Although this was the case prior to the COVID pandemic, the Pew Research Center conducted a National Survey on Drug Use and Health in 2017 that showed 13% of American teenagers aged 12-17 (3.2 million) expressed “they had experienced at least one major depressive episode (MDE) in the past year”—that number was 8% (two million) in 2007.1 The latest data show the rate has increased to 16.39% in the past year.2

Even more concerning than the number of youths struggling with depression is the figure (60%) of teenagers who received no mental health treatment for depression—not counseling or medication.3 This issue is made even more frightening by the increasing suicide rates among youth. In the U.S., suicide is the third leading cause of death among those ages 15-24 and the second leading cause for that same age group worldwide.4

One of the biggest challenges with depression in our kids and teens is simply helping parents, teachers, and other adults recognize the disorder. Many adults expect teens to be moody or withdrawn and accept it as typical teenage behavior, making it difficult to identify the symptoms of depression. These include changes in eating or sleeping patterns, overreactions to criticism, restlessness and agitation, or problems with authority. It can be challenging, even for professionals, to determine what is normal adolescence versus indications of a more serious mental health issue. 

That was true for Emma Benoit. Emma is now 22, but at 16, she shot herself in a suicide attempt. Miraculously, and thanks to God, she survived and has become an advocate for youth mental health and suicide awareness. “I never talked to my parents about my mental health, period,” says Emma. She says she was terrified of not being heard and not having her feelings validated. Emma silently struggled with anxiety and depression for years. By all appearances, her life was that of a typical, even successful, teen. She had good grades, many friends, and was a cheerleader. However, that was a mask Emma put on for the world. In the privacy of her room and her heart, she was battling low self-worth and intense depression. Now, she works with many young people who have told their parents they are depressed, hurting, or hopeless but are still not being taken seriously. 

The following are a few tips to help adults know the difference between what average teens experience and indications of depression.

  • If you notice your teen being moody or sad, consider how long the shift in mood lasts and how different it is from their normal personality. If the mood change is significant and lasts more than two weeks, it may be a sign of depression.
  • Is your teen experiencing a substantial change in school performance? One bad grade is not necessarily a reason for panic. However, a significant downward shift in overall academic performance over time may be caused by a concentration issue related to depression.
  • Everyone can experience sadness from time to time, but ongoing sadness that includes persistent hopelessness and consistent feelings of low self-worth can indicate a mental health issue.
  • Any teen substance abuse or self-harm, such as cutting, should be taken seriously and warrants support from a mental health professional.  
  • Any teen who talks about suicide, wishing they would die, or having never been born requires immediate attention from a mental health professional.  

It is also critical to know there are life situations and experiences that research shows have a significant correlation to depression and suicide in youth. 

Bullying. In 2014, the U.S. Centers for Disease Control and Prevention (CDC) issued the first uniform definition of bullying. A federal government Web site, www.stopbullying.gov, has been established to provide descriptions, statistics, and resources on this pervasive problem. According to the CDC, “Bullying is a form of youth violence and an adverse childhood experience (ACE).”5 It is defined as “… any unwanted aggressive behavior(s) by another youth or group of youths, who are not siblings or current dating partners, that involves an observed or perceived power imbalance, and is repeated multiple times or is highly likely to be repeated. Bullying may inflict harm or distress on the targeted youth, including physical, psychological, social, or educational harm.”6 

The CDC describes universal forms of bullying as: 

  • Physical – hitting, kicking, and tripping 
  • Verbal – name-calling and teasing 
  • Relational/Social – spreading rumors and being left out of a group 
  • Damage to property – theft, alteration, or damage to the victim’s property  

Technology is another form of bullying, which is labeled “electronic bullying” or “cyberbullying.” This dangerous practice of bullying can affect the offender, the recipient, or both (known as “bully/victim”). Current statistics suggest that one in five high school students has been bullied at school, and one in six high school students has been bullied electronically in the past year.7 Bullying rates are even higher in middle school, and some of this aggressive behavior even occurs in elementary school. Both those who are bullied and those who bully others are at an increased risk for mental health issues like depression and suicide. Cyberbullying victims are at a higher risk of harming themselves and experiencing suicidal ideation.8

Sexual Violence. Sexual violence is a broad term that includes, but is not limited to, sexual abuse, rape, and sexual harassment. Statistics show that one in five girls and one in 20 boys are victims of sexual abuse.9 Most of those who treat sexual abuse survivors as adults acknowledge that those statistics are probably lower than the actual numbers. Considering the number of sexual assaults by peers and authority figures, as well as the use of technology to engage in harassing and unsolicited and non-consensual sexual interactions, we know that many teens and young adults experience the trauma of sexual violence in one way or another. We also know there is a strong correlation between all types of sexual violence and depression. People who have been raped are three times more likely to experience a major depressive episode, and studies show those who have been raped are 4.1 times more likely than non-crime victims to contemplate suicide and 13 times more likely to attempt suicide.10

Substance Abuse. Substance use and abuse are linked to suicide across all age groups. Alcohol is a particular problem, and research has linked it to increased suicide risk. The disinhibition that occurs when a person is intoxicated contributes to suicide risk. In fact, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports, “… a diagnosis of alcohol misuse or dependence is associated with a suicide risk that is 10 times greater than the suicide risk in the general population, and individuals who inject drugs are at about 14 times greater risk for suicide.”11

Other significant issues, like the death of a parent, sibling or close friend or a serious illness, can also lead to depression. However, for many teens, no major event or trauma precipitates depression. An increasing number of young people with stable families, ordinary lives, and no substantial trauma are experiencing depression, and some become suicidal. Emma was one of those teens. 

Social Media. Emma believes social media played a huge role in her depression and anxiety and also has the same impact on other young people. The connection between social media use, depression, and suicide is apparent but complex. Studies show a correlation between time spent on social media and isolation and depression. Several studies show that teens and young adults who spend the most time on Facebook, Instagram, and other social media platforms report 13-66% higher rates of depression.12 

While research cannot entirely point causality at social media and screen time, we can all see that rates of depression and suicide have been rising in the same period that smartphone usage has soared among our youth. There are undoubtedly many reasons to contend that social media negatively impacts mental health. Emma believes that the false reality portrayed in social media leads to unrealistic expectations and standards and contributes to feelings of low self-worth and discouragement.  

So, how do counselors help, and what guidance do they give parents? Ultimately, one of the most critical aspects of addressing depression and suicide in our youth is having more open and honest conversations with them. Genuine relationships are the key, but that requires a significant investment of time and energy. It necessitates spending time with young people and truly making an effort to enter their world and reality. It means having conversations about what interests them instead of only what concerns you as their parents. It requires having honest discussions about their feelings, their friends, their faith, and, of course, their mental health. Emma believes that if her parents had introduced the conversation about mental health, it would have made a difference for her. “I know if they had initiated that conversation, I would have opened up,” she said.   

It is also critical to understand brain development and how it impacts thinking and mental health. Often, adults fail to consider that the pre-frontal cortex is not fully developed until the mid-20s.13 This affects many executive functions for youth, including impulse control and the ability to have a long-term perspective on challenging life events. Adults must try to understand teens’ viewpoints and realize that their pain is real and significant.  

Emma believes education and dialog about mental health in schools are also critical to turning the tide on youth mental health. “One of the best ways to initiate change is to put programs in schools that promote mental health awareness,” she said. That would have made all the difference for Emma and others whose pain leads to thoughts of suicide. “I didn’t want to die,” says Emma, “I just wanted to get rid of the pain I was stuck in.” Emma learned that there is so much help for that emotional pain. God is now a vital part of her daily life, and she feels His guidance and direction. She knows many people, including her parents, friends, mental health professionals, and advocates, who she can turn to for support. And spreading this vital message of hope to other hurting teens is now part of her life calling. 

Jennifer Cisney Ellers, M.A., is a counselor, life coach, and author. She is an approved instructor with the Critical Incident Stress Foundation and a faculty member. Jennifer co-authored the course, Youth Suicide, with her husband, Dr. Kevin Ellers. She serves as Senior Director of Advancement, Special Projects, and Church Engagement with the American Association of Christian Counselors.

Emma Benoit serves as an Ambassador for LivingWorks (livingworks.net), the world’s leading organization in suicide prevention training. She is a suicide survivor who shares her personal story at conferences and events, including the California Department of Education Youth Summit, the National Federation of Families for Children’s Mental Health Conference, the Hope Rising Suicide Prevention Summit, the Hope Squad National Conference, and more. The documentary film, My Ascension (myascension.us), tells her story. 

Endnotes

1 Geiger, A.W., & Davis, L. (2019, July 12). A growing number of American teenagers – particularly girls – are facing depression. Pew Research Center. Retrieved October 12, 2022, from https://www.pewresearch.org/fact-tank/2019/07/12/a-growing-number-of-american-teenagers-particularly-girls-are-facing-depression/.

2 The state of mental health in America (2022). Youth data 2023. Retrieved October 12, 2022, from https://mhanational.org/issues/2023/mental-health-america-youth-data.

3 The state of mental health in America (2022).   

4 Suicide statistics and facts. SAVE. (2022). Retrieved October 12, 2022, from https://save.org/about-suicide/suicide-statistics/.

5 Centers for Disease Control and Prevention. (2021, September 2). Fast fact: Preventing bullying |violence prevention|injury Center|CDC. Centers for Disease Control and Prevention. Retrieved October 12, 2022, from https://www.cdc.gov/violenceprevention/youthviolence/bullyingresearch/fastfact.html

6 Centers for Disease Control and Prevention. (2021, September 2).

7 Centers for Disease Control and Prevention. (2021, September 2).

8 John, A., Glendenning, A.C., Marchant, A., Montgomery, P., Stewart, A., Wood, S., Lloyd, K., & Hawton, K. (2018, April 19). Self-harm, suicidal behaviours, and cyberbullying in children and young people: Systematic review. Journal of Medical Internet Research. Retrieved October 12, 2022, from https://www.jmir.org/2018/4/e129/.

9 Child sexual abuse statistics – National Center for Victims of Crime. (n.d.). Retrieved October 12, 2022, from https://victimsofcrime.org/child-sexual-abuse-statistics/.

10 Pompili, M., Serafini, G., Innamorati, M., Dominici, G., Ferracuti, S., Kotzalidis, G.D., Serra, G., Girardi, P., Janiri, L., Tatarelli, R., Sher, L., & Lester, D. (2010, March 29). Suicidal behavior and alcohol abuse. Molecular Diversity Preservation International. International Journal of Environmental Research and Public Health, 7, 1392-1431. Retrieved October 12, 2022, from https://www.mdpi.com/1660-4601/7/4/1392.

11 Substance use and suicide: A nexus requiring a public health approach. (2016). In Brief. Retrieved October 12, 2022, from https://store.samhsa.gov/sites/default/files/d7/priv/sma16-4935.pdf

12 Miller, C. (2022, April 14). Does social media use cause depression? Child Mind Institute. Retrieved October 12, 2022, from https://childmind.org/article/is-social-media-use-causing-depression/.

13 Johnson, S.B., Blum, R.W., & Giedd, J.N. (2009). Adolescent maturity and the brain: The promise and pitfalls of neuroscience research in adolescent health policy. Journal of Adolescent Health, 45(3):216-21. doi: 10.1016/j.jadohealth.2009.05.016. PMID: 19699416; PMCID: PMC2892678.