Over the last decade, rates of clinical depression and anxiety among adolescents ages 12-17 have risen across the country.
Melissa Wilson, a licensed clinical social worker and therapist, has been working with teens in the mental health field for close to 20 years. In settings ranging from day treatment programs in Oregon to her private practice of five years in East Asheville, Wilson has watched as the intensity of teenagers’ symptoms have increased over time.
“When I think back to my early experiences working with adolescents,” Wilson explains, “most of what we saw was a lot of oppositional behavior, or acting-out behavior, and less internalized behaviors. But I’ve seen a huge increase in the number of adolescents that self-harm or engage in self-injurious behaviors.”
According to a study by Ramin Mojtabai, a professor at Johns Hopkins Bloomberg School of Public Health, the odds of an adolescent being diagnosed with clinical depression grew by 37% between 2005 and 2014, and research also shows that more dangerous behaviors, like self-harm, are increasing.
Based on their work with teens experiencing depression, Wilson and two other local professionals discussed their observations of a major factor that has changed in young people’s lives since 2005: near-universal use of social media.
“The unfortunate reality is the incidents and the prevalence of both the number of new cases each year and people who continue to struggle with depression are increasing for a variety of reasons,” says Dr. Craig Martin of Vaya Health. “It can be partly genetic and it can be partly environmental, and that’s where social media and some of the influences in our culture that affect youth growing up are different than they were 10 to 15 years ago.”
Martin is the chief medical officer for Vaya, an Asheville-based public managed care organization, and he oversees the care of a large number of adolescents in need of mental health help, ensuring that Vaya therapists are using the appropriate sensitivity when handling differences in culture, beliefs, values and identities of the teens that they work with.
“Back when I was growing up,” Martin continues, “the worst thing you had in terms of media was seeing a picture of a model called Twiggy, who had anorexia. [She] was on a cover of Life magazine, and people thought that that was what they should be. … Then, you’d worry about kids being given Barbie and Ken for Christmas because they were unrealistic in terms of their look and their body proportion.”
But in the age of Instagram and Snapchat, exposure to idealized and extreme imagery has become a part of everyday life. Sexting, cyberbullying and the ease of pressing “send” are all factors present in a modern teen’s life that were not present in the past.
A 2018 study by Pew Research found that 97% of teens participate in some form of social media, but 43% of those teens feel pressure to only post content that makes them look good or gets more “likes” than their friends, creating a deeply competitive and anxious culture — especially among teenage girls, who are more likely to post pictures of themselves online and normalize activities like self-harm.
“It’s like some of the protective insulation that we used to have in our culture has been stripped away with the pervasiveness of social media,” Martin says.
Social media at school
Jackie Dirscherl, a special education teacher at Owen High School, has seen many positive aspects of using technology in education, like Twitter being used as an educational tool to show students a world outside of themselves and Asheville. But when 97% of students are participating in some form of online communication, adapting to a world where online conversations often enter the classroom and cause conflict has been no easy task for teachers.
“It’s really easy to shoot somebody a text that says, ‘I hate you, and I hope you die,’” Dirscherl explains. “Which, if somebody says that I hate you and I hope you die, that’s superserious to me, but I can’t imagine a lot of these kids that would text that or Snap that would ever actually say that to somebody’s face. I think that [social media] takes away the person. It’s easy to send a Snapchat and just be really awful to somebody.”
For teachers like Dirscherl, making sure from day one that students know that cyberbullying is not acceptable in any form is the first step toward combating it. “Also,” Dirscherl says, “teaching kids what cyberbullying is. … What is bullying? What does bullying sound like? What does it look like?”
Dirscherl believes social media is giving teens an outlet to say things that they might have never said otherwise. One recent example came on March 21, when students at Asheville High School notified administrators of concerns about racially charged social media posts. Asheville City Schools Superintendent Denise Patterson explained what happened next in a message to parents on March 24; “Asheville Police Department determined that there was no credible threat of harm to any students. Asheville High School Principal Dr. Dingle and SILSA Principal Nicole Cush communicated to Asheville High School and SILSA families respectively via email and phone calls that an unfounded threat had been made against the campus. After looking into the situation, it had been determined that there was no danger.”
“I’ve seen things on kids’ phones that I had to report many times,” Dirscherl says. “We have to take it all seriously because violence is never OK in school on any level. From the very minor of ‘my boyfriend, your boyfriend’ to the very major of ‘there’s a gun involved…’ It’s the world that we live in.”
“Given what we know at this point in time, in terms of brain development in adolescents,” Wilson says, “there’s less of an ability to discern and fill in the rest of the picture.” She believes teens need the active involvement of parents and other caring adults to make sense of what they are experiencing online.
Still, Wilson recognizes that keeping a watchful eye on teens’ use of social media is tricky. Often, she says, “Parents aren’t seeing it, or like with so many of the platforms, it’s there for a second and then it’s gone, so there are fewer ways to monitor it.”
Even though most teenagers might groan at the intrusion, Wilson stresses that parents should nonetheless ask questions about what their teen is seeing on social media and who are they interacting with. Head off a problem before it becomes a struggle by participating in open engagement on a daily basis. She also advises that parents set a limited amount of screen time during which teens are allowed to engage in social media.
“When I talk to adolescents,” Wilson says, “a lot of time they are wanting to engage with their parents but don’t know how to start the conversation. A cellphone is a tool, but you can overuse a tool.”