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Adolescence

New Report Shows Teen Mental Health Worsening

Depression and suicidal ideation are on the rise. Here's what we can do.

Key points

  • 57% of female and 69% of LGBQ+ high-school students report symptoms of depression.
  • One in three girls and one in two LGBQ+ teens express suicidal ideation.
  • Emerging research indicates how crucial social acceptance and fitting in are to teens' well-being.
  • Greater opportunities for connection, with parents and the broader community, are neuroprotective.

American high school students are struggling. In a recent survey of 17,000 high-school students across the U.S., 42% reported clinical symptoms of depression. (As a comparison, the rate of self-reported depression in adults during this same timeframe was 22%.) For some sub-populations, it’s even worse: 57% of girls and 69% of LGBQ+ teens reported feeling depressed. And suicidal ideation is becoming shockingly commonplace: One in three girls and one in two LGBQ+ youth thought about suicide in the past year.

When asking what’s going on, we can point to myriad influences, such as increasing pressure to perform in school and extracurriculars, the effect of social media, and growing up in a world of school shootings and climate change. This post explores research on how these factors lead to depression and suicidality.

As a species, our brains are wired to prioritize fitting in above all else. In our hunter-gatherer days, if we did not mesh with the group, our very safety would be on the line. We could lose resources and opportunities within the clan, or be kicked out and forced to survive solo.

The threat of social rejection can trigger an immune response in the body. While that sounds strange, evolutionarily it was protective. If we were attacked by a bear while trying to survive solo, the immune system would be ready to heal those wounds; it is our body’s way of getting out ahead of the threat. This immune response, and the corresponding inflammation it produces, cause microglia, the brain's immune cells, to go into overdrive, over-pruning brain areas critical to mental health.

Teenagers today experience social stress on a magnified scale. Twenty years ago, if you were bullied in the hallway, the experience was between you and the few people standing there. Now, a bullying event may be recorded and posted online for the entire world to see. Teenagers experience rejection at school, over text, on apps, and in comments sections. It is endless.

Many adolescents report that to be popular today, you have to be popular on social media. Baked into their everyday lives of social survival is the use of platforms that can decrease well-being and feelings of connectedness. All of this amounts to significant stress and a continuous immune response that alters the neurobiology of their brains.

From the lens of social stress and fitting in, it makes sense that LGBQ+ youth are particularly vulnerable to feeling ostracized, given our heteronormative culture. For reasons too myriad to explore here, girls also experience more stress from social rejection than their male peers, making them more at risk of these ill effects.

So what can we do? The quickest way to mitigate the social stress response pathway is to create social safety — connectedness. Whether it is by a parent, peer, or caring member of the community, feeling seen and accepted soothes the nervous system, specifically the vagus nerve, shutting down stress and inflammation, and bringing the system back to homeostasis. We need to look for ways to increase connectivity in our teenagers’ lives.

Think about common suicidal thoughts people experience, like I don’t belong anymore, and I am a burden to others. You can hear our hunter-gatherer, tribal past in those words. The way to soothe these thoughts and feelings in our teenagers is to communicate to them that they do belong. They are an important member of the tribe. They matter. Not because they did well on that test, made the travel soccer team, or are physically attractive, as is often our teenagers’ perception. Just because they are. The more we can give our teenagers that solid foundation, the more likely they will be able to weather the storm of adolescence successfully.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.

References

Centers for Disease Control and Prevention. 2021. Youth Risk Behavior Survey. Available at: www.cdc.gov/YRBSS.

Kreisel, T., Frank, M.G., Licht, T., Reshef, R., Ben-Menachem-Zidon, O., Baratta, M.V., Maier, S.F., & Yirmiya, R. (2014). Dynamic Microglial Alterations Underlie Stress-Induced Depressive-Like Behavior and Suppressed Neurogenesis. Molecular Psychiatry, 19(6), 699-709.

McClure, E.B., Monk, C.S., Nelson, E.E., Zarahn, E., Leibenluft, E., Bilder, R.M., Charney, D.S., Ernst, M., & Pine, D.S. (2004). A developmental examination of gender differences in brain engagement during evaluation of threat. Biological Psychiatry, 55(11), 1047-1055.

National Center for Health Statistics. U.S. Census Bureau, Household Pulse Survey, 2020–2023. Anxiety and Depression. Generated interactively: from https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm

Porges, S. (2015). Making the World Safe for our Children: Down-regulating Defence and Up-regulating Social Engagement to ‘Optimise’ the Human Experience. Children Australia, 40(2), 114-123.

Primack, B.A., Shensa, A., Sidani, J.E., Whaite, E.O., Lin, L.Y., Rosen, D., Colditz, J.B., Radovic, A., & Miller, E. (2017). Social Media Use and Perceived Social Isolation Among Young Adults in the U.S. American Journal of Preventive Medicine, 53(1), 1-8.

Sebastian, C., Viding, E., Williams, K.D., & Blakemore, S. (2010). Social brain development and the affective consequences of ostracism in adolescence. Brain and Cognition, 72, 134-145.

Setiawan, E., Wilson, A.A., Mizrahi, R., Rusjan, P.M., Miler, L., Rajkowska, G., Suridjan, I., Kennedy, J.L., Rekkas, P.V., Houle, S., & Meyer, J.H. (2015). Role of Translocator Protein Density, A Marker of Neuroinflammation, in the Brain During Major Depressive Episodes. JAMA Psychiatry, 72(3), 268-275.

Slavich, G.M., & Irwin, M.R. (2014). From stress to inflammation and major depressive disorder: a social signal transduction theory of depression. Psychological Bulletin, 140(3), 774-815.

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