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Two Worsening Mental Health Issues for Teens

One expert explains why teen mental health treatment needs a paradigm shift.

Key points

  • Emergency rooms have seen a major spike in teens seeking immediate mental health treatment.
  • People are more comfortable talking about and listening to experiences with mental health.
  • Group therapy is so important and positive in teen treatment.
Nuno Silva / Unsplash
Nuno Silva / Unsplash

Adolescence is a difficult time for anyone to live through. But in today’s era of social media, easy access to substances, and unprecedented misinformation, the perils of being an adolescent can seem never-ending.

Here are a few of the realities of being a teenager in 2022:

  • A survey from Harvard’s Graduate School of Education found that the loneliness spike during the COVID-19 pandemic was most intense for teenagers.
  • Teens, on average, spend multiple hours per day on social media.
  • Today’s teens tend to get less sleep than teens of previous generations, and they have less social interaction.

All of this has led to an alarming spike in teenage mental health issues. The situation is so severe that it has caught the attention of legislators at the state and federal levels. A national task force on mental health recently recommended that all children get screened for anxiety regardless of whether they have clinical anxiety disorder.

I recently spoke to Dustin Wagner, a Licensed Professional Counselor and CEO of Paradigm Treatment Center, an adolescent mental health treatment provider in California and Texas, to get his perspective on what can be done to address the problem. Here is a summary of our conversation.

Mark Travers: Many leading psychologists, psychiatrists, and physicians have been calling attention to what they see as a growing mental health crisis among today’s youth. What is your take on the scope of the problem?

Dustin Wagner: I’ve been working in this field for almost 15 years and have seen a major spike in our mental health crisis. From my perspective, much of the crisis stems from teens being too isolated, which in turn has created too much self-awareness because of the lack of real relationships.

The increase in isolation and lack of social feedback has increased self-critical hyperawareness—meaning teens are very focused on their own feelings but are missing the important tools that allow some reality testing. This creates an environment where teens are too vulnerable to be negatively impacted by social media and the influence those platforms have. These dynamics directly feed into the depression and anxiety loop that we see in our clients.

Bigger picture, teens are just overloaded. Overloaded with information and access to things that our brains just aren’t built to compute and handle, like all the strains of the world. Teens are lacking a lot of resiliency at this point.

Travers: Are you noticing an increased amount of substance use among today’s youth? How does that feed into the current mental health crisis?

Wagner: We've been seeing an increase in drug and alcohol use since the pandemic, not just teens but adults too. In my experience, there is a lot of self-medicating happening these days. Sadly, for those teens and young adults struggling with depression and anxiety, substances do help alleviate some of those symptoms, at least at first.

I worry about some of the mixed messages we are giving our youth because self-medicating is becoming a bit too normalized. Brains develop well into someone’s twenties. A brain wrestling with depression and anxiety is in many ways an overactive and overstressed brain; substance use only exacerbates symptoms. The struggle is for teens to have enough space and energy to learn and practice therapeutic skills instead of quickly turning to immediate relief and distraction.

Travers: What’s your take on efforts to address the mental health crisis?

Wagner: I’ve been encouraged to see that it is more and more common for people to talk about mental health and acknowledge that we are in a crisis. We’ve seen a huge spike in people using therapeutic terms and vernacular, which can create an environment where people are more comfortable talking about and listening to one another’s experiences with mental health.

I do worry that we’ve become a bit too quick to slap labels and diagnoses on feelings and experiences. What I mean is we use terms like “depressed” and “trauma” now instead of talking things out and working towards actions and solutions. Labels are helpful but they can also be a bit too general and a way to avoid the actual issue at hand.

In all, it is good to see that more outpatient and residential programs are opening up. Teens and families need access to intensive services. Teens need earlier interventions to avoid issues growing into major issues.

Travers: Do you conduct any primary research? If so, how does it inform your work?

Wagner: Yes, we are very committed to research and outcome studies. Hospital emergency rooms have seen a major spike in teens seeking immediate mental health treatment. We took on a major research project last year where we wanted to better understand what leads teens to a crisis situation that requires hospitalization and what predicts success in treatment to help ensure a teen does not relapse into a hospital crisis in the future.

We’ve also conducted research to better understand teen social media use. We learned a lot from this study. One thing that stood out to us is that teens know that using social media to cope with unpleasant feelings often only makes those feelings more intense. But, despite knowing this pattern, teens continue to engage in high levels of use anyways. This study really enforced in us that teen social media use can easily turn into a problem and that this is something we need to place more focus on.

We also use internal research and outcome measures. Specifically, we want to know if our treatment is having a positive impact and if we are effective with the teens we are treating. We assess someone’s depression, anxiety, and stress scales. We are also measuring someone’s readiness to change. All of this is done during treatment and post-discharge. We want to know what works well and where we need to make changes in our programming.

Travers: Are there any therapeutic modalities that have been showing particular promise among patients?

Wagner: We focus heavily on evidence-based practices. But, as I shared, we are putting more and more emphasis on problematic social media use and social interaction.

Group therapy is so important and positive in teen treatment. Teens need real-time feedback and support. Honest communication, opportunities to set boundaries, and chances for teens to ask for what they need are vital in treatment and key to addressing mental health struggles. What is great about a residential treatment setting is that we get to practice this all day, every day. And not enough can be said about the importance of family therapy, which we prioritize and see the biggest payoff.

Travers: What advice do you have for parents who have children who are struggling with their mental health?

Wagner: I speak with a lot of parents who are contemplating bringing their loved one into residential treatment. We completed a study where we interviewed the parents of our teen clients. This study was priceless in that it allowed us to really hear about the parenting journey. Teen mental health and finding the right treatment is not easy or straightforward. And often, parents and teens wait too long to intervene and seek professional help.

Parents deal with a lot of guilt which can create some stagnation and navigating mental health can be a very isolating experience for a parent. We encourage parents to reach out for help and support, especially now that more and more people are more educated about mental health and have probably been impacted on a personal level in some way.

Travers: What would you say to young people struggling with their mental health but maybe don’t know how to ask for help, or even who to ask?

Wagner: For young folks, they just need to know that they’re not alone. Reach out to those around you because they have also lived their life and almost everyone has struggled with these things or know someone who has. They are not going to judge you, again because a lot of the stigma around mental health has been erased in the past ten years. I would encourage them not to wait to talk about it and to not isolate in those struggles.

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