Mental health problems have increased, but especially among teenage girls


The American Academy of Pediatrics recently declared a national emergency for child and adolescent mental health as rates of depression, anxiety, self-harm and suicidal thoughts have soared during the pandemic. But young people’s mental health had been deteriorating for some time before the pandemic, as psychologists like me have noticed for at least 10 years.

Possible causes abound: over-parenting, screens and social media, fierce academic and athletic competition, political acrimony, social injustice, climate concerns, gun violence and virtual learning, among others. What is obscured when we group all young people together, however, is that certain demographic groups are particularly vulnerable to psychological problems and may disproportionately explain the overall trend.

In my practice and that of my colleagues, it has been preteens aged around 10 to 14 who have had more difficulty than in the past. The belief has long been that middle school is the toughest time to get through, especially for girls, but a confluence of more recent societal and biological trends has led to a perfect storm for tweens.

A recent study of British girls aged 10 to 15, for example, found that behavioral difficulties and dissatisfaction with life increased more among this group of girls than boys during the pandemic, compared to the pre-pandemic period. Another study, with Canadian and Australian girls, reported more anxiety and depression, compared to boys, over the same period.

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Further back, the U.S. National Drug Use and Health Survey Found that the percentage of girls aged 12 to 17 who had experienced at least one major depressive episode in the past year increased from 12% to 25% between 2010 and 2020. For boys, the increase was 5 to 9% over the same period.

And researchers from the Centers for Disease Control and Prevention found that ER admissions for self-harm doubled for girls from 10 to 14 years old between 2010 and 2014, while they remained practically unchanged for the other demographic groups.

Long-standing research shows that girls and boys don’t differ much initially in their rates of anxiety and depression. But in college, girls get much more depressed and somewhat more anxious, and these differences persist into adulthood. What happens during this critical time to make girls especially vulnerable?

“Puberty interacts with stress to make girls prone to depression, self-harm and other psychological problems,” said Mitchell J. Prinstein, scientific director of the American Psychological Association (APA) and author of “Popular: Finding happiness and success in a world that cares too much about the wrong kinds of relationships.” “And the amount and variety of stress increases over the 20s.”

The hormonal and neural changes of puberty occur as does stress related to appearance, family, school, social life and extracurricular increases. During the college years, research has shown that girls usually start to care a lot more than boys how they fit into the world and what their peers think of them. And this is an area in which they have only limited control.

“Girls’ brain areas involved in social appraisal sensitivity become more active during puberty,” said Jennifer S. Silk, professor of clinical and developmental psychology at the University of Pittsburgh. “And the more this part of the brain is active, the more one is at risk of depression, anxiety and even suicidality.”

At the same time, girls face the same pressure as boys, which comes with more serious study and, for example, college athletic demands. But research suggests they often take more to heart the message that you must excel in everything. Between the ages of 12 and 13, the proportion of girls who say they have no right to fail increased from 18 to 45 percent.

“Tween girls work so hard to be perfect everywhere for everyone, that they inevitably fail and are exhausted by the time they get home,” said Phyllis L. Fagell, clinical vocational counselor, school counselor, and author of ” Middle School Matters: The 10 Key Skills Kids Need to Thrive in Middle School and Beyond – and How Parents Can Help.” “Many would be surprised to hear how harshly they judge themselves and how their inner dialogue seems self-critical.”

And girls often use less active coping strategies when faced with difficulties. While boys engage more in distraction with, for example, physical activity and real-world problem solving, previous research has shown that girls dwell on problems and their negative emotions. This tendency to overthink and regurgitate negative content, alone or with a friend, jumps with puberty.

Perfectionism, self-criticism and rumination are all, in turn, well-established risk factors for depression and related mental health problems.

Social changes hurt tweens more

puberty was start earlier over the past three decades among girls; the trend for boys is much less pronounced. It is not known why this may occur, but changes in nutrition, environmental toxins and stress have all been suggested. The pandemic seems to have accelerated the trend. Unfortunately, early onset of puberty has been linked to depression, anxiety, substance abuse, and other psychological issues in girls.

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The use of technology is the factor that most often contributes to the increase in mental health problems among young people. Although overall research on this link has not been conclusive, some studies suggest that girls seem particularly negatively affected through social media.

After years of slow but steady increases in social media activity, today’s tweens use it 17% more than in 2019. Not surprisingly, girls are more engaged in social media, while boys play more video games. The problem is that the increased use of social media by girls affects them more strongly than boys. The more time they spend on Instagram, Snapchat, YouTube and TikTok, among others, the more likely they will be live depression, low self-esteem, poor body image, poor sleep and other mental health issues.

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“In general, girls are more likely to engage in comparisons and be affected by interpersonal feedback. And these tendencies predisposed them to depression,” Prinstein said. social.”

A JAMA Network Study published this year, with 84,011 participants between the ages of 10 and 80, found that the relationship between social media use and life satisfaction is the most negative among young teenage girls, compared to any other demographic group. This finding suggests that 2 years could be a critical time when girls should avoid social media as much as possible.

In addition to being potentially toxic on its own, long hours of social media use prevent girls from engaging in behaviors that promote well-being, such as face-to-face interaction with friends, sleep and activity. physical.

For example, eighth graders who find their friends “almost every day” tear down from over 50% in the 1990s to around a quarter in 2015 – and it’s probably less now.

“What started before the pandemic has only gotten worse with restrictions on socializing and school and in-person activities,” said Deborah Roth Ledley, a clinical psychologist in Philadelphia and co-author of “The worry book for children.” “I saw that it affected the girls badly because they had completely changed their online social world.”

Parents should be aware that with the onset of puberty, their daughters may need more support than before. A good place to start is to look at the level of stress their daughters are feeling and, if necessary, help them reduce the pressure or the number of obligations expected.

“Our study of tween girls at the start of the pandemic showed that, somewhat surprisingly, many felt freer, had more time to sleep and relax,” Silk said. “We can see it as a pandemic silver lining but also as a wake-up call that our girls are too stressed.”

We can counter girls’ perfectionism and self-criticism with self-compassion.

“Be sure to model self-compassion based on how you treat yourself, because tweens look up to us even when we think they’re only focusing on their peers,” said Karen Bluth, assistant professor in psychiatry at the University of North Carolina at Chapel. Hill and the audiobook author”Self-Compassion for Girls: A Guide for Parents, Teachers and Coaches.” “And then help them question the validity of the self-critical voice by asking, ‘Is that true all the time? ‘Is it really, really true?’ “Are you absolutely sure, without a doubt? ”

As for which social media and smartphones they’re most often viewed on, do your best to delay both until high school. “Give them a flip phone until they’re 14 and always get the screens by 9 p.m.,” Prinstein said. online organization Wait until 8 can provide helpful advice.

To onboard your tweens, establish screen policies together by creating a family media plan. Then commit, implementing the consequences if necessary. Be sure to model healthy tech-related behaviors like having off-screen times and spaces, not sleeping with a phone, and discussing what you see online.

Talk to your daughters about their values ​​and goals using social media.

“Appeal to their beliefs of social justice, of not wanting to be manipulated by corporations,” Fagell said. “And discuss empathy – thinking about how their online involvement affects others. This will strengthen their sense of agency and counter helplessness and hopelessness.

Bluth suggested inviting tweens to experiment with social media by varying the type of use (passive vs. active or interactive), timing (first thing in the morning vs. later vs. late at night) and duration, and checking how they feel then.

“Ask them if they feel good, connected, having a sense of purpose against the evil in their skin, sad, worried, alone,” she said.

Finally, always keep the lines of communication open. Be curious about the girls’ lives, but don’t bombard them with questions or pressure them. Share your own college struggles and misadventures. And more than anything, listen.

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