Adolescence is tough and has been for every generation. But adolescence is also a developmental period with a high risk of onset of psychiatric disorders. Among the most prevalent is depression, a disorder characterized by sadness, anxiety, trouble with appetite and sleep, feelings of worthless, and suicidal behavior. While adolescent depression prevalence was relativelystable for about 50 years, accumulating evidence indicates that depression and suicide have increased among US adolescents in the past decade in a historically unprecedented way.
We contributed to this literature in a new study that reports on data from Monitoring the Future, which includes a yearly, nationally-representative survey of school-attending teens. Since 1991, identical questions about depressive symptoms have been asked. We assessed not only whether symptoms were increasing or decreasing over time among all adolescents, but we also tracked whether adolescents who were born in certain years have particularly accelerated changes in depressive symptoms across time.
We documented that depressive symptoms have been rapidly increasing across time and that this increase began occurring around 2012. These increases were not substantially different in any particular birth cohort, indicating that all adolescent cohorts, regardless of age at the time of the survey, are reporting more depressive symptoms than adolescents in any other time in the last 25 years. These increases are faster among girls.
The consistency of findings across data sources, outcomes, self-report, and administrative records indicates that these increases are real. Strong epidemiological studies are needed to elucidate causes of the increases, including reasons for a faster increase among girls.
Why are adolescents today experiencing more mental health problems than previous generations? Parents and non-parents alike are concerned that teens spend toomuchtime on smartphones and social media, which may engender mental health problems due to cyberbullying, envy, and negative self-worth through comparison, isolation from face-to-face interaction, and disrupted sleep, among other potential mechanisms. And certainly, smartphone and social media use skyrocketed in the past decade, coinciding with the increase in depressive symptoms and suicidality.
If phones aren’t the whole story, what is driving mental health trends in the US? The social and environmental landscape for today’s teens is different in many ways. The Sandy Hook shootings of 26 people, including 20 children, in 2012 led to a culture shift in schools. Active shooter and lockdown drills occurred in 95% of US primary and secondary schools by 2015-2016, and measures purportedly for ‘school safety’ (e.g. metal detectors, cameras, locked doors, etc.) have increased in frequency with concomitant student reports of fear and anxiety, and feelingless safe.
The ways in which each new cohort of young people entering and exiting adolescence, both in the US and elsewhere, experience the world anew and face new challenges and consequences is a complex phenomenon. While excessive smartphone and social media use may be concerning to parents, they are not a sufficient explanation for the troubling trends in adolescent mental health. We owe it to the coming generation to think deeply about the ways in which alleviating inequities and improving well-being can be achieved for all.
Katherine M. Keyes is an Associate Professor of Epidemiology at the Columbia University Mailman School of Public Health. Katherine’s research focuses psychiatric epidemiology across the lifecourse, including early origins of child and adult health and cross-generational cohort effects on substance use, mental health, and chronic disease.