A frightened and free-spirited 13-year-old girl in suburban Minneapolis ran from the house out a sliding door, across the patio, through the backyard and into the woods after she leaped from a chair in the living room.
Linda had taken a look at her daughter's phone moments earlier. The teenager grabbed the phone and fled. The family's privacy is being protected by M and the parents by first name only.
Linda was alarmed by the photos she saw. Some people showed blood from self-injury. There was a close-up of the character Genocide Jack, a brunette girl with a long red tongue who kills high school classmates with scissors.
Linda had watched M spiral downward in the preceding two years. She was 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884 888-349-8884
American adolescence is changing. The public health threats to teenagers in the United States came from binge drinking, drunken driving, teenage pregnancy and smoking. A new public health concern is soaring rates of mental health disorders.
A 60 percent increase in the number of adolescents having a major depression episode was reported in 2019. The number of emergency room visits by children and adolescents rose sharply. According to the Centers for Disease Control and Prevention, the suicide rate for people ages 10 to 24 leaped by 60 percent by the year of 2019.
Emergency room visits for self- harm by children and adolescents rose sharply over the last decade.
600 E.R. visits.
per 100,000
The emergency room can be visited.
For self-destructive injuries.
Ages 10 to 19
The last decade saw a rise in emergency room visits for self- harm by children and adolescents.
600 E.R. visits.
per 100,000
Emergency.
There are room visits.
For self-injury.
Ages 10 to 19
The decline in mental health among teenagers was intensified by the Covid pandemic but before it, spanned racial and ethnic groups, urban and rural areas. In December, the U.S. surgeon general warned of a mental health crisis among adolescents. Many hospital and doctor groups have called it a national emergency due to rising levels of mental illness, a severe shortage of therapists and treatment options, and insufficient research.
Young people are less likely to get pregnant, use drugs, and die from accidents, according to a psychologist. There are important trends in anxiety, depression and suicide that stop us in our tracks.
She said that it was life or death for these kids.
Solid data on the issue is limited, the findings are often conflicting and some adolescents seem to be more vulnerable than others to the effects of screen time. Teenagers are getting less sleep and exercise and spending less time with their friends at a time when it is normal to test boundaries and explore. Some adolescents have a kind of cognitive implosion: anxiety, depression, compulsive behaviors, self- harm and even suicide.
This surge has raised a lot of questions. Are these issues inherent to adolescence that went unrecognized before? Some data around teen anxiety and depression began to be collected recently, so historical comparisons are difficult. The physical nature of the threat has changed as the rates of emergency-room visits for suicide and self-injury have gone up.
Linda and her husband became part of an unenviable club when they realized they were part of an adolescent in profound distress.
Linda said that there was no control over what people were thinking.
A group of teenagers spoke to The New York Times about the changing nature of adolescence in the United States. The Times was given permission by M and the family to speak with the school counselor, as well as M's medical records, which were shared with The Times.
Emily Pluhar, a child and adolescent psychologist at Harvard University, described M as an internalizer.
M has a younger sister and older half brother. At the beginning of seventh grade, M asked to be called by the name of a popular Japanese animation character, whose first name starts with M.
According to the report, a psychologist assessed M's school readiness when he was 4 and concluded that his intellectual ability was in the very superior range. M was a member of the younger class.
M got a phone at 10. Linda and her husband, Tony, both of whom had busy work schedules, worried that the device might lead to heavy screen time, but they felt it was necessary to stay in touch. M reached puberty at 11.
The age of puberty for girls has dropped from 14 years old in 1990 to 12 years old today, while the age of puberty for boys has stayed the same. The shift is one of many factors that researchers are still trying to understand, and experts say it plays a role in the adolescent mental health crisis.
When puberty hits, the brain becomes hypersensitive to social and hierarchical information, even as media flood it with opportunities to explore one's identity and gauge self-worth. The ability to maturely grapple with the questions of Who am I is what a psychologist says. Who are my friends? Where do I fit in?
He said that the falling age of puberty has created a widening gap between incoming stimulation and what the young brain can process.
They are being exposed to this at an earlier age.
The first hint of trouble came in sixth grade. The school called a meeting with M's parents. Linda and Tony were skeptical of the idea of testing M for attention deficit hyperactivity disorder. According to the C.D.C., the number of A.D.H.D. diagnoses in the United States rose 39 percent from 2003 to 2016
Linda tried to help M stay organized with an app that parents and students used to track assignments. M was put under a microscope.
M recalled that Linda asked if she could bring her iPad so she could check schoology.
M was struggling socially by the fall of 2019. M came home from school and got into bed.
Tony had a different childhood and the behavior seemed alien to him. He fished and played outdoors as an adolescent in Vermont. He got his first serious girlfriend pregnant in the summer of 1990 when he was 15. Tony and the mother shared custody of their son after he was born.
The times have changed. According to federal research, 38 percent of high-school-age teenagers have had sex at least once, compared with 50 percent in 1990. The teen birthrate has fallen.
Smoking and alcohol use have been mentioned. The percentage of high school seniors who have had a cigarette in the last 30 days has fallen. High school students' alcohol use hit 30-year lows at the same time. Over the last 20 years, the use of drugs such as OxyContin has fallen. Nicotine and marijuana use went up in recent years, but dropped during the Pandemic.
Smoking, drugs, alcohol and sex rates have declined among high school students over the last decade.
Over the last decade, there has been a rise in excessive phone and computer use.
Use a phone.
There is a computer or a tablet.
At least a game console.
Not 3 hours a day.
Including school work.
You can watch television.
At least.
3 hours a day.
Get at least.
8 hours of sleep.
Over the last decade, feelings of sadness and hopelessness have increased.
It was persistently felt.
It is either sad or hopeless.
Really?
It was considered.
It is a suicide.
A person is injured in a suicide.
Attempt is needed.
Medical treatment.
Smoking, drugs, alcohol and sex rates have declined among high school students over the last decade.
Over the last decade, there has been a rise in excessive phone and computer use.
Use a phone.
There is a computer or a tablet.
At least a game console.
Not 3 hours a day.
Including school work.
You can watch television.
At least.
3 hours a day.
Get at least.
8 hours of sleep.
Feelings of sadness and hopelessness increased.
It was persistently felt.
It is either sad or hopeless.
Really?
It was considered.
It is a suicide.
Smoking, drugs, alcohol and sex rates have declined among high school students over the last decade.
Over the last decade, there has been a rise in excessive phone and computer use.
Use a phone.
There is a computer or a tablet.
At least a game console.
Not 3 hours a day.
Including school work.
You can watch television.
At least.
3 hours a day.
Get at least.
8 hours of sleep.
Feelings of sadness and hopelessness increased.
It was persistently felt.
It is either sad or hopeless.
Really?
It was considered.
It is a suicide.
Public awareness campaigns, antismoking laws, parental oversight and a changing social lifestyle are some of the factors experts cite.
Drug and alcohol use is part of a group dynamic, according to the director of the National Institute on Drug Abuse.
M retreated further in the spring of 2020. M lied about participating, felt guilty and 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611 888-270-6611
M became enamored of one of the characters, Genocide Jack, who is described on one fan site as a murderer who kills handsome men.
M was mad at himself for not doing homework, and he used scissors to cut the ankles.
M's parents noticed scratches on his thighs that looked like cuts, but they didn't raise the issue. Linda was worried about the time on the screen.
When school ended for the summer, M's mood improved. M discovered the mobile version of the video game and how to get around parental screen limits. M played all day.
M said that he was in front of his screen staring at Jack.
M said that he was lonely. I would want her to kill me but not, so we could spend the rest of our lives together.
Nick Allen, a psychologist at the University of Oregon, said that an obsession with a virtual character is not uncommon.
He said that online experiences like these can encourage users to think about where they belong.
The challenge and the progress of modern adolescence is that there are so many different types of identity. The mind is one of the factors shaping mental health.
Loneliness was the main source of their mental health challenges.
The adolescent crisis is unfolding in a more accepting environment, according to health experts. The stigma surrounding mental health issues has been removed, and parents and adolescents alike are more at ease discussing the subject with one another.
Linda was having conversations with other parents who wondered if the challenges their adolescents were facing represented typical teen behavior or something pathological. Linda was told about her daughter's eating disorder. Sarah told her that her daughter was in therapy for anxiety and depression.
Understand the signs. Depression and anxiety are different issues, but they share some indicators. Look for changes in the behavior of a youth. A teen in distress may express worry or profound sadness.
Approach with sensitivity. If you want to start a discussion with a teen who might be struggling, be clear and direct. Don't shy from hard questions, but also approach the issue with compassion and not blame.
The correct diagnosis should be obtained. Ask for recommendations to find the right doctor for your child. Ask the specialist if she uses the measurement tools to make medical assessments and if she has treated specific conditions in children.
Carefully consider the effects of your medication. If you want to know if a medication is working and how hard it is to wean off of it, you need to know the doctors experience treating children with specific drugs.
Don't forget the basics. Young people with developing brains need eight to 10 hours of sleep to promote mental and physical health. Lack of sleep can affect development. Physical activity is important.
In a suburb, the parents of the girl were trying to understand her desperation. As a young child, Elaniv was joyful, an eager student and graceful gymnast, her father said.
When she was 9 years old, her parents broke up, and she developed chronic pain from her ankle injury, which prevented her from gymnastics, and she went through a dark period. In 2016 a Black doctor was held at his home by the police in full view of his family after they responded to a call of a possible intrusion.
Black families are not protected from mental health issues the same way that white families are. Black adolescents have attempted suicide at a higher rate than white adolescents. The suicide rate is higher among white adolescents. The suicide rate for Black girls went up more than any other group from 2003 to 2017, according to new research.
Major depressive disorder was diagnosed in the fall of 2019. She wrote in her journal that racecars zoom constant in her head and that they speed ahead.
We changed so many things to try to help meet Elaniv where she was, and we worked on ourselves.
The mother of Elaniv Gainza was a clinical social worker. She counseled an adolescent who was afraid of not meeting expectations. She heard about a boy who killed himself.
There is something different about this era or generation that makes them more vulnerable.
Experts said a rise in loneliness is a key factor. Teenagers in the United States and around the world report feeling lonely even in a time when their internet use has exploded.
Bonnie Nagel is a psychologist at the Oregon Health & Science University.
She said that seeing pictures of people hanging out, flaunting it, as if to say, "Hey, I'm very socially connected."
Linda found M crying in bed one day in the autumn of 2020 when the Pandemic was in full swing and eighth grade was completely remote. M wanted to die.
Linda found a therapist. Linda said the therapist broke confidentiality after several sessions.
Tony found a pocketknife and box knife with a cat paw image on the handle that M had bought on Amazon and was using to self- harm. M tightened a red hair tie around their neck.
M entered full-day group therapy in February. M admitted to being unable to stop cutting when the doctor told the family. Linda hid all the pills in the house. M hit their head with an eight-pound workout barbell in a different kind of self-injury.
Linda said she had to get rid of the blunt objects.
M was diagnosed with depression and prescribed medication. The number of prescriptions for antidepressants for teenagers increased by 38 percent from 2015 to 2019.
M received a diagnosis of attention deficit disorder, not A.D.H.D., and was given a prescription for the generic name for Ritalin and Concerta.
There is a mental health counselor in the middle school. M visited him for the first time. On a scale of 0 to 10, M ranked his feelings of hopelessness and anxiety at 9, expressing fear at returning to school, a fear of falling behind and a wish to die.
At a meeting a month later, M ranked hopelessness and sadness at 5 and anxiousness at 2. The school counselor credited M's improvement to family support and getting back to school for his improvement to therapy. He told the parents that the pendulum could swing back.
Linda heard that a girl named Elaniv had died from an overdose. Her mother rushed her to the hospital, where she expressed regret at the overdose and described her terror. She died at the age of 15.
The news was still on Linda's mind when M ran into the forest.
The family recently returned from visiting their grandparents. One set criticized the other set's heavy screen use. Linda felt judged. She took a look at M's phone and saw some troubling photos.
She told M to go for a walk and then went upstairs. She followed them into the woods, texting as she frantically looked for M's white dress.
I don't want to talk to you.
Tony went out after Linda returned home. M was found by him along a trail. He recalled that they were ready to come home.
The school year ended and M got better. M and a friend walked home from the forest.
I was back to having no friends a few weeks later after a cruel text from a friend.
I don't know how to stop it, M said.
Linda confronted M after she saw the cuts. Linda was allowed to examine the wounds.
Linda said that she thought that was good.
In mid-April, I was speaking to the mother of a suicidal teenager whose struggles I’ve been closely following. I asked how her daughter was doing.
Not well, the mother said: “If we can’t find something drastic to help this kid, this kid will not be here long-term.” She started to cry. “It’s out of our hands, it’s out of our control,” she said. “We’re trying everything.”
She added: “It’s like waiting for the end.”
Over nearly 18 months of reporting, I got to know many adolescents and their families and interviewed dozens of doctors, therapists and experts in the science of adolescence. I heard wrenching stories of pain and uncertainty. From the outset, my editors and I discussed how best to handle the identities of people in crisis.
The Times sets a high bar for granting sources anonymity; our stylebook calls it “a last resort” for situations where important information can’t be published any other way. Often, the sources might face a threat to their career or even their safety, whether from a vindictive boss or a hostile government.
In this case, the need for anonymity had a different imperative: to protect the privacy of young, vulnerable adolescents. They have self-harmed and attempted suicide, and some have threatened to try again. In recounting their stories, we had to be mindful that our first duty was to their safety.
If The Times published the names of these adolescents, they could be easily identified years later. Would that harm their employment opportunities? Would a teen — a legal minor — later regret having exposed his or her identity during a period of pain and struggle? Would seeing the story published amplify ongoing crises?
As a result, some teenagers are identified by first initial only; some of their parents are identified by first name or initial. Over months, I got to know M, J and C, and in Kentucky, I came to know struggling adolescents I identified only by their ages, 12, 13 and 15. In some stories, we did not publish precisely where the families lived.
Everyone I interviewed gave their own consent, and parents were typically present for the interviews with their adolescents. On a few occasions, a parent offered to leave the room, or an adolescent asked for privacy and the parent agreed.
In these articles, I heard grief, confusion and a desperate search for answers. The voices of adolescents and their parents, while shielded by anonymity, deepen an understanding of this mental health crisis.
All Rights Reserved © 2024
