Perspectives on Rising Depression and Anxiety Among Teens and Young Adults Why It’s Happening and What Can Be Done About It Instances of severe depression and anxiety have been increasingly upsetting the lives of teenagers and young adults in the twenty-first century. The reporting and research on this topic over the past several years reveals a continuous, multi-level cautionary tale about the seriousness of troubling times young people are experiencing today in record numbers. An October 2016 Time magazine cover story — “Teen Depression and Anxiety: Why the Kids Are Not Alright” — paints a picture of millions of teens feeling severe anxiety and stress from an amalgamation of too much schoolwork, social media hyper connectedness and bullying, career goal pressure, complex college application and financial aid processes, climate change worries and woes, sexism, racism, terrorism, school shootings, poverty, inequality, intolerance, ad nausea. The Time cover story features data from the National Institute of Mental Health showing that 6.3 million kids have had an anxiety disorder, adding that such numbers are likely much higher, as only about 20% of young people with severe anxiety disorder get any kind of treatment. From High School to College By the time they reach college, nothing much has changed, with depression and anxiety numbers still on the rise. “Record Numbers of College Students Are Seeking Treatment for Depression and Anxiety — But Schools Can’t Keep Up,” shouts a March 2018 Time article in which several sobering statistics are presented. • Students visiting with counselors increased by 30% between 2009 and 2015. • In a spring 2017 survey of 63,000 college students at 92 schools, 40% acknowledged they had problems functioning and 61% said they “felt overwhelming anxiety.” • 2,700 UCLA students enrolled in an online screening test on depression that resulted in 250 identified as at-risk for severe depression, mania, or suicidal thoughts. • Pennsylvania State University approved a $700,000 budget increase for psychological services due to what they called a “dramatic increase” in demands for more student counseling services over the past decade. • College counseling centers nationwide are overwhelmed. “The average university has one professional counselor for every 1,737 students — fewer than the minimum of one therapist for every 1,000 to 1,500 students recommended by the International Association of Counseling Services.” A September 2019 article in the Philadelphia Inquirer reports on a heartbreaking tragedy related to college mental health counseling services. Six months after being hired, the executive director of counseling and psychological services at the University of Pennsylvania — a highly respected professional with 15 years of experience serving students — committed suicide. Sadly, the university has seen 14 student suicides since 2013. According to a 2019 report by the Center for Disease Control (CDC), U.S. suicide rates in 2017 were 33% higher than in 1999. Non-Hispanic American Indian or Alaska Native persons had the highest suicide rates for both females and males aged 15–24 and 25–44. A June 2019 American Medical Association research letter highlights trends in suicide death rates at ages 15–19 and 20–24. For both age groups the suicide rates “increased in 2017 to its highest point since 2000, with a recent increase especially in males and in ages 15 to 19.” Why Depression is On the Rise Reading through some of the research and expert opinions on this topic helps to provide a keener understanding of why all this is happening and what can be done about it. However, it’s also very important to recognize that mental health issues are enormously complex, and there is no one-size-fits-all solution and plenty of trial and error research geared toward discovering solutions that have yet to be discovered. For an in-depth, base-line resource that helps to answer the why question, see a 2012 paper titled “Depression as a disease of modernity: explanations for increasing prevalence,” by Brandon Hidaka, MD, PhD. Hidaka provides a review of the research, focusing his efforts on cross-cultural studies on depression. He claims that the past century has brought about drastic changes in our daily lives that have fueled “diseases of modernity,” such as atherosclerosis, hormone-related and gastrointestinal cancers, diabetes, and excess depression and anxiety. “Evidence suggests we may indeed be in the midst of an epidemic of depression,” he writes, with young people having a higher risk of depression than their parents and grandparents. What are some common modern-day causes of depression in teens and young adults (other than tragic life events such as loss of a loved one, serious illness, sexual abuse, and other negative fateful events beyond one’s control)? Many seem obvious if we take the time to fully recognize and closely examine how many of our daily habits have long-term negative effects on mental health. For instance, Hidaka points to the decline of physical well-being as a major contributor to depression. Overindulging in high- sugar, high-fat, high-calorie, and refined and fast foods, along with a sedentary lifestyle, brings on unnecessary weight gain, obesity, and poor body image, resulting in psychological distress and oftentimes severe depression. The CDC reports that “during 2013–2016, approximately 37% of adults consumed fast food on a given day.” Other physical well-being aspects of our lives that tend to induce depression include not getting enough sleep and not getting enough sunlight due to being indoors too frequently. Additionally, Hidaka cites research demonstrating a cultural shift “away from intrinsic goals, e.g. social relationships, community, and competence, to extrinsic goals, like money, status, and appearance.” Such cultural shifting typically coincides with increased incidences of loneliness and isolation among teens and young adults. And it’s no secret that isolation and loneliness, which can still occur if your social connections are large in quantity but lack in qualitative substance, are exacerbated through an unhealthy over-reliance on online social media networks and other Internet- based communications as opposed to face-to-face interactions. To bolster such claims, a September 2019 Experimental Economics journal paper on a study of 1,769 U.S. undergrads found that “a one-week Facebook restriction decreased feelings of depression and increased engagement in healthier activities.” Lastly, Hidaka references several studies that show accumulating evidence indicating “that the social environment in modern-industrialized countries, especially in the United States, has become increasingly competitive, threatening, and socially isolating,” with “increased competition most obvious in college admissions and economically, as populations now compete for jobs on a global scale.” He also mentions research on the so-called paradox of choice (too many options) so prevalent today, noting that “excessive choice can lead to paralytic indecision, greater expectations, stress, and eventual dissatisfaction, blame and regret.” A Journalist on a Mission with a Relatively Simple Solution UK journalist and author of “Lost Connections: Uncovering the Real Causes of Depression — and the Unexpected Solutions” Johann Hari offers a sensible overview on depression and anxiety in his book and in a July 2019 Ted Summit, titled “This could be why you’re depressed and anxious,” that has more than 1.3 million views. The 40-year-old Hari tells of his own lifelong battle with mental health issues and his sincere and deep desire to understand why so many people are getting depressed. He researched his book by traveling over 40,000 miles around the world interviewing numerous high-level experts about the causes and solutions of depression. Hari concludes that while some people have biological causes of depression that definitely require taking antidepressants, “most of the factors that have been proven to cause depression are not in our biology. They are factors in the way we live.” Hari adds that he personally took the highest legal doses of antidepressants possible for 13 years, and yet, “for a lot of those 13 years, and pretty much all of the time at the end, I was still in a lot of pain.” Factors that induce depression and anxiety outside of biology that Hari features include feeling lonely, working at a job you have no control over, rarely communing with nature, feeling that your life has no real meaning or purpose, and believing your outlook for the future does not make any good sense. These are the kind of negative psychological aspects of life, Hari believes, that do not require antidepressants to fix. “If you’re depressed, if you’re anxious, you’re not weak, you’re not crazy, you’re not, in the main, a machine with broken parts,” he says. “You’re a human with unmet needs.” So, the question becomes how can we overcome unmet needs? “It’s not like rocket science,” Hari answers. It’s recognizing that depression is more than likely a signal — not a biological malfunction or a weakness — that is telling people to seek out more meaning and purpose in life. How to Move Along a Life Path Towards Meaning and Purpose Despite the relative simplicity of Hari’s answer, finding meaning and purpose in life is much easier said than done, regardless of age and/or one’s station in life. It’s more of a lifelong process with plenty of twists and turns. A unique January 2018 listicle article in Greater Good magazine published by the Greater Good Science Center (GGSC) at the University of California, Berkeley offers six ways to discover purpose in life. GGSC online editor Jeremy Adam Smith writes that purpose “grows from our connection to others, which is why a crisis of purpose is often a symptom of isolation.” The six ways are: 1. Read — Studies show that adolescents who frequently read both secular and non-secular books that interest them have a stronger sense of purpose. 2. Turn hurts into healing for others — People who are willing to share experiences of suffering with others facing similar circumstances often find a correspondingly related purpose to pursue in life. 3. Cultivate awe, gratitude, and altruism — Research shows that those who count their blessings are more likely to contribute to the greater good, which is a sure way to have more meaning and purpose in life. 4. Listen to what other people appreciate about you — “Gratitude strengthens relationships — and those are often the source of our purpose.” 5. Find and build community — Seek out inspiration in the people around you and try to discover commonalities among each other that can result in making a positive difference in your community. 6. Tell your story — Writing about your life journey (your narrative) with a focus on challenges, growth and inner strengths can help bring more clarity about your authentic self and put you on a sensible and strong path toward more meaning and purpose in your life. In a December 2017 Great Good magazine article, Amy L. Eva, Ph.D., associate education director at GGSC, presents three research-based strategies for adults to support and engage in with youth who face roadblocks due to stress, poverty, and systemic racism and intolerance as they attempt to embark on purposeful life trajectories. They are: 1. Communicate high expectations — Showing that you firmly believe in a young person’s potential for growth increases their chances for success. 2. Be invested and accessible — When adults take a keen and sincere interest in supporting a young person’s life goals, they typically become energized and increasingly motivated. 3. Facilitate self-exploration — Talk about inspirational people and quotes related to meaning and purpose and relate them to a teen or young adult’s personal life. “Even a brief, 45- minute discussion of purpose, values, and interests can increase the sense of purpose that students feel.” Writer’s Note: When you come right down to it, in my opinion (and I’m not a professional counselor by any means), none of these meaning and purpose-oriented suggestions are overly esoteric or difficult to understand. Like Hari says, “it’s not like rocket science.” At the same time, diagnosing mental health is highly individualistic and not an exact science, and effective treatments are often illusive. It seems to be more of a matter of not giving up, regardless of how many failures, obstacles and setbacks might come into play, and consistently experimenting with different strategies, until a genuine love of life and a straight-on focus and movement toward reaching goals and aspirations kicks in on a more solid and permanent basis.