When kids grow into teens, they generally start separating from their parents and spend more time with their peers. But the isolation of Covid-19 has rewritten the script.
Remote schooling, quarantine orders, and the cancellation of sports teams and other activities have caused young people to lose contact with their peers, as well as with teachers, coaches, and counselors — all connections profoundly important to their development.
Those issues, along with other stressors of the pandemic, increase the risk of developing depression and anxiety in teens, says Hillary Urban, PsyD, a psychologist at Wildflower Center for Emotional Health in Oak Park and Chicago. There’s even an increase in obsessive compulsive symptoms related to a fear of becoming infected with Covid-19.
While daily life can be rocky with teens (hello, hormones), parents should stay in touch and watch for signs of mental health issues before they reach a crisis. It’s important to recognize the symptoms of anxiety (such as tension and worry) and depression (feelings of sadness and hopelessness) and know when to seek care, Urban says.
Teen mental health issues on the rise
Isolation to keep people safe from Covid-19 has undeniably taken a toll on teen mental health. Since Illinois’ first stay-at-home order in March 2020, the helpline call volume at National Alliance on Mental Illness (NAMI) Chicago increased roughly 200% to 250%. The average length of calls went from 12 to 20 minutes.
Teens called the helpline saying that they or their families were facing unemployment, food and housing insecurity, or parental relinquishment, such as when the Department of Children & Family Services removes a child from a parent’s custody or when a parent voluntary gives up their child for adoption.
“You can tell there is so much stress in the family, and it’s causing a lot of social service needs and disruption,” says Alexa James, CEO of NAMI Chicago. “Young people don’t have all the tools to manage how traumatizing this is. They can end up being directly impacted. We have prioritized our physical health and now are seeing the other side of this in mental health needs.”
And when teens can’t manage their mental health needs, they may end up in a hospital’s emergency department (ED) — often the first stop when a child is experiencing a mental health emergency.
During the pandemic, emergency departments across the country saw more teens than ever for mental health-related visits. From mid-April through October of 2020, EDs reported a 31% increase in mental health visits from children age 12 to 17 compared to 2019, according to the Centers for Disease Control and Prevention.
James says it’s best to seek professional help early — when teens begin experiencing impairment in functioning at school or home — rather than wait for them to reach a crisis state. A crisis state can involve language such as “I shouldn’t be here anymore” or “The world would be better without me.”
Checking in on teen mental health
Depression appears differently in each teenager, which is why emotional check-ins play a key role, James says. While adults may have learned how to express emotion and label it in a healthy way, teenagers may not have the maturity and vocabulary to vocalize their emotional experiences. If you notice that your teen’s behavior has changed, be present, support your teen without judgment, and ask questions about wellness, such as “How are you sleeping?” and “Has your sleep changed?”
To help them build resilience — the ability to manage high-level distress in life without it having a traumatic impact — show them how to find joy in what’s good in their lives, as opposed to focusing on the bad. And don’t forget that you can inspire that joy by finding fun ways to connect with them.
In light moments, when teenagers are feeling well, James suggests setting expectations with them on how to handle the difficult times. “Take the opportunity to say, ‘I knew you were sad last weekend, and I didn’t know what to do. What do you need from me when you feel that way?”
For Elk Grove Village mom Ellen Smith and her 17-year-old son Elliott, whose names have been changed for privacy, connection comes from playing music and dancing. They also schedule something to look forward to each week, like ordering takeout from their favorite restaurant.
Most importantly, Smith checks in with Elliott daily to find out what’s on his mind. “Oftentimes parents get so busy with wanting their kids to do well, they don’t show them how to get there,” Smith says. “To create open space, where kids can feel comfortable sharing whatever they have on their mind, that’s where we as parents really have to step up our game.”
Symptoms of anxiety and depression
Any change in everyday functioning should sound the alarm for parents to respond. If teens lose interest in school — skip homework or classes, have difficulty focusing on assignments, or get falling grades — parents should be curious and ask teens about what is going on in their lives.
But make sure to be validating and supportive when they confide in you, by replying “That sounds like it’s pretty rough,” says Frederica Malone, clinical coordinator of NAMI Chicago’s Helpline. If teens confide something heavy, parents can respond by telling them it is okay to feel that way. “It helps pave the way for trust, where they are more likely to start opening up about their feelings.”
If teens are in a crisis state, exhibiting suicidal ideation or self-harm, take them to the emergency room to be evaluated and connected to services, such as individual or group therapy or an outpatient-based program.
Other general signs of anxiety and depression include:
- Feeling more irritable.
- Experiencing more conflict in their relationships with peers, friends, and family.
- Having less desire to socialize with friends.
- Acting out or violating rules.
- Engaging in self-harm — scratching, hitting, or cutting.
- Experiencing physical issues, such as stomachaches, difficulty breathing, and chest tightness.
- Having sleep issues, such as trouble falling asleep, staying asleep, or sleeping more or less than usual
- Displaying changes in eating habits, such as an increase or decrease in appetite and significant weight loss or gain.
Anxious teens might have trouble processing information as quickly as they used to, or they might have difficulty focusing or recalling information. Additional red flags are low motivation, tearfulness, and an increase in impulsivity, Urban says. Teens may also start experimenting with drugs for the first time or increase their substance use.
NAMI staff is available — with a free helpline, support groups, and other resources — to help parents figure out how to have those difficult teen mental health conversations, James says. “What our kids want is to feel seen, noticed, and loved.”
It’s important to communicate openly with them and share some of your own struggles during this time, Urban says. “Let them know, ‘This is hard for me too.’ It can be very validating.”
Parents can encourage self-care for their teens and for themselves. “Make sure we, as adults, are well so that we have the capacity to give that to our children,” James says.
Realistically, she knows nobody is going to be an A+ parent all the time. “At the end of the day, if your kids feel loved and secure,” James says, “that’s more important than being able to sign in to Zoom.”
Families can call NAMI Chicago’s free helpline (833-626-4244) for counseling or to be connected to services. Just be sure to make the call together with your teen, James says, because it shows teens they are loved, valued, and part of the solution, not the problem.