The teen anxiety epidemic in the US and Australia — and what to do about it

Feelings of isolation and loneliness, as well as associated anxiety and depression, are growing everywhere — and most disturbingly, among our youth. 

Shocking data released by the Centers for Disease Control and Prevention (CDC) in 2023 indicated that close to 60% of teen girls felt persistently sad or hopeless in 2021.

The problem is hardly confined to the United States or to North America. 

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The profoundly important Child to Adolescent Transition Study, recently published in Lancet Psychiatry — the first long-term study of its kind — revealed depression and anxiety in close to two thirds of those studied in Melbourne, Australia, the most ever found anywhere. 

In this study, which is from the Murdoch Research Children’s Institute (MCRI) in Melbourne, 64% of respondents reported at least three episodes of anxiety or depression over their teen years. 

Girls were found to be much more likely to have chronic or persistent symptoms (84% versus 61% in boys). 

Some 1,239 children were studied (enrolled at the age of 8 in 2012) and their symptoms were tracked carefully from ages 10 to 18. 

This was the first major study to follow anxiety and depression longitudinally and the first to demonstrate that the worsening periods of anxiety or depression were associated with milestones such as graduation from primary school or high school — times of major changes in a child’s support structure.

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Dr. Susan M. Sawyer — renowned adolescent pediatrician, leader of the Centre for Adolescent Health at the Murdoch Children’s Research Institute in Melbourne, Australia, and chair of Adolescent Health at the University of Melbourne and the Royal Children’s Hospital — spoke to me from Melbourne in a recent interview. (See the video at the top of this article.)

She emphasized that the reason for the reported increase in anxiety is in part reflective of an increase in mental health literacy.  

"These days there is greater mental health literacy, which leads to more reporting of symptoms," she said. "And adolescents have a greater ability to recognize stress and emotional distress than we did and have the language for reporting it. The stigma is much less, which is healthy."

Sawyer said she thinks the increased rates of anxiety and depression at ages 12 to 13 observed in the study were likely due to a combination of puberty along with the stress of changing to secondary education. 

Also, "girls are more likely than boys to be exploring their emotions at this age," she said. 

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The older group, called the second cluster, took place on graduation from secondary school; emotional symptoms were measured in such characteristic responses as "afraid," "woke up scared" and "afraid something bad would happen to me." 

"Adolescence is a time for figuring out how to gain emotional control," said Sawyer. "It is a time for seeking mental health support. The ‘stiff upper lip’ approach of [older] generations was not healthy."

Unfortunately, as Sawyer pointed out, the resources for intervention remain limited in Australia, the U.S., and around the world. 

The COVID pandemic clearly played a role in worsening anxiety among our teens; yet the CATS study, based in Melbourne — where there was one of the most severe pandemic lockdowns — found that it only contributed around 25% to reported anxiety and depression. 

The problem existed before the pandemic — and it is worse now.

So what role does social media play? The concern is great enough in Australia that it is instituting a social media ban for all those under age 16, which Sawyer and other experts say is not likely to work. 

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"It is tough to implement," she said. 

"And we still need more evidence, though it is clear that the more time spent on social media, the more lonely and the less connected [people are]. We do need some system in place for delaying young people’s access to social media," she added. 

"And we do need to focus on the need for their development of independent skills, of standing on [their] own two feet without phones. Our children need a much safer place to be than social media."

Further research into the role of social media is ongoing at MCRI. In the meantime, children are not allowed to have their phones out in schools throughout Australia. 

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"Social media is a two-edged sword," Dr. Sawyer said. 

"On the one hand, a group that is more socially vulnerable and disconnected in a conflict situation can connect with like-minded peers and become connected via social media," she said.

"But on the other hand, more time spent on distant communities is not good for young people’s health. There is excess exposure to pornography, sexting, gambling and bullying. We need to do something to help our youth to disengage."

So what is the long-term cure for the epidemic of anxious depressed kids and their parents when we must "prioritize clinical services but can’t provide enough response"? 

Sawyer said the focus must be on prevention. 

"Clinical responses need to be overshadowed by prevention. Schools need to be important environments to stress health and well-being – to build a greater orientation to mental health," she said. 

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"There is a risk of glamorization of mental health problems. But prevention, through more attention to the physical environment, more nature, becoming less sedentary, rethinking opportunities, focusing on well-being — this is the real path forward."

Visit go.fox/MCRI to donate or to learn more about MCRI’s important research.