American teens are having a hard time. From 2008 to 2019, the rate of U.S. high school students reporting chronic feelings of sadness and hopelessness rose 65% from one in five to one in three, according to data from the Center for Disease Control and Prevention (CDC).
That was before the pandemic. By the fall of 2021, more than a year into the pandemic, the CDC reported that 42% of high school students, and almost 60% of girls, felt chronic sadness and hopelessness. A staggering quarter of teen girls had made a suicide plan.
Social media has been blamed, as well as sleep deprivation, spikes in loneliness, and increasing academic pressure. Not as much time has been spent focusing on one of the key ways we can bolster teens’ mental health and buffer vulnerable teens: healthy, attuned relationships with their parents.
The problem is, a lot of parents are in really bad shape, too.
According to two nationally representative surveys in the U.S., completed in December 2022, about 20% of mothers and 15% of fathers reported anxiety, compared to 18% of teens. About 15% of teens reported depression, alongside 16% of mothers and 10% of fathers. In total, about one-third of teens had a parent suffering from reported anxiety of depression.
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“Our data suggest that we would be just as right to sound the alarm about the state of parents’ mental health as about teens’ mental health,” writes Richard Weissbourd, director of the Making Caring Common Project at the Harvard Graduate School of Education, one of the authors of the report called Caring for the Caregivers: The Critical Link between Parent and Teen Mental Health.
The surveys were conducted by Making Caring Common, a nonprofit which is part of Harvard’s Graduate School of Education. One included teens and young adults, and another surveyed 748 parents or caregivers living in the U.S. By asking parents and teens in the same family questions, the researchers could glean information about the dynamics of when one party, both parties, or neither were depressed or anxious.
It is not surprising that parents are struggling. Inflation has made life more expensive, the job market is strong but uncertain, and the news feels like a firehose of war, wildfires, and indictments. But depressed and anxious adults who are parents of teens are faced with the double whammy of trying to manage themselves while simultaneously supporting teens.
For adolescents’ worrying about a parent or caregiver can be destabilizing at a time when life seems rocky enough. Weissbourd’s data show that depressed teens are about five times more likely than non-depressed teens to have a depressed parent, and that anxious teens are about three times more likely than non-anxious teens to have an anxious parent. About 40% of those surveyed were at least “somewhat” worried about a parent’s mental health.
The bottom line: If we want to help teens, we need to help their parents, too.
Depressed and anxious parents can be excellent caregivers. Their own experience can build empathy and give adults language they can use to help teens navigate similar emotional terrain. But research shows that children of parents with untreated depression have higher rates of behavior problems, difficulty coping with stress and forming healthy relationships, academic problems, and mental illness. If both parents and child are suffering,the two can set each other off, with adults lacking the energy required to focus on their child’s struggles. Anxious and depressed teens will show frustration lashing out at caregivers.
The research considered survey respondents anxious or depressed if they reported experiencing significant symptoms of anxiety or depression at least half the days in the last 2 weeks, a standard measure of anxiety/depression.
Being attuned to kids' emotional states is crucial for healthy development. When infants cry, and parents attend to them, important stress regulation skills are built. When a child babbles and a parent reacts gleefully, the child learns to keep talking and exploring. Child development specialists call it “serve and return”—the baby serves up a sound or venture and the parent returns affection and love, building a bond of trust and helping the infant self-regulate. The ways we stay connected to our children change as they grow and mature. But the principle remains the same: a child’s sense of self grows stronger and matures by being known and by feeling they matter, first and foremost, to their parents or caregivers (though the influence of peers clearly grows as they age) and being attended to.
“The human relationship has the power to relieve stress, promote resilience and restore a young person's sense of safety,” says Pamela Cantor, a child and adolescent psychiatrist who specializes in trauma. Stress releases cortisol to the body and brain, which causes the feelings of fight, flight or freeze. Having an adult who loves you unconditionally can buffer that. “Relationships that are strong and trustful release the hormone oxytocin and oxytocin can restore a child’s sense of safety,” Cantor explains.
But for a parent who is depressed or anxious, it can be hard to connect with anyone, much less teens who are jedi masters at pushing parents buttons. Providing the emotional support teens need becomes harder, from maintaining important daily routines like meals and help with homework, to more existential issues of countering the negativity of life in 2023 with some hope and optimism.
Making Caring Common’s data showed that significant majorities of parents are in tune with their teens. But the less aligned parents and teens were on questions both were asked, the worse off they both were in terms of mental health. The wider the gaps, the more likely both teens and parents were to report anxiety and depression.
Depression has two main classes of causes, explains William Beardslee, chairman emeritus of children’s psychiatry at Boston Children’s Hospital. One is familial and probably involves genetic vulnerability: families with a lot of history of depression tend to have more depression. The second important factor is psychosocial adversity, negative life events such as loss of a parent, or poverty or the effects of violence and racism. “The single, probably largest risk factor for depression, is having a parent die when you're a child,” he explains.
Beardslee studied families with diagnosable mental health problems, as well as helping to pioneer interventions to help. One of his key takeaways from a longitudinal study of families with diagnosable mental illness was that the children of parents with mood disorders have higher rates of mood disorders themselves, and the second was that “even in that situation, many of the kids were resilient to doing well.”
What to do
An intervention which has been studied, found to be effective and replicated is “Family Talk” when parents who have mental health struggles discuss them with their kids in structured ways.
Beardslee pioneered "Family Talk" an intervention which has been studied, found to be effective and replicated to help parents who have mental health struggles discuss them with their kids in safe and structured ways. In families with depression, the "depression shut down the capacity to have conversations and problem solve together,” Beardslee explains. The program involves talking to each party separately—parent and child—and then helping the adult plan a conversation about what depression is, who's getting treatment, how they're going to overcome it, and then actually having the conversation in a family meeting, led by the parents and assisted by the clinician. The parent then leads the family through the conversation, assisted by the clinician.
“We found that explaining what was happening and saying the kids can be normal and happy despite depression and the parents can be very good parents despite depression was very helpful,” Beardslee said. Actively being part of, and participating in the conversation is also powerful for a depressed parent.
Weissbourd’s report also embraces the importance of communication (it cites Beardslee’s work). The key, the authors write, is making sure teens know that adults lashing out or withdrawing love is due to the illness and not the child. “It can make a big difference if a parent simply tells a teen, ‘I’m struggling with some things right now. If I seem shut down or irritable, it’s not your fault.’”
Another recommendation from Caring for the Caregivers includes making sure parents get the help they need. Depression and anxiety are highly treatable, but one has to seek help to be treated. That help must also be made more available, through federal funding and improved community education and outreach.
The report offers some other key insights for parents—depressed or not. When teens were asked what they needed from adults, the number one answer—40% of respondents chose it—was that their parents to “reach out more to ask how [they’re] really doing and to really listen.” As one teen said: “Don’t only look at me through the keyhole. Open the door.”
Adults also need to recognize that teens are feeling lost. If this sounds trite, it is not. Thirty-six percent (36%) of teens surveyed reported little or no “purpose or meaning in life” and this absence strongly correlated with depression and anxiety.
Adolescence is a period of massive brain reconstruction and identity formation. A key way that identity is formed is through meaning—finding ways to matter in the world. The tsunami of focus on “wellness” right now places too much attention on how to make ourselves happy and not enough on how helping others actually makes us happy. Study after study shows that healthy relationships and giving back make humans happier. Teens don’t see this generally in the media or modeled in public life. Beauty and perfection sell, not altruism and kindness. That leaves it to us, the caregivers, to help them find meaning.
Parents can play a huge role in this, depressed or not, Cantor says. She cites research from Anna Freud, who studied the effect of World War II on children. Why did children who stayed with their mothers—enduring years of bombing in the Blitz—fare better than those kids who were evacuated?
“Somehow in the middle of the Blitz and London being bombed a mother would say to a kid, we're gonna make it through this. Did they know that? Did they have a crystal ball? No. But they knew that what they needed to do in that moment, was to shore up their child's beliefs that this was solvable,” Cantor explains.
She believes this message is not being communicated enough. "Humans heal," she explains. "Mentally and physically. They solve things. The human experience is about solving things."
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