By Katie Greeley
The State of Teen Mental Health
For the past few decades, concerns about adolescent health have dramatically shifted. Forty years ago, binge drinking, drinking, and driving, teen pregnancy, smoking, and illicit drug use topped the list. But when asked about the most pressing issues their generation faces today, Generation Z and Generation Alpha—youth now 11 to 24 years old— commonly cite anxiety, depression, suicide, self-harm, and other severe mental health concerns. Researchers echo these concerns. From 2001 to 2019, the suicide rate among American youth ages 10 to 19 increased by a staggering 40%, and emergency room visits for self-harm rose by 88%.
These numbers are not unique to the United States. Adolescents and young adults worldwide are facing similar mental health challenges. While the isolation of a global pandemic and the use of social media platforms like Instagram, Snapchat, and TikTok are factors in the rising rates of anxiety and depression among adolescents, researchers have identified these factors are only part of a trend that began well before the current decade. Simultaneously, alcohol and other drug use continue to be major concerns for parents.
Parents should be aware that adolescent mental health and substance use are intertwined. In order to effectively support teens, parents need to grasp the unique environmental and developmental challenges facing adolescents in 2023.
What is Causing this Crisis?
To fully grasp the teenage mental health crisis, it’s important to understand the developing adolescent brain. During puberty, the brain prepares young people to start to process new social information – keeping up with peers’ academic and athletic performance, dating, friendships, politics, climate change, and other global events. Not only are teens asking themselves the questions, “How do I measure up to my peers?” or “How do I fit in?” but they are also forced to assess how they fit into the world at large. Information and realities previously unnoticed or disregarded as children suddenly become critical to adolescents, and many times overwhelming. Today’s young people are exposed to more social information at an earlier age than any other previous generation, but the realities of a developing brain remain unchanged.
Additionally, in the past few decades, a notable mismatch has emerged: puberty for both girls and boys starts earlier. However, the rest of the brain, particularly the parts that help process this influx of stimulating information, hasn’t developed any faster.
It’s like giving a young person with a learner’s permit the keys to a high-speed race car in the midst of a torrential storm. Teens hit puberty earlier and are inundated with information from peers and sources like social media, online streaming services, and the 24/7 news cycle—they’re navigating an accelerated and overwhelming journey without the fully developed skills to manage it. Most parents are focused on the fear of their child falling behind in the race. The more important question for parents is actually simpler: How do we prevent the crash?
The Connection Between Mental Health and Substance Use
Several decades ago, adolescents faced predominantly externalised risks in the environment—behaviours and activities like binge drinking, drunk driving, cigarette use, teen pregnancy, and lack of safer sex practices. These risks have markedly declined over the last four decades. Today, youth confront a new set of predominantly internalised risks— earlier onset of puberty experienced by many of adolescents combined with an influx of environmental and social information has resulted in mounting stress, anxiety, and depression. Numerous studies consistently highlight stress, anxiety, or depression as the primary triggers for young people to start using alcohol and other drugs. Why? Just as with adults, getting drunk or high provides immediate relief for young people trying to alter their mood or cope.
The adolescent brain is uniquely vulnerable. When teens experience stress, sadness, and anxiety, they actually experience it more acutely on an emotional and neurological basis than adults. The amygdala, the area of the brain responsible for processing emotions and stress lies in the midbrain, also known as the limbic system. The limbic system is the same area of the brain responsible for pleasure. In an adolescent brain, the limbic system is underdeveloped, making adolescents more reactive to stressful stimuli compared to adults and more driven to seek pleasure or reward in response.
Additionally, the prefrontal cortex — the brain’s hub for judgment, decision-making, and assessing long-term consequences — is the final area of the brain to mature. The underdeveloped frontal lobe and an overcharged limbic system mean young people are more likely to look to substances to quickly alleviate negative emotional states.
The midbrain’s limbic system operates like a powerful magnet, irresistibly drawn to pleasures, while the prefrontal cortex is akin to a partially constructed dam, not yet fully capable of holding back the torrent of pleasure-seeking impulses. This makes teens more susceptible to impulsive, potentially detrimental choices rather than relying on healthy coping mechanisms that can help manage stressors. Elevated stress levels further amplify this vulnerability, creating a cycle that is a risk factor nudging teenagers towards substance use as an escape route.
What’s concerning is if teenagers turn to alcohol and drugs as a coping mechanism for anxiety, depression, or stress in this vulnerable developmental stage, any substance use heightens their risk of developing an addiction. Additionally, alcohol and other drugs can actually exacerbate the very symptoms they’re trying to alleviate, amplifying negative states. Substance use prevents adolescents’ still-forming brains from developing resilience over time to manage day-to-day stressors without alcohol or other drugs.
The Solutions For Students
At Prevention Ed, we collaborate with schools to bolster their existing social-emotional learning programs and engage students in meaningful conversations. One globally recognised, evidence-based therapeutic approach for supporting teens with mental health issues is cognitive behavioural therapy (CBT). Our curriculum introduces key CBT skills and concepts, focusing on the relationship between thoughts, feelings, and behaviours. We teach students to explore key questions: What am I feeling? What am I experiencing? How do I cope with that? Prevention Specialists aim to help students monitor these moments of intense emotion and provide them with evidence-based skills to pause, identify, and respond instead of react. These are the same skills used in high-quality, formal mental health treatment, but can be applied to keep healthy kids healthy.
The goal is twofold: First, to reduce the likelihood of a young person making an unhealthy choice in a stressful moment and help adolescents recognise that feelings such as stress, sadness, or being overwhelmed are natural and often temporary, and second, to equip them with tools to manage these emotions, develop healthy coping mechanisms, and mature into more rational, reflective individuals.
By establishing these skills during their formative years, teenagers are paving the way for future success. They are building a blueprint that will equip them, as adults, to confront challenges with grace, persistence, and healthy strategies that serve them throughout their lives.
The challenges faced by today’s adolescents are multifaceted and demand attentive, informed support from parents. Engaging in open dialogues, staying educated on current adolescent challenges, understanding the developing teenage brain, actively participating in their emotional and mental well-being, and promoting the delayed use of alcohol and other drugs is paramount.
It’s vital for parents to view themselves as role models for preserving mental health—how you respond to stress plays a crucial role in shaping how your adolescent will manage their own. Provide teens with tools or strategies to handle intense emotions, and consistently reinforce the value of seeking help when needed. Ask yourself: What coping skills do I model for my teenager? Do I reach for a glass of wine, or do I get in a workout, call a friend, or take a relaxing bath? By openly discussing your own mental health and wellness in an age-appropriate way, you’re giving your teen some ideas about how to care for themselves. Encourage your teen to find activities that work for them and prioritise self-care as a family.
Lastly, in a world inundated with misinformation, ensure your teen has access to accurate information. For example, make sure they recognise that using cannabis to address anxiety is not developmentally suitable, and recent research shows that it actually heightens their risk of experiencing anxiety or depression later on in life. Similarly, relying on alcohol to manage social anxiety can hinder the development of essential social skills needed now and in the future. Proper sleep, awareness of their family’s mental health and addiction histories, engagement in extracurricular activities like sports, art, music, and dance that produce natural highs, and understanding the symptoms of anxiety and stress—while normalising that seeking help when feeling overwhelmed is a strength—are the best protective measures for young people.