Mental Wellness in Adolescence
Essential Information: Around the globe, mental disorders affect one out of every seven individuals aged 10-19, contributing to 13% of the worldwide disease burden for this age group. Mental health issues such as depression, anxiety, and behavioral disorders are primary causes of illness and disability among teenagers. Suicide ranks as the fourth leading cause of death for individuals aged 15-29. Neglecting to address adolescent mental health issues can have long-term effects, impairing both physical and mental health in adulthood and limiting opportunities for a fulfilling adult life.
Overview: Adolescence, a period that one in six people are currently experiencing, is a distinctive and influential time. Various factors, including exposure to poverty, abuse, or violence, can make adolescents susceptible to mental health issues. It is crucial to protect adolescents from adversity, foster socio-emotional learning and psychological well-being, and ensure access to mental health care for their health and well-being during adolescence and into adulthood.
Globally, it’s estimated that 14% of individuals aged 10–19 experience mental health conditions, but these conditions often go unnoticed and untreated.
Adolescents with mental health conditions are especially susceptible to social exclusion, discrimination, stigma (which affects their willingness to seek help), educational difficulties, risk-taking behaviors, physical ill-health, and human rights violations.
Determinants of Mental Health: Adolescence is a critical period for developing social and emotional habits that are important for mental well-being. These habits include adopting healthy sleep patterns, regular exercise, developing coping, problem-solving, and interpersonal skills, and learning to manage emotions. Protective and supportive environments in the family, at school, and in the wider community are also important.
Various factors can affect mental health. The more risk factors adolescents are exposed to, the greater the potential impact on their mental health. Factors contributing to stress during adolescence include exposure to adversity, peer pressure, and identity exploration. Media influence and gender norms can exacerbate the disparity between an adolescent’s lived reality and their perceptions or aspirations for the future. Other important determinants include the quality of their home life and relationships with peers. Violence (especially sexual violence and bullying), harsh parenting, and severe socioeconomic problems are recognized risks to mental health.
Certain adolescents are at a higher risk of mental health conditions due to their living conditions, stigma, discrimination or exclusion, or lack of access to quality support and services. These include adolescents living in humanitarian and fragile settings; adolescents with chronic illness, autism spectrum disorder, an intellectual disability or other neurological condition; pregnant adolescents, adolescent parents, or those in early or forced marriages; orphans; and adolescents from minority ethnic or sexual backgrounds or other discriminated groups.
Emotional Disorders: Emotional disorders are common among adolescents. Anxiety disorders (which may involve panic or excessive worry) are the most prevalent in this age group and are more common among older than younger adolescents. It is estimated that 3.6% of 10–14-year-olds and 4.6% of 15–19-year-olds experience an anxiety disorder. Depression is estimated to occur among 1.1% of adolescents aged 10–14 years, and 2.8% of 15–19-year-olds. Depression and anxiety share some of the same symptoms, including rapid and unexpected changes in mood.
Anxiety and depressive disorders can profoundly affect school attendance and schoolwork. Social withdrawal can exacerbate isolation and loneliness. Depression can lead to suicide.
Behavioral Disorders: Behavioral disorders are more common among younger adolescents than older adolescents. Attention deficit hyperactivity disorder (ADHD), characterized by difficulty paying attention, excessive activity and acting without regard to consequences, occurs among 3.1% of 10–14-year-olds and 2.4% of 15–19-year-olds. Conduct disorder (involving symptoms of destructive or challenging behavior) occurs among 3.6% of 10–14-year-olds and 2.4% of 15–19-year-olds. Behavioral disorders can affect adolescents’ education and conduct disorder may result in criminal behavior.
Eating Disorders: Eating disorders, such as anorexia nervosa and bulimia nervosa, commonly emerge during adolescence and young adulthood. Eating disorders involve abnormal eating behavior and preoccupation with food, accompanied in most instances by concerns about body weight and shape. Anorexia nervosa can lead to premature death, often due to medical complications or suicide, and has higher mortality than any other mental disorder.
Psychosis: Conditions that include symptoms of psychosis most commonly emerge in late adolescence or early adulthood. Symptoms can include hallucinations or delusions. These experiences can impair an adolescent’s ability to participate in daily life and education and often lead to stigma or human rights violations.
Suicide and Self-Harm: Suicide is the fourth leading cause of death in older adolescents (15–19 years). Risk factors for suicide are multifaceted and include harmful use of alcohol, abuse in childhood, stigma against help-seeking, barriers to accessing care and access to means of suicide. Digital media, like any other media, can play a significant role in either enhancing or weakening suicide prevention efforts.
Risk-Taking Behavior's: Many risk-taking behavior's for health, such as substance use or sexual risk-taking, start during adolescence. Risk-taking behavior's can be an unhelpful strategy to cope with emotional difficulties and can severely impact an adolescent’s mental and physical well-being.
Worldwide, the prevalence of heavy episodic drinking among adolescents aged 15–19 years was 13.6% in 2016, with males most at risk.
The use of tobacco and cannabis are additional concern. Many adult smokers had their first cigarette prior to the age of 18 years. Cannabis is the most widely used drug among young people with about 4.7% of 15–16-years-olds using it at least once in 2018.
Perpetration of violence is a risk-taking behavior that can increase the likelihood of low educational attainment, injury, involvement with crime or death. Interpersonal violence was ranked among the leading causes of death of older adolescent boys in 2019.
Promotion and Prevention: Mental health promotion and prevention interventions aim to strengthen an individual’s capacity to regulate emotions, enhance alternatives to risk-taking behaviors, build resilience for managing difficult situations and adversity, and promote supportive social environments and social networks.
These programmed require a multi-level approach with varied delivery platforms – for example, digital media, health or social care settings, schools or the community – and varied strategies to reach adolescents, particularly the most vulnerable.
Early Detection and Treatment: It is crucial to address the needs of adolescents with mental health conditions. Avoiding institutionalization and over-medicalization, prioritizing non-pharmacological approaches, and respecting the rights of children in line with the United Nations Convention on the Rights of the Child and other human rights instruments are key for adolescents’ mental health.
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