Imagine for a moment that the future is going to be even more stressful than the present. Maybe we don’t need to imagine this. You probably believe it. According to a survey from the Pew Research Center last year, 60 percent of American adults think that three decades from now, the U.S. will be less powerful than it is today. Almost two-thirds say it will be even more divided politically. Fifty-nine percent think the environment will be degraded. Nearly three-quarters say that the gap between the haves and have-nots will be wider. A plurality expect the average family’s standard of living to have declined. Most of us, presumably, have recently become acutely aware of the danger of global plagues.
Suppose, too, that you are brave or crazy enough to have brought a child into this world, or rather this mess. If ever there were a moment for fortifying the psyche and girding the soul, surely this is it. But how do you prepare a child for life in an uncertain time—one far more psychologically taxing than the late-20th-century world into which you were born?
To protect children from physical harm, we buy car seats, we childproof, we teach them to swim, we hover. How, though, do you inoculate a child against future anguish? For that matter, what do you do if your child seems overwhelmed by life in the here and now?
You may already know that an increasing number of our kids are not all right. But to recap: After remaining more or less flat in the 1970s and ’80s, rates of adolescent depression declined slightly from the early ’90s through the mid-aughts. Shortly thereafter, though, they started climbing, and they haven’t stopped. Many studies, drawing on multiple data sources, confirm this; one of the more recent analyses, by Pew, shows that from 2007 to 2017, the percentage of 12-to-17-year-olds who had experienced a major depressive episode in the previous year shot up from 8 percent to 13 percent—meaning that, in the span of a decade, the number of severely depressed teenagers went from 2 million to 3.2 million. Among girls, the rate was even higher; in 2017, one in five reported experiencing major depression.
An even more wrenching manifestation of this trend can be seen in the suicide numbers. From 2007 to 2017, suicides among 10-to-24-year-olds rose 56 percent, overtaking homicide as the second leading cause of death in this age group (after accidents). The increase among preadolescents and younger teens is particularly startling. Suicides by children ages 5 to 11 have almost doubled in recent years. Children’s emergency-room visits for suicide attempts or suicidal ideation rose from 580,000 in 2007 to 1.1 million in 2015; 43 percent of those visits were by children younger than 11. Trying to understand why the sort of emotional distress that once started in adolescence now seems to be leaching into younger age groups, I called Laura Prager, a child psychiatrist at Massachusetts General Hospital and a co-author of Suicide by Security Blanket, and Other Stories From the Child Psychiatry Emergency Service. Could she explain what was going on? “There are many theories, but I don’t understand it fully,” she replied. “I don’t know that anyone does.”
One possible contributing factor is that, in 2004, the FDA put a warning on antidepressants, noting a possible association between antidepressant use and suicidal thinking in some young people. Prescriptions of antidepressants to children fell off sharply—leading experts to debate whether the warning resulted in more deaths than it prevented. The opioid epidemic also appears to be playing a role: One study suggests that a sixth of the increase in teen suicides can be linked to parental opioid addiction. Some experts have suggested that rising distress among preteen and adolescent girls might be linked to the fact that girls are getting their period earlier and earlier (a trend that has itself been linked to various factors, including obesity and chemical exposure).
Even taken together, though, these explanations don’t totally account for what’s going on. Nor can they account for the fragility that now seems to accompany so many kids out of adolescence and into their young-adult years. The closest thing to a unified theory of the case is that smartphones and social media are to blame. But that can’t explain the distress we see in kids too young to have phones. And the more the relationship between phones and mental health is studied, the less straightforward it seems. For one thing, kids the world over have smartphones, but most other countries aren’t experiencing similar rises in suicides. For another, meta-analyses of recent research have found that the overall associations between screen time and adolescent well-being range from relatively small to nonexistent. (Some studies have even found positive effects: When adolescents text more in a given day, for example, they report feeling less depressed and anxious, probably because they feel greater social connection and support.)
A stronger case can be made that social media is potentially hazardous for people who are already at risk of anxiety and depression. “What we are seeing now,” writes Candice Odgers, a professor at UC Irvine who has reviewed the literature closely, “might be the emergence of a new kind of digital divide, in which differences in online experiences are amplifying risks among [the] already-vulnerable.” For instance, kids who are anxious are more likely than other kids to be bullied—and kids who are cyberbullied are much more likely to consider suicide. And for young people who are already struggling, online distractions can make retreating from offline life all too tempting, which can lead to deepening isolation and depression.
This more or less brings us back to where we started: Some of the kids aren’t all right, and certain aspects of contemporary American life are making them less all right, at younger and younger ages. But none of this suggests much in the way of solutions. Taking phones away from miserable kids seems like a bad idea; as long as that’s where much of teenagers’ social lives are transacted, you’ll only isolate them. Do we campaign to take away the happy kids’ phones too? Wage a war on early puberty? What?
This article originally appeared in The Atlantic.