Few would argue against the fact that young people throughout the Western world are experiencing a mental health crisis. From my vantage point in general practice, levels of unhappiness, anxiety and self-harm in this age group seem to be sky rocketing. Secondary care services for mental health in children and teenagers are completely overwhelmed and this is despite the fact that they only deal with the sickest tip of a very big iceberg.
In the relatively short span of my medical career I have seen the use of antidepressants in teenagers go from a rarity to being fairly common place, albeit always under specialist guidance. When I started in general practice I would expect a consultation with a teenager to be a quick review of a sore throat or a rash, but my expectation when I see a teenager on my list today is of a consultation about complex, emotional issues.
Something seems to be going terribly wrong. As you will see elsewhere on this blog, I think social media has to shoulder a huge proportion of the blame. The correlation between the rise of social media use and the rise of mental health problems in young people is difficult to ignore, causality is more difficult to prove although there is a growing body of evidence to suggest that the utterly abnormal social environment in which our children are developing is truly damaging to their psychological wellbeing. No doubt other factors are also at play but, whatever the cause, the situation is becoming dire.
Perhaps we are simply better now at recognising when young people are suffering but, to me, what is happening now does seem to be a genuine step change from what went before. What is also apparent, is that we really don’t know how to manage this. Despite our ever increasing efforts to foster resilience and wellbeing, and despite the increasing availability of treatment, the problem continues to worsen. Clearly, we are doing something wrong.
When I was growing up in the 1990s, teenagers were unhappy and moody. It was called teenage angst. This phrase no doubt trivialised much of what was going on and I am sure many very distressed teenagers were swept into the heap of angsty but otherwise well teenagers by the use of this phrase. I suspect if I was to tell a teenager or their parent today that they were suffering from ‘teenage angst’ it would be a speedy route to a complaint. But I would defend this expression on two counts. First, it normalised the feeling of negative emotions that we all feel to a greater or lesser extent. Secondly, and perhaps more importantly, it suggested that there was an end in sight – once you were no longer a teenager, you would no longer feel like this.
We now diagnose our children with anxiety and depression. These words were hardly in my lexicon as a teenager. They are really formal medical diagnoses and yet their use has drifted into everyday speech, contributing to the increasing medicalisation of human experience. People are no longer shy but suffering with ‘social anxiety’. People are no longer moody but ‘emotionally dysregulated’, no longer sad but ‘depressed’. No longer do ‘exams make me nervous’, now ‘exams give me anxiety’.
The problem with labelling things in this way is that it suggests pathology and longevity. I can’t help but feel that telling a child that they have something wrong with them isn’t in some way more damaging than helping them to understand that sometimes it is OK to feel sad or worried.
I do not want to diminish what these children are currently suffering. I genuinely believe they are more unhappy on a much deeper level than the majority of people in generations gone by. But I do feel that whatever we are doing now, we are doing it wrong. We pour money and resource into treating these children, we put counsellors in schools, we expand the capacity of our mental health services, and we medicate our children. And yet still the avalanche of mental ill health in young people gathers pace.
All of the problems that our children face have been made worse through the covid pandemic. At the start of this crisis there was at least hope that this could be some kind of societal reset, that it was a chance for us to re-evaluate how we lived and create a less toxic society for our children to grown up in. And yet we are stumbling straight back into old ways. We have to find a way for our children to be less unhappy and this way should probably not be through treating them all as patients.
Read more at: