'A National Crisis': Tackling Adolescent Mental Health

Even before the COVID-19 pandemic, America’s youth struggled with mental health challenges. Between 2007 and 2018, mental health issues were the leading cause of disability in young people, according to the Centers for Disease Control and Prevention (CDC). 

It’s not easy being a teenager at any age or in any era. But after COVID-19 put the world in a headlock and one variant after another tried our patience and tired our souls, pediatric healthcare experts began reporting worrisome levels of anxiety disorders in children, with a variety of effects.

“There’s a national crisis in adolescent mental health,” says pediatric psychologist Errin Price, Psy.D., with Lee Physician Group, Pediatric Behavioral Health. Citing federal data, Errin notes between 2007 and 2019—one year before COVID-19—the percentage of children ages 3-17 years who reported having a major depressive episode soared by 60 percent.

“But the stress of the pandemic really pushed the crisis by affecting their experiences at home, school, and in our communities,” Errin says. “The devastating effect on their mental health shows us how important early intervention and early prevention are for addressing mental health issues, especially in pediatrics. That’s why it’s so important to monitor your child’s behavior for signs that suggest they may be struggling with certain issues.”

Warning signs and risk factors for teens

Adults may expect teens to act moody, so depression can be difficult to detect in teens. Also, adolescents don’t always understand or express their feelings well. Because they’re not aware of the symptoms of depression, they may not seek help.

Errin says withdrawing from social interaction is a key symptom of depression. An adolescent who regularly retreats to their room except for meals may be showing signs of depression.

“If they’re hanging out on the bed or always on their phone and don't seem engaged with the family or their friends, that may suggest something’s going on,” Errin says.

She says changes in eating and sleeping habits may also signal a mental health concern. While these behaviors can be expected during adolescence, extreme changes such as no interest in eating or its opposite, compulsive overeating, may signal depression.

Adolescents who sleep more instead of engaging in activities they used to enjoy doing is a common symptom, too.

“Don’t ignore the signs if you notice them. Depressive symptoms that aren’t treated can worsen,” Errin cautions, adding symptoms that last for more than two weeks may suggest depression.

According to Mental Health America, other key symptoms of depression include:

• Poor performance in school
• Withdrawal from friends and activities
• Sadness and hopelessness
• Lack of enthusiasm, energy or motivation
• Anger and rage
• Overreaction to criticism
• Feelings of being unable to satisfy ideals
• Poor self-esteem or guilt
• Indecision, lack of concentration or forgetfulness
• Restlessness and agitation
• Changes in eating or sleeping patterns
• Substance abuse
• Problems with authority
• Suicidal thoughts or actions

Errin says that sometimes a primary care physician uses a self-report screener and when certain questions are flagged, it may prompt the pediatrician to make a referral to a mental health clinician in the community.

Lee Health’s Pediatric Behavioral Health clinic receives referrals like these and will meet with children aged 3-21 for a variety of presenting issues, such as anxiety, behavioral concerns, and mood-related challenges.

“If your child is referred to Lee Health Pediatric Behavioral Health, they will be contacted by our intake team who will ask preliminary questions before scheduling an initial evaluation of about 90 minutes with the assigned clinician,” Errin explains. “During the initial evaluation, we attempt to get to know the child and their family along with gathering as much information about what’s been happening at home and at the child’s school. Based on that evaluation, we’ll work together with the child and their family to determine the goals and plan of care.”

How are depression and anxiety in children treated?

Treatment options for children with depression are like those for adults. Your child’s healthcare provider may recommend:

• Psychotherapy (counseling).
• Medication.
• Combination of the two.

Stay healthy by managing symptoms

Errin says that in addition to participating in treatment, leading a healthy lifestyle and maintaining a consistent routine can play a role in managing symptoms of depression or anxiety.

The CDC suggests these healthy behaviors may help:

Having a healthy eating plan centered on fruits, vegetables, whole grains, legumes (for example, beans, peas, and lentils), lean protein sources, and nuts and seeds

• Participating in physical activity for at least 60 minutes each day
• Getting the recommended amount of sleep each night based on age
• Practicing mindfulness or relaxation techniques

If you or someone you know is in crisis, get help quickly.

• Call your or your loved one’s health professional.
• Call 911 for emergency services.
• Go to the nearest hospital emergency room.
• Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); En Español 1-888-628-9454; TYY: 1-800-799-4TTY (4889).

The Lifeline is a free, confidential crisis hotline that is available to everyone 24 hours a day, seven days a week. The Lifeline connects callers to the nearest crisis center in the Lifeline national network. These centers provide crisis counseling and mental health referrals. People who are deaf, hard of hearing, or have hearing loss can contact the Lifeline via TTY at 1-800-799-4889.

• Crisis Text Line. Text “HELLO” to 741741

The Crisis Text hotline is available 24 hours a day, seven days a week throughout the U.S. The Crisis Text Line serves anyone, in any type of crisis, connecting them with a crisis counselor who can provide support and information.