Appreciating and Responding to The New York Times article, For Some Teens, It’s Been a Year of Anxiety and Trips to the E.R. by Benedict Carey

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Real-life Skills Program Manager and Coach, NESCA

As an occupational therapist working almost exclusively with teenagers and young adults over the past year, the title of Benedict Carey’s article jumped out at me like a tired and worn flag, waving frantically for acknowledgement. Our teens are anxious, tired, and dealing with living through the proverbial “unprecedented times” without the developmental capabilities needed to quickly adapt in this era of remote learning, remote social interaction, and remote extracurriculars. Remote everything!

It is important for me to note that I really enjoy working with teenagers. I find myself in constant awe of their resiliency, their willingness to confront hard truths that many of us shy away from, and their ability to push forward despite having huge questions about who they truly are. All of these things are tough and require immense emotional fortitude, but this year many of these challenges feel impossible.

Carey has taken the time to gather perspectives from multiple stakeholders. He provides a platform for parents, educators, professors, therapists, pediatricians, and directors of hospital programs to explain the struggles of supporting these kids without adequate resources. Parents describe the fear of supporting their children as they struggle with mental health. Doctors discuss the frustration of having inadequate resources and support in emergency rooms around the country. Carey highlights that, according to the Centers for Disease Control and Prevention (CDC), the proportion of adolescent emergency admissions for mental problems, like panic and anxiety, is up 31 percent. Some of my clients add to this statistic and are navigating their own path through chaotic hospitalizations and overwhelmed support systems. Carey’s article is absolutely worth taking the time to read, if only to see the ubiquity of these issues and how they are happening all around our country. Simply put, we have a clear problem. Less clear, is the solution.

When meeting with adolescents and young adults themselves, I hear three main fears popping up week after week. Here are a few thoughts and suggestions on how to support these specific fears or feelings.

1. “I can’t get this done, (and therefore) I am going to completely ruin my future.”

When looking at future success through a transition lens, we consider the areas of independent living, community participation, post-secondary education, and employment. In the school setting, most students’ curricula are focused solely on academic success. Sometimes, we do a poor job of teaching students about multiple intelligences or emphasizing the importance of hard work. While grades are important, they are not everything, and while standardized testing is returning to students’ schedules, they should not serve as students’ measure of self-worth. We know this, but do they? We have to teach our children that if they are hardworking, kind, and truly doing their best, the threat of “ruining their future” is much less likely than they fear. Let’s highlight the undeniably true narrative that everyone’s path can look different and still lead to success.

2. “I’m so tired. All of the time.”

Many of my clients tell me they are not sleeping. If they are sleeping, they fall asleep late with a phone in their hand, constantly refreshing apps or trying to maintain communication with their peers. In our current remote world, the phone can feel like a lifeline. Sleep is a foundational need for mental and physical health. Students who are 15 or 16 years old often have a limited understanding of how holistic the effects of decreased sleep can be. Sleep is not their priority. Recently, I have seen parents disable the internet or have their teenagers put their phones into a lockbox from midnight until 6:00am. This new boundary is often met with anger or frustration at the beginning, but then these students start to sleep. They are better able to manage their emotions. They have more energy. They start to see the benefits despite their skepticism. If a tech break doesn’t feel quite right for your family, it is still worth opening up a conversation about the need for strong sleep hygiene and modeling a routine that promotes calming down by limiting screens before bed, which can have hugely positive effects.

3. “This is never going to end.”

In many ways, a year feels much longer to a 17 year-old than it does to an older adult. Working at a job for four years never feels as long or as formative as the four years of high school. And objectively, a year to a 17 year-old is over five percent of their life, while it’s only two percent of 50 year old’s life. Let’s acknowledge that. Let’s verbalize the fact that teenage years are also full of milestones that have been constantly cancelled or changed to fit social distancing recommendations and safety precautions. There is a sense of loss and grief surrounding many events that these students have been looking forward to since elementary school. Encourage students to do their own research into what the next six months may look like as we start to open back up. Help them to understand the vaccine rollout and the pitfalls and successes that we have had as a nation tackling a novel disease.

Adolescent mental health is going to be an on-going challenge that we tackle as a community. As we slowly forge out of isolation, let’s center our conversations around the mental health of our teens and honestly acknowledge the unique position that they have found themselves in.

References

Carey, B. (2021, February 23). For some teens, it’s been a year of anxiety and trips to the e.r. The New York Times. https://www.nytimes.com/2021/02/23/health/coronavirus-mental-health-teens.html

Leeb, R.T., Radhakrishnan, L., Martinez, P., Njaj, R., Holland, K.M. (2020, October 27). Mental health-related emergency department visits among children aged <18 during the covid-19 pandemic. MMWR Morbidity and Mortality Weekly Report 2020:1675-1680. DOI: http://dx.doi.org/10.15585/mmwr.mm6945a3