What’s wrong?

For at least 20 years public discussion has assumed that adolescent depression, anxiety disorders, eating disorders and other internalising problems are constantly increasing. Research has not supported this assumption. With the sudden remarkable increase in referrals to all levels of adolescent mental health and psychiatric services in past three years, we decided to replicate the Adolescent Mental Health Cohort survey among ninth graders in Tampere. Our earlier replication study had invalidated the assumption of increase of either emotional or behavioural problems from 2002 to 2012 https://www.tays.fi/fi-FI/Sairaanhoitopiiri/Sairaanhoitopiirin_julkaisut/Julkaisusarja/Julkaisusarjan_julkaisut_2014(51433).

Perhaps surprisingly, the new results indeed suggest remarkable increases in adolescent depression and anxiety as well as symptoms like feeling tensed and nervous, feeling tired or exhausted, and low self-esteem. Question arises, what could be the reasons for such increase in emotional problems.

Commonly suggested explanations for the assumed increase in mental ill-health of young people have been, for example, assumed increase in substance use, assumed weakening of family ties, parental supervision and relationships with parents, assumed increasing subjection to bullying all the more common stress related to (excessive use of) social media. However, our data does not support any of these explanations. All these phenomena had developed towards the positive. I had to think beyond our data.

It seems to me that one plausible explanation is stress related to achievement pressures and right choices. All the younger students have to make choices that may define their future opportunities. University students in their twenties are commonly anxious and stressed about the demands of self-direction in planning their curriculum and schedules. Contemporary school is increasingly imposing such demands on middle, even early adolescents. Adolescents are afraid of wrong choices and feel constantly not good enough.

During 2000’s, various kinds of problem behaviours and externalising symptoms have been decreasing among adolescents in Finland and across Western countries. They commit less and less crimes, drink and smoke less, use less substances (I mean middle adolescents; the opposite is true for late adolescents / young adults). They engage less often in sexual risk-taking. Could it be that adolescents are already too decent and within too narrow limits, and this has now started to make them depressed and anxious? Or are they more decent because they have emotional problems and lack the energy to break rules?

Finally, perhaps the public discussion constantly reinforcing the notion that adolescents are unwell, burdened and lost has by now influenced the way the adolescents see themselves and rate their feelings in surveys. May be adolescents have similar swings of mood and similar problems and challenges as always, but, exposed to current discourse reinforcing worry and concern, evaluate their feelings, thoughts and experiences differently, and consequently appear more depressed, anxious, tired and dissatisfied with themselves.