The COVID-19 pandemic has been hard on all of us, but younger people have been particularly impacted. In February, they were attending school, hanging out with friends, and participating in sports and other extracurricular activities. By March, they were locked in the house and told they would be missing out on the rest of the school year, losing out on their role in the school play, and foregoing their chance at the varsity team -- all-important school-related activities that help teens feel fulfilled and develop a sense of identity outside the home. This loss of a normal teen life is a topic that many, including parents, educators, and students themselves, are concerned about and it's why we've put together this guide to teen mental health.
We have a range of practical schooling guidance for students and parents to help them through the coronavirus pandemic, but we also want to help with mental health during COVID-19. Here, we'll explain some of the preliminary data on how the crisis has affected teens across the country, give you some warning signs to look for in your child, and offer you some tangible ways that teens can keep themselves happy and healthy.
Teen Mental Health and Quarantine: By the Numbers
Researchers from around the globe started gathering teen mental health statistics as soon as quarantines were put in place. When we sat down to look at the data, we found that there were many studies that dealt with adults (during the pandemic, they've been three times more likely to experience anxiety, mental distress, or depression) but not many studies examined how teenagers were faring. Many of the ones that did specifically study students and teens were rudimentary and didn't offer much insight for parents. Others looked at teens in other countries whose school systems and societal structure didn't translate to American teens.
We did, however, find a couple of studies that will help you understand how this pandemic has affected adolescents and we'll break them down here.
The Surprising Effect of the COVID-19 Pandemic on Teens
One relevant study, the Teens in Quarantine: Mental Health, Screen Time, and Family Connection, conducted by the Wheatley Institution, looked at the lives of 1,523 U.S. teenagers (specifically 8th, 10th, and 12th graders) as they quarantined. It examined their mental health, their time with family, and their time in front of screens. It then compared this data with findings from a 2018 study on the same topic, and the results were surprising.
As a group, teens did better during the pandemic than we would have guessed. In fact, reports of depression were actually lower in 2020 during the lockdown than they were in 2018. For instance, 27% of teens surveyed in 2018 said they were depressed and only 17% reported feeling depressed in 2020. The same was true for loneliness, which was hovering around 30% in the original study and dropped down slightly to about 22% during quarantine. Dissatisfaction with life also dipped a little, although general feelings of unhappiness rose a bit.
Perhaps less surprising was that nearly all of these categories started to trend negatively as the quarantine moved into the summer months, with loneliness, depression, and feelings of dissatisfaction taking a sharp uptick after school let out for summer break. Yet, even at their summer peak, the numbers for depression and loneliness didn't hit the 2018 percentages.
The non-profit group America's Promise Alliance dove into the same subject and its findings weren't quite as sunny. In The State of Young People During COVID-19 study, researchers surveyed 3,300 students aged 13-19. More than a quarter said that they were losing sleep because of anxiety, losing confidence in themselves, or feeling unhappy or depressed. Around a quarter of these teens also said they felt less connected to their school communities, teachers, and classmates.
When asked what was bothering them the most during the pandemic:
- 52% said they were 'much more concerned than usual' about their health
- 40% were worried about their family's financial situation
- 39% were anxious about their education
- 30% had concerns about meeting their basic needs (food, safety, medicine)
These worries were more pronounced among certain demographics. Teens living in cities were 15% more likely to express health worries than kids in rural areas. Asian youth, Latinx youth, and those whose parents were born outside the United States reported cognitive and emotional health issues at significantly higher percentages than black and white teens, and those whose parents were born in the United States.
Factors That Influence Teen Mental Health During COVID-19
The Teens in Quarantine study tied teen mental health during COVID to a few influential factors.
More or Less Sleep
First, during quarantine, teens were getting more sleep than they did pre-pandemic. The 2018 study found that only 55% of teens were getting seven or more hours of sleep at night during the school year. During the quarantine, that number rose to 84%.
With in-person school, kids typically have to wake up early to get ready and make their morning commute, meaning many miss out on the biologically imperative sleep that puberty demands. Online classes and homeschooling have allowed them to sleep later and become more aligned with their bodies' natural circadian rhythms; studies have shown that this can have a significant effect on mental health. Of the teens who got more than seven hours of shut-eye a night, only 17% reported feeling depressed, compared to 31% of those who got less than seven hours.
More or Less Time With Family
Teens also said they had been spending more quality time with family. Positive family interactions have long been linked to good mental health and that could have played a significant role in offsetting the negative effects of quarantine. With parents working from home and teens doing online classes, 56% of students said they were spending more time with their families than before the pandemic; 54% said their family was eating dinner together more often and 46% said they were spending more time with siblings.
Most importantly, 68% responded that their family had gotten closer during the pandemic. Of this 68%, only 15% were depressed, compared to 27% of teens who felt their families hadn't grown closer. The same was true for other family-closeness factors: of those who were talking to parents more, only 16% felt depressed, versus 23% who were talking to parents less.
Further, 16% of teens who were eating dinner with family more reported feelings of depression, while 22% of those whose family dinners declined felt they were depressed.
Other factors that appeared to play a role in teen mental health during the coronavirus pandemic included the number of parents/guardians in the household and the level of financial security. Teens from two-parent households were less likely to suffer from depression (around 17%) than teens from one-parent households (20% to 23%, respectively).
One-quarter of the teens in this survey whose parents had lost a job reported depression; that number dropped to 16% for kids whose parents were employed. Likewise, 26% were depressed if they were worried about their family not having enough money, whereas just 13% of teens who didn't share this concern were depressed. When it came to other financial factors, food insecurity played the biggest role in depression with only 14% of food-secure teens feeling depressed, compared to 33% of food-insecure teens feeling depressed.
Teen Media Use During Coronavirus
One factor that's consistently been tied to mental health, even outside of quarantine, is screen time, especially texting, engaging with social media, and binge-watching shows and movies. With the pandemic forcing teens to relinquish their usual in-person get-togethers with friends, you'd naturally expect screen time to skyrocket. After all, it's their only way to socialize with peers during quarantine. Surprisingly, that didn't happen, at least for most forms of media.
Compared to 2018, teens actually spent less time gaming, texting, and using social media in 2020. Video chatting and TV watching did go up during quarantine but even those categories didn't see dramatic increases.
However, there were differences when it came to gender. While boys and girls watched the same amount of television (about 3.5 hours a day), boys spent more time gaming (nearly 4 hours vs. 2.5 for girls) and girls spent more time texting and using social media (about 3 hours a day).
Researchers were surprised that mediums designed for social connections decreased and mediums designed for passive enjoyment increased. But there are some reasons it makes sense.
Passive Media as a Coping Strategy
First, teens may be using streaming services as a method of coping during COVID-19. TV, movies, and video games are a way to relax and forget about the pressures of school, the worries of finances, and the anxiety about the pandemic for a little while. We also tend to think of these activities as solitary but many teens reported playing video games with parents and watching TV shows as a family, and this can be a healthy outlet when done in moderation.
Conversely, we tend to think of social media as connective and healthier, but it's actually been shown to have a more negative effect on mental health than TV and video games, which may also play a role in these surprising numbers.
Second, for this generation of teens, some of these activities are de facto social media. Video games allow teens to interact with friends online. Kids can watch TV and movies with friends over video chatting sites, and video-rich sites like YouTube are about much more than passively watching videos. Teens interact with them by posting comments, adding response videos, and communicating in ways that experts say are healthier than passively scrolling through page after page of traditional social media posts.
Is the Pandemic Affecting Your Teen's Mental Health?
So, the preliminary data about the pandemic seem to point to better teen mental health statistics than we would have predicted. It's happy news, to be sure, but it only gives us a glimpse of the group as a whole. Just because many teens have done okay, it doesn't mean they all have. It also doesn't mean this experience won't have negative effects down the road. That's why it's important to understand the warning signs and be equipped to help. Below, we'll take a look at identifying mental health issues in your teen, how to talk to your kids about these sensitive topics, and offer some steps you and your teen can take to make it through this difficult time together.
The Differences Between Sadness, Anxiety, and Clinical Depression
With everyone at home, as a parent, you have unprecedented access to your teen's daily activities and you might also be getting a bigger glimpse into your teen's emotional life. Yet, even with this new perspective, many parents find it hard to know whether a behavior is normal or if it warrants intervention. As a teen, you might also not understand if what you're feeling is typical under the circumstances or if you might need some help coping with a more serious mental health condition.
First, to understand what you or your teen is going through, it's important to know the differences between sadness, anxiety, and clinical depression.
Sadness is a part of being human, and it's something we all experience at one time or another in life. It's the normal reaction to life events that we find disappointing. That is, it's most often tied to a particular trigger -- losing a job, failing a test, having temporary financial issues, or experiencing interpersonal problems with those who you are close to. In the context of quarantine, sadness might be triggered by the loss of the traditional school experience, grief about losing contact with friends, or the difficulty of adjusting to a lifestyle of quarantining. Teens suffering from sadness usually find relief by venting, crying, or taking out frustrations. Sadness typically goes away as we adapt to these changes.
Similarly, anxiety is a normal human reaction to things that cause us concern, either real or imagined. It can manifest itself in a variety of ways. These might include:
- A sense of impending doom
- A feeling of nervousness
- Trouble concentrating
- Physical reactions like trembling, sweating, and increased heart rate
People are often anxious about speaking in front of people, trying a new experience, or thinking about some future event that hasn't happened (and may never happen). For many teens during the pandemic, COVID anxiety has meant worrying about finishing school, being concerned about loved ones (and themselves) getting the virus, and fretting about family finances. Anxiety can often be dealt with in small doses but chronic anxiety -- anxiety that's all-consuming or persists for a long time -- can be a cause for concern.
While sadness and anxiety are typically temporary changes to your mood, depression is a mental illness, a state of being rather than a reaction. Also known as major depressive disorder, or MDD, depression colors your entire life, while anxiety and sadness often relate to just one area of life. Since it is a diagnosed illness, there are specific markers that professionals use to diagnose someone with MDD. To be diagnosed with MDD, you must exhibit five of these symptoms on a persistent basis for at least two weeks:
- Loss of interest in friends and activities you previously enjoyed
- Low mood
- Feelings of worthlessness or guilt
- Loss of sleep
- Diminished ability to concentrate
- Changes in appetite
- Lower energy
- Slow movements
- Thoughts of suicide or death
Depression, sadness, and anxiety are complex, idiosyncratic, and interrelated. Anxiety or sadness can lead you to isolate or take less pleasure in the things that make you feel good (exercise, socializing, finding healthy outlets for worry), which can lead to a lower mood. That's why it can be really hard to tell the difference. Below, we'll look at some of the warning signs that transient mental health conditions have turned into something serious.
Teen Mental Health Challenges: Warning Signs for Parents
As a parent, it's not always easy to spot the difference between depression and the normal ups and downs of teenage behavior. The coronavirus pandemic has only made it harder; it's presented a number of unique challenges when it comes to identifying mental health issues. For example, it might be hard to tell if your teen is withdrawing from activities they love because they have no way of safely doing them during a pandemic. It's also tough to spot social withdrawal when social withdrawal is such a part of our lives right now.
That said, there are several warning signs that might signal depression in teens and we'll cover some of the biggest here.
Studies have shown that depression often manifests itself physically. These symptoms might include things like:
- Stomach pain
- Abdominal cramping and discomfort
- Aching muscles
- Lowered pain tolerance
- Fatigue or lower energy levels
- Digestive problems
- Irregular bowel movements
When teens start to disconnect from friends and family, it's a red flag that something's going on. Of course, during COVID, social withdrawal is part of the bargain. And a teen retreating to his or her room isn't necessarily a cause for concern; this is part of the growing process.
So, how can you tell if it's okay or not that your teen wants to spend time alone? One idea is to have your radar up for less interest than normal in activities that are 'social' right now, such as video chatting, texting, online gaming, or talking on the phone with friends. If you notice your teen withdrawing from those types of activities and not wanting to interact with their friends or family, then you might have a larger mental health issue on your hands.
Trouble Sleeping of Lack of Appetite
Having a night or two of fitful sleep or not feeling hungry at mealtime are perfectly normal. We all experience this and teens experience it at a higher rate. However, persistent disruptions of normal sleeping habits and sudden or prolonged loss of appetite are both strong indicators of a depressed state.
Drop in Grades
A sudden drop in academic performance or a lack of interest in participating in school (where there was interest in the past) may be signs of depression, especially if they're combined with some of these other symptoms. Considering the state of school during the pandemic, some fluctuations in grades and motivation are to be expected, but most teens will make adjustments to get back on track. So, if your teen is struggling in school and doesn't seem to care or want to improve, there might be a mental issue at play.
Drug or Alcohol Abuse
Many teens (and adults) deal with depression by using avoidance. That is, mentally or physically distancing themselves from the uncomfortable and often unbearable feelings. One of the easiest ways to mentally check out is by using drugs or alcohol to self-medicate. While this might temporarily feel good, it usually creates more isolation and exacerbates depression and other mental health issues in the long run.
For some teens, depression leads to feelings of worthlessness, ugliness, shame, or failure. They may criticize themselves frequently in front of you or other members of the family with statements like 'I suck,' 'I'm so dumb,' or 'Nothing I do is right!'
Different Kids, Different Responses
It's important to emphasize that most teens will demonstrate some of these depression-like symptoms during their adolescence. Teens feel down. They experience fluctuations in appetite. They have bouts with low self-esteem, they rebel, and they may even experiment with drugs and alcohol. These are all part of the process of growing up and they may be more pronounced right now during this unprecedented time of uncertainty.
You want to be on high alert for mental health issues but you don't want to create problems that aren't there. That's why it's so critical to know your child and understand their baseline (and make some more room for these natural traits during a quarantine). For example, if your teen is naturally introverted and derives energy from alone time, it may be perfectly natural for them to retreat a little more than usual. If your child is normally anxious, it's okay to cut them a little slack if they're more irritable or nervous than usual.
There are many depression symptoms that aren't a cause for alarm unless they're markedly outside your teen's normal behavior or they last for an extended period of time.
How to Talk to Your Teen About Mental Health
Teens are often reluctant to talk to adults about their problems and even those who do may not know how to express their feelings. It's a good idea to open the lines of communication with your teen. Here are a few pointers from experts for talking to your teen in a healthy and productive way:
Be Wise About Timing
Don't start a conversation about mental health with your teen if you've just had an argument or if they're in the middle of doing school or an activity they enjoy. Be careful about your mood, too. If you're irritated, it's going to come through, even unconsciously, and have an impact on the conversation. Choose a time when you're both calm, relaxed, and receptive.
If you've ever struggled with feelings of depression, be open and honest about it. Let them know how you felt and what helped you feel better. Doing this removes the stigma and lets your teen know that expressing these feelings is okay.
Don't dance around the subject. Be direct about which behaviors you find concerning and ask them if they've noticed them as well.
Let your teen know that you understand how difficult this time has been for them. Express to them that it's okay to feel distressed, anxious, and even depressed and make sure they know you've come to them because you care about their well-being.
Be Ready for the Blow-Off
There's a chance that your discussion won't go well. Your teen may refuse to talk or even feel hostile toward you for confronting them. Understand that this is a normal part of the process and don't push too hard. Give it a rest and try again another time -- you may plant a seed that helps make subsequent talks easier.
Teen Mental Health During Quarantine: Actions You Can Take
There are all sorts of things parents and teens can do to stay sane, healthy, and happy during the quarantine. We'll offer a few below, but we've also created a handy High School Student's Guide for Minimizing & Managing School Stress During COVID-19 that offers even more helpful tips and coping strategies.
Make a Routine and Know When to Break It
Create a routine that incorporates a:
- Wake-up time
- Homeschooling time
- Exercise time
- Family togetherness time
- Free time
- Friends (and family outside the home) time
Be consistent with the schedule -- knowing what your day will look like is a big factor in getting things done and feeling fulfilled. Schedules create structure and help us feel a sense of accomplishment, and experts say that sticking to these routines -- even small ones like brushing teeth, dressing for the day, and having that cup of coffee at 9 am -- are anchors that reduce anxiety. But you should also be able to break the routine sometimes for a refreshing change of pace.
Stay Connected Safely
Set up regular times to do fun family stuff like games, movie nights with popcorn, working on the house or garden, or any activity that everyone enjoys together. Stay connected to extended friends and family, too, by encouraging video chats, phone calls, and texting. Keep in mind that these don't need to be reserved for special occasions. For example, some families spend time together by turning on a video chat with grandma and grandpa and going about their day as usual.
Take a Break from Upsetting Content
Upsetting content in TV and movies, gloomy music, and bleak books all have their place, but during quarantine might not be the right time as they can exacerbate negative feelings that are already there. For a household-wide mood boost, experts say to stick to more uplifting content like lighthearted comedies, energetic music, and books that edify.
Get Out in Nature
Research has shown that getting out in nature -- by taking a hike, going for a bike ride, or just sitting in the park -- can have incredible benefits for mood and immune system function. These days, it'll also give teens something to look at besides their four walls.
There's no shortage of apps and videos that can help you do yoga, learn to breathe, or practice meditation. Use them! Their effects -- which include a calmer mind, increased focus, better sleep, and a boost to your mood -- have been proven by countless studies, and they're an invaluable way to calm yourself, refocus, and go about your day with intention.
There's nothing quite like physical exercise to lift the spirits. Physical movement releases endorphins that can reduce stress, quell anxiety, and raise self-esteem. It's a fantastic tool for coping during COVID-19. If you're a teen, you can turn on an exercise video, take a socially distanced bike ride, or go for a long walk to refresh your mind and body.
Set the Tone
As the parent, you're the leader of the household and the tone you set can help create a positive atmosphere or it can destroy it. Make sure you're setting a good example by staying positive, keeping the lines of communication open, and taking care of your own physical and mental needs.
Seek Professional Help
It can be tough to admit you or your teen need help but there are some issues that require intervention and professional counseling (look for counselors who specialize in working with teens). Here are a few instances where you should seek assistance right away:
- Depression is ongoing or worsening
- Self-harm or cutting
- Inappropriate anger or violence
- Eating disorders
- Drug use
- Participating in illegal activities
You can find a reputable therapist by getting a recommendation from your family doctor, doing detailed research online for local licensed mental health professionals, or asking friends or acquaintances. There are also many online therapy options popping up lately. These can be amazing resources for talking through issues and working toward healthier ways to approach life. However, online therapists often cannot offer official diagnoses and some experts worry about the quality of some of these online programs.
The organization Psychology Today also offers a tool for finding a therapist in your area.
Take Suicide Talk Seriously
Times of intense stress, like we're experiencing during the COVID-19 pandemic, often see increased rates of suicide. Understand that not every teen who's thinking about suicide will talk about it and not every teen who talks about suicide will follow through with it. But any suicide talk or ideation should be taken seriously. If you're concerned about your teen, remove anything from the house that could be a danger, including weapons and medications.
If you're a teen who's having thoughts about suicide, seek help immediately by calling the National Suicide Prevention Lifeline at 1-800-273-TALK or texting the Crisis Text Line by texting 'TALK' to 741741.