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Is modern life making today’s teenagers more depressed?

The media is full of stories about a teenage mental health crisis, but the reality is more complex. The real problem is we don't do enough to help those who need it
teens on phones
Bullying doesn’t just happen online
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IT’S a tough time to be a teen, with cyberbullying, exam stress and a selfie culture that piles on the pressure to always look good.

Perhaps it is little wonder newspaper headlines talk about a burgeoning crisis in our children’s mental health. Self-harm and depression are reported to be soaring. A survey by the UK’s National Union of Students found eight out of 10 people in higher education say they have had .

Similar fears are being voiced in other countries, including the US and Australia. This is surprising, considering that, by some measures, Western teenagers are living less turbulent lives than at any other time in history. They are less likely to take drugs and get drunk than they used to, and teen pregnancies have been falling for many decades.

So is there an underlying rise in rates of depression in teens? Or is something more subtle at play?

There are signs the rise is real, even if the size of the change is being overstated, says Simon Wessely, the past president of the UK’s Royal College of Psychiatrists. ā€œClearly, something is happening,ā€ he says. ā€œThere is a change.ā€

For instance, the UK’s , which uses an interview and questionnaire to clinically assess mental health and is repeated every few years, found that among 16 to 24-year-old females, depression and anxiety rose from 21 to 26 per cent between 2007 and 2014. Other studies have also shown a rise in problems among teen girls. This is undoubtedly cause for concern – but it is nowhere near the eight-in-10 numbers that make the headlines.

Indeed, not all the evidence points to a crisis. Among the under-30s, rates of suicide, which would seem to be an important measure of serious distress, , according to the UK’s Office for National Statistics. This is telling, says , who helped write a previous version of US psychiatrists’ main textbook, the Diagnostic and Statistical Manual of Mental Disorders. ā€œHuman nature is very stable. The way of measuring rates of mental disorder is remarkably unstable and subject to bias depending on the methods used.ā€

ā€œIt’s important to distinguish between normal sadness and clinical depressionā€

Still, there are other signs of an increase in problems. Teenagers seem to be self-harming more. The number of 13 to 16-year-olds seeing their doctor for this reason rose by nearly 70 per cent between 2011 and 2014, according to a UK study published last month.

ā€œWe can’t really explain this possible rapid increase in self-harm among girls,ā€ says Nav Kapur at the University of Manchester, UK, who led the work. It might reflect a real rise in psychological problems, but could also be due to better awareness or recording of self-harm, he says.

One frequently cited explanation for the uptick is constant exposure to social media and the cyberbullying this enables. For example, Jeremy Hunt, the UK’s chief government minister for health, tweeted the self-harming figures with the reaction: ā€œā€œ.

girl on laptop
Social media doesn’t help
Justin Paget/Getty

So is social media responsible? Cyberbullying is often painted as a uniquely dangerous threat. Yet this is contradicted by a recent study of over 100,000 English teens, which found there were more incidences of face-to-face bullying than internet abuse, and the former was .

ā€œ[Social media] is a new channel but it’s nothing different from traditional bullying,ā€ says at the University of Oxford, who took part in the research. He thinks parents and teachers are more nervous of bullying involving social media simply because they didn’t grow up with it – and that the dangers are exaggerated by firms selling cyberbullying training. ā€œThere has been a huge amount of hype,ā€ says co-author , also at the University of Oxford.

Nuance needed

Further, even a rise in self-harming may not indicate a rise in distress. ā€œThere seems to be more self-harm happening, but it’s not completely clear this is due to a greater level of underlying distress,ā€ says Max Davie, a paediatrician in London who treats children with this behaviour. ā€œIt may be becoming a more culturally acceptable way to show your distress.ā€

The same could be true for depression. People are now more likely to pay attention to negative emotions because of wider awareness of mental health issues due to public health campaigns, as well as celebrities speaking out about their own problems.

ā€œPeople are probably a bit more aware of their negative feelings,ā€ says Stephen Scott at King’s College London. ā€œThere’s much more emotional education in schools now.ā€

But that doesn’t ring true to at the University of Liverpool, UK. The stigma around mental health still remains, she says, and ā€œit’s not reduced by muchā€.

This disagreement is more than academic – it is crucial to understand why these figures are rising if we are to properly treat teen mental health, as exaggerating the problem could actually be making things worse. For example, getting schools to do mental health ā€œcheck-upsā€ is a helpful-sounding proposal that has the potential for harm. There is no easy way to diagnose mental illness with a simple questionnaire – all such screening tools give a high rate of false positives. In other words, people are wrongly labelled as having depression or anxiety when they are in short-term distress. That can lead them to panic, and confuse short-lived feelings with conditions serious enough to warrant a diagnosis of depression or anxiety, says . ā€œIt’s important to distinguish between normal sadness and clinical depression.ā€

Failing to do so carries a real risk, says Frances. ā€œBy putting the normal experience of being a teenager into mental illness terminology it reduces kids’ resilience,ā€ he says. ā€œThey change from thinking ā€˜this is part of life and I’m going to cope with it’ to ā€˜this is a mental illness and I’m going to need treatment for it’.ā€

ā€œThere is a real crisis in teenage mental health, and it is the lack of treatment availableā€

Similarly, the mental health awareness campaigns often proposed to combat perceived problems can be surprisingly counter-productive, says Wessely. They can cause a run on already overstretched mental health services, .

One thing about teenage mental health is not disputed: clinical depression in the UK is certainly not being treated effectively. There is a real crisis in teenage mental health, and it is the lack of treatment for people with diagnosed problems.

The UK’s National Īēҹø£Ąū1000¼ÆŗĻ Service has undergone successive rounds of cuts since the global recession began a decade ago, and children’s specialist mental health services are being stretched particularly thinly. Teenagers in acute need are having to wait weeks or even months before they get to see a psychiatrist. There are so few hospital places that they may have to stay in a clinic hundreds of kilometres from their home, cut off from family and friends.

Long waiting times

In August, a judge if the NHS continued to delay finding an inpatient bed for a 17-year-old girl who had tried to kill herself several times. After his intervention, a bed was found.

Just last week, the watchdog released a report warning that children with mental health problems are waiting up to 18 months for treatment. ā€œWe should put our efforts into getting more resources, because if we put them into increasing awareness we just increase wait times and burn out our staff,ā€ says Wessely.

Newer interventions are being trialled in schools, such as training in mindfulness, resilience and anti-bullying programmes. But it is essential that any interventions are tested in randomised trials before being widely implemented. Given the widespread perception of crisis, it can be tempting for politicians to roll out new interventions before the evidence is in, says Scott.

Wessely agrees it is vital we don’t act too hastily. ā€œSomething is changing. The first thing we should do is take a deep breath and find out what’s going on,ā€ he says. ā€œPeople say we can’t afford to wait that long. I say we can’t afford to not wait.ā€

  • Need a listening ear? UK Samaritans: 116123 (). Visit for hotlines and websites for other countries.

This article appeared in print under the headline ā€œIs life today bad for teens?ā€

Topics: Depression / Mental health / Social media / Teenagers