The United States is in the midst of a national emergency when it comes to teen mental health. Statistics show that teen depression and suicide are on the rise, made worse by the effects of the pandemic. In fact, suicide has become the second-leading cause of death among American adolescents ages 10 to 14 years old.
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“Mental health issues in children and teenagers have been steadily increasing over the last decade or so,” says pediatric psychologist Ethan Benore, PhD. “However, in the last two years — in part related to the pandemic — there has been a significant increase in teens who are facing mental health difficulties.”
Why is this happening, and what can parents and other adults do to best support the teens in their lives? Dr. Benore helps us look beyond the headlines and statistics to figure it all out.
What affects teens’ mental health?
It can be all too easy for adults to forget or downplay how stressful the teen years really are. “The standard teen experience can be a chaotic environment,” Dr. Benore says. “No one who is depressed wants to feel depressed, but teenagers especially struggle with modifying their emotions.”
At puberty, some parts of teens’ brains are fully developed, like the part responsible for generating emotions — but other functions are still in development, including the ability to manage and regulate those emotions. In other words, teens have big feelings that they can’t always figure out how to deal with.
Common stressors on teen mental health include:
- Pressure to achieve academically.
- Social pressures, including bullying.
- Family issues, like parents who are unsupportive, financial instability, abuse and more.
- Packed school and social calendars.
- Overexposure to social media.
- Poor sleep habits.
- Unhealthy food choices.
In short, it can be hard to be a teenager even in the best of times — and the last few years haven’t represented the best of times.
Recent challenges to teens’ mental health
In December 2021, U.S. Surgeon General Vivek H. Murthy issued a rare public health advisory warning of a “devastating mental health crisis among American youth” that he said was made worse by the COVID-19 pandemic.
“We know children benefit from stability, structure, routine and the support of trusting adults, but during the pandemic, we’ve seen an increase in overall instability and changing structures,” Dr. Benore says. “No, we’re seeing an increased volume of children needing a higher level of care.”
Additional factors that impact teen mental health include:
- Unpredictability at school. The pandemic changed school structures and schedules, with some kids learning remotely for long periods of time.
- Sociopolitical concerns. Systemic racism, gun violence, climate change and more can all make it hard for teens to see a proverbial light at the end of the tunnel.
- Financial insecurity. High inflation and increased economic instability have affected American families, and teens are feeling the impact. “Parents have stopped working or are unable to get work,” Dr. Benore notes, “and many families are struggling with less access to food and transportation.”
- Abuse at home. A 2021 study found that more than half of children experienced emotional abuse by their parents; 11% reported physical abuse.
- Death of loved ones. COVID-19’s high death toll means an estimated 140,000 American kids lost their primary caregiver to the virus.
“All of this and more can make our children feel like they’re living in an unsafe world, which can be overwhelming and fatiguing,” Dr. Benore says. “It can seem hopeless to a young person who’s just starting to understand this larger world.”
How many teens have mental health issues?
In a study after the first full academic year of the pandemic, the Centers for Disease Control (CDC) found that more than 4 out of 10 teenagers feel “persistently sad or hopeless,” and 1 in 5 teens has contemplated suicide.
And though anyone can experience mental health issues, some teens are at higher risk than others. Demographics like race, sexual orientation, gender identity and family income level all play a role.
- Black teens: A report from the Congressional Black Caucus’s Emergency Taskforce on Black Youth Suicide and Mental Health showed that suicide rates among teens who are Black nearly doubled from 2007 to 2017, making them the fastest rising suicide rate of any racial or ethnic group.
- LGBTQ+ teens: A 2021 study found that 42% of LGBTQ+ youth seriously considered attempting suicide the prior year, including half of transgender and nonbinary teens. Rates of attempted suicide are highest for Black, Indigenous and multiracial LGBTQ+ youth.
- Teen girls: Teen girls are twice as likely to report mental health struggles as boys. The CDC found that more than a quarter of teen girls seriously contemplated suicide during the pandemic.
What are the danger signs of teen depression?
Sometimes, warning signs of depression and suicide present themselves suddenly and drastically, while other times, your child just isn’t progressing the way you expect them to — in other words, something just seems off. In particular, look for:
- Changes in mood. If your child seems more sullen, quiet or irritable than usual, these could be signs that they’re struggling with their mental health.
- Changes in behavior. Notice when your teens are doing more or less of their usual activities: sleeping, eating, spending time with friends, participating in teams and clubs, even texting. “Changes in behavior aren’t necessarily a red flag, but they should signal you to pay closer attention,” Dr. Benore advises.
- Dangerous behaviors. Activities like drugs and drinking can indicate underlying mental health issues. And teens struggling with depression may self-harm, like through cutting, hitting, burning or otherwise hurting themselves.
If you’re worried about your teen’s mental health but aren’t quite sure they need help yet, try setting a timeframe. “Tell yourself, ‘I’m not going to wait this out. I’m going to give this two weeks, and if I don’t see any improvement, we’re calling the doctor,’” Dr. Benore suggests.
Treatment: How to help teens
Parents and other caring adults have an important role to play in helping teens through their mental health challenges. “Children can and do survive terrible things,” Dr. Benore says. “As adults, we can create a path to reduce the suffering they’re experiencing.”
He shares some ways you can try to prevent mental health issues in your kids and cope when they do arise.
1. Be there, period
Don’t underestimate the power of your presence, whether you’re a parent, teacher, coach or other mentor. “Research shows that the single most common factor for children who develop resilience is having at least one stable and committed relationship with a supportive caregiver or adult,” Dr. Benore states.
2. Offer help
This might sound like a no-brainer. You’re thinking, “Of course my child knows I’m here for them!” But kids don’t always feel brave enough to reach out. “Asking for help is hard,” Dr. Benore says, “so it’s important for caring adults in the child’s life to be there and to offer that help to them.”
3. Listen more than you talk
When your child opens up to you, put your listening skills to the test. “These conversations don’t happen through lecturing to your child,” Dr. Benore cautions. “Spending time being quiet and give them an opportunity to process out loud what they’re going through.”
4. Validate your teen’s identity
A loving and supportive home life can make or break a child’s mental health. In fact, although LGBTQ+ teens are at an especially high risk of depression and suicide, this risk decreases significantly when they have families who support and validate them.
“If their parents can’t see and respect them, it’s difficult for teens to believe they have a chance with others,” Dr. Benore explains. “It’s critical to listen to your child, respect them for who they are and who they’re becoming, and help them feel the love they deserve as they’re growing up.”
5. Explore supportive resources
Remember all those things you did when you were an expecting or new parent? You probably read tons of books and articles and asked friends for advice. This sort of research should continue as your kids get older, too.
“This is the stage where your child’s social behaviors and emotional function are truly developing, so it’s important, as a parent, to educate yourself about teenagers,” Dr. Benore stresses. He recommends the CDC website and professional associations like the American Academy of Pediatrics, along with informal educational resources, like TikTok and YouTube videos from credible medical professionals.
6. Talk to your doctor
If you’re considering therapy for your teen or are just generally concerned about them, start by speaking with your family doctor, with whom you already have a relationship.
“They often have an understanding of your child’s development,” Dr. Benore says. “They also have access to mental health resources and know where to go for the next step.”
7. Don’t just hope it will pass
It’s understandably upsetting to think that your child is dealing with mental health issues, and parents don’t always feel comfortable asking their kids if they need help. But it’s imperative that you take the lead. “Don’t wait patiently and expect your child to figure it out alone,” Dr. Benore also stresses.
8. Be a mental health role model
You may not even realize what your own actions say to your teen — but they internalize it all. “Your actions speak as loud as whatever you say to your child,” Dr. Benore says.
Eating well, exercising regularly and prioritizing positive social relationships all have an effect on your mental health. And don’t be afraid to talk about feelings (in an age-appropriate manner, of course).
“Let your child see that you also process emotions like fear, anger and sadness,” he adds. “This gives them hope that they can learn to do the same things effectively.”
Start now: Normalize conversations about mental health
It’s never too early to make conversations about mental health a regular part of your family’s interactions — which makes it a little easier to communicate when your kids are struggling.
“Have regular check-ins or huddles to talk about ups and downs, the good as well as the bad,” Dr. Benore says. “When those discussions are ongoing and habitual, it becomes easier to mention a concern, like, ‘Hey, you’re acting differently. What’s up?’ or ‘It looks like you’re sad. What am I missing?’”
To learn more on this topic from Dr. Benore, listen to the Health Essentials Podcast episode, “The Teen Mental Health Crisis.” New episodes of the Health Essentials Podcast publish every Wednesday.