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Seeking Answers and Solutions to Mental Health Concerns

By Michelle Hirschy, LJCDS director of wellness and Nicholas Chan, M.D., assistant clinical professor, psychiatry at UC San Diego
Shedding light on challenges to mental health that youth face today.
In a world where it feels as though compromise is fleeting and empathy is under siege, if you work with or have children, there is one universally acknowledged truth: the lived experience of our youngest generation is more complex than ever. We have seen rising evidence of this fact for over a decade in our schools, doctor’s offices, and even the emergency room. 

Recently, Oregon Health & Science University researchers found a startling increase in suicide attempts by pre-teens (ages 10–12) nationwide. When coupled with several other concerning data points during the pandemic, it is critical that we focus on the well-being of our children. 

The question that continues to polarize our society and many professionals is why. What can we do to combat this alarming trend affecting our children? La Jolla Country Day School and Rady Children’s Hospital combine efforts to seek an answer to this question and, hopefully, a solution. 

From our experiences in a PreK–12 academic institution and a children’s hospital, we have identified three key areas that contribute to the challenging circumstances plaguing our youth. 

Social Media
Social media has changed the landscape of what it means to be young. This is perhaps one of the most apparent and documented changes that our newest generation has had to navigate that current adults will never fully grasp. Our children have grown up with digital connections and technology at their fingertips. How and why social media has contributed to child and adolescent distress is a more nuanced issue. For some, access to technology, rather than socialization and conversation, is enough to sound the alarm. For others, the things that can happen in an unsupervised online environment are the most concerning. 

Research has found that time spent on social media is not linked to individual changes in depression and anxiety over eight years (Coyne, et. al., 2020). So, if it is not about the amount of time our children spend on social media, what is correlated to the rises in adolescent distress we are undoubtedly finding? It is more complicated than a simple threshold of daily or weekly time limits. It is far more important to consider what they are doing online and perhaps not finding the time or inclination to do offline as a result. 

Technology can be an inescapable tool for relational aggression. Children can watch Instagram stories and see their “friends” without them in real-time. There is a relentlessness to social media—it is pervasive and ever-present. Your biggest fears and embarrassing moments can play on a loop in perpetuity, which gives it a unique and unprecedented power. 

There are also exceedingly unhealthy and unrealistic depictions of life, beauty and body image. Additionally, there are neurobiological impacts at play—namely, the dopamine rush given for each TikTok video that was once found on a bike ride. It is far simpler to get a dopamine rush by watching videos in rapid succession than through the delayed gratification of spending time outdoors or exercising. 

The adolescent brain is susceptible and reactive to rewards, more so than adults or small children, so it makes sense to seek out anything rewarding early and often. 

Parenting Styles
Another generation change is the role of modern parenting. “Parenting,” as a goal-directed verb, is a relatively new phenomenon that has vastly shifted approaches to supporting our children. Author and leading child psychologist Alison Gopnik poses the question, “Is it our job to be a gardener or carpenter in our child’s life?” Are we responsible for helping build their future through a series of experiences and skills, or do we, more simply, nurture and water them to grow naturally and organically into who and what they are meant to be? 

Despite the most earnest intentions, are parents partially to blame for what appears to be children’s declining ability to navigate conflict, disappointment and challenge? Giving our children a sense of agency, when appropriate, to make decisions and mistakes is an integral part of their development. Knowing when to step back, support or save is one of the most challenging balances as a parent. 

This knowledge also should be balanced with emerging research. As opposed to the authoritarian parenting style, an indulgent parenting style is linked to well-being and even academic success (Garcia, O. et.al., 2019 and Garcia, F. et.al., 2019). While it is clear that warmth and safety are integral components of “successful” parenting, limits are also a show of love. In addition to warmth and connection, children thrive with consistency and predictability. Children need to feel your love and security to take risks and explore the world as required in adolescence and early adulthood. 

As professionals in schools and the medical field, we often see parents with the very best intentions unknowingly impacting their child’s development by shielding them from experiencing living in our flawed world. We must not lose sight of the critical challenges and upheaval that made us who we are today. Our children need experiences and life lessons to help them navigate the world they are inheriting. 

Genetic and Evolutionary Impacts on our Health
We are rapidly diverging from the lives that evolution has intended for us. Within this divergence are three critical principles: the process of habituation, the effects of constant distractions, and the quality of our interactions and relationships.

Our bodies have been programmed to conserve resources to ensure survival. Emotional states, including happiness and excitement, cost resources. The increase in dopamine and adrenaline that fuels these emotions causes our bodies to expend more energy to increase heart rate, respiratory rate and many other physiologic changes. This is why the process of habituation has accompanied our evolution. After repeated exposure, our response to either pleasant or unpleasant stimuli will dull to conserve resources. As much as our society promotes happiness, happiness is not a constant emotional state.  

What was a printed article has been replaced by an online post, which has been replaced by an online video, which now has been replaced with a more stimulating shorter video that can quickly be followed by more with a movement of a finger. This “hedonic treadmill” leaves us in a constant state of dopamine infusion and then withdrawal, which may contribute to many individuals’ struggles with maintaining a sense of contentedness.  

For the vast majority of human existence, the world has been dangerous. One who was not acutely aware of their surroundings, including predators and environmental hazards, was much less likely to survive than their more present tribespeople. Evolution pairs traits that help ensure our survival with rewards, such as feelings of pleasure or, in this case, more likely, feelings of contentedness or security. Today, it has become easy to focus our attention on distractions outside of our surroundings. Every notification on our phone or smartwatch removes our attention from the activities and individuals surrounding us. Every time we check our email or social media, we interrupt our brains and disconnect from our environment. This is why mindfulness, which has existed for thousands of years, has had such a strong resurgence in mental health treatment.

Though situational awareness has helped our species survive, our ability as human beings to socialize and create complex relationships is likely the biggest factor contributing to the success of our species. An emotional reward is attached to developing and strengthening deep relationships, particularly through in-person interaction. What prevents this from happening is the ease with which we can develop many casual relationships, either through social media or other less engaged interactions. Substituting these interactions for traditional in-person communication has made it much more daunting for our youth to approach one another in person. As a result, we’ve witnessed an enormous increase in social anxiety. 

While we continue to strive toward finding a “solution” to combat the mental health crisis in our youth, we also recognize that no one thing will provide the level of intervention our youngest generation needs. The wellness team at LJCDS is looking at this from an instructional model lens many educators are familiar with, backward design. We know what skills (e.g., empathy, collaboration, healthy coping skills, adaptability, etc.) produce the best outcome for our children, so we want to help infuse opportunities to practice and cultivate these areas from a young age through adolescence. 

Mental health clinicians are often tasked with teaching robust coping skills to a young person who meets the criteria for anxiety or depression. We want to explore what skills these children could have been developing at age 5 or age 10 to be better equipped now. 

We also acknowledge that the best outcomes will come from school-family-community partnerships that provide consistent and varied support to each child and family. Fostering that partnership and defining how we can all work together to achieve our shared goal—thriving children and adolescents—is the outcome we strive for. 

A longer version of this article was published in Intrepid Ed News.


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