Is economic deprivation the real cause of the teen mental health crisis?

A response to the Nature review of The Anxious Generation

It’s now nearly universally accepted that teens are in the midst of a mental health crisis. What’s still being debated, at least in academia, is what caused it.

With teen depression starting to rise in the early 2010s, the obvious explanation is the rise of smartphones and social media and the accompanying decline in sleep and in-person socializing. I first argued this nearly 7 years ago in iGen.

The “great rewiring” of childhood and adolescence is at the forefront again with the recent publication of Jonathan Haidt’s book The Anxious Generation. He posits that the combination of too much time online and not enough time being independent in the physical world is behind the mental health crisis.

This idea immediately resonates with parents and even with Gen Z themselves, but some academics are not convinced. One is Candice Odgers, a psychology professor at UC Irvine, who reviewed The Anxious Generation in Nature. Specifically, she argued that the evidence isn’t strong enough to conclude that smartphones and social media caused the teen mental health crisis. (Haidt’s response to the review is here).

So what did cause the increase in teen depression? Odgers proposes the opioid crisis or school shootings. But they can’t be primary causes, because those are issues relatively unique to the U.S., and the rise in teen depression, anxiety, and loneliness is international.

Odgers also theorizes that the rise in teen depression after 2011 could be caused by the economic harm of the Great Recession on lower-income teens in particular. She writes: “The current generation of adolescents was raised in the aftermath of the great recession of 2008. Haidt suggests that the resulting deprivation cannot be a factor, because unemployment has gone down. But analyses of the differential impacts of economic shocks have shown that families in the bottom 20% of the income distribution continue to experience harm. In the United States, close to one in six children live below the poverty line.” 

Thus, by Odgers’ hypothesis, the increase in teen depression since 2011 should be significantly larger among teens below the poverty line compared to better-off teens. If economic deprivation is the primary cause, there should be only a small increase in depression among better-off teens, or perhaps none at all.

These are ideas we can test, because the National Survey on Drug Use and Health – the largest U.S. screening study of depression prevalence – measures family income. Even better, it classifies family income based on the poverty line, which is adjusted for inflation each year and takes family size into account. Teens below the poverty line fall into the group Odgers mentions — families in the bottom 20% of the income distribution.

Is the increase in depression since 2011 notably larger among teens below the poverty line? It is not. In fact, the increase is actually larger among better-off teens (see Figure 1).

Figure 1: Percent of U.S. 12- to 17-year-olds experiencing major depressive episode in the last 12 months, by family income level. Source: Data from the nationally representative National Survey of Drug Use and Health; analysis by Jean M. Twenge for the Generation Tech Substack. NOTE: This is a screening study of the population, not a study of diagnoses or treatment. Thus the differences cannot be caused by willingness or ability to seek treatment. 2020 data excluded as sampling times varied from other years.

Among teens whose families make at least 2 times the poverty cutoff (roughly the top 60% of the income distribution), depression rates went from 7.97% in 2011 to 20.02% in 2022, a 151% relative increase. Among teens below the poverty line, depression rates went from 8.46% to 16.86%, a 99% increase. So depression increased among both groups, but more in the higher-income group. This is exactly contrary to Odgers’ hypothesis.

Odgers acknowledges that teens spend too much time on social media, and that some of Haidt’s solutions are reasonable. But she undermines this by claiming that “the bold proposal that social media is to blame might distract us from effectively responding to the real causes of the current mental-health crisis in young people.” What “real causes”? None of those Odgers proposes fit the data, and the proposed cause she elaborates on the most — economic deprivation — is exactly contrary to the data.

In contrast, the rise of smartphones and social media not only fit the data, but the solutions (no phones at school, keeping kids and younger teens off social media) are low-cost and have few downsides outside of diminished profit for the social media companies. Despite the continued and often misinformed tussling in academia, most other people are on board, especially parents, teachers, and psychologists who have seen the effects of the phone-based childhood firsthand. Many organizations are now working to promote less online time and more independence for our kids and teens. I hope more of my fellow academics will join them.