Hello! I’m Dr. Carole Swiecicki, a clinical psychologist specializing in helping adults, teens and children overcome symptoms of anxiety, depression, and challenging emotions.
The mental health field is beyond a tipping point right now. Wait lists have soared and therapists who don’t feel supported are leaving their agencies – and sometimes leaving the field. This has resulted in the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association declaring a mental health emergency (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/). The US Surgeon General has focused on well being in the workplace, because adult mental health has taken a toll too (more on that in an upcoming post).
Two recent studies have found that depressive symptoms among teens increased over the course of the pandemic (Mansfield et al., Racine et al., 2021;). The CDC has found that suicide attempts have increased among youth as well. I was interviewed for a Healthline story that described one of these studies.
Many factors contribute to adolescent symptom development. The Healthline reporter noted that adolescent depression had been increasing prior to the pandemic, which may have been due to improvements in screening and identification of symptoms. Increased social media use, especially in the absence of live, real connection, has also been linked to increased depression and anxiety among teens.
What was less covered (but perhaps most important) is trauma exposure, a known risk factor for mental health symptoms. In fact, one study found that trauma exposure accounted for just over 25% of adolescent psychiatric illness, and studies have found similar results related to adult-onset mental illness (McLaughlin et al., 2012).
Trauma exposure accounted for just over 25% of adolescent psychiatric illness (McLaughlin et al., 2012).
We also know that the impact of stress and trauma are cumulative. That is, when you have a history of a stressful or traumatic life event (such as physical abuse or exposure to domestic violence), and you experience another stressful life event (such as a pandemic), the impact is multiplied. As I mentioned in the story, humans, including teens, need connection and social networks to promote resilience and wellness. The pandemic disrupted many of these connections, both for youth and their parents. When parents are more stressed (or distressed), they sometimes are less emotionally available for youth, which also can exacerbate problems or lead teens to not open up about them. Additionally, many teens had fears about their own health or the health of their loved ones. Ongoing or chronic stress is a risk factor for mental illness. Lastly, we all do better with routines and predictability. The pandemic disrupted this, even if just whether a child would be at school in person or virtually. Again, this is a chronic stressor that, if happening for a week may not have much of an impact, but when a child has trouble predicting what the next six months or year will be like, is harder to cope. When our coping resources are overwhelmed, this is when symptoms can develop.
As we continue to look to the future and the “new normal” of coexisting with the pandemic and its impact, as helping professionals (and helping adults) we ask “what do we do?” to help mitigate these impacts. Young people need supportive adults checking on their mental health and asking how they are doing. We do this with the young ones in our personal lives, and through delivering evidence-based treatments for teens with depression (and trauma symptoms), as they involve adults to help support their coping. Teens need access to resources for learning social and emotional coping skills and ways to connect with healthy peers. Additionally, they need to have adults in their life know where to turn if the youth reports distress, appears distressed, or shows a notable change in emotion/mood/behavior, and connection with research-supported treatments to reduce their symptoms. Thankfully, there are very well-studied, evidence-based treatments for depression and anxiety – and while wait times are often high right now, reaching out for help is the first step to getting it.