More on Adolescent Mental Health

Long, depressing NY Times feature about adolescent mental health.  A few interesting/disturbing points:

First, the overall suicide rate for young American has only gone up a little lately, and it is still well below the peak years of the early 1980s.

But other numbers are much worse. In 2019, 13 percent of adolescents reported having a major depressive episode, a 60 percent increase from 2007.

And if you distrust that sort of self-reporting, how about this: among girls 10 to 19, emergency room visits for self harm nearly doubled between 1999 and 2019.

The suicide rate for black Americans used to be much lower than that for whites, but that is changing, at least among the young: "From 1991 to 2017, suicide attempts by Black adolescents rose 73 percent, compared with an 18 percent rise among white adolescents." White rate is still higher but the lines are converging.

All of this is happening as young people drink less, smoke less, use other drugs less, and have less sex. (And, although this article doesn't get into it, commit fewer serious crimes and are less likely to join gangs.) The problems that seemed like crises in my youth are all easing, replaced by depression and anxiety. 

The age of puberty continues to decline, to 11 for many; people wonder if this is a factor but there isn't any real data.

As we have discussed here, the data on cell phone and social media use is complex and doesn't clearly correlate with mental health problems. Other potential factors: "research shows that teenagers as a group are also getting less sleep and exercise and spending less in-person time with friends." But of course those things can all be symptoms of depression, so the causality is hard to figure out.

A couple of families gave the Times extraordinary access to themselves and their medical records. It struck me that when the Times visited the psychologist treating one self-harming teen whose mother is in complete panic, the therapist said, "she's a typical outpatient . . . an internalizer." What seems awful to you seems routine to mental health professionals.

The one theme that comes out most strongly is loneliness: teenagers are doing worse because they spend less time together. On the other hand, this may also be driving the declines in other pathologies; one of the experts consulted here said that drinking and drug use are things that teenagers do in groups, and since they spend more time alone and less in groups, of course they drink less. We used to worry a lot about peer pressure, but taking teenagers away from their peers obviously isn't a great solution.