May 31, 2022

In a world that feels as though compromise is fleeting and empathy is under siege, there is one universally acknowledged truth if you work with or have children: the lived experience of our youngest generation is more complex than ever before. We have seen rising evidence of this fact for well over a decade in our schools, doctor’s offices, and even in emergency rooms. Recently, OHSU researchers found a startling increase in suicide attempts by pre-teen children (aged 10-12) nationwide. When coupled with several other concerning data points during the pandemic, it is abundantly clear that societally we need to focus on the wellbeing of our children more than ever. The question that continues to divide our society and many professionals is why. How have we gotten to this point, and, perhaps more importantly, what can we do to combat this alarming trend affecting our children? La Jolla Country Day School and Rady Children’s Hospital in San Diego, CA, are combining efforts to seek not only answers to this question but, hopefully, solutions. 

As with any complex problem, we must start at the beginning. We are asking ourselves what societal trends, individual factors, and shifts have taken place in the past few generations that have led us to this place. Linking the efforts of a school and children’s hospital, both academic and medical, has given us unique insight into how this issue is evolving each day. In our work, we can point to three key areas that are contributing to the challenging circumstances plaguing our youth and leading to the alarming statistics we hear about too often. 

Social Media

Social media has changed the landscape of what it means to be young. This is perhaps one of the most obvious and documented changes that our newest generation has had to navigate, which current adults will never fully grasp. Our youngest ones have lived their entire lives with this type of digital connection and technology at their fingertips. How and why social media has contributed to child and adolescent distress is a nuanced issue. For some adults, the simple idea that children have access to technology, rather than socialization and conversation, is enough to sound the alarm. For other adults, the things that can happen in an unsupervised online environment are the most concerning. 

It should be noted that research has found that time spent on social media is not linked to individual changes in depression and anxiety over eight years (Coyne, et. al., 2020). This begs the question: If it is not about the amount of time our children spend on social media, then what correlates to the rise in adolescent distress we are undoubtedly finding? As we are discovering, it is more complicated than a simple threshold of daily or weekly time that each child should be held to. It is far more important to consider what they are doing online and perhaps, what they are not finding the time or inclination to do instead. 

Technology can, at times, be used as an inescapable tool for relational aggression. Gone are the days that you found out about the party or sleepover you weren’t invited to on Monday. Now you can watch their Instagram stories, and see your “friends” enjoying themselves without you in real-time. There is a relentlessness to social media: it is inescapable and ever-present. Your biggest fears and most embarrassing moments can play on a loop in perpetuity, which gives it a unique and unprecedented power. 

There are also exceedingly unhealthy and unrealistic depictions of beauty and bodies that can impact the confidence of anyone and everyone. Additionally, there are neurobiological impacts at play—namely, the dopamine rush experienced for each TikTok video when it was once felt on a bike ride. You should consider that it is far simpler to experience this rush of dopamine by watching videos in rapid succession than through the delayed gratification of spending time outdoors or exercising. Because the adolescent brain is particularly sensitive and reactive to rewards, more so than for adults or even small children, it makes sense that they would seek out anything rewarding early and often. It is not to be discounted that social media is, perhaps ironically, an individual activity. The lack of socialization when engaging with your device is perhaps the most impactful concern of all, given all that is learned and gained from these interactions. 

Parenting Styles

Another generational change faced by our youngest is the role of modern parenting. “Parenting,” as a goal-directed verb, is a relatively new phenomenon that has vastly shifted our approaches to supporting our children. Alison Gopnik expertly poses the question: Is it our job to be a gardener or carpenter in our child’s life? Are we responsible for helping to build their future through a series of experiences and skills, or do we, more simply, nurture and water them so that they can grow naturally and organically into who and what they are meant to be? As parents ourselves, we find it is incredibly easy to feel exceedingly responsible for our child’s future. At times, is it possible that despite our most earnest intentions, we are partially to blame for what appears to be a declining ability to navigate conflict, disappointment, and challenge? Giving our children a sense of agency when appropriate to make decisions and mistakes are an integral part of their development. Knowing when to step back, support, or save is one of the hardest balances and most critical skills a parent can develop. 

This knowledge also should be balanced with emerging research that seems to have a consensus: Indulgent and authoritative parenting styles, as opposed to authoritarian, are linked to well-being and even academic success (Garcia, O. et.al., 2019 and Garcia, F. et.al., 2019). While it is clear that warmth and safety are integral components of “successful” parenting, we would also argue that setting limits is loving. In addition to warmth and connection, children thrive with consistency and predictability. Children need to feel your love and security to take risks and explore the world as required in adolescence and early adulthood. As professionals in schools and the medical field, we often see parents with the very best intentions unknowingly impacting their child’s development. It happens when parents shield their children from the experiences of living in our flawed world. In our desire to create a better future for our children, we must not lose sight of the necessary challenges and upheavals that we experienced and made us who we are today. Our children need these same experiences and life lessons to be equipped to navigate the world they are inheriting. 

Genetic and Evolutionary Impacts on our Health

The last area to consider when assessing our worsening difficulties with mental health is how rapidly we are diverging from the lives that evolution has intended for us. Within this lies three important principles: the process of habituation, the effects of constant distractions, and the quality of our interactions and relationships.

Only until very recent times has the concept of starvation been an afterthought.  Therefore, our bodies were programmed to conserve resources in an effort to ensure survival. However, many emotional states, including happiness and excitement, are costly regarding resources. The increase in dopamine and adrenaline that fuels these emotions results in our bodies expending more energy to increase heart rate, respiratory rate, and many other physiological changes. This is why the process of habituation has accompanied our evolution.  After repeated exposure, our response to stimuli, either pleasant or unpleasant, will dull in an effort to conserve resources. As much as our society promotes it, happiness is not supposed to be a constant emotional state. However, more so than at any time in history, we are capable of striving for constant happiness. For example: What was recently a newspaper or magazine article has been replaced by a colorful website, which has been replaced by an online video, which now has been replaced with a more stimulating shorter video that can easily be followed by more with the movement of a finger. This “hedonic treadmill” leaves us in a constant state of dopamine infusion and then withdrawal, which may contribute to many individuals’ struggles with maintaining a sense of contentedness.  

For the vast majority of human existence, the world has been a dangerous place for us. One that was not acutely aware of their surroundings, including the weather, predators, and environmental hazards, was much less likely to survive than the more present tribesmen.  Evolution pairs traits that help ensure our survival with rewards, such as feelings of pleasure or, in this case, feelings of contentedness or security. Never before in human history has it become so easy or attractive to focus our attention on distractions outside of our surroundings and lose this benefit. Every notification that appears on our phone or smartwatch removes our attention from the activities and individuals that surround us. Every time we check our email or social media in an effort to prevent falling behind or missing something, we interrupt our brains’ ability to connect with our environment and feel at ease. This is a large reason why the practice of mindfulness, which has existed for thousands of years, has had such a strong resurgence in mental health treatment in recent times.

Though situational awareness has helped our species survive, our ability as human beings to socialize and create complex relationships is likely the biggest factor contributing to the success of our species. Once again, there is an emotional reward attached to developing and strengthening deep relationships, particularly through in-person interaction. What prevents this from happening is the ease with which we can develop many casual relationships either through social media or other less engaged forms of interaction. Furthermore, the substitution of these interactions for traditional in-person communication has made it much more daunting for our youth to approach one another in person. This increase in social anxiety has had an enormous increase during this pandemic in particular.

The “Solution”: Backward Design

While the notion of a “solution” is something we are and will continue to strive towards, we also recognize that no one thing will provide the level of intervention our youngest generation needs. Our team has chosen to look at this from an instructional model lens many educators are familiar with: backward design. We know what skills (e.g. empathy, collaboration, healthy coping skills, adaptability, etc.) produce the best outcome for our children, so we want to help infuse opportunities to practice and cultivate these areas from a young age through adolescence. To consider the same issue in a different scenario: Mental health clinicians are often tasked with teaching robust coping skills to a young person who meets the criteria for anxiety or depression, for example. We want to explore what we wish those children knew and were working on at age 5 or age 10 so that they would be even better equipped later in life. We also acknowledge that the very best outcomes will come from school-family-community partnerships that provide consistent and varied support to each child and family. Fostering those partnerships and defining how we can all work together to achieve our shared goal—thriving and well children and adolescents—is the outcome we are all striving for.