It's tough to be a teenager. Hormones kick in, peer pressures escalate and academic expectations loom large. Kids become more aware of their environment in the teen years — down the block and online. The whole mix of changes can increase stress, anxiety and the risk of depression among all teens, research has long shown.
But a recent study published in the journal Pediatrics suggests many more teenage girls in the U.S. may be experiencing major depressive episodes at this age than boys. And the numbers of teens affected took a particularly big jump after 2011, the scientists note, suggesting that the increasing dependence on social media by this age group may be exacerbating the problem.
Psychiatrist Ramin Mojtabai and colleagues at Johns Hopkins University Bloomberg School of Public Health wanted to know whether rates of depression among teens had increased over the past decade. They analyzed federal data from interviews with more than 172,000 adolescents. Between 2005 and 2014, the scientists found, rates of depression went up significantly — if extrapolated to all U.S. teens it would work out to about a half million more depressed teens. What's more, three-fourths of those depressed teens in the study were girls.
The findings are just the latest in a steady stream of research showing that women of all ages experience higher rates of depression compared to men, says psychologist and author Catherine Steiner-Adair. And no wonder, she says — despite gains in employment, education and salary, women and girls are still "continually bombarded by media messages, dominant culture, humor and even political figures about how they look — no matter how smart, gifted, or passionate they are."
Today's constant online connections — via texting, Facebook, Instagram and Snapchat, — can exacerbate that harsh focus on looks and other judgments from peers, she says. The uptick in teen depression Mojtabai found after 2011 could be evidence of that.
Mojtabai says girls, in particular, "are more likely to use these new means of communication, so may be exposed to more cyberbullying or other negative effects of this latest social media."
The effects can feel devastating, says Steiner-Adair.
"We know girls are very vulnerable to defining themselves in comparison to others," she says. Her young female patients often tell her they get their "entire identity" from their phone, she says, constantly checking the number of "tags, likes, Instagram photos and Snapchat stories."
Steiner-Adair urges schools to be proactive in trying to reduce teens' feelings of being "left out" or judged. One tool, she says, might be a course in mindfulness — a form of meditation that has been shown to offer measurable health benefits and can help reduce anxiety and depression.
Such training can help teach kids that their brain "on tech" actually needs a rest, Steiner-Adair says. Mindfulness training teaches the value of solitude and can help practitioners calm the urge to constantly check the phone — a useful skill for people of all ages and gender.
Meanwhile, Mojtabai says, parents and family doctors, as well as teachers and school counselors, should be on the lookout for any behavioral changes in the teens they live and work with that might be signs of depression. Symptoms can include changes in sleep patterns, appetite or energy, or a growing inability to pay attention and concentrate.
Even just one counseling session to evaluate such symptoms, Mojtabai says, can help get teens back on the right track.
RACHEL MARTIN, HOST:
It's tough to be a teenager. It's especially tough for girls, who are more vulnerable to depression than boys. New research shows that's getting even worse. As NPR's Patti Neighmond reports, girls are now three times more likely than boys to suffer major depression.
PATTI NEIGHMOND, BYLINE: There are lots of reasons why depression increases once a child becomes a teenager. Hormones kick in. Peer pressure escalates - so does academic expectation. Teens become more aware of their environment - economic pressures and violence in the neighborhood. This is true for both boys and girls. But psychologist Catherine Steiner-Adair says for girls, cultural pressures make things even worse.
CATHERINE STEINER-ADAIR: You are judged profoundly by how you look. Girls are still being given the messages that shopping and dieting are two essential tools for being successful, no matter how smart you are, how brilliant you are or how gifted or passionate you are.
NEIGHMOND: At Johns Hopkins School of Public Health, psychiatrist Ramin Mojtabai wanted to know whether depression was increasing among teenagers. He analyzed federal data from interviews with more than 172,000 adolescents and found that between 2005 and 2014, depression went up significantly, an estimated half a million more teenagers nationwide, three-quarters of them girls. Notably, he says, there was a sharp increase after 2011, around the same time the newest social media tools got going. This is especially true, he says, for girls.
RAMIN MOJTABAI: Young girls are more likely to use these new means of communication. And also, young girls might be more exposed to cyberbullying or other negative effects of this social media.
NEIGHMOND: For example, when teen girls eagerly go online to check in with their friends, psychologist Steiner-Adair says they can be in for an upsetting surprise.
STEINER-ADAIR: Girls describe, well, they'll go online to, you know, quote, "chill from doing homework." "I'll take a five-minute break." You know, that's what they say. I'm just going take a five-minute break. I'm going to go online. I'm going to meet up with my friends. And suddenly, they see that in two days, everyone's having a sleepover or going to a party that they knew nothing about.
NEIGHMOND: Their heart sinks. And frankly, the five-minute chill, she says, hijacks the homework.
STEINER-ADAIR: They can't go back and concentrate. They don't know what to do with this information. You don't want to look needy. You don't want to look desperate. You can't believe that one of the girls who you just spoke with at school that day said nothing about it to you.
NEIGHMOND: Which often causes feelings of sadness, stress and anxiety. Steiner-Adair's written and often speaks about the paradox of social media, the benefit of being connected with friends or family 24/7 versus a compulsion to check in almost constantly.
STEINER-ADAIR: For girls in particular, they will say to me things like, oh, my whole identity - I get my identity from my phone. And so I say - well, what do you mean you get your identity from my phone? She goes oh, my God, are you kidding me? Like, what Snapchat - you know, whose story am I in? What Insta (ph) have I been tagged? Where haven't I been?
NEIGHMOND: Which can put them in a state of near-constant anxiety, which only increases their risk of depression. Psychiatrist Mojtabai says teens who become depressed are often not diagnosed. Only 42 percent ever receive treatment.
MOJTABAI: It's of concern that the majority of these kids do not receive any attention. Now, this attention does not need to be a medication treatment. It could be a few sessions of counseling.
NEIGHMOND: Even one counseling session, he says, can be helpful. Mojtabai also says parents, school counselors and family doctors should be on the lookout for symptoms of depression - changes in sleep, appetite or energy, a growing inability to pay attention or concentrate. Steiner-Adair suggests schools get proactive and help kids negotiate a world of constant online activity. One idea she says - a course in mindfulness.
STEINER-ADAIR: How to understand their brains on tech and how their brains need a rest and how to self-regulate, how to manage ourselves.
NEIGHMOND: And, she says, most importantly, understand the value of solitude and how to calm the urge to constantly check the phone.
Patti Neighmond, NPR News. Transcript provided by NPR, Copyright NPR.