Did you know that more children who have depression also have a co-existing anxiety disorder as well? For that matter, kids aged 12-17 are more likely to be diagnosed with depression, anxiety, or both than younger children. Yet, there is still a strong stigma around teens and mental health. Children and adolescents are certainly being diagnosed more now because of the pandemic. Getting help from mental health services is even more of a challenge with offices being closed across the country. Many mental health professionals struggle with the uptick in people with mental health issues, temporary or otherwise. Mental illness has a great impact on our family units, relationships, employment, and society as a whole. Yet, society continues to treat people with mental health needs as “broken” or “abnormal.” This article is to help people understand mental health, provide insights regarding available treatments, and dispute myths. We will also share adverse experiences teens face stemming from the mental health stigma and how you can be a part of the growing movement to reverse the stigma.
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Factors For Mental Health Problems
There are a lot of things that can factor into someone’s mental health needs. The most common is childhood trauma; most often of an interpersonal nature. This might include childhood abuse, neglect, loss of a parent, chronic bullying, or domestic violence. Trauma can damage the brain of a survivor as the brain will never again follow the same neural firing patterns that it did before the trauma. Individuals who have experienced trauma often have difficulty distinguishing between “being safe” and “feeling safe” and this becomes a rooted way of thinking that lends itself to the development of mental health needs.
Economic status is a major factor in mental health and wellness. This is for quite a few reasons. First, mental health services are harder to obtain with a lack of funds and may not be available in the area. On top of that, the inability to make ends meet can cause incredible stress for any child. The constant wondering if the lights will stay on that month or where the next meal is coming from is more than anyone can handle, especially teens. The fear of homelessness or being homeless comes with plenty of shame and uncertainty for a child who needs stability in their life to maintain mental health stability.
This, of course, does not mean that families who are financially stable don’t have children with mental health needs. Everyone is susceptible to the development of mental health problems if they have other factors in their life.
Other factors include:
- Living with domestic violence
- Living with an alcoholic or drug addict
- Abusing alcohol or drugs
- Suffering from the loss of a loved one
Treatments For Mental Illness
Mental health services that are available can include residential treatment, in-hospital treatment, and outpatient treatment. Let’s review each type of option to understand better what they offer.
For acute mental health needs or when someone reports active thoughts of suicide or homicide, inpatient treatment at a hospital is one of the best options. Unfortunately, this is also the option that comes with the worst stigma for anyone of any age. A teen committed to a hospital stay will have their peers, teachers, friends, and even employers wondering where they are and teens often feel ashamed for struggling. Families have been known to make up “white lies” to tell them why their teen is not at school, church, or work; perpetuating the stigma.
The reality is, hospitalization is a wonderful way for a teen to learn to hit the reset button. They have access to a treatment team 24/7 while in the hospital and get to experience individual, family, and group therapy where they are provided a safe space to talk openly about their thoughts and struggles. Medication management is also provided by a psychiatrist; meds are dispensed safely and monitored for effectiveness. Teens learn that they are not alone and that they can feel more comfortable with themselves. They also learn coping skills to handle their own mental health care when they go back to their usual world.
The maximum time spent in the hospital is usually 7-10 days.
Residential treatment is also called rehab. Rehabilitation centers are often thought of for alcohol and drug abuse, but that is not always the case. These centers can provide rehabilitation in many ways for depression, anxiety, eating disorders, and substance abuse. Unfortunately, because of the association with substance abuse, many teens are equally ashamed of going to a residential treatment center.
Here is the good news, residential treatment works well for many mental health conditions. The teens are surrounded by their peers and professional help for mental health, dietary health, and physical health. In these facilities, the teens learn their coping skills by using Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT). They may have received a diagnosis before entering or receive it upon entry. Some teens will come from a psychiatric hospital to a residential treatment facility to continue with in-depth treatment. This is also a good option for teens who have tried outpatient treatment but have struggled to make any progress.
A typical stay in residential treatment facilities is 30-90 days.
Most mental health needs teens face are treatable with outpatient treatment. They take time out each week or month to see a therapist for talk therapy. They can unpack their trauma, struggles, shame, and fears to an unbiased individual who will not shame them for their thoughts or attitudes. Medication may be prescribed by a psychiatrist who monitors their progress. Many young adults will also engage in group therapy with their peers who have similar mental health disorders.
Outpatient treatment lasts as long as it needs to. As the teen learns new coping skills and changes their thinking, the treatment will adapt. Many young adults will continue seeing a therapist well into adulthood to stay on track. Some can stop taking medication (as guided by their physician) as their mental health improves and eventually utilize therapy on an “as needed” basis.
Outpatient treatment can be the sole form of treatment or be used with residential or hospital treatment.
Mental Health: Myth Vs. Fact
If we want to reduce stigma, we have to stop spreading myths and start talking facts. Of course, not everyone knows about mental illness or specifics for a mental health disorder, but education helps turn the stigma around. Here are some myths that need to be dispelled:
Myth: Teens aren’t really depressed or anxious; they are just teens with hormonal changes.
Fact: Teens are indeed going through hormonal changes that can affect how they think or behave. Anxiety and depression are very different from the hormonal changes that can take place. These issues can be exacerbated by hormones and get worse if it goes untreated, especially into adulthood.
Myth: People with mental illness don’t get better.
Fact: If this were true, no one would seek help. People with mental health disorders do get better. Not all diagnoses can be reversed but coping with the mental health issue is the best way people get better. Many people can overcome their struggles and live very productive lives.
Myth: People with mental illness are to blame, and they should “get over it.”
Fact: Mental illness is not something people are at fault for, and “getting over it” is different for everyone. Someone with depression needs a little more work to heal from a devastating death than one of their peers. Blaming someone for having struggles is the worst thing to do to anyone, regardless of mental health status.
There are so many myths around mental health that need to be combated, but this is a good start for teen mental health stigma.
Mental Health Stigma And Its Impact On Health
There are two types of mental health stigma; social and perceived. Social is related to the messages we receive every day. The comedian who makes jokes about anorexia or suicidal ideations can easily convey that those things are humorous and not traumatic. The person who yells at their neighbor for “being OCD” about the lawn diminishes the reality for people living with Obsessive-Compulsive Disorder. Many folks don’t even realize that they are contributing to the stigma of teen mental health. When we label teens as “moody and angsty,” we are confining them into a convenient label of hormonal changes and the expectation that this is normal behavior, rather than confronting the reality that they could be suffering mentally.
The unfortunate aspect of social stigma is that it feeds into the perceived stigma. Teens are not likely to seek help because they think they should “get over it.” Their depression, anxiety, and any other struggles are not worth mentioning because they will be relentlessly teased about them. They don’t want people at high school to know because they don’t want to be treated differently. Even though they are struggling mentally, they want to be accepted–often by any means necessary. Yet, they believe, through social stigma, that they are abnormal and unsupported.
What happens to the child who does not seek help for mental disorders? Many of them are likely to attempt suicide. Some of them will be successful in ending their lives. Whenever a teen attempts suicide, the community then suddenly comes to attention. Many will talk about the need for better mental health care; some will follow through and fight for it. Others will blame the teen, reinforcing the stigma. Sadly, many accept it as a reality and are indifferent altogether.
The reality is the indifference and blame cause an issue of public health. Fighting for good mental health care for all has been long shouted from the rooftops, more so each year. In areas where the stigma is strong, the less likely you will see funds go towards mental health services. In many low-income areas, getting mental health services is unavailable because the funds go to places with a better response to treatment. In short, treatment doesn’t show up where it’s needed most because of the dangerous beliefs about teen mental health.
Consequences Of Teen Mental Health Stigma
The biggest consequence of teen mental health stigma is that children and their families will not seek help. Yet, without treatment, undiagnosed mental health issues can spiral out of control and lead to dangerous situations for the teen and the community.
Many teens who do not get treatment for mental health needs will self-medicate with drugs and alcohol. Substance use disorders are prevalent with mental health issues in children and adolescents. Attitudes towards teens using substances can also reinforce the stigma around mental illness. It is better to admit you use drugs and alcohol in many communities rather than talk about the heart of the matter: a mental health issue.
Other methods of self-medication and self-soothing include:
- smoking cigarettes or vaping
- eating disorders
- social media addiction
- video game addiction
The Rise of Mental Health Diagnoses In The Time Of COVID
With the pandemic raging in the past year and a half, there are record numbers of mental health diagnoses for people of all ages. Children and adolescents are struggling with the feelings of things not ending and going back to normal. They have been removed from schools or now go back with masks and safety measures in place. They haven’t been able to hug anyone outside of their home. Zoom calls have become the connection method. Television and video game usage has increased substantially as everyone tries to cope with our new normal.
There is a sense of instability for teens. Some of them have become homeless because their families couldn’t work and lost what they had. Others wonder when they will eat next because of lower incomes. If the parents have negative attitudes towards mental illness and struggle with their own mental health changes, everything becomes exacerbated. So now, more than ever, mental health care is critical.
How You Can Help Reverse Mental Health Stigma
Talking about reversing mental health stigma is one thing; doing it is much harder. Many people feel like the issue is too large for them to take on. The reality is, you alone cannot solve the problem on a global scale. Rather, people must start small and allow their work to ripple out and impact change. If half the people who talked about mental health reform could reverse the stigma, we could change attitudes towards mental health care quickly. If you want to work small, here are a few suggestions you can try in your own corner of the world.
- If you have a mental health diagnosis – talk openly about it. The more people talk about it, the more it is heard, the more it changes attitudes. People are also less likely to criticize the brave person they know who is taking good care of themselves.
- Education for all – educate yourself and those around you. It is okay to be misinformed and re-educate yourself with facts. As we tell our children, you don’t know how to do something until you learn. The same applies here.
- Be mindful of your words – every one of us shows bias in our language, often without knowing it. Be mindful of the things you say before you say them. Stop telling people how OCD you are about your sock drawer when you do not have an OCD diagnosis. Stop calling others “bipolar” or other mental illnesses as a way to dismiss their behavior. If you are not capable of diagnosing someone, you should not engage in it. Even in jest.
- Be compassionate to others – most of us know someone with a mental health disorder; we may not be aware of it. If someone is having a hard time, acknowledge it and offer any help you are capable of offering. Don’t belittle someone for “not getting over it” or relying on medication to get out of bed in the morning. It’s not your experience, be compassionate to theirs.
- If you have been hospitalized for a diagnosis or suicide attempt – share your story. Not only do you combat the shame many of us feel, but it can also help someone else find the courage to get help. The more people realize it is normal to go to a hospital for mental health purposes; the fewer people will be afraid to do it.
Combating teen mental health stigma won’t happen overnight. It’s a long road, and yet we have made incredible progress over the last several years. We are seeing more teens speak out about the need for better mental health care. We are seeing more adolescents talk about their own mental health experiences. If we jump on board and keep that momentum going, we can see a significant change sooner than we believe.