Adolescent Mental Health: Myths vs Reality

The Prevalence of Adolescent Mental Health Issues

According to the World Health Organization, globally one in seven 10- to 19-year-olds now experiences some form of a mental health disorder. NHS data gathered as part of a follow-up to the 2017 Mental Health of Children and Young People (MHCYP) survey, suggests that in the UK the rates are even higher, at up to one in five.  

Since the Covid-19 pandemic, there has been a shift in attitudes towards mental health and wellbeing. Being open and proactive towards mental health can lead to more positive outcomes for all, especially young people who may be afraid to speak out or have limited access to resources.

There are many different kinds of mental health issues and conditions that can affect young people, with symptoms ranging from mild to severe. Recognising and addressing these signs early on can lead to improved outcomes for young people who are struggling with their mental health.

Young people and adolescents can suffer from a number of different mental health problems and conditions. Some common mental health issues that affect today’s youth include:

• Depression
• Anxiety
• Eating disorders (for example, anorexia and bulimia)
• Behavioural disorders (such as ADHD)

Being open and honest about youth mental health is vital:

• Suicide is the fourth leading cause of death among 15- to 29-year-olds in the world
• Urgent referrals of under 18s to NHS mental health crisis teams reached record highs in 2023
• Children in care are more likely than their peers to experience mental health difficulties, according to the NSPCC
• Children who have experience living in care in the UK may be four times more likely to have a diagnosable mental health condition
• American data suggests 2.7% of teens will experience an eating disorder in their lifetime

In this article, we will dispel some common myths about adolescent mental health. By perpetuating myths and stereotypes, we run the risk of spreading outdated ideas and harmful stereotypes and discouraging children from reaching out for help.

Myth 1: Adolescents Don’t Experience Real Mental Health Problems

Whilst some people may believe that adolescents are too young to experience genuine mental health problems, this is totally false:

• Children as young as nine have been known to require hospital treatment due to self-harming
• The number of youngsters aged nine to twelve being seen in hospital after hurting themselves intentionally more than doubled in seven years between 2013 and 2020.

Social media can expose children to unnatural expectations around beauty and body image, which can lead to feelings of depression, anxiety and worthlessness. Technology and social media have also allowed for ‘cyberbullying’ to occur which is a real problem for young people today. Although technology can help us to be connected and less isolated, it can also connect us to comments and messages from people that cause us harm. The digital world can be a precarious one for young people to navigate.

The internet also allows adolescents to know more about what is happening globally than ever before. This leads some young people to feel concerned about issues like climate change, job displacement due to AI or whether their generation will ever be able to afford to get on the housing ladder. Whilst some anxiety about the future is natural, these thoughts can start to become intrusive and invasive and can begin to have a serious impact on a child or adolescent’s wellbeing.

A survey of 3,000 youngsters conducted for Save the Children on the eve of COP27 found:

• 70% were worried about the world they will inherit
• 75% want the government to take stronger action to tackle climate change and inequality
• 56% think climate change and inequality are causing a deterioration in the mental health of children globally

Youngsters have other very real issues to worry about, including exams, pressure to perform well at school and their relationships with their friends. Some young people also experience additional pressures outside of school such as poverty, homelessness or absent parents.

In some ways, there is more pressure on young people now than ever before. Therefore, it is totally inaccurate to suggest that young people don’t experience real mental health problems, in the same way it would be inaccurate to suggest that they don’t experience real physical health problems or real social problems.

Myth 2: It’s Just a Phase, They’ll Grow Out of It

Assuming that a young person who is experiencing mental health problems is simply going to grow out of it is not helpful. Early intervention in mental health is key to improving outcomes, therefore it is vital to take these things seriously. 

It is a myth that mental health is temporary and is going to resolve itself naturally. Telling this to adolescents invalidates their feelings and experiences and may delay them seeking help or treatment.

The consequences of assuming that a young person who is exhibiting signs of having a mental health issue is simply going through a ‘phase’ when in fact they need help and intervention can be serious. These might include:

• Mental health symptoms getting worse
• Outbursts and anger
• Problems sleeping
• Weight loss/gain
• The young person hurts themselves or others
• Problems at school or truancy
• Dangerous or risky behaviour
• Suicide

Whilst it is important to differentiate between temporary negative thoughts, a bad mood or feeling upset from an actual mental health problem, simply trivialising mental health or labelling adolescents as ‘going through a phase’ is dangerous and dismissive.

Myth 3: Adolescents are Overdramatic or Seeking Attention

Emotional intensity is a normal part of adolescence; the intensity of first love, the crushing blow of first heartbreak, and the ups, downs and drama that comes with teen friendships – these are things that most of us will experience. Feeling upset, sad or angry as a teen is not the same as a mental health condition. 

While it is vital that everyone takes care of their mental wellbeing and that adolescents are treated with understanding and empathy, an adolescent who is experiencing symptoms of a serious mental health problem should get treatment from a professional. This could be a GP, mental health nurse, psychiatrist or therapist.

Perpetuating the stereotype that all teens exaggerate their mental health or use it as an excuse to avoid school or other commitments, runs the risk of alienating young people who are at risk of harm. It also sows the seeds of doubt about whether our emotions and feelings truly matter and whether we need to take care of our mental wellbeing the same way we do our physical wellbeing. 

Assuming that anyone who talks about their mental health is seeking attention is not a healthy way to think; it can also lead to problems later in life. 

At times, the media is guilty of feeding these stereotypes with headlines like ‘Generation Sick Note’ or using pejorative terms like ‘snowflake’ referring to Gen Z and Alpha.

• It is important to approach adolescents who are having a hard time with their feelings or emotions with empathy and understanding
• Perpetuating negative stereotypes about hysterical teens or ‘generation snowflake’ is unhelpful and can lead to harm
• Emotional intensity in teens is to be expected but if a young person’s life is seriously impacted by feelings, emotions or behaviours this could signify a mental health condition
• The sooner treatment is sought out the sooner a young person can get the help they need to feel better

Reality: The Impact of Stigma and Lack of Awareness

The stigma and lack of awareness around child, adolescent and adult mental health can exacerbate mental health issues. 

It can also result in:

• Reluctance to seek treatment
• Delay in getting help for mental health issues
• Using harmful coping mechanisms such as drugs or alcohol
• Increased risk of harm

Adolescence can be a tricky and difficult time in a young person’s life where they may not be fully comfortable with their identity or feel unsure of their place in the world. This can lead to a fear of being judged. Unfortunately, some young people fail to reach out to get the help that they need due to worrying about judgement or being labelled. 

It is important for everyone to understand that:

• Mental health is nothing to be ashamed of
• Having a mental health issue does not make you weak
• A mental health crisis or condition does not define a person

Increased awareness about how to access mental health support in the UK will also make it easier and faster for people to reach out and get the help that they need.

Breaking the Myths: Real-Life Stories

Skylar’s Story: Myth ‘It’s Just a Phase’

Fifteen-year-old Skylar (not their real name) began to become withdrawn and depressed around the time that their parents separated. This was put down to the recent changes in the household and the acrimony between their mum and dad who struggled with custody arrangements, time keeping and argued a lot. 

Getting Skylar to school became impossible and it was discovered bullying was an issue as Skylar had come out as gay and later non-binary. Dad was largely unsupportive and believed it was ‘a phase’; however, he reluctantly agreed to attend family counselling, on the condition that Mum paid for the sessions. 

School visited the home where Skylar stayed with Mum, due to Skylar’s truancy which led to explosive arguments and the parents placing blame on one another. After discovering a blade in their child’s room and blood on the sheets, Mum told Dad just how serious the situation was. Finally, this grim discovery prompted Dad into action and the three attended a GP appointment to discuss Skylar’s declining mental health and self-harming. A decision was made to withdraw Skylar from school and try home education to get away from the bullying and judgement they were experiencing. The GP also prescribed a course of antidepressants for Skylar to take to manage their mood.

The family counselling sessions continued for six months and, after the GP visit, Dad seemed to engage more with the counsellor. The parents had to agree to make changes, including a more structured routine of shared care and calmer drop-offs/pick-ups. Both parents also agreed to cut down on drinking as the counsellor told them to find healthier coping mechanisms and set a positive example for Skylar.  

In this scenario, the young person was already self-harming before both parents took it seriously. It is unfortunate that sometimes adults get so caught up in their own drama that they fail to see that their children are struggling. For Skylar it was important to know:

• Their feelings matter and their mental health matters
• They deserve to feel safe and cared for in both of their homes
• Alcohol or self-harm is not the answer to problems
• They have the support of their family
• Help was out there and available, in the form of both talking therapy and medication

Hannah’s Story: ‘Myth: It’s Nothing to Worry About, Adolescents Don’t Experience Real Mental Health Problems’

By the age of 10 Hannah was already feeling anxious in her own skin and insecure about her weight. The other girls at school were all slimmer and more petite than her; she dreaded changing for PE lessons and would often pretend to be ill so she could avoid school on those days. 

At a family gathering, her cousin made a passing remark about her weight and a few people laughed. This cemented in Hannah’s head that there was something wrong with her and she began obsessively watching videos on social media about dieting, visiting online forums and looking up pro-ana websites. When she looked in the mirror, she felt disgusting. 

At first her mother seemed pleased that Hannah was losing the weight and looking, in her mind, ‘healthier’. She didn’t see a problem with the skipped meals and she never found all the food from Hannah’s packed lunches that ended up stashed in the back of her wardrobe. She was happy her daughter was dieting.  

When Hannah dropped down to a size 8, her mum told her that she was ‘slim enough’. She said, “You can stop dieting now, you look fine”. But what her mother was failing to see was that when Hannah looked in the mirror, she didn’t feel fine and she didn’t see a slim girl – she saw an overweight, ugly girl that she hated. By now Hannah was 12. In her mother’s mind, still far too young to experience body issues – and besides, she was overweight and unhealthy to start with; this new Hannah was an improvement. 

Unfortunately, both Hannah’s weight and wellbeing continued to plummet: size 8 turned into a size 6, teetering on a size 4. Hannah’s periods stopped completely. She lacked energy and fainted twice at school. Finally, her mother realised that her daughter might have a serious problem.

Not knowing where to turn and as a single mum on a low income she looked online where she came across BEAT and called their helpline. She listened to their expert advice and made an appointment to take Hannah to the GP to discuss her low weight and her mental health. An urgent referral was made to see Hannah as an outpatient at an eating disorder clinic after the GP suspected her of suffering from Anorexia Nervosa. 

The road to recovery from anorexia can be long and hard. Although a full recovery is possible, those feelings that accompany having an eating disorder will often follow a patient through their life, and people need to be vigilant about triggers and recognising problematic behaviour. 

Although Hannah’s mother eventually took action, her lack of awareness about her daughter’s deteriorating condition delayed her getting help. The consequences of continuing to deny that Hannah had an issue could have been dire, with research suggesting that anorexia nervosa has the highest mortality rate of any psychiatric disorder.   

In conclusion, although a certain amount of turbulence and drama is an expected part of teen life, telling adolescents that they are too young to experience genuine mental health problems is untrue and puts them at risk of harm. We should listen to young people who are struggling psychologically with a sympathetic ear and signpost them to the right help and support.