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Key points
- COVID-19 has led to a significant worsening of the nation's mental health.
- Adolescents and children have been severely affected by these changes.
- A combination of factors, including social isolation and the use of video conferencing and Facebook technologies, are proximal causes.
- Ultimately, these factors cause stress on the prefrontal cortex, which young people are less able to manage, leading to mental illness for many.
During my 30-year career in psychiatry, there has never been anything like COVID-19 to test society's emotional vulnerability.
We have seen the results of this testing in the amount written about increases in mental health problems since the pandemic began. The most significant of these findings is research that has consistently shown young people, from school age through college, by far bearing the brunt of the psychological harm. What I will attempt to show is that COVID has forced our young people into an intense version of modern life by imposing isolation, technology, and the emotional manipulation used by Facebook technologies.
One study, which looked at 29 other reports from all over the globe and included over 80,000 young people, found a doubling in the rates of already accelerating anxiety and depression (roughly, during the pandemic, the rate of clinical levels of depression and/or anxiety increased from 1 in 10 to 1 in 5 young people). These are much higher than the changes in the rest of the population. As I noted above, this is in the context of the rates of problematic symptoms that were already known to be rising from before the year 2000.
Explaining the rise in mental health problems
Scientists have given thought to possible explanations for these COVID-era increases in symptoms of mental illness. Some possibilities include: Children and adolescents were lonely away from their normal routines and supports (teachers, coaches), and had missed milestones like proms and graduations. As time went on, their home lives may have become disrupted due to financial or other COVID-related issues.
However, I think it’s fair to say that most adults had their own versions of this scenario, many working from home just like students. In addition, adults have other concerns, such as money, jobs, children, the health of their family, and the future. Given this comparison, it does not seem to me that a difference in stressors, by itself, explains the large gap between young people and adults in their responses to the pandemic.
There must be another differentiating factor between these two groups. What I propose is that we can look at the lives of young people during the pandemic as small but intense versions of modern life. Most notably, as in modern life, they are cut off from others and highly dependent upon technology. The intensity of their social lives and fondness for technology, coupled with their lack of responsibility for things outside their world (such as children, jobs, and finances), make for a pandemic-induced life inside a bubble of modernity for young people.
So, it may seem like we have found a difference between young and adult populations to account for the different findings. But how, exactly, does this explain things? It seems like adults’ lives are more stressful than the modern-life bubble of the young.
The answer lies in the effects on the brain of the exceedingly modern types of lives that the pandemic has made for the young.
Let’s dig a little deeper into this situation by looking at the most important dimension of modern life for school-age children and adolescents: their social lock-in to computers. Social experiences online are either by video conferencing or social media. (Facebook and Instagram are the major two in the U.S.; What’sApp would be first or second in other countries. Of note, they are all owned by Facebook, now Meta.) In addition to their previous use of these remarkable apps to socialize and communicate, they have had to use video for entire school days.
Experts have noted that spending a lot of time on video apps like Zoom can be taxing. In normal life, we need to be able to see someone clearly, see all their nonverbal facial movements as well as their body language in order to fully understand them. With video chat apps, we have distortions and delays, unnatural camera angles, lighting, and sound, and the distraction of seeing ourselves constantly in the corner. There is much more to this than we know, but nonetheless, it is quite unnatural and mentally taxing to maintain.
With the Facebook family of apps, these principles all hold, but the experience is much more complex. There are multiple ways to communicate (at the same time) or express yourself while receiving feedback in equally numerous forms. Feedback, however, can come from more people than anyone would normally communicate with, while the people communicating can maintain various levels of identified presence.
Facebook allows many types of response and, it turns out, values high levels of emotion, especially the negative kind. Recent disclosures from the “Facebook papers,” leaked by a whistleblower, reveal that Facebook displays more content with a negative emotional slant. This, then, inspires highly emotional states in people who see it and thus “engage” them more. The result is more clicks, more ads seen, and more ads sold.
It also results in emotional difficulties in some young users. While the emphasis of the reporting of the Facebook papers has been on disinformation, previous reports have focused on Facebook’s placement of ads for weight loss, alcohol, and vaping. Even though this does not represent not a scientific study, most parents, like myself, easily recognize these patterns of absorption in the emotional content in social media.
Gossip, bullying, and other social discord are common. For our purposes, this lends credence to a picture of an unmodulated experience of a vast social world. A world adolescents can barely manage. Adolescent development is evolved in the slow and clear world of physical reality.
COVID isolation and the brain
To broaden this picture, COVID has forced young people into an intensified version of modern life with near-total isolation and most relationships existing only virtually. The part of the brain that must maintain the artificial world that these young people are constructing in their minds is the prefrontal cortex (PFC), the same area that, when overly stressed, can release any propensity to mental illness.
What we’re seeing in these high rates of anxiety and depression in young people is a continuation of something that has been happening for decades. Adults also suffer the strains of modernity, including stress on the PFC, and show the same climbing rates and severity of mental illness. But in humans, the PFC does not fully develop until the late 20s. This gives adults an advantage of having a mature PFC for managing the intensified modern stress of the pandemic.
What the COVID pandemic is doing, aside from its devastating death rate and the long list of health and social problems, is to exacerbate what we have all been living through our entire lives: too much isolation, a technology-based culture, and its effects on our brains. The result, plain and simple, is more mental illness and less psychological well-being, especially for the young.
