By now, the facts are undeniable: Adolescents are in the midst of a mental health crisis. One in 5 American teens experienced clinical-level depression in 2021, more than twice the rate just ten years ago. Emergency room admissions for self-harm behaviors among 10- to 14-year-old girls quadrupled, and the youth suicide rate doubled.
With numbers this staggering, it’s imperative to find out why so many teens are suffering. The rise is especially mysterious because the last 10 years have brought many positive trends for youth, including less alcohol use, fewer teens getting pregnant, less child poverty, and less child abuse. The COVID-19 pandemic and its disruptions cannot be the primary cause: Teen depression had already doubled by 2019 before the pandemic began.
Six years ago, I first began to argue that smartphones and social media might be the primary culprit. Teen depression started to rise around 2012, right as smartphones became common and social media use went from optional to virtually mandatory among teens. Teens also started to spend a lot less time with their friends around this time, and less time sleeping. That is not a good formula for mental health.
At the time, though, the data were somewhat limited. Most of it was from the U.S., for example. It soon became clear that teen depression was rising in other countries as well, particularly English-speaking countries. Ideally, though, it would be best to have data on teen mental health from many countries worldwide. That way, we could examine many different possible causes across different countries in a more systematic way. Plus, if mental health issues were increasing among teens in many different countries, issues unique to the U.S. (like school shootings or Trump’s presidency) would be unlikely to be the cause.
Now that type of data is finally available. At long last, we can see trends in teen anxiety across 43 countries – and we can get a better view of what’s at the root of the teen mental health crisis.
That’s thanks to the Health Behavior in School-aged Children (HBSC) study, which includes data from 680,269 teens ages 13 to 15 from 43 countries between 2002 and 2018. The survey asks teens how often they experience “feeling low,” “irritability or bad temper,”, “feeling nervous,” “difficulties getting to sleep.” Responses could range from about every day to rarely or never. Five collaborators and I analyzed this data in a new paper, with Maartje Boer taking the lead.
In the paper, we call these symptoms psychological complaints; here, I’ll call them anxiety as that is the most concise label. Anxiety is closely related to depression; one often follows the other. If teen mental health got worse in these countries over time, these items should pick up on it.
We wanted to answer two primary questions: 1) Has teen anxiety increased worldwide? and 2) if so, why?
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