens offline, and a lot of it is not good. Millions of young people deal every day with <a href="https://ncsacw.acf.hhs.gov/research/child-welfare-and-treatment-statistics.aspx#">alcoholic, drug-abusing or neglectful parents</a>; peers who <a href="https://drugabusestatistics.org/teen-drug-use/">drink, vape and use drugs</a>; violence at <a href="https://www.cdc.gov/violenceprevention/communityviolence/index.html">their schools or in their streets</a>; and overwhelmed caregivers – whether parents or others – preoccupied with financial or other personal problems. </p>
<p>For an adolescent already struggling to make sense of the world, any one of these issues can be overwhelming. </p>
<h2>Not enough time or money</h2>
<p>The U.S. health care system does very little to support these children or their families. This pattern begins at the moment of birth, and it is baked into the system. </p>
<p>Ideally, prospective parents or those who are pregnant would receive parenting classes that continue through the child’s developmental phases. That generally <a href="https://www.gse.harvard.edu/ideas/ed-magazine/19/08/parent-approved">does not happen</a>. Then, many new parents do not have <a href="https://www.americanprogress.org/article/universal-home-visiting-models-can-support-newborns-families/">nursing and maternal care visits</a> or <a href="https://www.pewresearch.org/short-reads/2019/12/16/u-s-lacks-mandated-paid-parental-leave/">paid parental leave</a>. And for those families struggling financially, there is <a href="https://doi.org/10.1007/s10826-022-02322-0">not an adequate safety net</a>. </p>
<p>Nor can some families afford mental health treatment to support their children’s needs. <a href="https://www.nami.org/Support-Education/Publications-Reports/Public-Policy-Reports/The-Doctor-is-Out/DoctorIsOut">Many mental health providers don’t take insurance</a> and instead opt for out-of-pocket payments from patients. This is due to the low reimbursement rates from most insurers, which makes it very difficult to sustain a practice. Depending on the service, the cost could be anywhere from US$100 to $600 per session. </p>
<p>To see providers that do take insurance, there are usually co-pays – typically between $20 to $50 a week. But it can often be challenging for the insured to find a suitable in-network provider to meet a child’s needs.</p>
<p>The payments add up, particularly when mental health treatment takes many months, and sometimes years, to have an effect. There is a reason why it takes so long. Unlike medical doctors, mental health professionals do not simply make a diagnosis and provide medication or surgery. Instead, for treatments to work and to change the outcome for young people who are struggling, an ongoing – and lengthy – <a href="https://www.apa.org/monitor/2019/11/ce-corner-relationships">relationship between the therapist and the patient is needed</a>. </p>
<p>Treating a child is significantly more difficult than treating an adult. That is, in part, because children are constantly developing and changing. But perhaps the most formidable challenges are the <a href="https://doi.org/10.1186/s40723-021-00094-6">multiple entities</a> a child therapist may have to work with: caregivers, the school system, the courts and child welfare agencies. What’s more, getting a diagnosis, treatment or both often involves working with multiple providers, such as a primary care doctor, individual therapist, family-focused therapist and psychiatrist. </p>
<p>In the institute where I work, the psychiatry department loses money on almost every patient we treat. If it weren’t for fundraising and fostering relationships with donors, the department could only provide care to a select few. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/EHCeodippgo?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Emotional abuse by parents includes threats, bullying, humiliation and insults.</span></figcaption>
</figure>
<h2>Possible solutions</h2>
<p>Struggling children and teens in the U.S. need earlier interventions. Although schools are ideal places to teach social skills, they still do not offer enough activities to help young people <a href="https://raisingchildren.net.au/school-age/behaviour/understanding-behaviour/resilience-how-to-build-it-in-children-3-8-years">develop resilience to cope with adversity</a>. </p>
<p>Sometimes, young patients see primary care doctors who don’t have enough training in this area. Telephone hotline programs, which offer these doctors free consultations from mental health professionals to help assess problems in young patients, should be available throughout the U.S. But right now, <a href="https://www.rand.org/news/press/2019/07/15.html">only 19 states have such programs</a>. One bright spot: The <a href="https://theconversation.com/as-suicides-rise-in-the-us-the-988-hotline-offers-hope-but-most-americans-arent-aware-of-it-210356">988 Suicide and Crisis Lifeline</a>, which launched in July 2022, is available 24/7. </p>
<p>When a young person needs treatment, parents should prioritize finding a mental health provider right away. Asking the child’s primary doctor and school counselors for a reference is a good start. If the child is already on a waiting list, a parent or guardian should call the provider weekly to check in and make sure the child is not forgotten. </p>
<p>The process can be discouraging and daunting, but in our current environment, which provides limited support, that’s the way it is. And without a heavy lift from parents, the child remains at great risk.</p><img src="https://counter.theconversation.com/content/207476/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Steven Berkowitz is affiliated with Sensye, inc. I am a consultant to Senseye, Inc. a startup developing a device to make objective psychiatric diagnoses</span></em></p>Millions of young people in the US are suffering, whether from abuse at home, pressure from social media or exposure to violence. But navigating the mental health care system can be disheartening.Steven Berkowitz, Professor of Psychiatry, University of Colorado Anschutz Medical CampusLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2024812023-04-09T12:07:32Z2023-04-09T12:07:32ZOver-emphasis on safety means kids are becoming more anxious and less resilient<figure><img src="https://images.theconversation.com/files/519676/original/file-20230405-24-iwbwzp.jpg?ixlib=rb-1.1.0&rect=7%2C44%2C4912%2C3230&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Parents being over-protective can deny children the experiences they need to learn and grow.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/over-emphasis-on-safety-means-kids-are-becoming-more-anxious-and-less-resilient" width="100%" height="400"></iframe>
<p>We are facing a mental health crisis. Teenagers and young adults are more <a href="https://doi.org/10.1111/j.1939-0025.2011.01115.x">depressed, suicidal, anxious</a> and <a href="https://doi.org/10.1177/0265407519836170">lonely</a> than ever before. </p>
<p>Depression rates among teens have been increasing since the early 2000s. A 2018 national survey found that <a href="https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report">13.3 per cent of U.S. adolescents experienced a major depressive episode in the last year</a>. </p>
<p>But it’s not just teens — young adults are suffering too. A 2016 international survey of university counselling centres revealed 50 per cent of university students sought help for <a href="https://www.aucccd.org/assets/documents/aucccd%202016%20monograph%20-%20public.pdf">feelings of anxiety and 41 per cent for depression</a>. Suicide rates are also increasing. The <a href="https://wisqars.cdc.gov/reports/?o=MORT&y1=2001&y2=2015&t=0&d=&i=2&m=20810&g=00&me=0&s=2&r=0&e=0&yp=65&a=custom&g1=0&g2=199&a1=15&a2=19&r1=YEAR&r2=NONE&r3=NONE&r4=NONE">number of teenage girls in the U.S. who died by suicide nearly doubled</a> between 2000 and 2015. </p>
<p>The mental health statistics for Canadian youth are similarly grim. In 2003, <a href="https://www150.statcan.gc.ca/n1/pub/42-28-0001/2021001/article/00001-eng.htm">24 per cent of Canadians aged 15-30 self-reported that their mental health was either fair or poor</a> (compared to very good or excellent). <a href="https://www150.statcan.gc.ca/n1/pub/42-28-0001/2021001/article/00001-eng.htm">By 2019, that number had risen to 40 per cent</a>.</p>
<p>The COVID-19 pandemic worsened the mental health of Canadian youths. In 2020, <a href="https://www150.statcan.gc.ca/n1/pub/45-28-0001/2020001/article/00003-eng.htm">58 per cent of Canadians aged 15-24 reported fair or poor mental health</a> and nearly <a href="https://www.cihi.ca/en/children-and-youth-mental-health-in-canada">one in four hospitalizations for children and youth aged 5-24 were due to mental health conditions</a>.</p>
<p>What has changed in the last decade to explain this rise in poor mental health among youth? <a href="http://www.jeantwenge.com/igen-book-by-dr-jean-twenge/">Some psychologists</a> point to the recent <a href="https://www.thecoddling.com/buy">cultural emphasis on safety</a> as a contributor. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/519679/original/file-20230405-24-vudswh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A young sad-looking boy leans his head on a wall." src="https://images.theconversation.com/files/519679/original/file-20230405-24-vudswh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/519679/original/file-20230405-24-vudswh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/519679/original/file-20230405-24-vudswh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/519679/original/file-20230405-24-vudswh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/519679/original/file-20230405-24-vudswh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/519679/original/file-20230405-24-vudswh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/519679/original/file-20230405-24-vudswh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Parental overprotection has been shown to foster unhealthy coping mechanisms in children.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<h2>Shift in children’s safety</h2>
<p>In previous decades, American and Canadian children enjoyed more freedom, even though there were rising crime rates. The crime wave in Canada <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/220802/dq220802a-eng.htm">rose steeply from the 60s through the 80s until it peaked in the early 1990s</a>. <a href="https://www.thecanadianencyclopedia.ca/en/article/television">Cable TV became widespread</a> during the same period, meaning that news of crimes spread farther and quicker than ever before. </p>
<p>This surge spurred safety initiatives like sharing pictures of <a href="https://www.theglobeandmail.com/news/world/worldview/who-started-the-milk-carton-campaign-to-find-missing-children/article4101849/">missing children on milk cartons</a> and crime shows like <a href="https://tvtropes.org/pmwiki/pmwiki.php/Series/AmericasMostWanted">America’s Most Wanted</a>. It’s no wonder parents became increasingly fearful and protective.</p>
<p><a href="https://doi.org/10.4000/champpenal.448">Crime rates began to come down in the 1990s</a>, but fear among parents remained. This is where the problem of being over cautious begins. The concept of safety started to extend beyond children’s physical safety to emotional and psychological comfort. This denied children experiences they needed to learn and grow.</p>
<p>Parental overprotection has been shown to <a href="https://doi.org/10.1111/sode.12590">foster unhealthy coping mechanisms in children</a>. Overprotected children are more likely to both internalize problems (as in anxiety and depression) and externalize them (as in delinquency, defiance or substance abuse). </p>
<p>Some psychologists propose that overprotection can morph into what they call <a href="https://www.thecoddling.com/">“safetyism,”</a> which teaches kids negative thought patterns similar to those experienced by the anxious and depressed. Safetyism can over-prioritize a young person’s safety to the exclusion of other practical and moral concerns.</p>
<p>It is natural to want to avoid problems, but <a href="https://doi.org/10.1177/0956797614543022">avoiding things that bring us discomfort can reinforce a belief that we cannot handle certain issues</a> and, over time, make us less capable.</p>
<h2>Unhelpful thought patterns</h2>
<p>Here are three unhealthy thought patterns to monitor in yourself and your children:</p>
<p><strong>Identify negative filtering</strong>. Do not underestimate the positives of experiences like unsupervised play (joy, independence, problem-solving, risk-assessment, resilience) when considering the potential negative consequences.</p>
<p><strong>Be aware of dichotomous thinking</strong>. Do not fall into the good or bad trap. There’s a world of possibility between one or the other. Considering people, ideas, places or situations as either good or evil (but never both or somewhere in between) fosters a polarizing “us vs. them” attitude and eliminates nuance.</p>
<p><strong>Recognize emotional reasoning</strong>. Feeling “unsafe” (uncomfortable or anxious), does not mean you are actually physically unsafe. If you avoid all stress, you will never learn to overcome stressors or understand your full potential. Avoiding hurdles can make us think we are more weak or fragile than we are. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/519678/original/file-20230405-16-1wl7zt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Young people wearing backpacks seen from behind." src="https://images.theconversation.com/files/519678/original/file-20230405-16-1wl7zt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/519678/original/file-20230405-16-1wl7zt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/519678/original/file-20230405-16-1wl7zt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/519678/original/file-20230405-16-1wl7zt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/519678/original/file-20230405-16-1wl7zt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/519678/original/file-20230405-16-1wl7zt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/519678/original/file-20230405-16-1wl7zt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Avoiding things that bring us discomfort can reinforce a belief that we cannot handle certain issues and, over time, make us less capable.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
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<p>Painting the world as a place with dangers at every turn has created anxious youths who avoid activities they previously would have experimented with. Rising rates of loneliness and anxiety mean some youth are delaying <a href="https://doi.org/10.1111/cdev.12930">getting a job, driving a car, having sex, drinking alcohol and dating</a>. Research supports that <a href="https://doi.org/10.1007/s10826-020-01716-2#Sec16">overprotective parenting</a> (such as “helicopter parenting”) decreases adolescents’ <a href="https://doi.org/10.1007/s10826-013-9716-3">well-being</a>, <a href="https://doi.org/10.1007/s10826-019-01360-5">motivation</a>, <a href="https://doi.org/10.1016/j.adolescence.2012.03.007">independence</a> and <a href="https://doi.org/10.1111/sode.12590">ability to deal with problems in a healthy way</a>. </p>
<p>Generational trends show that across all social and economic demographics, <a href="https://doi.org/10.1353/foc.0.0044">American teens are putting off activities they deem “adult”</a> and don’t crave adult freedom as previous generations did. </p>
<p><a href="https://doi.org/10.1177/0265407519836170">They spend less time unsupervised by parents</a> because they’re worried about what’s out in the world, and they think they can’t handle it. <a href="https://www.cdc.gov/healthyyouth/data/yrbs/yrbs_data_summary_and_trends.htm">They don’t date or have sex</a> because they’re worried about broken hearts, pregnancy and sexually transmitted infections. <a href="https://doi.org/10.1017/S0954579412001228">They don’t drink</a> <a href="https://doi.org/10.1111/dar.12664">alcohol</a> because they’re worried about drunkenly making mistakes and what people will think of them afterwards. <a href="https://doi.org/10.3141/2495-01">They don’t drive</a> because they are happy to rely on their parents for transportation. </p>
<p>While some of these are rational consequences to avoid, they shouldn’t feel so overwhelming as to keep youths from transitioning into adulthood. Broken hearts teach you about what you want in a romantic partner, young people can be taught about safe sex, alcohol can be drunk in moderate amounts and mistakes are healthy, human and normal. Teens shouldn’t be so afraid of life that they no longer feel excited to live it.</p>
<p>Without opportunities to explore and learn their limits, youths risk internalizing a false sense of helplessness and becoming depressed and anxious. </p>
<h2>Helpful thought patterns</h2>
<p>Positive thought patterns must be developed within ourselves. That means giving ourselves, our teens and our children the opportunities needed to become independent, resilient and autonomous. And that means embracing negative experiences like frustration, conflict and boredom.</p>
<p>Here are some words of advice:</p>
<p><strong>Mind your mind.</strong> Your thoughts are powerful. They dictate how you see the world, others and yourself, so foster positive, rational thought patterns.</p>
<p><strong>Raise your voice.</strong> Encourage curiosity and productive disagreement. We will never learn to be open-minded or become well-rounded people if we do not challenge our own beliefs, listen to others’ perspectives and recognize our potential to be wrong. Every aspect of our lives, including our relationships and jobs, depends on our ability to argue in an effective, respectful and productive way without becoming overemotional.</p>
<p><strong>Open your heart.</strong> Try to give others the benefit of the doubt because most people do not intend to do harm. Do not let fear dictate your thoughts and actions.</p>
<p><strong>Trust yourself.</strong> Life will always throw curve balls and there will not always be an authority to defer to. Life is not safe or risk-free. The best protection is the knowledge that you can handle life’s challenges.</p><img src="https://counter.theconversation.com/content/202481/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Simon Sherry receives funding from the Social Sciences and Humanities Research Council of Canada. He also owns CRUX Psychology, a private practice in psychology.</span></em></p>Some psychologists suggest a cultural emphasis on safety is contributing to rising anxiety and depression among teens.Simon Sherry, Clinical Psychologist and Professor in the Department of Psychology and Neuroscience, Dalhousie UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2000522023-02-23T13:17:13Z2023-02-23T13:17:13ZHow to help teen girls’ mental health struggles – 6 research-based strategies for parents, teachers and friends<figure><img src="https://images.theconversation.com/files/511459/original/file-20230221-22-bwnz8d.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C6038%2C4019&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Social media can sometimes damage the self-esteem of teen girls.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/bad-news-over-the-phone-royalty-free-image/614833928?phrase=teenage%2Bgirl%2Bdepressed">stock-eye/iStock via Getty Images Plus</a></span></figcaption></figure><p>It’s a well-established fact that children’s and teens’ mental health <a href="https://doi.org/10.1177%2F20503121221086712">took a hit during the pandemic</a>. But new research suggests that teen girls in particular are suffering in unprecedented ways.</p>
<p>A survey by the Centers for Disease Control and Prevention that was published in early February 2023 found that, in 2021, 57% of high school girls reported experiencing “persistent feelings of <a href="https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBS_Data-Summary-Trends_Report2023_508.pdf">sadness or hopelessness in the past year</a>,” <a href="https://www.axios.com/2023/02/13/teen-girls-sadness-violence-cdc-report">up from 36% in 2011</a>. That’s nearly twice as high as the 29% of males who reported having those feelings in 2021.</p>
<p>What’s worse, 30% of the girls surveyed reported seriously considering suicide and 13% attempted suicide one or more times in 2021. That is beyond shocking. It’s appalling.</p>
<p>We are a <a href="https://www.marccenter.org">research team</a> that studies children and their <a href="https://www.marccenter.org/research-resources">social and emotional development</a>, and during the pandemic we’ve been specifically focused on mental health in children and adolescents. Since 2020, we’ve seen more changes in girls, overall, including increases in depression and thoughts of suicide. </p>
<p>In our view, a number of key factors have converged to create this mental health crisis in teen girls.</p>
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<figcaption><span class="caption">The stress experienced by teens is unique and significant.</span></figcaption>
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<h2>A perfect storm of factors</h2>
<p>Previous CDC research has shown that the COVID-19 pandemic <a href="https://www.cdc.gov/nssp/partners/Understanding-the-impact.html">disproportionately affected girls</a>. And in a 2021 study that our team conducted with 240 teens, 70% of girls said that they “very much” <a href="https://doi.org/10.3390/pediatric13030064">missed seeing people</a> during the pandemic, compared with only 28% of boys reporting that sentiment. </p>
<p>A second factor is social media, which can be a <a href="https://www.ingentaconnect.com/content/prin/csj/2018/00000052/00000004/art00009">wonderful source of support</a> but also, at times, a crushing blow to the <a href="https://doi.org/10.1016/j.copsyc.2022.101304">self-esteem and psychological well-being of girls</a>. </p>
<p>Finally, we think that all young people are struggling with issues like climate change and social upheaval. These aren’t just abstractions for many boys and girls: They are their future. Children and teens are usually neither <a href="http://www.ourenergypolicy.org/wp-content/uploads/2013/05/American-Teens-Knowledge-of-Climate-Change.pdf">indifferent to nor unaware of political realities</a>. </p>
<p>So how can parents, teachers and friends help girls through this crisis? </p>
<p>Here are six strategies that research shows can work.</p>
<h2>1. More emphasis on social support</h2>
<p>Social and emotional connectivity between humans is likely one of the most potent weapons we have against significant stress and sadness. Studies have found strong links between a <a href="https://doi.org/10.1016/j.childyouth.2018.03.001">lack of parental and peer support</a> and depression during adolescence. Support from friends can also <a href="https://doi.org/10.1007/s10802-013-9844-7">help mitigate the link</a> between extreme adolescent anxiety and suicidal thoughts. In one study of teens, <a href="https://doi.org/10.1006/jado.2000.0353">social support was linked to greater resilience</a> – such as being better able to withstand certain types of social cruelty like bullying. </p>
<h2>2. Supporting one another instead of competing</h2>
<p>During the 1970s and 1980s, competition between women was seen as something that held women back. Unfortunately, this message seems to have been lost in the <a href="https://online.king.edu/news/social-media-and-body-image/">tsunami of media coverage</a> about bodies, looks and social achievement. Research has found that <a href="https://doi.org/10.1016/j.chb.2015.09.011">social media encourages competition between girls</a>, particularly around their physical appearance. </p>
<p>Teaching girls at young ages to be cheerleaders for one another – and modeling that behavior as grownups – can help ease the sense of competition that today’s teens are facing.</p>
<h2>3. Showcasing achievements</h2>
<p>Thinking about your own appearance is natural and understandable. But an overemphasis on what you look like is clearly not healthy, and it is <a href="https://doi.org/10.1111/j.1471-6402.2006.00265.x">strongly associated with depression and anxiety</a>, especially in women. </p>
<p>Adults can play a key role in encouraging girls to value other qualities, such as their artistic abilities or intelligence. Childhood can be a canvas for children to discover where their talents lie, which can be a source <a href="https://doi.org/10.1002/sce.21066">of great satisfaction in life</a>.</p>
<p>One way that adults can help is simply by acknowledging and celebrating those qualities. For instance, at the <a href="https://www.marccenter.org/">Massachusetts Aggression Reduction Center</a>, an organization we direct and manage that is focused on prevention of bullying and cyberbullying, staff members post female achievements – be they intellectual, artistic, scientific, athletic or literary – on social media channels every Friday, using the hashtag #FridaysForFemales. </p>
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<figcaption><span class="caption">This young woman once felt sad, anxious and trapped.</span></figcaption>
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<h2>4. Empowering women</h2>
<p>Girls look to grown women for examples of how they can behave and what they can do. You may not be the chief executive officer of a huge corporation, but maybe you are a wonderful teacher, or maybe you run a small business that provides an important product or service. Modeling pro-women attitudes means valuing <a href="https://globalvolunteers.org/global-role-of-women/">all of the roles</a> that people play in a society.</p>
<p>In addition, teaching the history behind women’s movements and other important steps toward equality, such as the <a href="https://www.archives.gov/milestone-documents/19th-amendment">women’s right to vote</a>, is key to empowering girls to value themselves and their roles. Women played central roles in <a href="https://www.nationalww2museum.org/students-teachers/student-resources/research-starters/women-wwii">war efforts during World War II</a>. Women have led <a href="https://nmaahc.si.edu/sites/default/files/images/black_women_civil_rights_movement_5.pdf">social movements and fought for people’s rights</a>. And women have been <a href="https://www.nobelprize.org/prizes/physics/1903/marie-curie/biographical/">renowned scientists</a>, <a href="https://oxfordsummercourses.com/articles/famous-female-writers-in-history/">writers</a>, <a href="https://www.harpersbazaar.com/culture/art-books-music/g7916/best-female-artists/">artists</a> and experts in virtually every other profession you can name.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/511780/original/file-20230222-20-xuao0x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Black and white image of Marie Curie sitting in front of a work table watching as her daughter adjusts an instrument." src="https://images.theconversation.com/files/511780/original/file-20230222-20-xuao0x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/511780/original/file-20230222-20-xuao0x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=850&fit=crop&dpr=1 600w, https://images.theconversation.com/files/511780/original/file-20230222-20-xuao0x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=850&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/511780/original/file-20230222-20-xuao0x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=850&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/511780/original/file-20230222-20-xuao0x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1068&fit=crop&dpr=1 754w, https://images.theconversation.com/files/511780/original/file-20230222-20-xuao0x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1068&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/511780/original/file-20230222-20-xuao0x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1068&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Marie Curie, seated, was a Polish-born physicist and pioneer in radioactivity. Together with her husband she won a Nobel Prize for Physics in 1903. Her daughter, Irene, standing in photo, won a joint Nobel Prize for Chemistry in 1935.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/marie-curie-and-her-daughter-irene-1925-mc-polish-born-news-photo/171191031?phrase=marie%20curie&adppopup=true">Culture Club/Hulton Archive via Getty Images</a></span>
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<h2>5. An honest look at social media</h2>
<p>Social media represents a unique form of human interaction that has taken on an outsize role in the lives of teens. This is magnified for teenage girls, for whom every social media interaction may feel <a href="http://doi.org/10.1177/2056305119886025">consequential and potentially cataclysmic</a>.</p>
<p>Interacting in a fun and positive way with peers on social media platforms can be a <a href="https://doi.org/10.15804/tner.2016.46.4.01">positive and affirming experience</a>. On the other hand, seeing the things that others post, and comparing it with your own stuff, can make people of any age feel anxious about how they’re appearing, and whether they’re being socially included or excluded. This anxiety applies to both boys and girls, but the potential for emotional distress <a href="https://doi.org/10.1089/cyber.2019.0079">seems to be higher for girls</a>. </p>
<p>Awareness of how social media has the capacity to <a href="https://doi.org/10.1016/j.bodyim.2017.09.001">influence your feelings and mental health</a> seems to help people keep some distance from their interactions on social media. Adults can help girls by discussing with them how social media influences their feelings, their self-perception and even their body image. </p>
<h2>6. Teaching kids to recognize their feelings</h2>
<p>Learning to recognize and label feelings doesn’t come automatically for many people. The good news, though, is that kids can learn ways to help themselves when they’re experiencing <a href="https://doi.org/10.3390/jcm9103064">anxiety or depression</a>. Kids can learn to appreciate how hugging their dog, playing a board game, or talking with their parent(s) can help reduce anxiety, once they understand the feelings.</p>
<p>We think it’s worth noting that everything discussed here can also be helpful for boys, who are by no means <a href="https://www.apa.org/monitor/2022/01/special-childrens-mental-health">immune to mental health problems</a>. Encouraging achievement recognition, understanding how moods can be influenced by social media, and increasing support for both boys and girls is a positive step as we move toward a post-pandemic world.</p>
<p><em>This article has been updated to correct Marie Curie’s place of birth.</em></p><img src="https://counter.theconversation.com/content/200052/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The mental health of teenagers has grown far worse over the last decade. But a new report shows that, compared with boys, teen girls are disproportionately experiencing sadness and hopelessness.Elizabeth Englander, Professor of Psychology, Bridgewater State UniversityMeghan K. McCoy, Adjunct Faculty in Psychology and Childhood Studies, Bridgewater State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1929272022-12-01T13:41:18Z2022-12-01T13:41:18ZHow parents can play a key role in the prevention and treatment of teen mental health problems<figure><img src="https://images.theconversation.com/files/494260/original/file-20221108-24-2nnrfi.jpg?ixlib=rb-1.1.0&rect=6%2C12%2C4015%2C2653&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Early detection is key to treating depression in teenagers.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/sad-young-girl-royalty-free-image/888960804?phrase=teen%2Bdepression">dragana991/iStock via Getty Images Plus</a></span></figcaption></figure><p>More than 44% of teens reported <a href="https://www.cdc.gov/mmwr/volumes/71/su/su7103a3.htm">persistent feelings of sadness and hopelessness</a> in the first half of 2021, according to a report from the Centers for Disease Control and Prevention. The early 2022 report, which was based on an online survey, also found that nearly 20% had seriously considered suicide, and 9% attempted suicide. </p>
<p>The COVID-19 pandemic is a likely contributor to these startling figures, but rates of teen mental illness have been <a href="https://doi.org/10.1016/j.jadohealth.2019.04.033">rising over the past decade</a>. </p>
<p>One crucial factor that has received little attention in supporting teen mental health is the role that parents can play.</p>
<p>This is surprising, since research has clearly established that <a href="https://doi.org/10.1007%2Fs10567-015-0182-x">participation by a caregiver</a> in their child’s mental health treatment is directly related to a successful outcome. A key reason for this is that parents generally interact with their teen on a daily basis and can model and cultivate coping skills. </p>
<p>Yet, for mental health professionals, it can be challenging to integrate parents into teens’ treatment when there are discrepancies between the perspectives, goals and expectations of teens and parents. In addition,
<a href="https://www.guttmacher.org/gpr/2000/08/minors-and-right-consent-health-care">consent and privacy</a> laws sometimes limit providers’ abilities to disclose key details about a teen’s mental health to parents. </p>
<p>As researchers <a href="https://www.solutionsnetwork.psu.edu/t32-grant/fellows">studying childhood trauma</a> <a href="https://scholar.google.com/citations?user=wcuxj5gAAAAJ&hl=en">and adolescent development</a>, we see parents and caregivers as a critical link in addressing the urgent mental health crisis among teens. </p>
<h2>The teenage years can be brutal</h2>
<p>Parents often <a href="https://www.washingtonpost.com/parenting/2022/10/18/teen-years-dread-parenting/">dread the teenage years</a>, anticipating mood swings, risk-taking behaviors and endless arguments. Some of this is developmentally normal: Teens are developing their identities, testing limits and <a href="https://doi.org/10.1111/cdep.12278">asserting their autonomy</a>. These combined factors can lead to hostility and <a href="https://doi.org/10.1111/cdep.12278">a lower-quality</a> parent-teen relationship. </p>
<p>Physically, <a href="https://theconversation.com/school-start-times-and-screen-time-late-in-the-evening-exacerbate-sleep-deprivation-in-us-teenagers-179178">teens are sleep-deprived</a>, in part due to <a href="https://doi.org/10.1542/peds.2014-1697">overly early</a> <a href="https://www.cdc.gov/sleep/features/schools-start-too-early.html">school start times</a> and hormonal changes associated with puberty. As a result, teens can be irritable and sensitive to stressors. They also haven’t developed the <a href="https://doi.org/10.1177/0963721413480170">self-control to manage their reactions</a>. </p>
<p>And it’s important to note that half of all mental illness emerges <a href="https://www.nami.org/about-mental-illness/mental-health-conditions">by age 14 and 75% by age 24</a>, making adolescence a <a href="https://theconversation.com/anxiety-detection-and-treatment-in-early-childhood-can-lower-risk-for-long-term-mental-health-issues-an-expert-panel-now-recommends-screening-starting-at-age-8-192380">highly sensitive period for the prevention</a> and treatment of mental health problems.</p>
<h2>Signs and symptoms of a mental health concern</h2>
<p>Mental health problems in teens can sometimes take unexpected forms. Depression and anxiety can manifest as irritability and noncompliance, which parents may reasonably view as disrespect and laziness. Understanding what is beneath those behaviors is challenging. Teens are quite secretive, so they may not disclose the extent of their struggles. </p>
<p>Traumatic experiences like <a href="https://www.mcleanhospital.org/essential/mental-health-impact-bullying-kids-and-teens">bullying</a>, <a href="https://www.cdc.gov/violenceprevention/intimatepartnerviolence/teendatingviolence/fastfact.html">dating violence</a> and <a href="https://www.nsvrc.org/sites/default/files/publications/2019-02/Teenagers_508.pdf">sexual harassment and assault</a> are unfortunately too common in adolescence and can cause drastic changes in behavior and affect.</p>
<p>Although anxiety is a normal emotional response at any age, about a third of adolescents <a href="https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder#part_155096">have some type of anxiety disorder</a>, and about 10% experience severe impairment as a result. Teens struggling with chronic anxiety may experience agitation or irritability, issues with sleep, perfectionist tendencies, or may try to avoid stressful things altogether. </p>
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<figcaption><span class="caption">Keeping a journal, exercising regularly and maintaining a sleep routine are three ways for teens to cope with stress.</span></figcaption>
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<p>Among teens, <a href="https://www.nimh.nih.gov/health/statistics/major-depression">17% struggle with depression</a>. Depression generally involves a loss of interest or pleasure in daily activities, but it is more than feeling blue. For teens, symptoms of depression may look like withdrawing from family or social activities, shutting down during conversations or conflict, lethargy, difficulty concentrating, hopelessness about the future or negative feelings of self-worth. </p>
<p>Depression can also be associated with <a href="https://theconversation.com/why-do-teens-engage-in-self-harm-clinical-psychologists-explain-how-to-help-teens-reduce-their-emotional-distress-181419">self-harm</a> and suicide.</p>
<p>In determining whether a teen is experiencing a mental illness, parents should consider how behaviors are affecting their teens’ everyday lives and plans for the future. Those who are falling behind in school, damaging important relationships or engaging in high-risk behaviors may be most likely to be experiencing a mental health issue – as opposed to typical teenage challenges. </p>
<h2>A shortage of mental health care</h2>
<p>Despite the growing need for mental health care, the U.S. has <a href="https://www.aacap.org/AACAP/Press/Press_Releases/2018/Severe_Shortage_of_Child_and_Adolescent_Psychiatrists_Illustrated_in_AAACP_Workforce_maps.aspx">a dire shortage of professionals</a> to meet the demand. Insurance companies create barriers to accessing mental health care by restricting the numbers of <a href="https://www.gao.gov/assets/gao-22-104597.pdf">in-network providers</a> and approved sessions. As a result, many providers prioritize patients who will <a href="https://www.theatlantic.com/health/archive/2016/06/the-struggle-of-seeking-therapy-while-poor/484970/">pay out of pocket</a>. </p>
<p>Parents and teens may wait months for an appointment, and the quality and effectiveness of the services they receive are highly variable. All the while, symptoms may worsen, straining the family and compromising teens’ social and academic opportunities.</p>
<h2>The powerful role parents can play</h2>
<p>This is where parents come in, since they can <a href="https://doi.org/10.1111/j.1467-9507.2007.00389.x">serve as role models</a> for teens’ coping and emotional development. </p>
<p>While good sleep, consistent exercise and quality meals can often be the first line of defense in preventing and managing symptoms of mental health problems, there are several behavioral strategies for parenting struggling teens. Indeed, foster parents care for children with complex histories of trauma, and many of the <a href="https://www.cebc4cw.org/program/together-facing-the-challenge/detailed">behavior management strategies</a> taught to foster parents may be useful for traditional family settings as well. </p>
<p>When teens are unkind or disrespectful, parents may take it personally. But parents who are aware of and able to manage their own triggers can react calmly to challenging behavior, creating opportunities for effective communication with their teen. </p>
<p>Building and maintaining the parent-teen connection, such as by watching a TV show together or other low-pressure opportunities to be together, is key. These experiences <a href="https://doi.org/10.1016/j.pop.2014.05.004">create safe spaces and opportunities for teens</a> to communicate about difficult emotions or situations. Parents who assist teens in recognizing, talking about and dealing with difficult thoughts and feelings help them to understand how their thoughts and feelings can affect their behavior. </p>
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<figcaption><span class="caption">Set up a behavior contract with your teen.</span></figcaption>
</figure>
<p>Parents can also help their teens manage negative emotions by <a href="https://kidshealth.org/en/teens/self-esteem.html">reinforcing their self-esteem</a> and strengths and encouraging self-efficacy. Parents who offer praise to their teens who are working hard to overcome challenges – as opposed to focusing solely on the outcome – can help teens see their worth beyond their accomplishments. </p>
<p>At the same time, teens require boundaries that allow them to build self-reliance, exercise independence and practice compromise in certain situations. Behavior contracts – in which teens and their parents agree to certain conditions in writing – can provide a structured way to establish shared expectations. </p>
<p>When consequences are necessary, natural consequences allow teens <a href="https://sites.duke.edu/tftc/files/2020/06/March-2020-DB-TH-article.pdf">to learn without parental intervention</a>. For example, if a teen stays up late the night before a big softball game, their coach may bench them for playing poorly. Parents can help teens to connect the frustration and disappointment they experience to their choices regarding sleep, which can be more helpful for their future decision-making than getting into an argument with a parent about their decision or receiving a parent-imposed consequence, such as removing phone privileges. </p>
<p>When natural consequences are not an option, discipline should be specific, time-limited and focused on a specific outcome, such as not allowing preferred activities until homework and chores are complete.</p>
<p>It is also important that parents <a href="https://www.psychologytoday.com/us/blog/promoting-empathy-your-teen/201707/how-avoid-power-struggles-your-teen">avoid power struggles</a> with their teens by modeling respectful communication without trying to manage the teen’s reaction or perspective. Teens are unlikely to admit to being wrong – particularly in a heated moment – and if the point is made, there is rarely a benefit to insisting upon a particular reaction such as a forced apology.</p>
<p>Parents can best support their teens by maintaining connection alongside enforcing structure and discipline. While challenging behaviors can be the status quo of adolescence, parents should be on the lookout for signs that might reflect a pervasive mental health issue, since early detection and treatment is crucial.</p><img src="https://counter.theconversation.com/content/192927/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Nearly 1 in 5 US teenagers battle depression. But parents can help by communicating openly, creating a behavior contract and finding low-pressure opportunities to interact with their teen.Toria Herd, Postdoctoral Researcher in Psychology, Penn StateSarah A. Font, Associate Professor of Sociology and Public Policy, Penn StateLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1917572022-10-04T02:30:59Z2022-10-04T02:30:59ZCoroner finds social media contributed to 14-year-old Molly Russell’s death. How should parents and platforms react?<figure><img src="https://images.theconversation.com/files/487947/original/file-20221004-20-3ev5by.jpeg?ixlib=rb-1.1.0&rect=70%2C50%2C6639%2C4416&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Last week, London coroner Andrew Walker <a href="https://www.insider.com/social-media-likely-contributed-molly-russell-death-coroner-2022-9">delivered his findings</a> from the inquest into 14-year-old schoolgirl Molly Russell’s death, concluding she “died from an act of self harm while suffering from depression and the negative effects of online content”.</p>
<p>The inquest heard Molly had used social media, specifically Instagram and Pinterest, to view large amounts of graphic content related to self-harm, depression and suicide in the lead-up to her death in November 2017. </p>
<p>The findings are a damning indictment of the big social media platforms. What should they be doing in response? And how should parents react in light of these events?</p>
<h2>Social media use carries risk</h2>
<p>The social media landscape of 2022 is different to the one Molly experienced in 2017. Indeed, the initial public outcry after her death saw <a href="https://www.theguardian.com/technology/2019/feb/04/instagram-to-launch-sensitivity-screens-after-molly-russell-death">many changes</a> to Instagram and other platforms to try and reduce material that glorifies depression or self-harm. </p>
<p>Instagram, for example, <a href="https://about.instagram.com/blog/announcements/supporting-and-protecting-vulnerable-people-on-instagram">banned</a> graphic self-harm images, made it harder to search for non-graphic self-harm material, and started providing information about getting help when users made certain searches.</p>
<p>BBC journalist Tony Smith <a href="https://twitter.com/TonyNewsCamera/status/1576102984177491968">noted</a> that the press team for Instagram’s parent company Meta requested that journalists make clear these sorts of images are no longer hosted on its platforms. Yet Smith found some of this content was still readily accessible today. </p>
<p>Also, in recent years Instagram <a href="https://www.bbc.com/news/uk-47637377">has</a> <a href="https://www.buzzfeednews.com/article/emilybakerwhite/instagram-pro-eating-disorder-scale-report">been</a> <a href="https://www.techtransparencyproject.org/articles/thinstagram-instagrams-algorithm-fuels-eating-disorder-epidemic">found</a> to host pro-anorexia accounts and content encouraging eating disorders. So although platforms may have made some positive changes over time, risks still remain. </p>
<p>That said, banning social media content is not necessarily the best approach. </p>
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Read more:
<a href="https://theconversation.com/instagram-can-make-teens-feel-bad-about-their-body-but-parents-can-help-heres-how-168093">Instagram can make teens feel bad about their body, but parents can help. Here's how</a>
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</em>
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<h2>What can parents do?</h2>
<p>Here are some ways parents can address concerns about their children’s social media use.</p>
<p><strong>Open a door for conversation, and keep it open</strong></p>
<p>It’s not always easy to get young people to open up about what they’re feeling, but it’s clearly important to make it as easy and safe as possible for them to do so.</p>
<p>Research <a href="https://thefoodmedic.co.uk/2019/03/child-adolescent-mental-health/">has shown</a> creating a non-judgemental space for young people to talk about how social media makes them feel will encourage them to reach out if they need help. Also, parents and young people can often learn from each other through talking about their online experiences.</p>
<p><strong>Try not to overreact</strong></p>
<p>Social media can be an important, positive and <a href="http://www.danah.org/books/ItsComplicated.pdf">healthy part</a> of a young person’s life. It is where their peers and social groups are found, and during lockdowns was the only way many young people could support and talk to <a href="https://psyarxiv.com/5stx4/">each other</a>.</p>
<p>Completely banning social media may prevent young people from being a part of their peer groups, and could easily do more <a href="https://www.washingtonpost.com/news/parenting/wp/2018/06/12/why-its-a-mistake-to-ban-social-media-and-what-to-do-instead/">harm than good</a>.</p>
<p><strong>Negotiate boundaries together</strong></p>
<p>Parents and young people can agree on reasonable rules for device and social media use. And such agreements can be very powerful.</p>
<p>They also present opportunities for parents and carers to model positive behaviours. For example, both parties might reach an agreement to not bring their devices to the dinner table, and focus on having conversations instead. </p>
<p>Another agreement might be to charge devices in a different room overnight so they can’t be used during normal sleep times.</p>
<h2>What should social media platforms do?</h2>
<p>Social media platforms have long faced a crisis of trust and credibility. Coroner Walker’s findings tarnish their reputation even further. </p>
<p>Now’s the time for platforms to acknowledge the risks present in the service they provide and make meaningful changes. That includes accepting regulation by governments.</p>
<p><strong>More meaningful content moderation is needed</strong></p>
<p>During the pandemic, more and more content moderation was automated. Automated systems are great when things are black and white, which is why they’re great at spotting extreme violence or nudity. But self-harm material is often harder to classify, <a href="https://www.wired.com/story/opinion-the-perils-of-moderating-depression-on-social-media/">harder to moderate</a> and often depends on the context it’s viewed in.</p>
<p>For instance, a picture of a young person looking at the night sky, captioned “I just want to be one with the stars”, is innocuous in many contexts and likely wouldn’t be picked up by algorithmic moderation. But it could flag an interest in self-harm if it’s part of a wider pattern of viewing.</p>
<p>Human moderators do a better job determining this context, but this also depends on how they’re resourced and supported. As social media scholar Sarah Roberts writes in her book <a href="https://yalebooks.yale.edu/book/9780300261479/behind-the-screen/">Behind the Screen</a>, content moderators for big platforms often work in terrible conditions, viewing many pieces of troubling content per minute, and are often traumatised themselves.</p>
<p>If platforms want to prevent young people seeing harmful content, they’ll need to employ better-trained, better-supported and better-paid moderators.</p>
<p><strong>Harm prevention should not be an afterthought</strong></p>
<p>Following the inquest findings, the new Prince and Princess of Wales astutely tweeted “online safety for our children and young people needs to be a prerequisite, not an afterthought”.</p>
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<p>For too long, platforms have raced to get more users, and have only dealt with harms once negative press attention became unavoidable. They have been left to self-regulate for too long. </p>
<p>The <a href="https://mollyrosefoundation.org/">foundation</a> set up by Molly’s family is pushing hard for the UK’s <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/985033/Draft_Online_Safety_Bill_Bookmarked.pdf">Online Safety Bill</a> to be accepted into law. This bill <a href="https://www.gov.uk/government/news/world-first-online-safety-laws-introduced-in-parliament">seeks</a> to reduce the harmful content young people see, and make platforms more accountable for protecting them from certain harms. It’s a start, but there’s already <a href="https://5rightsfoundation.com/uploads/5Rights-Parliamentary-Briefing---Online-Safety-Bill.pdf">more that could be done</a>.</p>
<p>In Australia the eSafety Commissioner has pushed for <a href="https://www.esafety.gov.au/industry/safety-by-design">Safety by Design</a>, which aims to have protections built into platforms from the ground up.</p>
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<p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call <a href="https://www.lifeline.org.au/">Lifeline</a> on 13 11 14.</em></p><img src="https://counter.theconversation.com/content/191757/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tama Leaver receives funding from the Australian Research Council (ARC) as a chief investigator in the ARC Centre of Excellence for the Digital Child.</span></em></p>Imposing outright social media bans can do more harm than good.Tama Leaver, Professor of Internet Studies, Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1814192022-04-28T15:50:24Z2022-04-28T15:50:24ZWhy do teens engage in self-harm? Clinical psychologists explain how to help teens reduce their emotional distress<figure><img src="https://images.theconversation.com/files/459399/original/file-20220425-22-7zvx20.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C6720%2C4456&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Nearly 1 in 5 young people worldwide intentionally injure themselves every year.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/sadness-teenage-girls-sitting-in-tunnel-royalty-free-image/1309858578?adppopup=true">xijian/E! via Getty Images</a></span></figcaption></figure><p>Emotions are tricky things. They allow for humans to fall in love, wage war and, as it turns out, engage in self-harm. </p>
<p>It is hard to imagine an era in which young adults were more distressed than today. Recent Centers for Disease Control and Prevention data indicates that more than 40% of high school students <a href="https://www.cdc.gov/media/releases/2022/p0331-youth-mental-health-covid-19.html">reported they felt</a> persistently sad or hopeless over the past year. In the same survey, about 20% reported that <a href="https://www.washingtonpost.com/education/2022/03/31/student-mental-health-decline-cdc/">they seriously considered suicide</a>. Worldwide, approximately 17% of youths ages 12-18 <a href="https://doi.org/10.1016/j.jaac.2018.06.018">intentionally injure themselves each year</a>.</p>
<p>By all accounts, young people are experiencing a seemingly <a href="https://www.nytimes.com/2022/04/23/health/mental-health-crisis-teens.html">unprecedented level of emotional distress</a>. </p>
<p>Humans tend to behave in a way to <a href="https://doi.org/10.1016/j.cognition.2021.104904">seek pleasure and avoid pain</a>. Why then would some intentionally hurt themselves? In a new meta-analysis, a summary of research studies that we and our colleagues published in the journal Nature Human Behavior, we reported that people felt better <a href="https://www.nature.com/articles/s41562-022-01340-8">immediately after they self-injured or thought about suicide</a>. </p>
<p><a href="https://scholar.google.com/citations?user=SeU_WBkAAAAJ&hl=en&authuser=1">We are a doctoral candidate</a> in clinical psychology at the University of Washington, researching why youths and young adults self-injure, and <a href="https://scholar.google.com/citations?user=ifgFwvcAAAAJ">a clinical psychologist</a> studying young adult substance use. Our research suggests that this reduction in emotional distress following acts of self-harm and suicidal thoughts likely maintains these types of thoughts and behaviors. </p>
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<figcaption><span class="caption">Research shows that people often cut as a way to deal with strong emotions.</span></figcaption>
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<h2>The challenges with studying self-harm</h2>
<p>In his book “<a href="https://www.worldcat.org/title/about-behaviorism/oclc/805018">About Behaviorism</a>,” the preeminent psychologist <a href="https://psychology.fas.harvard.edu/people/b-f-skinner">B.F. Skinner</a> coined the term “reinforcement” to explain why behaviors are more likely to occur if that same behavior previously resulted in a desired outcome. Over the past 20 years, <a href="https://doi.org/10.1037/0022-006X.72.5.885">leading theories have hypothesized</a> that self-injury operated in the same manner. That is, if someone experienced relief from emotional suffering after they injured themselves, they would be more likely to repeat the behavior in the future. </p>
<p>Self-injury is difficult to research. Until the last decade, most researchers asked people to reflect on what they were thinking or feeling when they were self-injuring, but those episodes could have been months or even years ago. We humans, though, are remarkably bad at accurately reporting on our own behaviors, <a href="https://doi.org/10.1126/science.3563494">especially when we try to explain why things happened</a>. It’s especially challenging for researchers to get a clear timeline of events, which makes it difficult to pinpoint how someone was feeling immediately before or after they self-injured. </p>
<p>Recently, researchers have tried to fill those gaps by making use of the <a href="https://doi.org/10.1016/j.copsyc.2017.07.026">ubiquity of cellphones</a>. In those studies researchers asked participants to complete brief surveys about how they’re feeling multiple times per day over their cellphones as they go about living their lives. </p>
<p>Our meta-analysis <a href="https://www.nature.com/articles/s41562-022-01340-8">analyzed 38 such survey-based studies</a>, with data contributed from researchers around the U.S. and Europe, involving 1,644 participants. In all the studies, participants rated the intensity of their emotions and indicated whether they had thought about self-injury in the past few hours. </p>
<p>We found that the participants reported higher levels of distress right before they self-harmed or thought about suicide, and reported significantly reduced levels of distress immediately following. Together, this suggests that relief from distressing emotion acts as a powerful reinforcer, likely increasing the probability that people continue to experience self-injurious thoughts and behaviors. It also implies that treatments should focus on how to help people replace self-injury with alternative ways of relieving stress. </p>
<p>Since roughly 40% of people who attempt suicide <a href="https://www.nytimes.com/2022/01/19/health/suicide-attempts-us.html">do not receive mental health services</a>, we think it is important to share strategies for helping individuals at risk of self-harm talk about their emotions and to offer resources for finding professional help. </p>
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<figcaption><span class="caption">Family and the broader community play a role in reducing suicide risk.</span></figcaption>
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<h2>Strategies for discussing self-harm</h2>
<p>Teens who <a href="https://doi.org/10.1111/sltb.12841">self-injure and/or think about suicide are a heterogenous group</a> – people are unique, after all. However, our finding suggests that self-harm serves an important function for youth: to help regulate emotions. </p>
<p>It is essential that teens experiencing self-injurious thoughts and behaviors <a href="https://doi.org/doi:10.1001/jamapsychiatry.2018.4358">find adults and/or peers</a> to whom they feel connected. The previously mentioned CDC survey showed that <a href="https://www.cdc.gov/media/releases/2022/p0331-youth-mental-health-covid-19.html">youths who felt connected</a> were much less likely to contemplate or attempt suicide than those who did not feel connected. Thus, ensuring that teens feel cared about and supported or that they “belong” at home and school may be one way to protect against self-injury.</p>
<p>We’ve found in our clinical work with youths who self-injure that it’s important to balance validating their emotions – in other words, acknowledging and accurately understanding their feelings – while not responding to self-injury in ways likely to inadvertently reinforce it. If, for example, teens felt as if the only way they received support or validation were to self-harm, then it would be important to ensure that validation is provided when they are not self-harming. </p>
<p><strong>Here are some key ways to validate and show support:</strong></p>
<p>– Pay attention: We all know what it feels like to speak with someone who is not paying attention or is looking at their phone. Make eye contact and show you’re interested in what the person is feeling. </p>
<p>– Reflect back: Summarize what the person is saying to demonstrate that you are listening and taking in the information. You could say something like, “Let me make sure I understand …” and then paraphrase what you’re hearing.</p>
<p>– Try to read their thoughts: Imagine yourself in the person’s shoes or guess what they may be feeling, even if they haven’t said it directly. You could say something like, “I imagine you must be feeling like nobody understands what you’re going through.” If the teen says you’re wrong, give up on being right and try again later. </p>
<p>– Validate based on prior events: Show that you understand how the feelings make sense given what you know about the person. For example, you could ask, “Are there times when you’ve had experiences similar to now?” You could say something like, “I could totally see how you would feel afraid about failing this test, since you studied hard for the last one but didn’t do as well as you wanted.” </p>
<p>– Acknowledge how the feelings make sense in the present: Would other people in that exact same situation have the same feelings? For example, “Anyone would feel afraid.” This communicates to the other person that there isn’t anything wrong with the way they’re thinking and feeling. You won’t be able to validate everything; for instance, you shouldn’t validate that self-injuring is an effective response to distress. However, you can validate that self-injuring is understandable because it can provide temporary emotional relief even if it causes problems in the long run.</p>
<p>– Be “radically genuine”: Be authentic and try to show the other person you respect them and care about them. Treat them as a person of equal status who has important expertise about how to help solve the problem of their self-harm.</p>
<h2>Extending a helping hand</h2>
<p>It’s important for people to know that help is available. The National Suicide Prevention Lifeline (800-273-8255) is free for anyone experiencing emotional distress. <a href="https://nowmattersnow.org/">Now Matters Now</a> is another free resource that offers coping strategies to manage self-harm and suicidal thoughts from individuals with lived experience. </p>
<p>[<em>Over 150,000 readers rely on The Conversation’s newsletters to understand the world.</em> <a href="https://memberservices.theconversation.com/newsletters/?source=inline-150ksignup">Sign up today</a>.]</p>
<p>Prior research has shown that certain behavioral interventions, such as <a href="https://doi.org/10.7326/M19-0869">cognitive behavioral therapy</a> – an approach that focuses on the interplay among thoughts, emotions and behaviors – or <a href="https://doi.org/10.1080/15374416.2019.1591281">dialectical behavioral therapy</a> – a comprehensive treatment package that teaches mindfulness, emotion regulation, distress tolerance and interpersonal coping skills – are effective at reducing self-injurious thoughts and behaviors. Both treatments are designed to provide individuals with skills for recognizing their emotions as well as changing their feelings without self-injuring. </p>
<p><a href="https://services.abct.org/i4a/memberDirectory/index.cfm?directory_id=3&pageID=3282">Find a cognitive behavioral therapist</a></p>
<p><a href="https://behavioraltech.org/resources/find-a-therapist-app/">Find a therapist who provides dialectical behavioral therapy</a>, ideally a therapist who has been certified by the <a href="https://dbt-lbc.org/index.php?page=101163">DBT-Linehan Board of Certification</a> who has demonstrated the knowledge and ability to deliver DBT with adherence to the manual.</p><img src="https://counter.theconversation.com/content/181419/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kevin Kuehn received funding from the National Institute of Mental Health.</span></em></p><p class="fine-print"><em><span>Kevin King receives funding from the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism</span></em></p>New research shows that many young people report a sense of temporary relief following episodes of self-harm. But there are clear ways to help teens replace injurious behaviors with healthy ones.Kevin Kuehn, PhD Student in Clinical Psychology, University of WashingtonKevin King, Professor of Psychology, University of WashingtonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1710082022-02-15T13:22:33Z2022-02-15T13:22:33ZAfter the FDA issued warnings about antidepressants, youth suicides rose and mental health care dropped<figure><img src="https://images.theconversation.com/files/445533/original/file-20220209-19735-a32t0l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The link between antidepressant use and increases in suicidal thoughts or behaviors among treated youth is unproven.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/having-a-bad-day-royalty-free-image/640139784?adppopup=true">FatCamera/E+ via Getty Images</a></span></figcaption></figure><p>Depression in young people is vastly undertreated. About two-thirds of depressed youth don’t receive <a href="https://doi.org/10.1542/peds.2016-1878">any mental health care at all</a>. Of those who do, a significant proportion rely on antidepressant medications.</p>
<p>Since 2003, however, <a href="https://doi.org/10.1176/ajp.2007.164.6.884">the U.S. Food and Drug Administration has warned</a> that young people might experience suicidal thinking and behavior during the first months of treatment with antidepressants. </p>
<p>The FDA <a href="https://doi.org/10.1176/appi.ajp.2007.07050775">issued this warning to urge</a> clinicians to monitor suicidal thoughts at the start of treatment. These warnings appear everywhere: on TV and the internet, in print ads and news stories. The most strongly worded warnings appear in black boxes on medication containers themselves. </p>
<p>We are professors and researchers at <a href="https://www.populationmedicine.org/SSoumerai">Harvard Medical School</a>, the <a href="https://ldi.upenn.edu/fellows/fellows-directory/ross-koppel-phd/">University of Pennsylvania Perelman School of Medicine</a> and University at Buffalo. For over 30 years, we have been studying the intended and unintended effects of health policies on patient safety.</p>
<p>We have found that FDA drug warnings can sometimes prevent life-threatening adverse effects, but that <a href="https://doi.org/10.2307/3350088">unintended consequences of these warnings</a> are also common. In 2013, working for the FDA itself, we published a systematic review of the <a href="https://doi.org/10.1002/pds.3480">effects of previous FDA warnings</a> on a variety of medications. We found that about a third backfired, resulting in underuse of needed care and other adverse effects. </p>
<p><a href="https://doi.org/10.1176/appi.prcp.20200012">In our more recent study</a> from 2020, we found that the FDA antidepressant warnings have led to reduced mental health care and increased suicides among youth – even though researchers <a href="https://doi.org/10.1038/sj.npp.1300996">have yet to find a clear link</a> between antidepressants and increased suicidality in young people. </p>
<p>Further, despite the warnings, monitoring by clinicians of suicidal thoughts at the start of treatment has not increased <a href="https://doi.org/10.1176/appi.ajp.2007.07010205">from its tiny rate of less than 5%</a>.</p>
<h2>Youth suicides rose following FDA warnings</h2>
<p>For <a href="https://doi.org/10.1176/appi.prcp.20200012">our 2020 study</a>, we obtained 28 years of data, between 1990 and 2017, on actual suicide deaths in the U.S. among adolescents and young adults. We used data from <a href="https://wonder.cdc.gov/">the WONDER Database</a>, maintained by the U.S. Centers for Disease Control and Prevention, which contains mortality counts based on death certificates for U.S. residents and population counts for all U.S. counties.</p>
<p>We found that during the pre-warning period, there was a 13-year stable downward trend in youth suicides, following availability of new and safer antidepressants. </p>
<p><a href="https://doi.org/10.1176/appi.prcp.20200012">That trend reversed</a>, we found, soon after the FDA began antidepressant warnings in late 2003. Youth suicide deaths increased significantly.</p>
<p>Then we applied our findings to the whole U.S. population of adolescents and young adults. The results of that analysis suggest that there were almost 6,000 additional suicide deaths in just the first six years after the FDA issued the boxed warnings, from 2005 through 2010. The rates also continued to rise thereafter.</p>
<p>Over this same time period, older adults – whose depression is not targeted by the warnings – experienced much lower increases in suicide.</p>
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<h2>Fewer depressed youths got treatment</h2>
<p>Our findings align with a growing body of research that confirms these warnings have had serious unintended effects: <a href="https://doi.org/10.1056/NEJMp1408480">scaring many patients</a>, as well as their parents and doctors, away from both <a href="https://doi.org/10.1136/bmj.g3596">antidepressant medications</a> and <a href="https://doi.org/10.1001/archgenpsychiatry.2009.46">psychotherapy</a> that can reduce major symptoms of depression. </p>
<p>These studies include a rigorous 2017 study that <a href="https://doi.org/10.1002/da.22681">analyzed mental health care trends</a> among 11 million youths who rely on Medicaid for insurance coverage. This research documented that immediately after the FDA warnings began in 2003, there was a sudden and sustained 30%-40% drop in youth visits to doctors for all depression care, including antidepressant prescriptions. </p>
<p>Seven years after the first FDA warning, doctor visits for depression by young people had dropped by around 50%, compared with the pre-warning trend, thus <a href="https://www.nimh.nih.gov/health/statistics/major-depression">severely reducing treatment and suicide prevention</a>. </p>
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<p>That trend included Black and Latino youths, who have already <a href="https://www.dovepress.com/racial-and-ethnic-differences-in-depression-current-perspectives-peer-reviewed-fulltext-article-ND">long suffered from undertreatment</a>. </p>
<p>Almost simultaneously, youth poisonings via prescription drugs, such as sleeping pills, went up. <a href="https://doi.org/10.1136/bmj.g3596">Research has shown</a> that prescribed medications are a widespread method by which young people attempt suicide. This finding adds to the evidence that the antidepressant warnings increased suicidal behavior. </p>
<figure class="align-center ">
<img alt="A tattooed teenage girl speaks to a therapist during a group psychotherapy meeting. Three other young people, sitting in the background, are listening." src="https://images.theconversation.com/files/436824/original/file-20211209-23-1nkokvf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/436824/original/file-20211209-23-1nkokvf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/436824/original/file-20211209-23-1nkokvf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/436824/original/file-20211209-23-1nkokvf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/436824/original/file-20211209-23-1nkokvf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/436824/original/file-20211209-23-1nkokvf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/436824/original/file-20211209-23-1nkokvf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">About two-thirds of depressed young people in the U.S. receive no mental health treatment at all.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/tattooed-rebel-teenage-girl-sitting-in-front-of-a-royalty-free-image/1006550718?adppopup=true">Katarzyna Bialasiewicz/iStock via Getty Images</a></span>
</figcaption>
</figure>
<p><a href="https://doi.org/10.3389/fpsyt.2019.00294">In 2018, researchers reported on two patients in their 20s</a> whose experiences illustrate the potential real-life impacts of the black-box warnings. Both young adults had been prescribed antidepressants for major depression and severe panic attacks, but they refused to take them because of the FDA’s message. </p>
<p>Their conditions worsened, and eventually both attempted suicide. Fortunately, family members were able to intervene in time, and each young adult was then hospitalized.</p>
<p>After they accepted the reassurances of hospital psychiatrists that the benefits of the medications would likely exceed any risks, both patients began to take their prescribed antidepressants. These medications, combined with talk therapy, alleviated their symptoms without intensifying suicidal thoughts. </p>
<p>[<em>Understand new developments in science, health and technology, each week.</em> <a href="https://memberservices.theconversation.com/newsletters/?nl=science&source=inline-science-understand">Subscribe to The Conversation’s science newsletter</a>.]</p>
<h2>Reevaluating the warnings</h2>
<p>As scientists, we are trained to always seek potential alternative explanations – some additional factor not included in the research – that could explain the reduction in care or increase in suicides that we and others have recorded in our studies. </p>
<p>However, the sudden, simultaneous and large effects – all of which directly reduced treatment and increased suicidal behavior – strongly suggest this is not a coincidence. It is unlikely that any outside factor can account for the multiple parallel effects on depression care, suicidal behavior and suicide deaths.</p>
<p>A large and growing body of evidence shows that the FDA’s black-box warnings on antidepressants need to be reevaluated.</p>
<p>More generally, there’s a need for independent researchers to monitor the effects of FDA warnings on public health – both intended and unintended.</p><img src="https://counter.theconversation.com/content/171008/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stephen Soumerai receives funding from the NIH.. </span></em></p><p class="fine-print"><em><span>Ross Koppel does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A well-intentioned public health message has had serious negative impacts on the treatment of young people for depression.Stephen Soumerai, Professor of Population Medicine, Harvard Medical School, Harvard UniversityRoss Koppel, Professor of Medical Informatics and Adjunct Professor of Sociology, University of Pennsylvania; Professor of Biomedical Informatics, University at BuffaloLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1242392019-10-07T16:27:34Z2019-10-07T16:27:34ZStrong family ties during teen years can help ward off depression in later life<figure><img src="https://images.theconversation.com/files/295144/original/file-20191002-101470-1tpqhpk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Teens who suffer from depression tend to fare better in years to come if they have supportive families. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/portrait-smiling-african-american-young-mom-1289387383?src=nj7WeFusawegnQ2XmUvblg-2-65">fizkes/Shutterstock.com</a></span></figcaption></figure><p><a href="https://mphdegree.usc.edu/blog/mental-illness-and-public-health/">Depression</a> is a leading cause of disability and disease for people around the world. It often begins during adolescence, especially for females, may continue or recur in adulthood and tends to become a lifetime chronic health condition. </p>
<p><a href="https://www.who.int/news-room/fact-sheets/detail/depression">More than 300 million</a> people suffer from this mental health disorder worldwide. Depression is not only about feeling blue. It can also harm one’s social relationships, school or work and physical health. Poor mental health and depressive symptoms may also be associated with the <a href="https://www.pnas.org/content/112/49/15078;%20">recent increase in midlife premature deaths of despair</a>due to suicide, alcohol and drugs. </p>
<p>Although treatment methods and intervention efforts continue to advance, many depressive conditions remain <a href="https://doi.org/%2010.1192/bjp.184.6.526">irreversible</a>. The push for prevention and early, affordable and feasible intervention is stronger than ever, especially for young people. </p>
<p>We are <a href="http://pingchen.web.unc.edu/">both</a> <a href="https://www.cpc.unc.edu/fellow/kathleen-mullan-harris/">social demographers</a> who study family processes and health. We use a life course perspective in our research, meaning that we use longitudinal data to follow individuals as they move through various stages of life and examine how the social contexts they experience influence their health. </p>
<p>Recently we were interested in understanding how mental health changes from adolescence through mid adulthood. We wanted to see if we could identify family processes that might protect teens from depression in adolescence and later. We found that close and cohesive family relationships, understanding, and shared good times protected them then and later.</p>
<h2>Prevention a worthy goal</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/295836/original/file-20191007-121060-t4b9ek.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/295836/original/file-20191007-121060-t4b9ek.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/295836/original/file-20191007-121060-t4b9ek.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/295836/original/file-20191007-121060-t4b9ek.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/295836/original/file-20191007-121060-t4b9ek.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/295836/original/file-20191007-121060-t4b9ek.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/295836/original/file-20191007-121060-t4b9ek.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Teens who feel supported by their parents during depressive episodes fare better for many years.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/mature-parents-teen-girl-smartphone-cafe-708504049?src=cGzHa5UHT8O66ZQ5J0jylQ-1-5">Lightfield Studios/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>It is well known from the scientific evidence that close family relationships reduce the risks of depression during adolescence, a life stage when depression often begins, especially for girls. We were interested to know whether the mental health benefits of close and cohesive family relations in adolescence last into young adulthood, and so we used longitudinal data from a nationally-representative sample to address this question. </p>
<p>The family context is a key area that draws wide scholarly and public attention for <a href="https://www.guilford.com/books/Handbook-of-Depression-in-Children-and-Adolescents/Abela-Hankin/9781593855826/reviews">early intervention efforts</a>. Most research on the role of the family context for depression focuses on risk factors, such as neglect, abuse and financial insecurity. We wondered, however, whether preventive efforts may be more effective if focused on protective factors. We could not find major studies that could shed enough light on the topic.</p>
<p>Some small <a href="https://doi.org/%2010.1111/j.1467-8624.2007.01062.x">cross-sectional studies</a> with clinical and community samples suggest that being part of a close and cohesive family in adolescence helps alleviate depression symptoms for teenagers.</p>
<p>But does this protective effect last long into adulthood when adolescents move out of their parent’s house and embark on their independent lives? This intriguing and pressing question remains unknown due to a dearth of longitudinal studies that follow the same people over time.</p>
<p>A <a href="https://doi.org/10.1001/jamapediatrics.2019.3336">study</a>, which we published on Oct. 7 in JAMA Pediatrics is, so far as we know, the first to examine this topic in a nationally representative sample by tracking individuals over a 30-year life course from early adolescence to midlife. Our findings suggested that, yes, the protective effect not only helps in the tough teen years but also protects later.</p>
<h2>Some good news, and good insights</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/295838/original/file-20191007-121051-v21t16.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/295838/original/file-20191007-121051-v21t16.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/295838/original/file-20191007-121051-v21t16.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/295838/original/file-20191007-121051-v21t16.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/295838/original/file-20191007-121051-v21t16.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/295838/original/file-20191007-121051-v21t16.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/295838/original/file-20191007-121051-v21t16.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Depression often first appears in adolescence and can come back throughout young adulthood and even middle age.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/ptsd-mental-health-concept-young-depressed-1157218930?src=y00n2Srz1y9I072Z1konMg-1-39">Chanintorn.v/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>The data we used come from the <a href="https://www.cpc.unc.edu/projects/addhealth">National Longitudinal Study of Adolescent to Adult Health</a>, a nationally-representative study that has followed over 20,000 adolescents starting in 1995 into adulthood. The group of adolescents who started in the cohort have been re-interviewed five times, adding valuable knowledge about development over the course of life. The new data from the 2017 round of interviews have enabled us to examine how what happens in adolescence matters for later life mental health.</p>
<p>Our findings provide a new contribution to the research on early family experiences and lifetime depression and insights into how depression can be prevented from developing into a lifetime illness.</p>
<p>First, we found gender differences in depression over time. Females experienced significantly higher levels of depressive symptoms than males between early adolescence and their early 40s. </p>
<p>The overall trajectory of depressive symptoms was high in adolescence, fell in the early 20s, and then slowly rose again in the late 30s. The growth curve of depression is flatter for men than women. </p>
<p>Teenage girls are vulnerable to high levels of depression during middle to late adolescence. Teen boys, in comparison, experienced a shorter period of depression in late adolescence. Women then experienced the highest levels of depression in their late 30s. Men’s highest levels of depression occurred in their mid-30s to early 40s in the face of increasing challenges from work, family and social life. </p>
<p>Our primary interest, however, was to examine whether cohesive family relationships in adolescence protect young people from depression in adulthood and how long those protections last.</p>
<p>Our findings indicate the mental health benefits of cohesive family relationships during adolescence last through midlife. Individuals who experienced positive adolescent family relationships had significantly lower levels of depressive symptoms from early adolescence to midlife (late 30s to early 40s) than did those who experienced less-positive family relationships.</p>
<p>We also see this benefit working differently for men and women. Women benefit more from positive adolescent family relationships than men, especially in adolescence and the early 20s. But men with low parent-child conflict benefit for a longer time throughout young adulthood than women. </p>
<p>Living in a cohesive home, having someone around who understands and pays attention, and having fun together as a family can build up warmth, trust and attachment between the family members and adolescents and positive feelings for teens. The absence of parent-child conflict reinforces parental support and approval for them. Close relations may provide sources of social and emotional support that encourages the development of skills for coping with changing and cumulative stressors.</p>
<p>Our research findings emphasize the urgent need for early preventive interventions of depression in adolescent family life. Adolescence is a critical life stage where profound transformations in neurological, biological, cognitive and social development take place. These profound changes during adolescence make teens especially vulnerable to the development of lifetime depression. </p>
<p>Public health initiatives can teach and encourage parents and family members to nurture positive family relationships with their adolescents. Programs can be developed to promote family cohesiveness for adolescents by providing tips on how families can show affection and understanding, spend time together and work through conflict. This preventive approach will be most effective in fostering long-term healthy mental development into adulthood. </p>
<p>Our study, however, does not imply that adolescents in less cohesive families are doomed to lifetime depression. Depression is an extremely complex mental disorder. No one knows exactly what causes it. Factors such as genetics, abuse or serious illnesses can increase risks of depression too. Teens may be able to find similar sources of social support and gain coping skills through other social connections with friends, in religious and other institutions, and in the local community. </p>
<p>The skills and strategies that youth learn to cope with emotional problems may last throughout life, continue to promote mental health well into adulthood, and help to prevent negative outcomes and premature deaths due to suicide, alcohol or drugs in middle age.</p>
<p>[ <em>You’re smart and curious about the world. So are The Conversation’s authors and editors.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=youresmart">You can read us daily by subscribing to our newsletter</a>. ]</p><img src="https://counter.theconversation.com/content/124239/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The teen years are filled with fun for some, but many youth begin to experience serious depression, which can set them up for recurring bouts. A new study offers hope: Support and understanding help.Ping Chen, Senior Research Scientist, University of North Carolina at Chapel HillKathleen Mullan Harris, Professor of Sociology, University of North Carolina at Chapel HillLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1137762019-03-18T14:05:56Z2019-03-18T14:05:56ZHow can I help a friend with depression?<figure><img src="https://images.theconversation.com/files/264358/original/file-20190318-28499-7vke2s.jpg?ixlib=rb-1.1.0&rect=0%2C451%2C4816%2C3426&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/_tfFjSyIUZY">Luke Ellis-Craven/Unsplash. </a>, <a class="license" href="http://artlibre.org/licence/lal/en">FAL</a></span></figcaption></figure><blockquote>
<p><strong>How do I help a depressed friend? She’s 13 and she says it’s due to trauma, and even though we’re bffs she’s never told me what the trauma is.</strong> </p>
<p><strong>– Anonymous.</strong></p>
</blockquote>
<p><em>This article is part of I Need To Know, a Q&A service for teenagers by The Conversation.</em></p>
<p>What a thoughtful friend you are, the fact you have asked how you can help shows how much you care. Your friend may not have told you about the trauma, but she has opened up to you about feeling depressed, which must mean she really trusts you and this is something you can definitely help her with.</p>
<p>Depression is a common mental health problem that can affect people at many different stages in life. How bad it gets and how long it lasts can really vary. It’s often something that people find hard to talk about, as many people don’t really understand what it is. </p>
<h2>Understanding depression</h2>
<p>We all feel sad or down from time to time, but depression is worse than that, and typically affects the way we feel, how we think and how we behave. We know <a href="https://www.tandfonline.com/doi/pdf/10.1080/02699931.2016.1232698?needAccess=true">from research</a> that people with depression often withdraw from friends and family, stop doing things they enjoy and have more negative thoughts, which make them feel hopeless. You may have noticed some of these signs with your friend.</p>
<p>You can help her just by letting her know that you care and that she can talk to you if she wants. If she opens up to you, all you have to do is listen. Letting someone express how they feel <a href="https://www.sciencedirect.com/science/article/pii/S0140197115002201">is very therapeutic</a>. It may be that your friend doesn’t feel she can talk to her family or may not know where else to find support. </p>
<p>The next thing you could do is give your friend some information about what support is out there. For example, she can speak confidentially with <a href="http://www.childline.org.uk">Childline</a> or find out more information on the <a href="https://youngminds.org.uk">Young Minds website</a>. These are professional organisations that are specialised in helping young people with depression and trauma-related problems (I’ve linked to some sources below). </p>
<h2>Coping with trauma</h2>
<p>Most victims of trauma find it hard to talk about the trauma itself, as this can bring back the feelings and physical sensations that they experienced at the time. <a href="http://www.georgiadisaster.info/Schools/fs%207%20school/PTSD%20in%20Children%20&%20Adolescents.pdf">Trauma is defined</a> as a deeply distressing or disturbing experience. It can be triggered by a one off event, or can be the result of ongoing stress.</p>
<p>People can experience trauma as a result of ordinary life events such as illness, divorce or losing a loved one, <a href="https://s3.amazonaws.com/academia.edu.documents/32495504/complex-trauma-in-children.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1552916993&Signature=TzgVB5hoKc3gKFoPJR8OQnNSQCI%3D&response-content-disposition=inline%3B%20filename%3DComplex-trauma-in-children.pdf">or more extreme events</a> such as assault, injury or natural disasters. No matter how the trauma came about, I would urge you to be very careful about uncovering this with your friend – it would be better if you could seek support together from a trusted adult, or through a specialist service.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/264365/original/file-20190318-28492-1io4pbc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/264365/original/file-20190318-28492-1io4pbc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/264365/original/file-20190318-28492-1io4pbc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/264365/original/file-20190318-28492-1io4pbc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/264365/original/file-20190318-28492-1io4pbc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/264365/original/file-20190318-28492-1io4pbc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/264365/original/file-20190318-28492-1io4pbc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Keep moving.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-girl-dribbling-soccer-ball-596460">Shutterstock.</a></span>
</figcaption>
</figure>
<p>You can also help you friend by encouraging her to keep up her usual activities, such as doing sports and seeing friends. Getting <a href="https://link.springer.com/article/10.1007/s11036-013-0484-5">good quality sleep</a> can also help with mood, and <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1744-6171.2012.00341.x">keeping a journal</a> could help her to make sense of how she feels and process difficult emotions. </p>
<h2>Don’t go it alone</h2>
<p>But the most important advice I can give you is not to take on all the responsibility for helping your friend. There are many people and services who can support you and your friend, and this will give you the freedom to enjoy your time together having fun and sharing each other’s company.</p>
<p>For more information about what depression is and how to find support, take a look at the websites of these mental health services:</p>
<ul>
<li><a href="http://www.mind.org.uk">Mind</a></li>
<li><a href="http://www.rethink.org">Rethink Mental Illness</a></li>
<li><a href="https://youngminds.org.uk/">Young Minds</a></li>
<li><a href="http://www.childline.org.uk">Childline</a></li>
</ul>
<hr><img src="https://counter.theconversation.com/content/113776/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lowri Dowthwaite-Walsh does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Depression can affect people at any stage in life – here, an expert in psychology answers a young reader’s question about how to help.Lowri Dowthwaite-Walsh, Lecturer in Psychological Interventions, University of Central LancashireLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1018822018-08-24T10:39:56Z2018-08-24T10:39:56ZTeens who feel down may benefit from picking others up<figure><img src="https://images.theconversation.com/files/232955/original/file-20180821-149466-195vxtr.jpg?ixlib=rb-1.1.0&rect=358%2C515%2C4455%2C2661&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Boosting someone else may deliver a mood boost to you too.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/QqJiA8cZ3Ds">Mohamed Nohassi/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p><em><a href="https://theconversation.com/como-apoyar-a-un-hijo-con-depresion-ensenale-a-ayudar-a-otros-102143">Leer en español</a></em>.</p>
<p>Think about the last time you helped someone out. Maybe you sent a supportive text to a stressed-out friend or gave directions to a lost stranger. </p>
<p>How did it make you feel? </p>
<p>If you said good, happy, or maybe even “warm and fuzzy,” you’re not alone. Research shows that helping others offers a number of important psychological and health benefits.</p>
<p>In daily life, people report better mood on days that they <a href="https://doi.org/10.1177/2167702615611073">assist a stranger</a> or <a href="https://doi.org/10.1037/emo0000084">offer an empathetic ear to a friend</a>. Adults who <a href="https://doi.org/10.1177/002214650704800408">volunteer</a>, <a href="https://doi.org/10.1016/j.paid.2014.05.013">spend money on others</a> and <a href="https://doi.org/10.1111/1467-9280.14461">support their spouses</a> also experience improved well-being and <a href="https://doi.org/10.1111/1467-9280.14461">reduced risk of death</a>.</p>
<p>Helping others is beneficial in part because it <a href="https://www.researchgate.net/profile/Richard_Ryan2/publication/41087502_When_Helping_Helps_Autonomous_Motivation_for_Prosocial_Behavior_and_Its_Influence_on_Well-Being_for_the_Helper_and_Recipient/links/02e7e53274d556c5f8000000.pdf">promotes social closeness and feelings of personal competence</a>. </p>
<p>As <a href="https://scholar.google.com/citations?user=6Y0_gc8AAAAJ&hl=en&oi=ao">a researcher who studies adolescent development</a>, I decided to investigate how all this might play out in teenagers. I’m interested in studying teens’ prosocial behavior – things like helping, comforting and sharing – in the context of their close relationships. Given that adolescence is a time of <a href="https://doi.org/10.1111/desc.12373">heightened emotional intensity</a>, do teens reap mood benefits from helping out others in everyday life?</p>
<h2>Teens and depression</h2>
<p>Looking back on your own high school years, you might recall feeling intensely anxious about looking cool in front of classmates or being liked by your crush. During adolescence, youth become increasingly <a href="https://doi.org/10.1146/annurev-psych-010213-115202">preoccupied with the opinions of their peers</a>, including their friends and romantic partners. Indeed, adolescence is a time when experiences of social exclusion or rejection can <a href="http://doi.org/10.1177/0963721413476512">sting particularly badly</a>.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/233345/original/file-20180823-149475-1i6s2gq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The teenage years can be a hard time for some adolescents.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/noizephotography/3302465543">Paul De Los Reyes</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>The teenage years are also a high-risk time for developing depressive symptoms. Almost <a href="http://doi.org/10.1542/peds.2016-1878">1 in every 11</a> adolescents and young adults in the U.S. experience a major depressive episode. And, even youth with depressive symptoms who don’t meet criteria for an official diagnosis of depression are <a href="https://doi.org/10.1017/S095457941300093X">at risk for adjustment problems</a>, such as loneliness and romantic relationship difficulties.</p>
<p>Depressed adolescents, in addition to feeling hopeless and lacking self-esteem, often respond to <a href="http://psycnet.apa.org/record/2008-01178-004">social stress</a> with intensified negative emotions. For example, adolescents with major depressive disorder <a href="https://doi.org/10.1093/scan/nst175">take peer rejection harder</a> than do their healthy peers.</p>
<p>If depressed adolescents feel especially bad after negative social encounters, might they feel especially good after positive social encounters? Psychologists know that in general adolescents’ concerns about social approval can make positive interpersonal interactions – like offering a peer support or assistance – <a href="https://doi.org/10.1016/j.dcn.2016.11.008">all the more rewarding</a>. I wanted to see if that held even for teens who were feeling down.</p>
<h2>Did you help someone today?</h2>
<p>In <a href="https://doi.org/10.1037/emo0000494">our 2018 study</a>, <a href="https://dornsife.usc.edu/labs/margolinfamilystudies/graduate-students/">my colleagues and I</a> examined teenagers’ prosocial behavior in their everyday interactions with friends and romantic partners. Our goal was to understand whether giving help is particularly mood-enhancing for youth with depressive symptoms. </p>
<p>We recruited 99 late adolescents from the community around us in Los Angeles. Most of them were high school students or recent high school graduates. First we assessed their depressive symptoms in the lab so we could find out how they’d been feeling the prior couple weeks.</p>
<p>Then we asked them to complete 10 consecutive days of short surveys at home. Each of the 10 days, participants told us whether they helped out their friends or romantic partners – things like doing them a favor, or making them feel important. They also reported their own mood.</p>
<p>On days that teens helped their friends or dating partners, they experienced increased positive mood. Even if their mood wasn’t great the day before or if they themselves didn’t receive any social support that day, helping someone else was still related to a boost in their spirits.</p>
<p>But does helping help some teens more than others? The positive effects of day-to-day prosocial behavior on mood that we saw were strongest for teens with higher levels of depressive symptoms. So youth with elevated emotional distress reaped the greatest mood benefits from lending their peers a helping hand. </p>
<p>While we often talk about the importance of receiving social support when we’re feeling down, these findings highlight the unique value of providing support to others.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/233355/original/file-20180823-149490-11p3lz8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Teens felt better when they supported a friend.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/gRj8fOks0eg">Justin Groep/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<h2>Helping others helps yourself</h2>
<p>This study provides a glimpse into the potential benefits of help-giving for teens, particularly those experiencing depressive symptoms. Our finding builds upon previous research demonstrating that prosocial behavior is most rewarding for people experiencing <a href="https://doi.org/10.1037/a0027761">social anxiety</a>, <a href="https://doi.org/10.1111/jopy.12299">neuroticism</a> and <a href="https://doi.org/10.1016/j.paid.2017.10.042">body dissatisfaction</a>.</p>
<p>Although we did not test for underlying mechanisms for why this might be, it’s possible that providing help can make individuals feel <a href="https://doi.org/10.1371/journal.pone.0051380">appreciated by others</a> or promote <a href="https://doi.org/10.1080/17439760.2016.1209541">their sense of purpose</a> and <a href="https://doi.org/10.1016/j.adolescence.2017.04.002">self-esteem</a>. For youth with high levels of social-emotional distress, opportunities to strengthen social connections and feel competent within close relationships might be especially important for improving mood.</p>
<p>Many studies linking prosocial behavior to mood, ours included, are correlational — we cannot conclude that helping friends or romantic others causes more positive mood. Experimental studies that <a href="https://doi.org/10.1037/a0027761">randomly assign some participants to engage in acts of kindness</a> and others to engage in non-helping social activities will help rule out the possibility that it’s actually positive mood that drives subsequent prosocial behavior.</p>
<p>It’s also important to keep in mind that very few of our participants were clinically depressed. Research still needs to determine whether prosocial behavior is similarly linked to positive mood among adolescents with a diagnosed depressive disorder. An interesting question is whether some depressed youth experience emotional “burnout” from very frequent help-giving.</p>
<p>Although the word “adolescence” may conjure up images of reckless teens experiencing interpersonal conflict and emotional turmoil, the adolescent years are a time of great social opportunity and growth. Understanding when, how and why teens behave prosocially – and for whom help-giving most promotes well-being – can contribute to our understanding of adolescent social development.</p><img src="https://counter.theconversation.com/content/101882/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This material is based upon work supported by a National Science Foundation SBE Postdoctoral Research Fellowship awarded to Dr. Hannah L. Schacter under Grant No. 1714304.
This project is also based on work supported by NSF BCS-1627272 (Dr. Gayla Margolin, PI) and NIH-NICHD R21-HD072170 A1 (Dr. Gayla Margolin, PI).
Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author and do not necessarily reflect the views of the National Science Foundation or the National Institutes of Health.</span></em></p>Psychology researchers found that daily acts of kindness were linked to increases in positive mood – especially for teens who felt depressed.Hannah L. Schacter, Postdoctoral Research Fellow in Psychology, USC Dornsife College of Letters, Arts and SciencesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/909822018-03-23T10:51:09Z2018-03-23T10:51:09ZAchieving then failing in primary school is a sign of future teenage depression<figure><img src="https://images.theconversation.com/files/211544/original/file-20180322-54903-1ln8b4q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Struggling to keep up.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/male-pupil-finding-school-exam-difficult-432363745?src=JvVElrfuRTkggUa0ed8KOA-1-23">SpeedKingz/Shutterstock</a></span></figcaption></figure><p>Millions of people all over the world are experiencing mental health problems. And though the causes vary, we know that half of all these illnesses <a href="https://www.ncbi.nlm.nih.gov/pubmed/18221350">will have started</a> in childhood or the teenage years. </p>
<p>In the UK, referrals for and reports of teenagers with depression and anxiety and other mental issues have risen significantly in recent decades – reportedly <a href="https://www.independent.co.uk/life-style/health-and-families/features/teenage-mental-health-crisis-rates-of-depression-have-soared-in-the-past-25-years-a6894676.html">increasing by 70%</a> in the 25 years to 2016. </p>
<p>Researchers have known for many years that education and mental health are strongly <a href="https://www.sciencedirect.com/science/article/pii/S0277953607006776?via%3Dihub">linked</a> <a href="https://www.sciencedirect.com/science/article/pii/S0277953613002608?via%3Dihub">and</a> that doing well in school gives children a strong sense of feeling good about themselves – which in turn is linked to higher levels of well-being in <a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/370686/HT_briefing_layoutvFINALvii.pdf">adulthood</a>. </p>
<p>Depression, on the other hand, is linked to poor future academic success, and this link between depression and school failure is stronger for girls than for <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0101751">boys</a>. </p>
<p>However, while depression leads to poor academic success, it is not clear if poor academic success leads to depression. So, for our recent <a href="https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/school-achievement-as-a-predictor-of-depression-and-selfharm-in-adolescence-linked-education-and-health-record-study/F1DEAF5E0D6874373B319AF4852BF54F/core-reader">study</a>, we looked to see if the risk of future mental health problems could be predicted from school key stage test results.</p>
<h2>Achievement and depression</h2>
<p>We looked at the education and health records (consisting of GP and hospital admission files) from more than 600,000 children from across Wales, and at their school test results. These children were aged between 11 and 18, so that we were looking just at teenage mental health. And they were born or living in Wales between 1990 and 2014.</p>
<p>Looking at these records, we found that children who “declined” in school were more likely to be depressed as a teenager. The children were identified as doing well in school at age seven, but after that were not meeting their key stage milestones in reading, writing and numeracy. So, by age 11, they were not achieving well – or “declining”. During their teenage years, they were then diagnosed with depression.</p>
<p>It is unclear whether the children had depression in primary school which wasn’t picked up until they are teenagers, or if not doing well in primary school leads to depression. Either way, our study suggests that helping children who are declining in primary school could help to identify and prevent depression at the early stages.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/211684/original/file-20180323-54898-1ws0acy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/211684/original/file-20180323-54898-1ws0acy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/211684/original/file-20180323-54898-1ws0acy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/211684/original/file-20180323-54898-1ws0acy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/211684/original/file-20180323-54898-1ws0acy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/211684/original/file-20180323-54898-1ws0acy.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/211684/original/file-20180323-54898-1ws0acy.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Depressed.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/portrait-university-student-on-campus-255908731?src=tSbe9Kn_tzI624r1KyGNGA-1-15">Lopolo/Shutterstock</a></span>
</figcaption>
</figure>
<p>In addition, we found that seven per cent of all girls and three per cent of all boys were treated or diagnosed with depression by age 19. That is 33,500 children just from these records that were treated for depression. Not only is this difficult for the individuals and families involved, but can be a great cost to the NHS, too.</p>
<p>The research also uncovered that teenagers who self harm show lower school achievement just before they are identified by a GP as self-harming. This means they decline in school and start self-harming around the same time. However, teenagers who self-harm are not more likely to be declining in primary school. So self-harming is not linked to experience in primary school, but is linked to experiences in the teenage years. </p>
<p>Our study has important implications which suggest that depression symptoms may be being missed in primary school children, and that support for emotional and social development in primary school could improve and reduce future mental health problems. </p>
<p>There is also a case for more <a href="https://theconversation.com/childrens-mental-health-needs-to-be-at-the-heart-of-school-policy-56091">support for teachers and families</a> in helping children understand emotions and dealing with difficulties. Parenting skills, supportive school environments and community programmes may be more cost effective for the NHS as well, and prevent the young people ever having to experience a mental health problem.</p><img src="https://counter.theconversation.com/content/90982/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sinead Brophy receives funding from Welsh Government (Health and Care Research Wales), Medical Research Council, British Heart Foundation and Economic and Social Research Council. </span></em></p>A study of 600,000 children has found links between achievement and depression.Sinead Brophy, Professor in Public Health Informatics, Swansea UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/870862018-01-29T18:14:07Z2018-01-29T18:14:07ZMore children are starting school depressed and anxious – without help, it will only get worse<figure><img src="https://images.theconversation.com/files/203716/original/file-20180129-100902-18xzg2s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Transition to school is a difficult time for children.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/cRRDzGxqVe8">Photo by Piron Guillaume on Unsplash</a></span></figcaption></figure><hr>
<p><em>This article is <a href="https://theconversation.com/au/topics/back-to-school-2018-48951">part of a series</a> that draws on the latest research on back to school transitions. In it, experts explain how best to prepare children for school, and counter difficulties such as stress or bad behaviour.</em></p>
<hr>
<p>Starting school for the first time can be stressful. Children are suddenly thrown into a foreign environment, juggling the pressure of learning new academic skills and establishing relationships with peers. Some thrive, but others may need support through this transition.</p>
<p>Our <a href="https://www.ncbi.nlm.nih.gov/pubmed/28795830">study found</a> that at the ages of six to seven, which is just after the time children start school, 14% of Australian children had noticeably high levels of emotional problems. Emotional problems generally refer to depressive and anxiety symptoms, somatic (physical) complaints such as headaches, and withdrawn behaviours. </p>
<p>There are roughly <a href="http://www.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/036">1.5 million children aged six to seven going to school</a> in Australia. This means around 200,000 of them are dealing with some kind of emotional problem. These problems become worse as the children progress through school. We found that three years later, when the same cohort of children were ten to 11, an additional 60,000 had developed symptoms of depression or anxiety.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-to-gently-prepare-your-child-for-prep-90122">How to gently prepare your child for prep</a>
</strong>
</em>
</p>
<hr>
<h2>Emotional problems</h2>
<p>A <a href="http://www.aedc.gov.au/resources/detail/2015-aedc-national-report">2015 report</a> from the Australian Early Development Census (<a href="https://www.aedc.gov.au/">AEDC</a>) has warned that one in five (22%) children who enter school in Australia is developmentally vulnerable in one or more areas, including emotional maturity, communication and cognitive skills (such as memory). </p>
<p>It was also noted that children’s mental health was becoming worse since the 2012 report. The emotional maturity domain, for instance, saw a decrease in the number of children developmentally on track (from 78.1% to 76.4%) and an increase in the number of those who were developmentally vulnerable (from 7.6% to 8.4%) and at risk (from 14.2% to 15.3%).</p>
<p>While we know emotional problems <a href="https://www.aihw.gov.au/getmedia/7752644b-e6f0-4793-b4e0-74ef3093c589/19748-ah16-ib.pdf.aspx?inline=true">are prevalent among young Australians</a>, we have little knowledge of how these issues develop throughout childhood. Such knowledge is crucial to inform early prevention and intervention, and to alter the development of emotional problems into adolescence and adulthood.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/australian-teens-doing-well-but-some-still-at-high-risk-of-suicide-and-self-harm-83303">Australian teens doing well, but some still at high risk of suicide and self-harm</a>
</strong>
</em>
</p>
<hr>
<p>Our <a href="https://www.ncbi.nlm.nih.gov/pubmed/28795830">study</a> used data from the Longitudinal Study of Australian Children (<a href="http://www.growingupinaustralia.gov.au">LSAC</a>). The LSAC has been following the development of 10,000 children and families since 2004 in two cohorts – the birth cohort and the kindergarten cohort. Each cohort has about 5,000 children and families. </p>
<p>The LSAC <a href="http://www.growingupinaustralia.gov.au/about/faq.html#q2">explores areas</a> such as children’s social and emotional development, the health status of children and their families, learning and cognition outcomes, parenting, and relationships. This <a href="http://www.growingupinaustralia.gov.au/about/faq.html#q6">information is collected</a> through face-to-face and telephone interviews, as well as computer-assisted self interviews and/or questionnaires.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/202548/original/file-20180119-80161-55a1a7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/202548/original/file-20180119-80161-55a1a7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/202548/original/file-20180119-80161-55a1a7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=423&fit=crop&dpr=1 600w, https://images.theconversation.com/files/202548/original/file-20180119-80161-55a1a7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=423&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/202548/original/file-20180119-80161-55a1a7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=423&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/202548/original/file-20180119-80161-55a1a7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=532&fit=crop&dpr=1 754w, https://images.theconversation.com/files/202548/original/file-20180119-80161-55a1a7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=532&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/202548/original/file-20180119-80161-55a1a7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=532&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Girls are more at risk of their emotional problems escalating than boys.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/cEf2lvyhNAI">Photo by pan xiaozhen on Unsplash</a></span>
</figcaption>
</figure>
<p>We analysed the data on the emotional problems of 3,200 children from the kindergarten cohort who had completed questions relevant to our study; first at the ages of six to seven, then again at eight to nine, and ten to 11. We found that children’s emotional problems, on average, were increasing over time. </p>
<p>However, the rate of increase did not differ based on children’s initial emotional vulnerability. </p>
<h2>What are the reasons?</h2>
<p>In addition to analysing data on the rates of children’s emotional problems, we also identified a range of risk and protective factors that fall into four categories: individual aspects, social and cultural environment, parenting, and peer group experience. </p>
<p>We found a number of factors to be associated with the increase in emotional problems of the children in our sample over time. For example, compared to boys, girls started with higher levels of emotional problems at six to seven years, and these escalated at a faster rate. There is <a href="http://dx.doi.org/10.1007/s10802-005-6734-7">well-established evidence</a> that adolescent girls often have more emotional problems than boys, but the evidence in childhood is not robust. </p>
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<strong>
Read more:
<a href="https://theconversation.com/why-we-should-put-yoga-in-the-australian-school-curriculum-89962">Why we should put yoga in the Australian school curriculum</a>
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</em>
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<p>Our findings suggest that girls with early signs of emotional problems, and their parents, should be considered for parent and child development support programs in the early years of school. Signals can include showing anxiety, chewing nails, not being able to make friends, having sleep problems and signs of depression. </p>
<p>How children regulate their emotions is another factor that influences their emotional wellbeing, particularly during the <a href="https://www.cambridge.org/core/journals/development-and-psychopathology/article/developmental-cascades-externalizing-internalizing-and-academic-competence-from-middle-childhood-to-early-adolescence/596E8F631C1F34A67DEA435C69345E85">transition to school</a>. This is the period when children face increasing demands to regulate their emotions in formal school settings.</p>
<p>We found peer problems to be an important risk factor linked to children’s escalation of emotional problems, especially during the transition to school. Peer problems include issues such as not being able to make friends, having difficulty getting along with peers or being picked on by other children. Children need to learn skills related to making friends and maintaining friendships, such as cooperation, sympathy and helping others.</p>
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<strong>
Read more:
<a href="https://theconversation.com/back-to-school-blues-how-to-help-your-child-with-shyness-90228">Back to school blues: how to help your child with shyness</a>
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<p>One thing to note is that the absence of peer problems <a href="http://www.sciencedirect.com/science/article/pii/S0022440516300565">does not necessarily suggest</a> the presence of positive relationships. Teachers tend to view children without problematic behaviours more favourably than children with problematic behaviours, and so are less likely to support them. However, lack of peer problems might also mean that the child is isolated and does not have many friends. </p>
<p>It’s important that teachers and parents proactively assist children to develop their social skills. Among the most important ones are to encourage children to help others, cooperate, express their emotions and understand others’ emotions. </p>
<p>Our study also found that the mother’s mental health was important for children’s emotional wellbeing. We included mothers’ mental health scores when children were four to five, and six to seven years. A poor score for a mother’s mental health when her children were four to five years was linked to children’s escalation of emotional problems from six to seven and then ten to 11 years. </p>
<p>This suggests that the early years may represent a sensitive period during which maternal mental health problems have lasting and harmful implications on children’s emotional wellbeing across middle childhood. </p>
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Read more:
<a href="https://theconversation.com/how-to-gently-prepare-your-child-for-prep-90122">How to gently prepare your child for prep</a>
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<h2>How parents can help</h2>
<p>Two important ways in which parents can prepare their children for school is by teaching them self-regulation and friendship skills. </p>
<p>To have better self-regulation skills, children need to learn to have some discipline early on. Trying to stick to a schedule, for example, is important. </p>
<p>Also important is helping children understand their emotions and express them in a constructive way – for example, to be able to say when they feel frustrated instead of having a tantrum. </p>
<p>To help children have <a href="https://www.sciencedirect.com/science/article/pii/S0885200617301266">better friendship skills</a>, parents can encourage them to help other children, be involved in group activities with them and to act sympathetically towards others.</p>
<p><em>More resources for parents can be found <a href="http://www.triplep-parenting.net.au/au-uken/triple-p/">here</a>, and <a href="http://www.janetlansbury.com/">here.</a></em></p><img src="https://counter.theconversation.com/content/87086/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>At the ages of 6-7, when children are transitioning to starting school, 14% have high levels of emotional problems, including depression and anxiety. This percentage is higher in the later years.Dr Amelia Shay, Research Fellow in Developmental and Educational Psychology, Australian Catholic UniversityCen Wang, Research Fellow in Educational and Developmental Psychology, Charles Sturt UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/869962017-11-14T14:36:31Z2017-11-14T14:36:31ZWith teen mental health deteriorating over five years, there’s a likely culprit<figure><img src="https://images.theconversation.com/files/194386/original/file-20171113-27576-a1s7xf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/silhouette-very-sad-man-sitting-alone-606930839?src=_mc5uyh7kV2fNORBqE8nVw-3-10">pimchawee</a></span></figcaption></figure><p>Around 2012, something started going wrong in the lives of teens.</p>
<p>In just the five years between 2010 and 2015, the number of U.S. teens who felt useless and joyless – <a href="https://adaa.org/understanding-anxiety/depression/symptoms">classic symptoms of depression</a> – surged 33 percent in large national surveys. Teen suicide attempts increased 23 percent. Even more troubling, the number of 13- to 18-year-olds who committed suicide jumped 31 percent.</p>
<p><a href="http://journals.sagepub.com/doi/full/10.1177/2167702617723376">In a new paper</a> published in Clinical Psychological Science, my colleagues and I found that the increases in depression, suicide attempts and suicide appeared among teens from every background – more privileged and less privileged, across all races and ethnicities and in every region of the country. All told, our analysis found that the generation of teens I call “<a href="http://www.simonandschuster.com/books/iGen/Jean-M-Twenge/9781501151989">iGen</a>” – those born after 1995 – is much more likely to experience mental health issues than their millennial predecessors. </p>
<p>What happened so that so many more teens, in such a short period of time, would feel depressed, attempt suicide and commit suicide? After scouring several large surveys of teens for clues, I found that all of the possibilities traced back to a major change in teens’ lives: the sudden ascendance of the smartphone.</p>
<h2>All signs point to the screen</h2>
<p>Because the years between 2010 to 2015 were a period of steady economic growth and <a href="https://data.bls.gov/timeseries/LNS14000000">falling unemployment</a>, it’s unlikely that economic malaise was a factor. Income inequality was (and still is) an issue, but it didn’t suddenly appear in the early 2010s: This gap between the rich and poor had been <a href="https://fred.stlouisfed.org/series/SIPOVGINIUSA">widening for decades</a>. We found that the time teens spent on homework barely budged between 2010 and 2015, effectively ruling out academic pressure as a cause.</p>
<p>However, according to the Pew Research Center, smartphone ownership <a href="http://www.pewresearch.org/fact-tank/2017/01/12/evolution-of-technology/">crossed the 50 percent threshold</a> in late 2012 – right when teen depression and suicide began to increase. By 2015, <a href="http://www.pewinternet.org/2015/04/09/teens-social-media-technology-2015/pi_2015-04-09_teensandtech_06/">73 percent</a> of teens had access to a smartphone. </p>
<p>Not only did smartphone use and depression increase in tandem, but time spent online was linked to mental health issues across two different data sets. We found that teens who spent five or more hours a day online were 71 percent more likely than those who spent less than an hour a day to have at least one suicide risk factor (depression, thinking about suicide, making a suicide plan or attempting suicide). Overall, suicide risk factors rose significantly after two or more hours a day of time online. </p>
<p>Of course, it’s possible that instead of time online causing depression, depression causes more time online. But three other studies show that is unlikely (at least, when viewed through social media use). </p>
<p>Two followed people over time, with <a href="https://hbr.org/2017/04/a-new-more-rigorous-study-confirms-the-more-you-use-facebook-the-worse-you-feel">both</a> <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0069841">studies</a> finding that spending more time on social media led to unhappiness, while unhappiness did not lead to more social media use. <a href="http://online.liebertpub.com/doi/abs/10.1089/cyber.2016.0259?journalCode=cyber">A third</a> randomly assigned participants to give up Facebook for a week versus continuing their usual use. Those who avoided Facebook reported feeling less depressed at the end of the week. </p>
<p>The argument that depression might cause people to spend more time online doesn’t also explain why depression increased so suddenly after 2012. Under that scenario, more teens became depressed for an unknown reason and then started buying smartphones, which doesn’t seem too logical.</p>
<h2>What’s lost when we’re plugged in</h2>
<p>Even if online time doesn’t directly harm mental health, it could still adversely affect it in indirect ways, especially if time online crowds out time for other activities. </p>
<p>For example, while conducting research for my book on iGen, I found that teens now spend much less time interacting with their friends in person. Interacting with people face to face <a href="http://ronaldvoorn.com/wp-content/uploads/2015/09/1995-The-Need-to-Belong-Desire-for-Interpersonal-Attachments-as-a-Fundamental-Human-Motivation.pdf">is one of the deepest wellsprings of human happiness</a>; without it, our moods start to suffer and depression often follows. Feeling socially isolated is also <a href="http://www.apa.org/science/about/psa/2009/06/sci-brief.aspx">one of the major risk factors for suicide</a>. We found that teens who spent more time than average online and less time than average with friends in person were the most likely to be depressed. Since 2012, that’s what has occurred en masse: Teens have spent less time on activities known to benefit mental health (in-person social interaction) and more time on activities that may harm it (time online). </p>
<p>Teens are also sleeping less, and teens who spend more time on their phones <a href="https://theconversation.com/teens-are-sleeping-less-but-theres-a-surprisingly-easy-fix-85157">are more likely to not be getting enough sleep</a>. Not sleeping enough is <a href="http://www.sciencedirect.com/science/article/pii/S0165178108004113">a major risk factor</a> for depression, so if smartphones are causing less sleep, that alone could explain why depression and suicide increased so suddenly.</p>
<p>Depression and suicide have many causes: Genetic predisposition, family environments, bullying and trauma can all play a role. Some teens would experience mental health problems no matter what era they lived in. </p>
<p>But some vulnerable teens who would otherwise not have had mental health issues may have slipped into depression due to too much screen time, not enough face-to-face social interaction, inadequate sleep or a combination of all three. </p>
<p>It might be argued that it’s too soon to recommend less screen time, given that <a href="http://eprints.lse.ac.uk/66927/1/Policy%20Brief%2017-%20Families%20%20Screen%20Time.pdf">the research isn’t completely definitive</a>. However, the downside to limiting screen time – say, to two hours a day or less – is minimal. In contrast, the downside to doing nothing – given the possible consequences of depression and suicide – seems, to me, quite high. </p>
<p>It’s not too early to think about limiting screen time; let’s hope it’s not too late.</p><img src="https://counter.theconversation.com/content/86996/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jean Twenge has received funding from the National Institutes of Health and the Russell Sage Foundation. </span></em></p>According to a new analysis, the number of US teens who felt “useless” and “joyless” grew 33 percent between 2010 and 2015, and there was a 23 percent increase in suicide attempts.Jean Twenge, Professor of Psychology, San Diego State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/824772017-08-22T01:56:34Z2017-08-22T01:56:34ZHow the smartphone affected an entire generation of kids<figure><img src="https://images.theconversation.com/files/182831/original/file-20170821-4987-1byqiui.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">New research is putting the first generation of kids to grow up with the smartphone into sharp relief.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/young-girl-using-smart-phone-darkness-328952438?src=hRmx3HekkkvUQ_P3NZDVKw-2-62">Olga Tropinina</a></span></figcaption></figure><p>As someone who researches generational differences, I find one of the most frequent questions I’m asked is “What generation am I in?”</p>
<p>If you were born before 1980, that’s a relatively easy question to answer: the <a href="https://en.wikipedia.org/wiki/Silent_Generation#cite_note-1">Silent Generation</a> was born between 1925 and 1945; <a href="https://en.wikipedia.org/wiki/Baby_boomers">baby boomers</a> were born between 1946 and 1964; <a href="https://en.wikipedia.org/wiki/Generation_X">Gen X</a> followed (born between 1965 and 1979). </p>
<p>Next come millennials, born after 1980. But where do millennials end, and when does the next generation begin? Until recently, I (and many others) thought the last millennial birth year would be 1999 – today’s 18-year-olds.</p>
<p>However, that changed a few years ago, when I started to notice big shifts in teens’ behavior and attitudes in the yearly surveys of 11 million young people that I analyze for my research. Around 2010, teens started to spend their time much differently from the generations that preceded them. Then, around 2012, sudden shifts in their psychological well-being began to appear. Together, these changes pointed to a generational cutoff around 1995, which meant that the kids of this new, post-millennial generation were already in college. </p>
<p>These teens and young adults all have one thing in common: Their childhood or adolescence coincided with the rise of the smartphone.</p>
<h2>What makes iGen different</h2>
<p>Some call this generation “Generation Z,” but if millennials aren’t called “Generation Y,” “Generation Z” doesn’t work. Neil Howe, who coined the term “millennials” along with his collaborator William Strauss, <a href="https://www.forbes.com/sites/neilhowe/2014/10/27/introducing-the-homeland-generation-part-1-of-2/#7dc592322bd6">has suggested</a> the next generation be called the “Homeland Generation,” but I doubt anyone will want to be named after a government agency.</p>
<p><a href="http://www.cbsnews.com/news/among-teens-iphones-reign-supreme-facebook-falters/">A 2015 survey</a> found that two out of three U.S. teens owned an iPhone. For this reason, I call them iGen, and as I explain in my new book “<a href="http://www.simonandschuster.com/books/iGen/Jean-M-Twenge/9781501151989">iGen: Why Today’s Super-Connected Kids are Growing up Less Rebellious, More Tolerant, Less Happy – and Completely Unprepared for Adulthood</a>,” they’re the first generation to spend their adolescence with a smartphone.</p>
<p>What makes iGen different? Growing up with a smartphone has affected nearly every aspect of their lives. They spend so much time on the internet, texting friends and on social media – <a href="http://www.monitoringthefuture.org/">in the large surveys</a> I analyzed for the book, an average of about six hours per day – that they have less leisure time for everything else. </p>
<p>That includes what was once the favorite activity of most teens: hanging out with their friends. Whether it’s going to parties, shopping at the mall, watching movies or aimlessly driving around, iGen teens <a href="https://www.theatlantic.com/magazine/archive/2017/09/has-the-smartphone-destroyed-a-generation/534198/">are participating in these social activities at a significantly lower rate</a> than their millennial predecessors.</p>
<p>iGen shows another pronounced break with millennials: Depression, anxiety, and loneliness have shot upward since 2012, with happiness declining. </p>
<p>The <a href="https://www.cdc.gov/mmwr/volumes/66/wr/mm6630a6.htm">teen suicide rate increased</a> by more than 50 percent, as did <a href="https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015.pdf">the number of teens with clinical-level depression</a>. </p>
<h2>A link that can’t be ignored</h2>
<p>I wondered if these trends – changes in how teens were spending their free time and their deteriorating mental health – might be connected. Sure enough, I found that teens who spend more time on screens are less happy and more depressed, and those who spend more time with friends in person are happier and less depressed.</p>
<p>Of course, correlation doesn’t prove causation: Maybe unhappy people use screen devices more. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/182839/original/file-20170821-4938-mi9ww9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/182839/original/file-20170821-4938-mi9ww9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=443&fit=crop&dpr=1 600w, https://images.theconversation.com/files/182839/original/file-20170821-4938-mi9ww9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=443&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/182839/original/file-20170821-4938-mi9ww9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=443&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/182839/original/file-20170821-4938-mi9ww9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=557&fit=crop&dpr=1 754w, https://images.theconversation.com/files/182839/original/file-20170821-4938-mi9ww9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=557&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/182839/original/file-20170821-4938-mi9ww9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=557&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Social media use has been tied to unhappiness.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/girl-smartphone-lying-bed-hand-drawn-587291741">Olga Tropinina</a></span>
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</figure>
<p>However, as I researched my book, I came across three recent studies that all but eliminated that possibility – at least for social media. In two of them, <a href="https://hbr.org/2017/04/a-new-more-rigorous-study-confirms-the-more-you-use-facebook-the-worse-you-feel">social media use led to lower well-being</a>, but <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0069841">lower well-being did not lead to social media use</a>.</p>
<p>Meanwhile, <a href="http://online.liebertpub.com/doi/abs/10.1089/cyber.2016.0259?journalCode=cyber">a 2016 study</a> randomly assigned some adults to give up Facebook for a week and others to continue using it. Those who gave up Facebook ended the week happier, less lonely and less depressed.</p>
<h2>What else is lost?</h2>
<p>Some parents might worry about their teens spending so much time on their phones because it represents a radical departure from how they spent their own adolescence. But spending this much time on screens is not just different – in many ways, it’s actually worse. </p>
<p>Spending less time with friends means less time to develop social skills. A 2014 study found that sixth graders who spent just five days at a camp without using screens <a href="http://www.sciencedirect.com/science/article/pii/S0747563214003227">ended the time better at reading emotions on others’ faces</a>, suggesting that iGen’s screen-filled lives might cause their social skills to atrophy.</p>
<p>In addition, iGen reads books, magazines and newspapers much less than previous generations did as teens: In the annual <a href="http://www.monitoringthefuture.org/">Monitoring the Future</a> survey, the percentage of high school seniors who read a nonrequired book or magazine nearly every day dropped from 60 percent in 1980 to only 16 percent in 2015. Perhaps as a result, average SAT critical reading scores <a href="http://blog.prepscholar.com/average-sat-scores-over-time">have dropped 14 points</a> since 2005. College faculty tell me that students have more trouble reading longer text passages, and rarely read the required textbook.</p>
<p>This isn’t to say that iGen teens don’t have a lot going for them. They are physically safer and more tolerant than previous generations were. They also seem to have a stronger work ethic and more realistic expectations than millennials did at the same age. But the smartphone threatens to derail them before they even get started.</p>
<p>To be clear, moderate smartphone and social media use – up to an hour a day – is not linked to mental health issues. However, most teens (and adults) are on their phones <a href="http://www.cnn.com/2015/11/03/health/teens-tweens-media-screen-use-report/index.html">much more than that</a>. </p>
<p>Somewhat to my surprise, the iGen teens I interviewed said they would rather see their friends in person than communicate with them using their phones. Parents used to worry about their teens spending too much time with their friends – they were a distraction, a bad influence, a waste of time. </p>
<p>But it might be just what iGen needs.</p><img src="https://counter.theconversation.com/content/82477/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jean Twenge has received funding from the National Institutes of Mental Health and the Russell Sage Foundation. </span></em></p>Move over millennials, there’s a new generation in town. Dubbed ‘iGen,’ they differ from their predecessors on a range of measures, from mental health to time spent with friends.Jean Twenge, Professor of Psychology, San Diego State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/702112016-12-15T19:21:40Z2016-12-15T19:21:40ZHow to be a healthy user of social media<figure><img src="https://images.theconversation.com/files/150049/original/image-20161214-18895-vfz4rn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Around half of young people are heavy social media users, with one in four teen users constantly connected. </span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/garryknight/8331105136/in/photolist-o9dz4K-dGc6iJ-duZ1b4-pQXWNX-ibbj7D-roLS89-fYWDir-59h4nh-7p1vwD-euYoS-7fJfcX-nRspxb-5Lfy7t-5eC9kP-4CArm6-bCUWtR-9sanNx-5M3JV4-59ywqw-bmBGag-drYR8E-7SLQGz-eCh5jy-8ZE6bh-8AZdSA-4dFcED-4dJwrs-FoGnm-qZuGev-BQHdGn-CgW4iP-CmUZTQ-u319iw-uZhPiR-Nok8gG-K6GLBz-czA9Gf-5SBvdW-9vfdi3-4MYA8z-8MbfM4-2qsT5-8HbrLk-qyeZmZ-qmcFYA-weKCqg">garryknight/flickr </a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>We can learn a lot about people through how they use social media. For example, Twitter language can be used to predict the <a href="http://newsroom.melbourne.edu/news/twitter-can-predict-hot-spots-coronary-heart-disease">risk of dying from heart disease</a>. </p>
<p>Analyses of Facebook updates show <a href="https://pursuit.unimelb.edu.au/articles/how-gender-shapes-our-facebook-chats">women tend to be warmer than men, but just as assertive</a>, and <a href="https://www.ncbi.nlm.nih.gov/pubmed/24322010">people high in extraversion</a> tend to express positive emotions, whereas those with neurotic tendencies are more likely to write about being lonely and depressed. </p>
<p>Concerns exist about the negative effects social media can have on mental health, <a href="http://pediatrics.aappublications.org/content/127/4/800.short">especially for young people</a>. </p>
<p>The incidence of <a href="http://theconversation.com/online-bullying-on-the-rise-in-australia-30213">cyberbullying</a>, <a href="http://theconversation.com/how-sexting-is-creating-a-safe-space-for-curious-millennials-56453">sexting</a> and <a href="http://theconversation.com/domestic-violence-and-facebook-harassment-takes-new-forms-in-the-social-media-age-50855">victimisation</a> has risen. People manage their profiles, presenting an image of a perfect life, while hiding real struggles they might have. Despite having thousands of “friends”, some people still <a href="http://www.sciencedirect.com/science/article/pii/S0747563216302552">feel completely alone</a>. </p>
<p>The potential for social media to be used to detect signs of mental illness is reflected in Facebook’s implementation of a <a href="https://www.facebook.com/help/contact/305410456169423">suicide watch program</a>. </p>
<h2>What to look for in your use of social media</h2>
<p>Is there a way to tell if your use of social media is healthy or reflective of underlying mental health conditions? </p>
<p>With my colleagues, PhD student Liz Seabrook and <a href="http://med.monash.edu/psych/school/staff/rickard.html">Dr Nikki Rickard</a>, we recently conducted <a href="http://mental.jmir.org/2016/4/e50/">a systematic review</a> of 70 different studies that linked social media use to depression, anxiety and mental well being. Turns out, <a href="https://pursuit.unimelb.edu.au/articles/is-social-media-good-for-you">social media is not all good, nor all bad</a>. It’s more about how you use it. </p>
<p>If you are concerned about your own social media use or that of a family member, here are some aspects to look out for. </p>
<h3>1. Content and tone</h3>
<p>One of the main things that distinguished users who reported high well-being versus those with depression or anxiety was what they wrote about and how they wrote it. </p>
<p>Depressed people used a lot more negative language, reflecting on things that were going wrong, or complaining about life or other people. They posted angry thoughts and emotions. </p>
<p>After writing a post, take a moment to read through it. What is the tone? Consider ways you can focus on some of the good things that happen in your life, not just the negative. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/150063/original/image-20161214-18890-fubik8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/150063/original/image-20161214-18890-fubik8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/150063/original/image-20161214-18890-fubik8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/150063/original/image-20161214-18890-fubik8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/150063/original/image-20161214-18890-fubik8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/150063/original/image-20161214-18890-fubik8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/150063/original/image-20161214-18890-fubik8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Social media users with depression behave differently online than those with good mental health.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/wentongg/2717345676/in/photolist-5987cw-dy1PDy-95nfYB-dP8PNB-f9Umke-eSzteS-nNyy6o-eSobAc-f9UmcB-ifE4Fq-7D7PPY-aahCHb-7erzYD-ifEpKT-66StMg-7sDr81-66WKbA-66StRH-66StQz-qfLgUa-8trz3H-jBdAco-8trz3p-7SsMXZ-gSMMUE-7SsMY2-7RFxr1-dPeqMb-81bVNH-7SsMXX-gSMN3W-aUDbS2-ERR39-7SsMXR-dt9Kj4-oSEczD-9UjV8m-gSNHBi-7YJNNo-poZma8-7QDAVM-5U8YVj-5U4C4H-6TeQEB-5U4Cj6-ke5x8P-ke5wU2-ke68en-BaDhoq-NZJ4uX">wentongg/flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<h3>2. Quality</h3>
<p>After a conversation with a friend, sometimes I feel really good about the conversation. Other times I don’t. </p>
<p>Similarly, we found the quality of interactions on social media made a big difference. Depression related to negative interactions with other people, being more critical, cutting others down or feeling criticised by others, and hostility. </p>
<p>In contrast, by supporting and encouraging others and feeling supported by them, it can help you feel good.</p>
<h3>3. Time online</h3>
<p><a href="https://www.psychology.org.au/psychologyweek/survey/results-fomo/">A recent Australian survey</a> found adults spend over two hours a day using social media. It also found more than 50% of young people are heavy social media users, with one quarter reporting being constantly connected. </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/150066/original/image-20161214-18882-1hixd9q.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/150066/original/image-20161214-18882-1hixd9q.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=1067&fit=crop&dpr=1 600w, https://images.theconversation.com/files/150066/original/image-20161214-18882-1hixd9q.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=1067&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/150066/original/image-20161214-18882-1hixd9q.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=1067&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/150066/original/image-20161214-18882-1hixd9q.PNG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1340&fit=crop&dpr=1 754w, https://images.theconversation.com/files/150066/original/image-20161214-18882-1hixd9q.PNG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1340&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/150066/original/image-20161214-18882-1hixd9q.PNG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1340&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Comparing yourself to Rebecca Judd may not support good mental health.</span>
<span class="attribution"><span class="source">Instagram/becjudd Dec 14 2016</span></span>
</figcaption>
</figure>
<p>In our review, some studies found depressed users spent more time online while other studies were inconclusive. </p>
<p>Notably, no study found spending more time online was a good thing. </p>
<p>This is something to keep on the radar as people spend more and more time connected to their devices. Many young people have a <a href="http://psychcentral.com/blog/archives/2015/10/12/fear-of-missing-out/">fear of missing out (FOMO)</a>, and thus stay constantly connected. Indeed, in our review we found feeling addicted to social media was associated with higher levels of depression. </p>
<p>We see growing evidence that <a href="https://www.youtube.com/watch?v=3gEZSD-2RIk">simplifying life</a>, including spending time offline, has health and well-being benefits. </p>
<p>If you feel concerned about how much time passes by while you are online, consider stepping away from social media for a few days. </p>
<h3>4. Passive versus active use</h3>
<p>Some people post many updates, providing blow-by-blow descriptions of their lives. Others read through news feeds, liking posts and passing interesting tidbits on to others. </p>
<p>In our review, simply reading posts and browsing news feeds did not positively or negatively impact well-being. </p>
<p>The difference was for active users: those who posted their thoughts and feelings and responded to others. People who were depressed posted a lot of negative content. Those who were happy actively engaged with other users, sharing their lives.</p>
<h3>5. Social comparisons</h3>
<p>Social media provides opportunities to compare ourselves with others, for better or for worse. </p>
<p>Social media can provide support groups that can help spur you on towards reaching a specific goal. For example, <a href="http://www.huffingtonpost.com/dan-collinson/are-you-up-to-the-strengths-challenge_b_9096378.html">the Strengths Challenge</a> used social networks to encourage people to look for good things about themselves and their co-workers, resulting in higher levels of well-being. </p>
<p>But comparing yourselves with others can also be quite destructive. Depressed individuals were more likely to see others as better than them. Envy plays a particularly destructive role. </p>
<p>If you find yourself jealous of friends and others in your network, it might be a good time to disconnect and find other sources to build up your self esteem. </p>
<h3>6. Motivation</h3>
<p>Why do you use social media? People who used social media to connect with friends felt it contributed to their well-being. </p>
<p>In contrast, those who were depressed sought out social support on social media, but felt like their friends were letting them down. </p>
<p>If you are feeling lonely and trying to fill a void through social media, it could be doing more harm than good. </p>
<h2>Take a good look at yourself</h2>
<p>Social media is here to stay. It offers a great way to connect with others, but can also exacerbate social anxieties that exist in the offline world. </p>
<p>So how do you best use social media? Take a few minutes to think about how social media makes you or your family and friends feel. Is it a positive addition to your life, or does it make you feel bad, consuming time and energy you could use in other ways? </p>
<p>By taking stock of your social media habits, it can help you choose ways – and encourage others – to use it in a manner that keeps you healthy.</p><img src="https://counter.theconversation.com/content/70211/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peggy Kern does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>How you use social media can provide warning signs of depression or anxiety.Peggy Kern, Senior Lecturer in Positive Psychology, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/634282016-08-04T07:10:42Z2016-08-04T07:10:42ZMany wealthy countries face a mental health crisis – here’s what governments can do<figure><img src="https://images.theconversation.com/files/132807/original/image-20160802-17180-17bxo0y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Deprivation makes it worse.</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>The evidence suggests that the UK, among other high-income countries, is in the midst of a mental health crisis. A recent <a href="http://www.nhsconfed.org/%7E/media/Confederation/Files/Publications/Documents/MHN%20key%20facts%20and%20trends%20factsheet_Fs1356_3_WEB.pdf">report</a> by the Mental Health Network, found that 19% of adults had been diagnosed with depression at some point in their lives, while as many as <a href="https://www.mentalhealth.org.uk/sites/default/files/fundamental-facts-15.pdf">one in four</a> people experience a mental health problem in any given year. Even more worryingly, mental illness is <a href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216853/CYP-Mental-Health.pdf">high among the young</a>, suggesting that the burden on the NHS and other social services will grow in the years to come.</p>
<p><a href="http://www.dailymail.co.uk/debate/article-1278510/Depression-Its-just-new-trendy-illness.html">It is commonly thought</a> that depression and mental illness are “middle class problems”, yet this idea is not supported by evidence. Although mental health issues have risen among affluent social groups, studies have repeatedly shown that mental health remains inversely associated with social class. The risk of developing a mental disorder <a href="http://digital.nhs.uk/catalogue/PUB06116/ment-heal-chil-youn-peop-gb-2004-rep2.pdf">rises alongside socioeconomic disadvantage</a> and the odds of reporting depression are almost <a href="http://aje.oxfordjournals.org/content/157/2/98.short">twice as high</a> among those in the lowest socioeconomic groups, compared with the highest. </p>
<p><a href="http://www.sciencedirect.com/science/article/pii/S0277953613002608">Reviews</a> also find that socioeconomically disadvantaged children are at greater risk of mental illness than those from more privileged backgrounds, suggesting that inequalities are intergenerational and start early in life.</p>
<h2>Can policy make a difference?</h2>
<p>The causes of these inequalities in mental health are <a href="http://www.sciencedirect.com/science/article/pii/S0140673608616906">thought to be the same</a> as those which affect other aspects of the social distribution of health: poverty, unemployment, unhealthy lifestyles, poor working conditions, poor housing. Importantly, the <a href="http://www.sciencedirect.com/science/article/pii/S0140673608616906">negative impact</a> of these “social determinants of health” can be reduced through well-designed social and labour market policies, as I discovered while researching my thesis on this topic.</p>
<p>The evidence to date reveals only broad links between social and labour market policies and inequalities in mental health. A number of studies have looked at variations and inequalities in mental health across “welfare regimes”. These are clusters of countries ranked according to their generosity of social protection, levels of social investment, and quality of working conditions. Those which are more generous and with better labour market conditions, are expected to have narrower inequalities in mental health as they will reduce the negative impact of poverty, unemployment and other “social determinants of health”.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/132828/original/image-20160802-17183-13flnp9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/132828/original/image-20160802-17183-13flnp9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/132828/original/image-20160802-17183-13flnp9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/132828/original/image-20160802-17183-13flnp9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/132828/original/image-20160802-17183-13flnp9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/132828/original/image-20160802-17183-13flnp9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/132828/original/image-20160802-17183-13flnp9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Good work can have a positive effect.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/dl2_lim.mhtml?src=pp-same_model-264200777-9CtLjZZCA4J8h1RvyBbDoA-3&clicksrc=download_btn_inline&id=301082705&size=medium_jpg&submit_jpg=">Shutterstock</a></span>
</figcaption>
</figure>
<p><a href="http://jech.bmj.com/content/early/2010/08/06/jech.2009.098541.short">One such study examined</a> rates of depression across European welfare regimes. They found that on average depression was highest in liberal (UK) and southern (Italy, Spain, Greece) welfare states and lowest in Scandinavian (Sweden and Denmark) and conservative (Germany, Netherlands, Belgium, France, Switzerland and Austria) regimes. This they linked to the weaker social protection and poorer quality of work in the liberal and southern welfare states, compared with Scandinavian and conservative ones. </p>
<p>Another study which focused <a href="http://esp.sagepub.com/content/19/4/301.short">more directly on inequalities</a> examined how links between depression and education varied across European welfare regimes. They also found that the southern (Italy, Spain, Greece) welfare state, with its poorly developed systems of social protection and high poverty rates, was less successful at reducing the link between education and depression, particularly when compared with the northern (Sweden and Denmark) welfare state. This, they suggested, may be partly explained by the generosity of the Nordic welfare regime.</p>
<p>Other studies reach similar conclusions and overall the evidence suggests that countries with generous social protection, low unemployment, high levels of social investment (education and training/support for the unemployed) and a well-regulated labour market, perform better in terms of inequalities in mental health. </p>
<p>Despite this, there is still a lack of convincing evidence about exactly <em>how</em> welfare states reduce (or widen) inequalities in mental health. In my thesis, I began to explore these questions and examine if and how policies to reduce unemployment (public employment services, training, employment incentives), might also reduce inequalities in mental health. </p>
<p>Building on the approach of <a href="http://onlinelibrary.wiley.com/doi/10.1111/spol.12206/pdf">Carter and Whitworth</a>, I suggest this might happen through two mechanisms. First, participation in well-resourced training programs might reduce inequalities in mental health by improving the experience of unemployment. The negative effects on mental health linked to unemployment are believed to be partly related to the <a href="https://books.google.co.uk/books?hl=en&lr=&id=rCM4AAAAIAAJ&oi=fnd&pg=PR7&dq=jahoda+unemployment&ots=HbN-4wzDnA&sig=FFQ-HgPHHznq4DFEGn-N3ZC8wa8#v=onepage&q=jahoda%20unemployment&f=false">damage to self-esteem and sense of purpose</a>, which training programs could reduce. And second, better employment outcomes might reduce inequalities in mental health, particularly among socially disadvantaged groups as good quality work is <a href="https://books.google.co.uk/books?id=bEZlEmznJccC&printsec=frontcover&dq=is+work+good+for+your+health&hl=en&sa=X&ved=0ahUKEwiJ0_WK-qLOAhVqIsAKHSYsDPQQ6AEIJzAA#v=onepage&q=is%20work%20good%20for%20your%20health&f=false">beneficial to mental health</a>. </p>
<h2>Policy Implications</h2>
<p>There would certainly be broader benefits to using policies to reduce inequalities in mental health. Most recipients of incapacity benefit, one of the most widely claimed benefits, are from <a href="http://etheses.lse.ac.uk/192/">lower socioeconomic groups</a> and claim it for <a href="http://www.bbc.co.uk/news/health-13309755">mental health reasons</a>. Social inequalities in mental health may therefore contribute to incapacity benefit claims, suggesting that social and labour market policies that reduce inequalities in mental health will (paradoxically) reduce costs to the welfare system. </p>
<p>Similarly, inequalities in mental health increase demands on NHS services in disadvantaged areas, where budgets are often already overstretched. Reducing these inequalities through social policies which target the social determinants of mental health may relieve strains on health care services in deprived areas and also contribute to wider health equity.</p>
<p>There are also moral arguments for tackling the social determinants of mental health. It is unfair that those who experience a poor quality of life are also more likely to suffer from debilitating mental illness. Moreover, inequalities in mental health may matter for the social gap in life expectancy, too, as mental illness is a <a href="http://www.psychrights.org/Research/Digest/NLPs/CDConMortality.pdf">strong predictor of mortality</a>. Therefore, if we are interested in reducing inequalities in mortality (as Theresa May <a href="https://www.gov.uk/government/speeches/statement-from-the-new-prime-minister-theresa-may">recently pledged</a> in her first statement as UK Prime Minister) then we must also consider reducing inequalities in mental illness. Well-funded and appropriately designed social and labour market policies may help to do just that.</p><img src="https://counter.theconversation.com/content/63428/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Owen Davis receives funding from the Economic and Social Research Council. He is affiliated with the Labour Party. </span></em></p>One in four people experience a mental health problem in any give year.Owen Davis, PhD Candidate in Social Policy, University of KentLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/506592015-11-17T03:37:23Z2015-11-17T03:37:23ZAdolescence is hard, but it’s not necessarily getting harder<figure><img src="https://images.theconversation.com/files/102092/original/image-20151117-4973-wp7c5u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Adolescence has always been hard, but there's not much evidence to suggest it's worse for kids these days.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/chillmimi/7885047912/">Petra Bensted/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>Adolescence can be tough. On <a href="http://www.abc.net.au/4corners/stories/2015/11/16/4350533.htm">Four Corners</a> last night we heard some wonderfully candid reports from young people about the stresses and difficulties they face in contemporary Australia. Many of the pressures were age-old: doing well in school, finding a boyfriend or girlfriend, fitting in. Others were newer: the competition for the most social media followers, the pressure to look “Tumblr-ey” (12-year-old Olivia’s word).</p>
<p>Are kids today more depressed and anxious than those of a generation or two ago? In truth, as best as we can tell, probably not. But mental illness remains an enormous burden for young people: depression and anxiety are the <a href="https://www.mja.com.au/journal/2011/194/5/what-are-major-drivers-prevalent-disability-burden-young-australians">biggest cause</a> of disability for adolescents and young adults in Australia by a wide margin. And while rates of depression and anxiety are probably not getting worse, few would argue that the rates are getting any better, which we might have hoped for with improvements in many other areas of health.</p>
<h2>Adolescence</h2>
<p>Adolescence is marked by rapid changes. If we think for a moment what the period encompasses – if we strip it back from the more recent concept of being a “teenager” – then at heart it is about the transition from dependence to independence, from being reliant on our parents for our sustenance to having the capacity to become a parent. We move from the relative comfort of family and local community into the big wide world with all of its complexity.</p>
<p>Adolescence is heralded by the obvious external changes that come with sexual maturity – the extra hair, curves and bulges – but also less obvious internal ones. These include a slowly emerging sense of identity, the ability to cope with strong emotions, and the capacity to navigate a much more complex social milieu. Alongside all of this are <a href="http://www.nimh.nih.gov/health/publications/the-teen-brain-still-under-construction/index.shtml">profound changes</a> in brain organisation. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/102093/original/image-20151117-4952-1ynjkpr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/102093/original/image-20151117-4952-1ynjkpr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/102093/original/image-20151117-4952-1ynjkpr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/102093/original/image-20151117-4952-1ynjkpr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/102093/original/image-20151117-4952-1ynjkpr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/102093/original/image-20151117-4952-1ynjkpr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/102093/original/image-20151117-4952-1ynjkpr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/102093/original/image-20151117-4952-1ynjkpr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">All adolescents have felt pressure to fit in, but social media can make the feeling more profound.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/jasonahowie/7910370882/">Jason Howie/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>It is an intense period for all of us — we remember adolescence more clearly and vividly than any other period of our lives, giving rise to the so-called “<a href="http://www.abc.net.au/science/explore/memory/reminiscencebump.htm">reminiscence bump</a>”. </p>
<p>Most of us emerge from adolescence intact, becoming the people we are today. But it’s also a period of vulnerability. It is the period when most of the <a href="http://www.nimh.nih.gov/news/science-news/2005/mental-illness-exacts-heavy-toll-beginning-in-youth.shtml">significant mental illnesses emerge</a> – and no wonder.</p>
<h2>Is it getting harder?</h2>
<p>Are depression and anxiety now more common in adolescents? That is the thesis of much recent commentary, including last night’s Four Corners episode. <a href="http://www.ncbi.nlm.nih.gov/pubmed/2648043">Some studies</a> do suggest that young people are more depressed (I will focus on depression, because that is the illness for which we have most data). </p>
<p>Many of these studies have relied on asking people about past periods of depression and when they began. Older people, born in more distant epochs, report having had less depression and anxiety in their youth than people born more recently. As people get older, though, they tend to have <a href="http://www.ncbi.nlm.nih.gov/pubmed/12799778">poorer recollection</a> of adolescent periods of depression: perhaps it is a time they would rather forget or, more likely, with distance it just doesn’t seem that it was so bad. </p>
<p>More reliable studies, which collect data on depression as it occurs – or shortly after – aren’t so worrying. They suggest that there <a href="http://www.ncbi.nlm.nih.gov/pubmed/17176381">hasn’t been an increase</a> in the rate of depression over recent decades: at least since the 1970s, when reliable data started being collected.</p>
<p>Neither does Australian suicide data support the idea that things are getting ever worse. Suicide is the <a href="http://www.mindframe-media.info/for-media/reporting-suicide/facts-and-stats">leading cause</a> of death for young people – in 2013 it caused more than one in three deaths of young men between 15 and 19 – and a tragedy in every way. </p>
<p>But after the youth suicide rate peaked in the 1990s, it has plateaued at a somewhat lower rate. It is a rate that is too high and that we must work on getting down – in the same way we have reduced the number of young people <a href="http://bitre.gov.au/publications/ongoing/road_deaths_australia_annual_summaries.aspx">dying in car accidents</a> – but it is not getting inexorably worse.</p>
<p>Adolescence has always had its pressures – many remain the same from generation to generation, but others are new, or at least more intense. If there was a theme from last night’s Four Corners episode it was the intense social scrutiny that young people experience with the rise of social media.</p>
<p>Lilli, 13, put it wisely:</p>
<blockquote>
<p>it’s pretty much like the same thing that was happening 40 years ago […] but now it’s escalating. </p>
</blockquote>
<p>While some stresses are no longer so apparent – today’s adolescents don’t have the same worry about dying from infectious diseases, or being conscripted to fight in bloody wars – they are preoccupied more than ever with how they appear to their peers. This isn’t a trivial concern. </p>
<p>If in the past we could only imagine we were being excluded from social events, young people today are left in no doubt. They can see the anticipatory messages leading up to the event they haven’t been invited to, and then the celebratory photographs of the event itself. And the relentless focus on appearance abetted by social media seems now to have a crueller and more mocking edge. </p>
<p>Adolescence is hard, and if many of us are glad to have made it through to adulthood, we never really escape it. We continue to return to our adolescent years in our memories and dreams for the rest of our lives – with all its pains, all those awkward moments, but with pleasures and an intensity we don’t experience again.</p><img src="https://counter.theconversation.com/content/50659/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christopher Davey receives funding from the National Health and Medical Research Council. </span></em></p>Many adolescent pressures are age old, others newer, such as having followers on social media.Christopher Davey, Consultant Psychiatrist and Head of Mood Disorders Research at Orygen, The National Centre of Excellence in Youth Mental Health, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.