Depression and suicide have increased among adolescents and young adults, and this may be due to increased use of smartphones and other digital media, according to a recent article in the Journal of Abnormal Psychology. I suspect, however, that there are other powerful factors at work, particularly the impact of “adverse world events.”
Although there is some debate about whether there really has been an increase in mental illness among young people, considerable evidence indicates that the prevalence of mental disorders among adolescents has been increasing. The National Survey of Drug Use and Health (NSDUH) shows an increase in major depressive episodes, as is noted in the article in Journal of Abnormal Psychology and elsewhere. In addition, a study about children and adolescents who are eligible for SSI by virtue of mental disabilities found an increase in most disorders from 2004 through 2013. And CDC “surveillance during 1994-2011 has shown the prevalence of [mental health] conditions to be increasing.” Perhaps most significant is the documented rise in adolescent and young adult (13-25) suicide rates from 8.9 to 11.6 per 100,000, a 30% increase since the turn of the 21st century.
Why the increase?
One common speculation is that there has been a decline in mental health services in this century. But that is not the case. The use of mental health services by adolescents has increased.
Perhaps it is the factors that are commonly called “social determinants,” most notably poverty, violence, and “adverse childhood experiences” (ACEs).
Could be, but the article in the Journal of Abnormal Psychology notes a number of reasons to doubt this.
More interesting, I think, are the findings of a recent survey conducted by the Harris Poll for the American Psychological Association, in which adolescents and young adults gave their own explanations of why they are so distressed.
The survey asked about the mental health of people of different generations — Gen Z (15-21), Millennials (22-39), Gen X (40-53), Baby Boomers (54-72), and “matures” or older adults (73+).
According to the survey, Gen Z (the adolescents) “are most likely of all generations to report poor mental health and … also significantly more likely to seek professional help for mental health issues.”
And what are the sources of their distress? The Gen Zers themselves point to world events that are making headlines — gun violence; sexual harassment and assault; treatment of immigrants, especially separation of families and deportation; the economy and discouragement about having a secure financial future; housing instability; drug problems in their families; racial discrimination; the current, divisive, and vituperative political climate; their skepticism about the future of America; and more.
Clearly, there has been much to fuel concern about the state of America and the world since the beginning of the 21st century — through the administrations of Bush, Obama, and now Trump. The rise of terrorism, the decline of the environment, the possible spread of nuclear weapons, increasing disparity, rising racial tensions, the plight of refugees, and more.
But do these big social issues contribute to the rise in diagnosable mental illness?
There are reasons to be doubtful. Many people who experience depressive or anxiety disorders grasp for reasons that might explain their unhappiness or fear and often don’t come up with accurate explanations. So, Gen Zers could be wrong about what’s causing stress in their lives.
In addition, distress and mental illness are not one and the same. The Gen Zers could be right about their sources of stress, but it could be wrong to assume that a rise in stress is contributing to a rise in mental illness.
The authors of the recent article in the Journal of Abnormal Psychology speculate that the rising use of smartphones and social media is a powerful contributing factor. But 55% of Gen Zers reported that social media was a primary source of support when they are distressed. They also reported that it could be a source of distress, due to cyberbullying and the like. So in their experience, social media is a mixed bag.
I think the Gen Zers may be right that their mental state is affected by world events. If we use the usual simplistic model of mental illness as the outcome of innate vulnerability and social and psychological stressors, it would make sense that the state of the world is having an impact on the state of mental health — particularly for adolescents and young adults, who are by nature a bit less stable than more mature people.
And this would have important implications for mental health policy. It may be that child and adolescent mental health advocates need to add adverse world events to their list of concerns, not just because the future of humanity may depend on the outcome of these issues, but more narrowly because the mental health of the next generations will fall, or hopefully rise, with the outcome.
Of course, taking on the flaws of the world we live in may be far too much for mental health providers and advocates to do. Nevertheless, long-term improvement of the mental health of our youngest generations may depend on mental health advocates entering the fray to fix the world so that generations to come will have the life we hope for them.
Michael B. Friedman, LMSW, is adjunct associate professor at the Columbia University School of Social Work.