Dr. Kevin Most: Stress in Adolescents and Teens

Dr. Kevin Most

We discuss the increasing rate of suicide among adolescents and teens and the causes behind it. Mental Health Awareness is crucial, especially with youth as they face various challenges presented by school, cyberbulling, and more. We touch on what other states are doing to help and tips parents can use in their everyday interactions with their children to prevent excess amounts of stress.

What happened to the stress free life that many of us felt we encountered growing up. The new world of stress in children is something many of us never encountered, so is it a surprise that we have not handled this major change in a timely manner? If you are a baby boomer, you probably did not play on a travel sports team, chances are you played on a local park district team for baseball and a local sports team for other sports. Volleyball, Lacrosse and hockey were not even options for most of us as we grew up. The thought of traveling to a baseball game was as simple as getting on your bike and riding a few blocks to the game. In the winter you may have gone straight from your last class to basketball practice in the local gym. The pressure to make great grades was not highlighted as much as it is now. Many of us had no clue what a GPA was and class rank often had a social aspect to it versus a number. The stress to be in the top 25% of your graduating high school class was nonexistent. For the baby boomers who went on to college the thought of “study abroad” was not on our checklist. We focused on our classes and the weekend football games.

My how times have changed and what a change we have seen.  For many, Sports for many are no longer local, getting to a game may involve a plane ride to another state, hotels and interacting with kids from many non-local areas. The spectrum of sports has changed as well, no longer are we limited to football, basketball, baseball and track. We now see Lacrosse, Rugby and believe it or not Video gaming Teams.

High School grades are so important and pushing the students to excel so they can get into the “right” college is certainly a focus.  Students are focused and stressed to make great grades every day.Parents are often not helpful as they push their children and set expectations that may not be realistic

The word Cyberbullying was not considered a word, and we were more concerned about our Yearbook picture, as Facebook was nonexistent. Bullying was done in person or thru verbal conversations, not thru texts and on line posts.

How is this playing out in society? Over 7% of Children aged 3-17 have been diagnosed with anxiety that is close to 4.5 million children, experts feel the number of undiagnosed is a multiple of that. Well, suicide rates among adolescents and young adults have reached their highest level in more than two decades. The increase has not been subtle, in 2017 we saw 47% more suicides in this age group when compared to the year 2000.

Suicide is the number 2 cause of death in this age group, second only to unintentional injuries/Motor Vehicle Accidents. 

 So why discuss this? Last week we had 3 major stories break about Stress in adolescents and teens.


The first in Oregon where students will now be able to take “Mental Health Days” just as they would sick days. Oregon and Utah are the first states that are telling the schools that mental and physical health should be treated equally. Students in Oregon will be able to take time off up to 5 days for each 3 month period for emotional or mental health issues.  Educators are applauding this as they are faced with dealing with the emotional health of students on a daily basis with little to recommend. This may allow for mental health issues to be identified that may have been missed in the past. Others are concerned as Oregon already suffers from one of the worst absenteeism rates in the nation.

This plan may actually save lives as it allows adolescents and young adults to opportunity to open up about mental health concerns and perhaps identify an issue early and get treatment started and perhaps preventing a major issue.

Oregon has taken this up as they see their suicide rate 40% higher than the national average.



In Florida, the State Board of Education voted that week to add mandatory mental health classes starting in the 6th grade. The plan sets the requirement of at least 5 hours of mental health classes each year from 6th thru 12th grade. The classes are designed to instruct students how to recognize the signs and symptoms of mental illness and what opportunities and resources there are for treatment. It will focus on self-awareness as well as looking out for others. Florida has followed New York and Virginia that put similar requirements in place last year.

Some estimates are that 50% of all mental illness will begin by age 14, so the importance of early identification and treatment cannot be minimized.

These programs allow for identification and early treatment of mental illness, it will also lower the stigma that mental health continues to carry. This program should allow more children to hit their full potential by starting treatment during these early years. Not starting the treatment early will rob them of reaching their full potential and may actually end up with physical harm as well. Remember the Stoneman Douglas killings were done by a 19 yo student with a history of mental illness so Florida has stepped up this issue. 


Screen Time

A study released in JAMA Pediatrics last week looked at the association with screen time in teens and depression and anxiety. This study showed that teens had increased symptoms of depression associated with use of social media use over time. The study showed that each extra hour per day of social media time was associated with an increase in depression scores. The study attempted to see if different types of screen time impacted depression and anxiety differently in teens.

The study showed that teens who spend at least 7 hours in front of a screen ( 20% do) have twice the risk of anxiety and depression when compared to kids who spend a single hour on screens. The link between screen time and depression appears to be stronger in females than males. What was interesting was that video gaming did not have an impact on adolescent depression. The thought is that these games are often played in groups so there may be social and emotional benefits.

One concern they did note was that teens with depression may seek out media that has more depressive content and may cause symptoms to worsen, known as reinforcing spiral. Parents or friends of a known individual who is suffering from depression may find that monitoring the sites visited by the individual may give insight to the advancement of the symptoms.

What should we all be looking for as signs of stress in children? We may see children that complain of physical complaints that are often associated with stress, these include headaches and stomachaches. You may see children withdraw socially and are spending more time alone. You may see new sleeping patterns which may include inability to fall asleep or excessive sleeping. Changes in their school work is often a red flag, the student who is doing well and all of a sudden is not doing well may be a sign of stress. Negative behavior and increased irritability are also signs of stress.



So what can you do?  Many of the suggestions are pretty straightforward but with some regular monitoring you may see positive results or you may see that you need to seek more professional help. 

Some simple things families and individuals can do:

1.)    Spend more time with them. If you think they are stressed try to get them in a comfortable place, do not force them to share their worries but make a comfortable environment and they may share their concerns.

2.)    Review their schedule and your  schedule and make sure they are not totally over loaded, just  looking at a schedule can cause stress. There should always be some downtime during the day

3.)    Make mornings calmer, this sets the tone for the day. You may need to get up earlier and be more prepared to not add to the stress of your children. A well laid out morning can lower the stress and set a good tone for the day.

4.)    We know the importance of sleep, making sure the child gets sufficient sleep and rest empowers them and allows them to avoid stress.

5.)    The importance of a healthy diet cannot be overlooked, children and teens especially when left alone will migrate to a non-healthy diet. Making sure that they get the fruits and vegetables needed for our vitamins is important.

6.)    Manage your own stress well. Acknowledging stress and normalizing it can be helpful as the child will now see that stress is normal and finding ways to deal with it are available.

7.)    Keep them active. We know that activity and physical activity is a great way to manage stress.

8.)    Using relaxation techniques, yourself, around them will show acceptance as well as signal that these tools have worked for you.

9.)    Monitoring web site address and social media interactions may give insight and prevent advancing illness.

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