Funding for To the Contrary, provided by: This week, on To the Contrary: We were seeing increases in the percent of students who said that they had considered suicide, that they had made a suicide plan, that they had attempted suicide.

That's why we need this movie more than ever because anxiety disorders and depression are medical conditions.

This week, a mental health crisis among adolescent girls and young women.

For at least a decade, government and academic organizations have reported a trend showing an increase in anxiety and depression.

One of the most striking findings is that girls are suffering at nearly twice the rate of boys.

“Just Like You: Anxiety + Depression” was produced by filmmaker Jen Greenstreet, who is known for her medical documentaries.

She decided to make the movie after a friend asked her if she ever considered making a film about anxiety and depression.

I thought about it and I'm like, I'm definitely open to that.

But Kathy, we usually make movies about medical conditions.

That's kind of our thing.

And she said exactly, exactly.

That's why we need this movie more than ever because anxiety disorders and depression are medical conditions.

And because I put them in a separate category, and I think most people do put them in a separate category.

And I think it feeds the stigma around this conditions.

Stigma.

Despite numerous campaigns to destigmatize mental health issues, stigma continues to prevent those in need from seeking help.

We are seeing increases in the percent of students who said that they had considered suicide, that they had made a suicide plan, that they had attempted suicide.

And so even prior to the pandemic, we started to really get concerned.

Then came COVID-19, with its fears and lockdowns.

The pandemic really had a negative impact.

And so after the pandemic, we really had seen an escalation in poor mental health and in suicidal thoughts and behaviors among young people.

But really what we also started to see was that the disparity between girls and boys had been widening and that the increase in poor mental health was really accelerated among teenage girls.

Dr. Kathleen Ethier is director of Adolescent and School Health at the CDC, where they conducted the nationwide research on young people.

The results proved to be a real eye opener.

37% of girls reported feeling depressed and/or anxious.

That's compared with 14% of boys.

The number jumps to 70% for LGBTQ+ young people.

Mental health emergency room visits increased beyond expected rates for girls near the end of the pandemic, and continued rising after the COVID emergency had subsided.

They were stressed out enough to need psychiatric hospitalization.

Dr. Artha Gillis, a child and adolescent psychiatrist at UCLA health, says there continues to be a higher rate of mental health cases at the hospital among young people.

Our emergency department was flooded with kids under age 12 who were stressed out by the election.

And if you think about that age, they are nowhere near voting age, but they are hearing things and seeing things on the internet that they have no control over, and it's raising all levels of fear in these kids when they should be focused on school and, you know, playing video games and having sleepovers.

It would be naive to think that much of the the strife and the discourse that we're all experiencing in our environments, in our communities these days is not affecting young people.

It's absolutely what's going on in all of society and what's going on globally.

It is about the climate, it is about the political environment.

And again, these are things that 20 years ago, kids didn't have access to the information about it as much.

Another recent study found women of childbearing age, but not men, reported increased anxiety in states with abortion bans enacted after the Supreme Court overturned Roe v. Wade.

The study used data from the Census Bureau and other federal agencies, and there are many reasons anxiety is more prevalent in females than males.

There's so much pressure on young ladies to have a certain appearance and meet a certain standard that social media or whomever may set for them.

Jen points to one young lady in her film as an example.

Morgan also shared, she got to a point in high school where she was so anxious about walking into the school that she stopped going to high school.

I think some parents think, well, we all experienced pressure when we were adolescents, right.

It's a part of growing up, but it seems to be different these days.

I think there's a X factor because of social media.

It has made childhood and adolescence more complex, and it's made parenting during childhood and adolescence more complex.

Is it really more challenging today for girls and young women than for prior generations?

Girls have a lot of pressures, and they're to an extreme that we didn't have growing up or that their parents didn't have growing up, their mothers.

It's pressures based on appearance.

It's social pressures.

It's pressures to succeed academically, its pressures to succeed athletically.

And those pressures take a toll.

They are more vulnerable to developing depression and because of the performance piece, they need to appear a certain way.

It can often not be okay for our girls in particular to say that they're not okay.

And so they may engage in things like risky behaviors.

They may engage in self-harm behaviors.

They may start using substances.

We also know that not feeling that sense of connectedness can negatively impact girls.

And we know that girls and LGBTQ+ youth are all less likely to have that protective sense of connection at schools and in their communities.

Dr. Ethier says parents ask what they can do to support young people's mental health.

Making sure that they get enough sleep, that they get proper nutrition, that they engage in physical activity.

Those are everyday things that really support good mental health.

There are other things that we need to do in young people's environments.

And this particular really holds for girls.

And that is to make sure that their school and their community environments are safe.

The greatest skill is listening.

Listening.

I think kids are talking from the moment they start to talk, and it's more about learning to listen as a parent and understand the child's perspective and how they see things, and being curious and not always feeling like you need to be prescriptive, meaning telling the kid everything to do this is how you need to handle that.

You're developing an adult, and so you need to think as a parent about what skills they need as an adult.

The other thing is parents can think about emotion regulation, and that starts with even labeling emotions.

I think talking more about that, trying to understand what's happening and why and what solutions might be.

Were seeing some glimmers of hope specifically for girls.

We actually saw a decrease in depressive symptoms among female students.

And so while that decrease is relatively small, it is significant.

We're not out of the woods by any stretch.

And there's so much more we need to work on on this issue.

But we are starting to see some, as I said, small glimmers of hope.

Joining me today are Dr. Artha Gillis, who was interviewed in the piece, and Dr. Vaile Wright, senior director of the Office of Health Care Innovation at the American Psychological Association.

So tell me, doctors are there new studies showing boys are suffering, too?

And what do you make of that?

We certainly do know that boys are suffering as well.

There has been some emerging research coming out of the pandemic that it might have had a disproportionate effect on boys.

I think the reasoning behind that is still unclear, but I would argue that one of the things that we did see during the pandemic was increased isolation.

And we know one of the ways that boys get their social connection is via activities and less so verbal kind of emotional connecting.

So that could have had an impact.

So I think there is a real increase.

I also think there's probably an aspect of culture that's occurring as well, where we are seeing more acceptance of boys and men acknowledging depression without being seen as weak.

Boys and girls may respond differently and have different needs in terms of their emotional and social development, and they do tend to be more active and need to participate in sports and other things, and maybe rely less on verbal interactions, socially and such.

So that could be a reason why boys have been impacted as well.

Well, let's dig a little deeper into the differences between girls and boys.

You say, Dr. Gillis that, you know, boys rely more on sports and girls are more sociable.

Tell me more about that.

Why did these differences occur?

Is it just due to hormonal differences?

I don't know that there's so much due to hormonal differences.

Dr. Wright talked about culture.

It also could be related to historically how we've socialized boys and girls.

I would say girls are becoming more involved in sports.

This is the 50th anniversary, I believe, of Title IX.

And so there's definitely, if you look at women's basketball, it is really hot right now.

And so, there are ways that women and girls are turning to different resources they're using to support their emotional development.

For girls and boys, I think historically it's just been the way that we've socialized in society.

Women in particular, we tend to be more social and draw a lot from our social interactions with our peers.

So boys are not getting as much face time with other boys.

Is that what is going on?

I mean, I think it's a little bit of that.

I think that during the pandemic, at least, girls were probably able to take advantage of technologies, to stay connected in ways that boys maybe didn't take advantage of.

If, you know, most of your interaction is typically face to face.

So I think that's probably part of it.

There could be other reasons why the pandemic was particularly hard on boys and men.

I think this is the kinds of things that we'll see research on for the next decade, probably is trying to really impact, how this collective trauma that everybody experienced is going to impact us for potentially the rest of our lives.

What is it about this young generation that has changed in terms of perceptions of mental illness?

Are they any less harsh than prior generations were?

Are they more accepting of it?

I think they're definitely more accepting of mental illness.

They're more aware they have more access to information at a younger age because of social media and the internet.

And so I, I don't think they've been exposed to the extent that older generations have been to the stigma around mental illness.

Yeah.

I think if there is one of the most positives that came out of the use of social media has been its ability to tell narrative stories about people's lives and particular stories around mental illness and emotional well-being, which in turn has probably reduced some of the stigma.

And has normalized it, particularly when you have, you know, male athletes come out and talking about their depression or celebrities.

I do think that that has an impact on younger generations, and that is certainly not something that I remember growing up seeing as much.

Absolutely.

Celebrities, even politicians, I mean, you name it, its definitely more of a spoken about it, a lot more on social media, TV, you name it.

So what, how can this be used by psychologists to help both girls and boys with anxiety and depression?

And what do you think knowing this now about these problems, what should schools do to help kids along with them?

I mean, you're certainly seeing psychologists use some of these platforms as a way to educate the public about mental health.

One of the challenges, one of the opposite challenges of social media is that there's also a lot of misinformation out there.

So it becomes really important that those with the subject matter expertise really get the truth.

And so the, you know, appropriate advice out there.

In terms of schools, I think there's a lot of opportunities for schools to really recognize the need for mental health services so that it can include things like screenings on a regular basis, offering services in schools themselves, because that's where kids spend the majority of their time.

As well as really engaging in the local community, because every school, every communities mental health needs might not look exactly the same.

So really becomes a group effort.

Yeah, I think they also can integrate conversations about mental health into the curriculum.

One of the biggest predictors of someone's success is their emotional intelligence, their ability to regulate emotionally.

And so it seems remiss that we teach about core subjects and even elective subjects, but not, we don't integrate how to regulate emotions or coping strategies.

And so it could be lost on a kid who's very intelligent, can get through the academic parts of things, but have a difficulty regulating emotionally and it's skills that we all need.

So they should be taught in school.

These skills should be taught in school as a part of the curriculum.

Are schools going to have the resources to do this?

I mean, they're pretty strapped right now, right?

They are.

It's a matter of priority.

Again, we're investing so much into our young people, into their academic development but we should be developing them socially and emotionally in parallel.

And we can no longer just rely on parents to do that at home, because we have to regulate school so many hours of the day, and there's just so many pressures theyre exposed to throughout their lives at a much earlier age.

The two primary movers, I would guess, for this anxiety are social media and possibly the COVID epidemic when everybody was locked in at home for, you know, years.

How do those two particular aspects of our culture change the way, the amount of anxiety and depression that young girls and boys are having?

And how does it change from one racial group to another, or do they experience it differently?

The overarching theme of what is driving a lot of the anxiety of this generation is an uncertain future, and I think you can load into that uncertain future.

Yes, the potential for another pandemic, the unbelievable number of mass shootings, particularly school shootings that occur, climate change is something that younger adults are very concerned about as well as I do think social media plays a role in, if nothing else, the way it exposes young people to, again, images of trauma across the globe.

And so I think all of these things most certainly have an impact on youth these days, and disproportionately probably by subgroups.

So, you know, social media in and of itself isn't a good thing or a bad thing, right?

It's really about what are you seeing, how are you interacting with it?

What are your preexisting strengths and weaknesses, and what's the context in what you live, in which you live?

Also, are people more judgmental or less judgmental, especially young people in the internet age?

I don't know that we can say they're more or less judgmental, and I don't know that research has been done to quantify the degree were judgmental.

I think people were more aware of what people's judgments are.

And I think social media and the internet create this context where people can hide behind their screen, so to speak, and be able to say things that maybe they wouldn't say socially, face to face.

And so we're exposed more to other people's private judgments about others, about ourselves.

And that's harder to deal with and just in general to highlight what Dr. Wright was saying, kind of the context of each, the intersection of all these societal changes with the internet, with social media means that kids today get exposed to things a lot quicker.

Whereas when I was growing up, you didn't hear about news until you got home in the evening and your parents really could shield you from some of the really big things or help create a narrative and reassure you.

Your child can get exposed to these things at school, through social media, through peers, and in doses that are much higher than what we were exposed to growing up without sufficient coping strategies, without sufficient supports and scaffolding while they're trying to learn.

And how about the different cultural reactions African Americans, Hispanic Americans, Asian Americans, Native Americans?

And do they have different reactions than white boys and girls have?

I would assume that such would be true.

I don't know to what extent it is true and in what ways.

I think we need to study that.

Our children today are probably more exposed to a global culture, and it's less kind of regimented or kind of factored, like kind of sectioned into our different communities.

I think it's less segregated in that way on social media, and they're exposed to a lot more for better or for worse.

So it'll be interesting to study the impacts and based on gender, sex, race over the next decade, like Dr. Wright said.

So overall, would each of you, despite the fact we've been talking about that boys and girls have problems with anxiety and depression, would you both agree that it's worse, still worse for women and girls, young women and girls?

That's certainly what the data suggests, right?

That up until about puberty, boys and girls report similar levels of depression and anxiety And so something does shift for girls as they hit puberty.

Many of the things that we've already talked about, including, you know, girls have a tendency to then stop actually engaging in sports and some other activities as they, as their bodies begin to change.

I think that women are under extreme pressures around body image and around sexualization of their bodies.

There are so many stressors that everybody in this country and globally are experiencing that, unfortunately, we're going to continue to see mental illness rates rise if we cannot help address both, at a preventive level, but also at an illness level when people are suffering.

And why do you think girls do suffer more anxiety and depression?

Are they, is it because there's so much of focus on girls looks, is it the, you know, the thought of having a career or the fears of having, handling having a career and kids when they grow up, what's going on?

So I think there are pressures that girls have and to a greater degree these days, but also there's brain development to, the male brain and the female brain develop in different ways, in a different time frame.

Socially, girls can develop in a more advanced ways, faster than boys as well.

I think there is a catch up period, but the trajectory is different.

And expectations, I think, in society are different.

What we've added in as a factor is exposure to social media, exposure to news through social media.

And I don't think we quite know how the male and female brains are quite dealing with this new exposure, and how, what, how much stress it places on development or how it might be altering development even.

Dr. Wright, yeah, I'd love your thoughts on that.

What?

Why it is the girls, what about the human brain makes it that girls develop more, become mature younger.

And how that impacts anxiety and depression?

I don't know that we know developmentally why boys and girls develop at different rates.

You know, I'm sure, you know, there are many factors at the cellular level, at the biological level, at the exposure to environmental level that are involved.

It's hard to just pinpoint kind of one thing that makes it so that girls have it harder than boys.

But it does seem like, you know, to Dr. Gilliss point that the expectations that women face in the society are clearly more stressful in a lot of ways, not entirely.

There are still obviously stressors that men experience, too.

But I think that the degree of cultural support for women's stressors isn't as strong.

And I think that there is a certain level of competitiveness and perfectionism that exists for girls and women that I'm not sure men experience to the same degree, at least at that young of an age.

At the end of the day, we end up equating our accomplishments with our worth, our self-worth, right?

In ways that I don't think are very helpful.

Right?

Instead of weighing up my self-worth to making the swim team or getting straight A's, those are great things.

But what if we also measured our self-worth by how kind we were to others?

And the degree to which we were generous with our time, our resources, and our love.

What about commercialism and materialism, which has always blighted society?

But these days more than ever, I mean, I think, I grew up in New York City, and I remember going to Times Square as a kid and the signs are so much bigger, brighter, illuminated, blinking, moving.

You know, it's just crazy.

It's a total emotional overload to go down there.

I should think especially for a young child.

Yes or no?

Yes, absolutely.

And I definitely agree with that.

I think our children are exposed to more images of what it means to be perfect.

This is the perfect body.

This is the perfect lifestyle and their expectations of what they should be able to do at certain ages, and what they should have access to at certain ages are just completely unrealistic, and parents need to be aware of what their children are exposed to so they can manage those expectations and give them a proper kind of expectation of where they should be at a certain point.

I think before I was given an example of a parent I was treating, she was talking about her 13-year-old wanting plastic surgery to fix certain things about her body, and she was quite alarmed by her child, who was exposed to social media, exposed to peers, who are also exposed to social media, and just have these unrealistic expectations of what their body should look like as they grow through puberty, and also not valuing that her body is unique and it's okay for her body not to look like someone's body, someone's filtered image on social media, and maybe not understanding that there are a lot of filters on social media.

And much like we had to learn growing up, the things we see on TV aren't necessarily real, that things on social media aren't real.

And you don't need to compare yourself to that.

All right, to each of you, before we go, please.

Research has shown that depression is falling a little bit among girls, students.

What do you make of that?

And where do you think this is coming from?

I think it's too early to tell exactly what the causes are of that.

And hopefully it's not just an anomaly in terms of the data, but that maybe it is sustainable.

You know, certainly I remain hopeful.

I remain hopeful that because there are more open conversations that maybe people are seeking out resources in different ways, maybe not traditional therapy because we haven't seen necessarily rises in therapy use across the board.

But in other types of resources.

One of the great things about technology is the fact that there are so many great resources that are at our fingertips that don't cost a lot of money.

And so that's what I'm hopeful that some of that and some of these discussions are actually helping people feel seen, feel heard and not feel alone.

Yeah same.

I maintain the same hope.

I'm hopeful about those numbers.

I hope it is a trend.

I would say with any study like that, the findings have to be contextualized.

Did they ask the people who were sampled or, you know, surveyed in the study why they thought, how they were managing their depression, what they found helpful in managing their mood?

But I hope it is a trend, a positive trend in the future.

Thank you both, Dr. Gillis and Dr. Wright.

That's it for this edition of To the Contrary.

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