In February, the Centers for Disease Control and Prevention released a report titled the “Youth Risk Behavior Survey Data Summary & Trends Report: 2011-2021,” or Y.R.B.S. According to the C.D.C., “nearly 3 in 5 (57 percent) U.S. teen girls felt persistently sad or hopeless in 2021 — double that of boys” and “the highest level reported over the past decade.”
Since the report’s release, there’s been a steady stream of think pieces devoted to coming up with different reasons for this troubling downward spiral.
There’s the social-media-is-the-devil camp (“Smartphones and social media are destroying children’s mental health”); there are those using the report as a jumping-off point to talk about a different study showing that liberal girls, in particular, seem to be depressed and anxious (“Why the Mental Health of Liberal Girls Sank First and Fastest”); there’s the view that anxious parents are causing kids to be anxious; and there’s the school-is-too-stressful argument.
I find aspects of each persuasive. But as my colleague Jane Coaston tweeted, in response to an article published back when the report had just emerged, “The most predictable thing in the world is for people to respond to this article with their own reasons for why this is taking place based entirely on their own specific hills on which they have decided to die.” We tend to see the data as a ratification of our own theories about what’s wrong with our world.
I, too, have a hill to die on, or at least a bias I should declare up front: I’m skeptical of any report that tilts toward the notion that there’s something innately wrong with teenage girls.
“L.G.B.Q.+” teenagers are also tabbed as a group that’s struggling, with the C.D.C. reporting that within that group, 52 percent “had recently experienced poor mental health,” another finding that shaped some of the subsequent analysis. (The report says “the 2021 national Y.R.B.S. did not have a question assessing gender identity” and “does not highlight data specifically on students who identify as transgender.”)
To be clear: Suicide and suicidal ideation are extremely serious, and we need to do everything we can to help any teenager who’s in that much pain. There’s been an uptick in anxiety and depression diagnoses in recent years, and we should be aware when our children’s moods are significantly impeding their lives.
And yet. When we veer toward a focus on the mental health challenges of everyone except straight teenage boys, it’s time to take a step back. Historically, it hasn’t worked out great for women and girls when our emotional lives are treated as a crisis: We’ve been painted as hysterical, even susceptible to demons, and, alternatively, depending on the era, frigid or oversexed.
The discourse around the C.D.C. report reminded me that we saw a similar round of adult upset over teen girls and their moods with the 1994 best seller, “Reviving Ophelia: Saving the Selves of Adolescent Girls.” In 1990, The Times reported, “Girls as young as 12 are more prone to depression than boys, new studies show, and a prime factor is their preoccupation with their appearance.”
Instead of using the C.D.C.’s report to confirm our prior suspicions, we need to get curious — about the results, about how to think differently about potential causes of mental health challenges and about what teenagers are really trying to tell us about the world when they say they’re stressed, anxious or depressed.
The Limitations of a Snapshot in Time
First, it’s important to remember that the most recent data from the Y.R.B.S. was collected in the fall of 2021. Let’s think about that time period, and look at the way two questions — about persistent sadness and about poor mental health — were written:
During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities?
During the past 30 days, how often was your mental health not good? (Poor mental health includes stress, anxiety and depression.)
Lisa Damour, a clinical psychologist in Ohio and the author of “The Emotional Lives of Teenagers,” says the responses from the survey data track with the way teenagers she sees in her practice were feeling during that year, specifically. “Teens were extremely unhappy,” she told me over the phone. Questions asked in the fall of 2021 received answers that were related to the preceding 12 months, which overlapped with the fall of 2020, when teens all over the country were attending school remotely and were disconnected from their peers and “usual activities.”
During the spring of 2021, they shared adults’ disappointment that the release of Covid vaccines didn’t result in an immediate return to prepandemic life. Damour said that even kids who were feeling good about the school year in the fall of 2021 were worried, because they anticipated that when they finally returned to school, “We’re gonna get there and get settled and it’s all gonna be ripped away from us again.”
Second, we need to think about the differences in the ways boys and girls tend to express and label their discontent. When I spoke with Laurence Steinberg, a professor of psychology at Temple University and the author of “You and Your Adolescent,” he said that “the current popular narrative is about adolescent girls and no one is really talking about whether adolescent boys, you know, might be feeling distressed.”
That may be because boys “probably wouldn’t describe it as being sad,” Steinberg said; it’s less socially acceptable for them to be sad or anxious. “They might describe it as being angry.” Or, he added, “it might just manifest itself behaviorally,” with substance abuse, aggression or acting out.
Finally, we should keep in mind that certain problems — drinking and teen pregnancy — were more prevalent for teens in the early ’90s. And if you look at the percentage of high school students who seriously considered attempting suicide from 1991 to 2019, there’s been a decline since 1991, when the figure was 29 percent. Over that time span, the low was in 2009, at 13.8 percent. It was 22 percent in 2021 — that second pandemic year — which was up from 18.8 percent in 2019. In all cases far too high, but still markedly below the 1991 level.
So, What Should We Do for the Teenagers in Our Lives?
The teens who responded to the Y.R.B.S. are telling us something, and it’s up to adults to listen and figure out how to interpret what we hear without over-pathologizing our adolescents’ emotions.
Damour says it’s important to discern the point at which a child’s low mood crosses from the normal range into worrisome territory. “We expect mood to go up and down in teenagers. We don’t expect it to stay low or for a teenager to be so nervous or anxious that it undermines their ability to live their lives or it undermines daily functioning,” she said. She also said parents should be on the lookout for “costly coping strategies” like substance abuse.
And we need to consider that teenagers may be expressing their feelings in a different way than the way we might have in our day. Anxiety is a good example of a term that’s now ubiquitous, whose meaning, as a result, has become more diffuse. “Teenagers, in my experience over the last 25 years, use the term ‘anxiety’ more than they used to” and “they often use it in a pretty elastic way to describe the experience of not feeling calm,” Damour explained. If teenagers tell her they’re anxious, she asks them to tell her more about what’s happening in their lives.
“I will listen to see if they tell me that they’re in a fight with a friend or they’ve got a big game coming up, or if they’re worried about an upcoming test and then based on what they tell me, I will try to offer a description of their feelings that may be more specific than anxiety,” she said. Maybe they’re actually angry, or maybe they’re mostly excited.
Or, if they’re not ready for that upcoming test in school, they may be truly anxious — but that’s not necessarily a bad thing, or a feeling that won’t pass. “You may be very aware that there’s a threat that you’re not prepared for, and that anxiety may help you to start studying or tackle the problem in front of you,” Damour added.
But I also think we can tell our kids that feeling anxious, angry or sad is part of being human. Teens sometimes see gloom in the world, and sometimes their reaction makes them the canaries in the coal mine when it comes to different societal problems. After all, they tend to see the world through less jaded eyes.
A new book by the philosopher Mariana Alessandri, “Night Vision: Seeing Ourselves Through Dark Moods,” offers another way of thinking about feelings like anger, sadness, grief, depression and anxiety.
Alessandri asks: “What if truth, goodness and beauty reside not only in light but also in darkness? What if believing otherwise has been a huge mistake?” She examines the work of philosophers throughout the ages and rejects what she calls the “brokenness story,” the narrative we tell ourselves when we can’t smile through pain — when we start to feel as if our brains are broken if we can’t find the sunny side of everything.
She writes that anxiety has appeared to increase among her students over the years, and about how she believes part of their struggle is thinking that experiencing anxiety is a sign of weakness and should cause them shame. As she puts it: “When the societal expectation of anxiety is set at zero — Keeping Calm and Carrying On 100 percent of the time — then any amount of anxiety feels like too much.”
I talked to Alessandri, and she observed that teenage girls and L.G.B.T.Q. teenagers across genders see a society where some of their rights are being taken away, and that a measure of despair is, perhaps, an appropriate response, and can be channeled toward taking action out in the world rather than having it churn inward. As she put it, “The solutions that are being already offered are about how to fix the little girl who is hopeless rather than fix the world that is making her hopeless.”
It’s complicated, there aren’t easy answers and it’s certainly correct to stay attuned to the emotional lives and behavior of our teenagers. But there’s nothing intrinsically wrong with teen girls that needs mending, and there never has been.
Want More?
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As noted above, social media is often cited as the prime reason for the decline in teenage girls’ mental health. Jacqueline Nesi, an assistant professor of psychiatry at Brown University who studies how technology use affects teenagers, wrote an excellent post summarizing the state of the research on teenagers and social media for her newsletter Techno Sapiens. Crucially, Nesi links to research indicating that there isn’t necessarily a gender difference in how social media affects teens, and writes that there’s not scientific consensus on this point. She also writes that suicide rates have increased among nearly all age groups, and notes they are higher among boys.
About social media specifically, Nesi writes: “it’s not clear to me why many of the mechanisms we would expect to drive the relationship between social media use and mental health (e.g., interference with in-person activities, sleep disruption, exposure to problematic content) would necessarily differ by gender.”
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More from the department of same as it ever was: This Times headline from June 28, 1961: “Anxieties Over College Heighten Youths’ Woes,” and summary: “Teenage anxiety over college admission is becoming a mental health problem in this country, a pediatric psychiatrist warned yesterday.” In 1976, The Times reported that “large numbers of the men and women who grew up in the ’60s are now experiencing a generational malaise of haunting frustrations, anxiety and depression. (Midlife malaise, it’s not just for millennials!)
Tiny Victories
Parenting can be a grind. Let’s celebrate the tiny victories.
My 1-year-old hates to have his hands and face wiped after breakfast regardless of how much oatmeal is caked on. I discovered that if I pretend the wet washcloth is a “washcloth monster” with accompanying sound effects, he is too distracted and giggling when the monster attacks him to realize he is getting cleaned.
— Katie Strader, Madison, Wis.
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