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Thursday, March 28, 2024 | Back issues
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With more opportunities than ever, why are teen girls so depressed?

Huge swaths of teenage girls told researchers they think about killing themselves, part of a nearly 60% uptick in persistent sadness, compared with 10 years ago.

(CN) — A staggering CDC report showing extremely high rates of depression and suicidal thinking among teenage girls has left experts — and parents — scrambling to solve the mystery of what’s causing it.

Some 57% of teen girls in the U.S. felt “persistently sad or hopeless” in 2021, a nearly 60% increase in the last decade. Even worse, 30% said they seriously considered suicide over the previous 12 months, 24% made a plan for suicide and 13% attempted it.

The latest version of the study, which the Centers for Disease Control and Prevention runs every two years, includes responses from more than 17,000 students. It shows depression rates are twice as high among girls as among boys.

The attempted-suicide figures have to be considered with context, cautioned Victor Schwartz, who teaches at the CUNY School of Medicine and spent eight years as the medical director of the Jed Foundation, a nonprofit devoted to preventing teen suicide.

“For teenagers, the ratio of self-reported suicide attempts to actual suicides is about 10,000 to 1, and for younger teens it’s 50,000 to 1,” Schwartz said. “Many teenagers will say they tried to kill themselves when they had a fight with their parents and hit themselves in the head or took four Tylenol or cut themselves superficially.”

But even if only a small number of teen girls are actually killing themselves, the number who are depressed and who say they’re thinking seriously about suicide is nothing less than shocking.

The findings come at a time when young women would seem to have greater opportunities in life than ever. Women outnumber men 57% to 43% at four-year colleges, according to the Federal Reserve Bank of St. Louis, the exact opposite of the ratio in 1970. And today’s teenage girls can’t remember a time when a glass ceiling prevented women from being taken seriously as presidential contenders.

What’s more, many factors that are frequently associated with teen depression don’t seem to be playing a role. Bullying — both online and in person — has declined for teen girls in the past decade, the CDC study shows. Alcohol consumption among teen girls has dramatically declined as well, and girls are using fewer drugs and having less sex with fewer partners.

One logical suspect is the pandemic, with its lockdowns and school closures. But the latest study was conducted in 2021 when the pandemic was waning, and it’s unclear why school closures would drive suicidal thoughts for girls more than for boys — or more than adults who lost loved ones or livelihoods to the virus.

The trend toward depression has been accelerating steadily since 2011, and “there’s not much evidence of a Covid effect,” Jonathan Haidt, a professor at NYU’s business school, wrote in a detailed analysis of the data.

Another logical suspect is social media, given that teens spend an average of 87 minutes a day on social media sites, according to a survey by the nonprofit research organization Common Sense Media.

Long before the pandemic there was a massive shift from in-person to online friendships. Even before the pandemic hit, according to a study at the University of Rochester in New York, the average amount of time that people ages 15-24 spent in person with friends declined from more than two hours a day in 2013 to less than an hour.

Many people have been skeptical that social media can cause depression ever since an influential 2019 study by Oxford University researchers found a very tenuous relationship between exposure to digital media and teen mental health. But that study looked at all digital media (including Netflix) and didn’t separate subjects by gender, Haidt noted.

A 2022 analysis by the Pew Research Center found that teen girls are far more likely than boys to spend time on social media sites such as Instagram, Snapchat and TikTok, while boys favor Twitch, Reddit and YouTube.

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Even though online bullying has declined, girls still spend a lot of time being exposed to unhealthy messages about how they should look and behave. The Seattle school district recently filed a groundbreaking lawsuit claiming that Facebook, Instagram, Snapchat, YouTube, TikTok and Google deliberately addict children to their platforms and serve up inappropriate content that encourages anxiety, depression, eating disorders and self-harm.

In late 2021 a bipartisan group of U.S. senators revealed that they had signed up for social media posing as teenage girls and within a very short time saw their accounts flooded with content promoting anorexia, body dysmorphia and plastic surgery. This encourages “a desperate competition over being hot and thin and taking photos,” Schwartz said.

So it’s possible that teen girls’ use of social media is a major factor in the depression epidemic. But that doesn’t explain why teen girls are voluntarily exposing themselves to so much social media in the first place. Of course if a girl’s social circle is interacting online predominantly, there will be enormous pressure to be online as well, but researchers still don't understand what is originating the initial choice among girls to spend time on social media.

One interesting theory has to do with the fact that girls are going through puberty younger and younger.

In 1860 the average age of puberty onset was 16.6 years in girls. In 1920 it was 14.6, in 1950 it was 13.1, in 1980 it was 12.5 and by 2010 it had dropped to 10.5. The trend is continuing, and today it’s not at all uncommon for girls to develop characteristics of puberty at age 8 or 9.

No one is sure why this is; better diet may be a cause but there may also be links to childhood obesity and chemicals called phthalates that have become common in consumer products and are believed to affect hormones.

It’s been known for years that girls who go through puberty early are more prone to depression. Karen Rudolph, a psychology professor at the University of Illinois, pointed to the fact that so many girls are going through puberty earlier than before as a possible, and only partial, explanation for the sudden prevalence of depressive symptoms.

Girls who go through puberty early often experience a “mismatch” between their physical development and their emotional and social development, Rudolph said. They become subject to social expectations and comparisons that they’re not ready for, and they don’t know how to respond and behave, which often causes stress and feelings of inferiority.

There’s also often a lag between the prefrontal cortex — the rational decision-making part of the brain — and the amygdala, which is more involved in emotional reactions, Rudolph noted. The result is that girls who experience early puberty sometimes have weaker emotional regulation and may be less likely to use constructive problem-solving techniques or ask for healthy types of support.

This may drive many girls down the rabbit hole of social media looking for approval and an understanding of social norms and how to fit in.

Because early puberty can make girls seem more mature than they are, it can also cause them to hang out with older peers who engage in riskier behaviors, Rudolph continued.

And even though bullying is down overall, when it does occur on social media it can be more devastating. “Social media is 24/7,” Rudolph observed. “It was bad before but you could escape. Now it’s constant and the whole school knows about it.”

Schwartz discussed some other factors that are likely at work, including a new emphasis on gender identity that many teenagers find confusing, and the “frenzy” over college admissions.

College enrollment in the U.S. has more than doubled since 1972 and has skewed far more female, which means that many more girls are applying to college at a time when desirable schools have become much more competitive. This not only produces anxiety but requires students to plan earlier and engage in more application-building activities, which reduces their free time. And this correlates with a general recent trend toward young people being overscheduled and having no downtime.

When something has to give, that something is often sleep — in fact only about one-fifth of teenagers now get the recommended eight hours of sleep a night, a sharp drop just since 2013, according to the CDC.

And lack of sleep correlates with depression. In fact a study of 28,000 teens in Fairfax County, Virginia, concluded that “just one hour less of weekday sleep was associated with significantly greater odds of feeling hopeless, seriously considering suicide, [and] suicide attempts.”

Notably, both the CDC and the Fairfax study found that girls are getting even less sleep than boys, and the Fairfax study also concluded that “the reduction in sleep in the transition from middle school to high school was more pronounced for females.”

Yet another problem is that, once enough girls become depressed, the symptoms can be contagious.

A popular theory is that cognitive vulnerability to depression occurs when the prefrontal cortex isn’t properly regulating the amygdala, as can happen when girls experience early puberty. One study of college freshmen found that roommates of students who were prone to depression often “caught” their cognitive styles and became significantly more likely to be depressed themselves.

The result of all this is a toxic brew that is creating a teen girl mental health crisis — although, to some extent, the reduced stigma around mental health in general may mean that some problems that existed before are now showing up in the data simply because girls feel more comfortable discussing them. “Some of it is more reporting and awareness of things that weren’t talked about before,” Rudolph said.

Schwartz added that “we have made progress in helping young people to be more open about their feelings and asking for help. But now we're not sure what to do about it.”

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