INSTITUTE FOR POLICY RESEARCH

The Kids Are Not All Right

IPR experts share what we know about the surge in teen mental health issues

American teenagers are not all right.

For over a decade, they have struggled with declining mental health. Growing rates of anxiety and depression, emergency room visits for mental health issues, and suicides point to an alarming trend—teenagers are living through a serious mental health crisis. 

Why? Some academics and public health experts like the former U.S. Surgeon General believe that social media is the biggest culprit. Other scholars paint a more complicated picture, with some raising doubts about the direct role of social media.

IPR spoke with four of its experts on teen mental health and wellbeing about what their research says about the causes and how to help struggling teenagers.

Unpacking the Crisis

Around 2011—nearly a decade before the COVID-19 pandemic—teenagers’ mental health issues began to climb, says Northwestern postdoctoral fellow Sarah Collier Villaume. Between 2011 and 2021, teenagers who reported experiencing symptoms of a major depressive episode in the last year went up from roughly 8% to 20%, while rates of anxiety also jumped. And the suicide rate for kids and young adults between the ages of 10 and 24 went up by a staggering 62% between 2007 and 2021.

“It's not just visible in self-reported data,” IPR developmental psychobiologist Emma Adam said. “It's also visible in hospital admissions and clinically diagnosed data.”

What’s less clear a few years after the end of the COVID-19 pandemic—which worsened mental health issues for teens and adults—is whether those rates have plateaued or if they are continuing to rise.

Girls and LGBTQ+ youth are the most likely to report challenges with mental health, according to data from the Centers for Disease Control and Prevention (CDC). In 2023, 53% of teenage girls reported feeling persistently sad or hopeless over the last year, jumping from 36% in 2011. Among LGBTQ+ teenagers, 53% say they recently experienced poor mental health in the last 30 days.

“The sheer prevalence means that it affects many, many young people in the U.S., so knowing that people are hurting on a mental and emotional level is of concern,” Collier Villaume said.

Some argue that the rise in poor mental health coincides with the fact that young people are more literate about their emotions, wellbeing, and therapy and may be self-reporting more issues like depression and anxiety. But Adam argues that data consistently point to worsening mental health.   

One reason those between the ages of 10 and 19 could be more vulnerable to mental health issues is because they’re experiencing rapid change.

“There's a lot going on in adolescence,” Adam said, calling it a “second sensitive period,” with the first being between the prenatal period and age five. Social changes in the family, at school, and among peers, can be stressful, along with rapid growth in the body and the brain. 

“There does seem to be a true increase in suffering,” Adam said.

Understanding the Growing Brain

IPR psychologist Katie Insel, who studies brain development in adolescents, says while the brain is done growing in size, regions like the prefrontal cortex—which controls planning and impulse control—are still maturing during these years. Importantly, the prefrontal cortex continues to develop in how it communicates with other regions of the brain that react to emotional cues or rewards.

“We see that adolescents sometimes have different motivational drives,” she explained. “Sometimes they experience temporary lapses in how they engage in self-control. Or they make decisions that look impulsive or might also seem out of character in certain moments if they're with their peers or in an exciting environment.”

Insel, who also examines how teenagers respond to different types of rewards, finds that teens with depression respond to rewards in different ways than healthy teens. Their reward centers didn’t distinguish between small and big rewards. This suggests that teenagers experiencing depression might have blunted reactions to larger rewards, which could interfere with their ability to experience pleasure or excitement.

“They may not gauge what's an important difference and what feels exciting and rewarding,” she said.

Right now, we don’t know a lot about what puts some teenagers at a higher risk for mental health issues than others, Insel explains. Ideally, researchers would use brain scans to understand which teens are most at risk, but science isn’t advanced enough to have an exact biomarker—or measurable sign to show what’s happening in the body—in the brain to diagnose mental health disorders. Instead, many researchers currently use large publicly available datasets to understand the differences between groups of healthy and unhealthy teenagers.

Scholars are starting to learn more from datasets that follow individuals longitudinally as they grow older, which can shed light on differences in the brain among individual teenagers. In her Child & Adolescent Translational Science (CATS) lab, Insel plans to conduct a study monitoring teens’ moods and brain function over several weeks using MRI scans. These scans, along with information about their sleep, mood, and emotions, can provide insights about how moment-to-moment changes in mood affect the brain.

“There's a lot of promise, but right now, it's really hard to fine-tune what is the mechanism, or what's going on under the hood, that really differentiates teens that are at risk versus those who aren’t,” Insel said.

What’s Behind the Decline in Mental Health?

One of the biggest debates around the mental health crisis is what’s driving it.

When it comes to social media, Ellen Wartella, a communications studies researcher and IPR associate who studies how media affects kids, says that while teenagers are spending a lot of time on social media, the research on the connection between it and mental health issues is mixed and inconclusive.

“Some kids are affected and some aren’t, but it is not at all clear that social media use is the major cause of adolescents mental health issues,” she said.

Wartella says many things could be affecting the upward trend in mental health issues, including the rise in gun violence in schools, noting that “Violence is unfortunately a part of adolescents’ lives in the U.S. today.”

While social media is a means for teens to connect with friends and family, it can also restrict their social connections, Wartella says. Adam agrees, saying the cell phone itself has been a major disruptor, affecting relationships, attention spans, and sleep. 

“The cell phone is “both taking away positive relationships, face-to-face, positive relationship experiences, and adding, for some people, some more toxic relationship experiences,” Adam said.

Some researchers argue that while they can’t conclude that social media is bad for everyone, it is bad for some teenagers, she says, but they were struggling with emotional issues before they started using social media.

What the evidence does show is that stress is often a cause of anxiety and depression, Adam says. “Interpersonal stress,” or stress caused by relational conflict, is the strongest driver of a depressive episode.

Lack of sleep has also been linked to poor mental health. Research by Collier Villaume and Adam finds that teenagers who got less sleep were more likely to report more negative emotions the next day, increasing their risk for depression later on. 

There’s also evidence linking stress from what they call “economic precarity,” or financial instability, to higher rates of mental health issues among teens. Teens facing financial instability might live with parents with less education or might be juggling college and work.

“We see pretty strong evidence that that's a predictor of worse mental health,” Collier Villaume says. 

Two of their studies point to financial instability as a possible cause: During the pandemic, teenagers experienced more stress and negative emotions if their parents had less education, suggesting that they may have been more stressed because of family finances or because their parents were less likely to work remotely. Another shows 18- to 39-year-olds were more likely to report higher rates of anxiety and depression compared to older adults during the pandemic—largely driven by stress linked to earning less income or renting instead of owning a home.

“What's really complicated about all of this is the thing that may be causing any one person to get depressed may be different than the thing that's causing the societal trend in increased depression and anxiety,” Adam said.

How Can We Support Struggling Teenagers?

When it comes to helping teenagers with mental health issues, researchers have found promising evidence around interventions like practicing mindfulness.

One study Adam is conducting tests how teenagers who are more likely to experience negative emotions respond to a mindfulness app. Teenagers complete exercise on the app and meet weekly with a coach. Adam and her colleagues at the University of California, Los Angeles and Vanderbilt University already see evidence that using the app has a positive impact on teenagers’ moods and reduces depressive symptoms. 

Another practical way to lower the risk for mental health issues is to push back the start of the school day for older students, who often don’t get enough sleep.

For teens, beginning classes later in the morning could have real benefits because getting enough sleep each night can decrease their risk for negative moods, along with depression and anxiety. States like California and Florida have already passed laws requiring middle and high schools to start later.

“It's not just that they like to hang out with friends more late at night or be or be awake later,” Adam said. “It's that their body wants to be awake later—there's a biological shift.”

Collier Villaume points out that it’s important to address teen mental health challenges because struggling with them at a young age can have ripple effects later in life.

Adam says mental health challenges also have physical consequences including changes to inflammation, heart health, and eating habits, which can be costly for individuals, the healthcare system, and society.

“We're really talking about the future of our workforce,” said Adam. “If you're talking about a whole generation that is more anxious and depressed than the last generation—these are our future leaders.”

If you are struggling with thoughts of suicide, contact the 988 Suicide and Crisis Lifeline.

Sarah Collier Villaume (PhD 2022) is a postdoctoral fellow in Northwestern’s School of Education and Social Policy E4 Center and a former IPR graduate research assistant. Emma Adam is the Edwina S. Tarry Professor of Human Development and Social Policy and an IPR fellow. Katie Insel is assistant professor of psychology and an IPR fellow. Ellen Wartella is a professor of communication studies and an IPR associate.  

Graphic by Ysa Quiballo

Published: February 27, 2025.