Teen and youth anxiety and depression are getting worse since COVID lockdowns began in March, early studies suggest, and many experts say they fear a corresponding increase in youth suicide.
At the end of June, the Centers for Disease Control and Prevention surveyed Americans on their mental health. They found symptoms of anxiety and depression were up sharply across the board between March and June, compared with the same time the previous year. And young people seemed to be the hardest-hit of any group.
Almost 11 percent of all respondents to that survey said they had "seriously considered" suicide in the past 30 days. For those ages 18 to 24, the number was 1 in 4 — more than twice as high.
Data collection for several studies on teen mental health during the pandemic is currently underway. And experts worry those studies will show a spike in suicide, because young people are increasingly cut off from peers and caring adults, because their futures are uncertain and because they are spending more time at home, where they are most likely to have access to lethal weapons.
"Teenagers are in a developmental space where it is critically important that they have regular contact with their peers and are able to develop close and ongoing relationships with adults outside the home, such as their teachers, their coaches, their advisers," says Lisa Damour, an adolescent psychologist who is a columnist and host of the podcast Ask Lisa: The Psychology of Parenting. "And I worry very much about what it means for that to be disrupted by the pandemic."
The stressors of COVID come as youth suicide was already at a record high before the pandemic, with increases every year since 2007. Suicide is the second leading cause of death among people ages 10-24, after accidents, as it has been for many years, according to the most recent data available from the CDC.
Not having guns in the home, or keeping them safely locked away, is another overlooked factor in suicide risk. A new analysis of the latest CDC data, just released by the advocacy group Everytown for Gun Safety, found that the rate of specifically firearm suicides increased 51% for 15-24 year olds in the decade ending in 2018. Among 10- to 14-year-olds, who have a lower rate of suicide to begin with, suicide by gun increased a staggering 214% in that time frame.
Gun suicide is astonishingly lethal: Of all suicide attempts not involving guns, 94% fail, and most of those people do not try again, Everytown reports. Of all suicide attempts that do involve guns, 90% succeed. That's one reason that gun ownership correlates with the youth suicide rate, state by state. A study last year found that for each 10 percent increase in household gun ownership in a state, the suicide rate for 10- to 19-year-olds increases by more than 25 percent.
And, the presence of guns is another community risk factor that has increased during the pandemic: From March to July 2020, Everytown reports, gun sales doubled compared with the year before.
Carrson Everett, 17, says when he himself attempted suicide, the fact that his parents kept their guns safely locked away and out of reach most likely helped save his life. He says that during the pandemic, "Teenagers are already having the effect of isolation, staying at home and everything. And now there's all these new firearms in their homes and, you know, we can't tell who's safely storing their guns and who isn't. And it's very dangerous."
Everett has started his senior year of high school in Kingsport, Tenn., on a hybrid schedule. On the days that he's home, he says he wonders what he's missing out on at school. "Everyone feels isolated, and it's been very tough for everybody."
He says these past few months have been especially hard for him because he has depression and anxiety. Plus, he says he's been bullied for years for being gay, including over video chat during distance learning.
Everett is a volunteer for Students Demand Action, an anti-gun violence group that is part of Everytown. He said he's learned that gun violence isn't just a matter of crime or mass shootings, but also suicide. "I wrote an op-ed about a kid that was my age over in Cookeville, Tennessee, that had taken his own life with a firearm because he had been outed [as gay] at school. So, you know, it's very relatable for me."
Damour, the teen psychologist, explains that not having guns in the home, or keeping them safely locked away, is important especially for adolescents because "teens are impulsive."
What parents can do
She says parents need to know that suicide is preventable. A red flag is when sadness is more than a passing mood. Caregivers need to check in regularly — which can be unexpectedly complicated when the whole family is spending so much time at home.
A common pattern, she notes, is parents trying to work during the day, and teenagers staying up late at night to have time to themselves. This isn't inherently a problem, Damour says, but "there's a difference between allowing privacy and allowing a teenager to hole up in their room for days at a time."
If a teen talks about harming themselves or wanting to disappear, a parent should ask directly, "Is that something you think you might really do or you think about doing? Or are you just letting me know that you're very upset right now?" And, she adds, hear them out without dismissing what they're saying.
She also says parents should look out for anger: "In teenagers, uniquely, depression can take the form of irritability. That depression in teenagers sometimes looks like a prickly porcupine. Everybody rubs them the wrong way. And that is easy to miss because sometimes we'll just dismiss that as being a snarky teenager."
If school is all-virtual, she says, parents should look for safe sports, work or volunteer opportunities that allow teens to have social time and contact with other caring adults.
Finally, Damour says she sees one bright spot: During the pandemic, she and other clinicians are finding that telemedicine — therapy over video chat — is working surprisingly well with adolescents.
"The teenagers that I see are often talking to me from their bedrooms, sometimes flopped over in their beds," she says. "There's something unguarded about it that's very different than having them sit in my office."
And, virtual therapy can lower barriers to access for families who might have had to travel to get accessible mental health care.
If you or someone you know is having suicidal thoughts, reach out for help. The National Suicide Prevention Lifeline is open 24 hours a day at 800-273-8255.
STEVE INSKEEP, HOST:
People who feel that the pandemic is affecting their mental health should know they're not alone. Early studies of younger people show a special problem. Anxiety and depression in teens and youth are getting worse since March. We should advise you this story involves suicide, which, among young people, was at an all-time high even before the pandemic. What happens now? NPR's Anya Kamenetz joins us. Good morning.
ANYA KAMENETZ, BYLINE: Good morning, Steve.
INSKEEP: What makes psychologists particularly concerned now?
KAMENETZ: So it's early for a lot of data. But at the end of June, the Centers for Disease Control and Prevention did survey Americans on their mental health. And they found, yes, symptoms of anxiety and depression are up sharply across the board this spring compared with the previous year and especially for young people. Almost 11% of all respondents in that survey said, I have seriously considered suicide in the past 30 days. But for those ages 18 to 24, that number, Steve, was more than 1 in 4, more than twice as high.
INSKEEP: Jaw-dropping number. I can guess the reasons. But what do the reasons seem clearly to be?
KAMENETZ: You know, so much uncertainty about their futures, their education. Their routines are gone. And to some extent varying across the country, young people have been so cut off not only from their peers but from caring adults. I talked to Lisa Damour, an adolescent psychologist. And she told me because of teens' developmental needs...
LISA DAMOUR: It is critically important that they have regular contact with their peers and are able to develop close and ongoing relationships with adults outside the home, such as their teachers, their coaches, their advisors. And I worry very much about what it means for that to be disrupted by the pandemic.
INSKEEP: So all of that is disrupted for millions of people. What other factors could affect suicide rates?
KAMENETZ: So it's a little bit overlooked, but Everytown for Gun Safety, which is an anti-gun-violence group, has just put out an analysis noting that gun sales actually doubled between March and June in America compared to the year before. Ten million guns were sold during that time frame. And as we've reported on NPR, at least one estimate shows that 40% went to brand new gun owners. And Everytown calls that a red flag because firearms are already used in half of all youth suicides. And youth firearm suicides have already been growing very fast over the past decade. In fact, a study last year showed that gun ownership in a particular state was the strongest single predictor of youth suicide rates in that state. I talked to Carrson Everett about this. He's 17 years old, and he volunteers for Students Demand Action, in - which is part of Everytown.
CARRSON EVERETT: Teenagers that are already having the effect of isolation, staying at home and everything. And now there's all these new firearms at their homes. And we can't tell who's safely storing their guns and who isn't.
KAMENETZ: And this is super personal for Carrson because he himself says he has attempted suicide in the past. And if his parents hadn't had their guns locked up safely, he says he might have succeeded.
INSKEEP: What should parents keep in mind?
KAMENETZ: Psychologists emphasize to me that suicide is preventable. You should talk to your teen. Don't be afraid to ask them directly if they thought about harming themselves. And remember teletherapy can be effective during the pandemic and safe, of course.
INSKEEP: NPR's Anya Kamenetz, thank you very much.
KAMENETZ: Thank you, Steve.
INSKEEP: If you or someone you know is having suicidal thoughts, the National Suicide Prevention Lifeline is available 24 hours a day - 800-273-8255. Transcript provided by NPR, Copyright NPR.