Part 2: Observations from the therapy office
In my last video and blog post, I discussed why the pandemic might be affecting teens’ mental health in unique ways. Here, I’d like to share some observations from working with teens’ during the pandemic – from the days of scrubbing groceries with Clorox wipes, to googling: “how do you pronounce omicron?’”. What follows are some trends I’ve noticed, and of course do not represent the full scope of teens’ experience during the pandemic.
I’ll refer to these trends as:
- “The great malaise” (“this doesn’t feel real…”)
- “The social anxiety swing”, and
- A Rise in Self-harm
The great malaise:
As unbelievable as it now seems, in the early days of the pandemic we believed that the lockdowns, school closures, and social distancing would be short-lived sacrifices. However, there came a point when we collectively acknowledged, “oh, this isn’t going away any time soon.”
For many of my teen clients, the transition from the pandemic being a departure from normal, to being the new normal, triggered a downward slide. Many began presenting with depression-like symptoms. They reported having less energy, their sleep schedules became erratic and things that they typically enjoyed became less interesting. There was a general undercurrent of helplessness.
And then there was school. Many once high-achieving students began to feel less and less motivated. I often was told “it (school) doesn’t feel real.” The virtual learning wasn’t working for them. The routine became wake up, log-on, turn off the camera and microphone, and go back to sleep or play video games.
Many of these clients weren’t technically in a major depressive episode (though I did see a significant uptick in teens presenting with a major depressive disorder during this time). Rather, what I observed was a pervasive fog of low-level depression amongst teens.
The social anxiety swing:
For my teen clients with social anxiety, the pandemic initially led to relief from their symptoms. The reason was obvious: lockdowns and social distancing removed the triggers of the anxiety. More than that, they were being required to not interact with others. So, there wasn’t the uncomfortable push from parents (or their therapist) to continue doing the anxiety-provoking work of exposing themselves to social situations.
Why do I call this the social anxiety swing? Well, as restrictions lifted and they began in-person school and activities, their social anxiety was more intense than when the pandemic began. This is also not surprising given how anxiety often works. If something triggers anxiety, it is avoided, leading to temporary relief. However, as one gets stuck in these anxiety/avoidance loops, that same trigger brings on more intense anxiety over time. Additionally, two years of significant isolation during adolescence can stunt the development of social skills, which can also contribute to social anxiety.
Rise in self-harm:
A rise in suicide attempts during the pandemic, particularly among young girls, has rightfully received a lot of attention. Indeed, the surgeon general report states:
In early 2021, emergency department visits in the United States for suspected suicide attempts were 51% higher for adolescent girls and 4% higher for adolescent boys compared to the same time period in early 2019.
However, the form of self-harm I’m discussing is different. I’m referring to my teen clients cutting, burning, hitting, or scratching of themselves as a coping mechanism. Typically to help deal with intense, out of control feelings, or conversely, if they’re unable to feel anything at all.
I had many parents bring their teenage kids in after discovering they were self-harming. In most of these cases there was no prior history of self-harm. Now,the causes for any particular client are typically complex. However, a common theme expressed to me was that they felt that their and their family’s lives, and the world itself, was out of control. A feeling I believe we can all empathize with.
I hope this helps give a feel for the struggles many adolescents experienced during this pandemic. If you or your teen is having a hard time, you’re not alone. Please reach out for help!