How age influences mental health: Children are more anxious and adolescents are more depressed

Being young is generally associated with good health, but when it comes to mental health, things take a different turn. According to a recent study based on the 2019 Global Burden of Disease (GBD) data, mental disorders significantly affect the lives of people between the ages of five and 24. The study published in the JAMA Psychiatry journal reveals that one in 10 people in this age group (293 million people worldwide) live with at least one diagnosable mental disorder.

“The mental health of young people globally is in crisis,” said David C. Saunders, a child psychiatrist at Columbia University, in an editorial about the research study he led. The study’s findings align with global data on youth mental disorders. Overall, 13.4% of children and adolescents up to age 18 are affected. However, this study provides further insights by breaking down the data into age and gender groups, revealing significant variations across different conditions. Notably, anxiety is more common among five to-nine-year-old group, while depressive disorders are prevalent in the 15 to 19-year-old and 20 to 24-year-old groups. Gender also plays a role, with males more prone to alcoholism and drug abuse, while females exhibit higher rates of anxiety, depression and eating disorders. For conditions like schizophrenia and bipolar disorder, where social conditioning is less decisive, age and gender differences are minimal.

The Global Burden of Disease (GBD) is a study that assesses the impact of major diseases, injuries and risk factors on mortality and disability. Over 3,600 researchers from 145 countries collaborate in the GBD. The study provides a wide-angle view of all the diseases affecting the world, while the study led by Saunders focuses on youth mental health. The results are alarming, but not surprising. Last November, the PNAS scientific journal published a study that warned of worsening mental health among youth in Australia. Depressive symptoms are also more common among British teenagers born in the 2000s than among those born in the previous decade.

“This study aligns with what we see here [in Spain],” said José Luis Ayuso Mateos, professor of psychiatry at the Autonomous University of Madrid. “Clinical reality has long shown that we have a problem that needs addressing.” Ayuso, who conducts field research for the World Health Organization, was not involved in this particular study. He’s currently working on the 2021 GBD and says, “The pandemic has had a significant impact. Once [the 2021 GBD is] published, we can expect to see a significant increase in depression, anxiety disorders, and attempted and completed suicides. The magnitude of the problem will become more apparent.”

When discussing mental health, many people note a turning point during the pandemic. With millions of people confined to their homes and limited access to medical care, everyone had ample time for introspection. However, research indicates that the trend was already underway prior to the pandemic. “The mental health of young people is deteriorating,” Saunders notes in his editorial. “However, this study cannot address certain crucial questions, such as the causes [of the deterioration].” The psychiatrist suggests that stressors like social media and climate change (eco-anxiety) may impact depression rates.

Another topic that comes up when discussing youth mental health is the fragility of the so-called “glass generation.” However, the data once again offers insight into this notion. Saunders says it’s possible that more awareness and less stigma have resulted in more diagnoses. But he also notes the rise in youth suicide attempts, indicating that the increase in mental illness diagnoses among young people is real.

It’s not new, either. Since the first GBD studies in the 1990s, evidence has shown that mental disorders often emerge during adolescence, peaking around age 14. This critical period, spanning childhood to young adulthood, involves significant developmental changes like brain maturation, school entry, puberty and workforce transition. This is why Saunders suggests extending the GBD study range to age 24 to capture the complete transition into adult life.

“This is not new information,” said Ayuso. “In fact, it’s been a long-standing observation in epidemiology. Younger cohorts have higher rates of mental illness compared to earlier generations. For instance, individuals born after World War II in the United States showed a higher prevalence of depression than those born before the war.” Since then, numerous epidemiological studies like the one led by Saunders have consistently validated this result.

The study acknowledges the need for further research to better comprehend the root causes of the ongoing crisis and identify more vulnerable populations. It recommends that future research should also consider factors like social media exposure, and virtual reality and artificial intelligence technologies. The study also forewarns about the impacts of a factor that it did not address — the pandemic.

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