Using more than 59,000 responses from surveys on Icelandic teens, researchers found that rates of depression and worsened mental well-being increased among both adolescent boys and girls during the pandemic compared to earlier levels, but girls were significantly more affected. However, the data also showed that substance use among 15- to 18-year-olds dropped during the pandemic—a silver lining on an otherwise gloomy report. Let’s take a closer look at the latest research on teens’ mental health during the pandemic, along with expert insight into the ways to support young adults as the world slowly gets back to normal.
The Study
For this study, researchers set out to understand how the pandemic affected mental health problems and substance use among adolescents of different ages and genders using data from the Youth in Iceland study. That study invites all teenagers up to age 18 in Iceland to complete a survey every two years. The researchers looked at a total of 59,701 survey responses collected in 2016, 2018, and 2020. The participants included roughly equal numbers of boys and girls, most of whom lived in two-parent households in the capital area of Reykjavík. The results showed that depressive symptoms and mental well-being got worse among all adolescents in 2020 compared with pre-pandemic levels. “Although we need to conduct more studies on this subject, I would contend that adolescents are affected far more than any age group, as many of them depend upon social interaction and activities to attain contentment,” says Leela Magavi, MD, psychiatrist and regional medical director at Community Psychiatry in Newport Beach, California. “Many adolescents have expressed considerable anhedonia, or inability to feel pleasure when partaking in once preferred activities.” People between 16 and 18 years old were more negatively affected than younger teens during the pandemic, which may have been at least partly a result of disruptions in education. While teens age 13 to 15 continued to attend school in person, the older students typically switched to remote learning in Iceland. The authors note that older teens tend to have a higher need for autonomy and peer interactions—both of which were limited under lockdowns and physical distancing mandates—than younger adolescents. “Developmentally, teens are seeking independence, peer connections, and greater self-expression as they formulate their identities,” explains Rebekah Roulier, LMHC, deputy director at Doc Wayne Youth Services in Boston. “However, the reduction in social experiences increased dependency on the family unit, and created the loss of milestones (like first jobs or graduation celebrations), which has overwhelmed most teens’ ability to cope.” When comparing genders, the researchers found the jump in the rates of depressive symptom scores in 2020 compared to previous years was significantly higher among girls than boys. Mental well-being also worsened over time, with teen girls showing overall lower scores than boys. The researchers say that while the study was conducted in Iceland, its findings can be generalizable to teens in the U.S. or other countries who also endured lockdowns, remote learning, and prolonged separation from friends. “Adolescent and young adult mental health may have been especially negatively impacted because of their limited previous experience in living through and navigating extended crisis. Most older adults can look back on previous challenges in their lives to gain perspective and the confidence they need to trust that they will be able to navigate through the challenges,” says Sarah Harte, LICSW, director at The Dorm, which offers therapy and other services to support the well-being of young adults. She adds: “It is possible that teenagers and young adults have not yet had significant challenges to navigate, resulting in less self-trust that they have the tools to get through to the other side of the crisis.”
Lower Rates of Substance Use
Interestingly, participants in this study did experience one potential benefit during the pandemic: lower rates of substance use. Teens between the ages of 15 and 18 drank less alcohol and smoked fewer cigarettes (including e-cigarettes), perhaps due to less social pressure and reduced access to those substances amid restrictions that kept them away from peers. That could lead to long-term mental health benefits for teens, experts say. “While teens’ brains and impulse control are developing, [delaying] any use of substances, especially those that are addictive, can be protective against long-term struggles with addiction in their adulthood. Time will tell if a ‘positive pandemic effect’ on substance use over their lifespan occurs,” says Roulier.
Why Girls Faced Worse Mental Health Outcomes
A variety of factors may have contributed to teen girls’ worsening rates of depression and other mental health outcomes in 2020. Part of this trend may be related to hormonal changes girls go through during puberty that make them more sensitive to interpersonal stressors, the study authors say. “While both male and female teenagers are significantly impacted by hormone changes through puberty, teenage girls often experience increased anxiety and depression as their hormones cycle,” Harte explains. Dr. Magavi adds: “Many girls are also empaths and absorb others’ emotions, which at a tumultuous time like this, could lead to an emotional breakdown. Without listening to our own emotions, it is difficult for us to be fully present when listening to others.” There are also differences in the ways teen girls experience and express mental health challenges, says Roulier. “Adolescent girls exhibit mental health symptoms differently than adolescent males, and girls at this age typically have more skills around the expression of difficulties,” she says. That may mean that the actual rates of depressive symptoms and other negative mental health outcomes may be higher than the study results indicate, Roulier says. “Teenage boys are not often socialized to be aware of or discuss their emotional struggles, so they may be less able to identify how they are feeling, or may feel more shame about self-reporting feelings of depression and anxiety,” adds Harte.
Helping Teens Recover
Despite the differences in genders, the overall worsening mental health outcomes among all teens indicate a need for additional support for this group as the world recovers from the pandemic. “Schools have the opportunity and momentum to meet the moment by integrating emotion management skills into the curriculum, increasing mental health staffing, and creating safe spaces for students to come together to support each other,” Harte advises. At home, parents can try to engage in open communication with their teens and encourage them to open up about what they’re going through. Dr. Magavi gives an example of what a parent could say: “I have noticed you are not talking to your close friend as much as you used to. This has been such a tough time. I am here for you to support you in any way I can whenever you are ready.” “Communication can be as simple as asking open-ended questions and actively listening,” she adds. Parents should also look out for warning signs that their teen may need professional mental health support. These include:
sleeping more or lesschanges in diet and weightpersonality shiftsdrop in school performanceavoiding social connectionstrouble focusing on daily tasksemotional withdrawalparanoid behavior
“In particular, it is important to seek out professional mental health support if they disclose that they are thinking of suicide or engaging in self-harm or other high-risk behaviors,” says Harte. The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page. The results indicate a need for greater emotional support for teenagers as the world returns to normal. Educators may consider implementing emotion-management skills into their lessons, while parents may want to practice open communication at home. Therapy can also be a helpful tool in giving teenagers a safe space to work through their emotions and develop healthy coping sills.
