Delayed Development? Teens in the Pandemic Era

COVID-era teens are revealing signs of trauma after 2 years of fear and isolation

Kids are going to need a lot of parental support and guidance to successfully process the last two years events. (fizkes/Shutterstock)

A high school senior from California described teen COVID-19 mental fallout in a nutshell:

“It’s not that I’m mad that I missed the events. I wouldn’t have gone to prom anyway. I just feel bad about all the experiences I missed that never had the chance to happen. I wonder what those years would have been like if none of it ever happened.”

A grown adult who has already lived a life and whose days are filled with routines that rarely change may be content with missing some time outdoors during lockdowns. But for teens living in one of the most dynamic periods of their lives, growing up in the time of COVID-19 takes a larger toll, according to mental health professionals looking to make sense of the pandemic’s effect on teens.

Teens have missed college opportunities, their driver’s tests, and countless life-shaping experiences with friends.

This was the longest pause button ever pushed—a purgatory that teenagers used to think only existed in dystopian films. Pandemic countermeasures hurt some more than others, but no one can really say how much.

Andrea Hussong, professor and associate director of clinical psychology and neuroscience for the University of North Carolina, said in a November interview that teen mental health has been deteriorating since as early as the first few months of the pandemic’s onset, with severity varying on the individual teen.

One thing is for certain, according to Hussong.

“Youth in the United States are reporting that the biggest impact of the pandemic is on their mental health,” she said.

Some mental health practitioners think the COVID-19 mental fallout in certain teens should be labeled as a “full-blown trauma” and be treated as such.

The current state of child and adolescent mental health is a national emergency, according to a joint statement made by the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association. The organizations are asking for increased federal funding to address mental health care.

“Rates of childhood mental health concerns and suicide rose steadily between 2010 and 2020 and by 2018 suicide was the second leading cause of death for youth ages 10–24. The pandemic has intensified this crisis: across the country we have witnessed dramatic increases in Emergency Department visits for all mental health emergencies including suspected suicide attempts,” the statement reads.

The Centers for Disease Control and Prevention (CDC) released a new report on April 1 based on a survey on adolescent behaviors during COVID-19. It found more than one in three high school students felt sad or hopeless during the pandemic. One in three students also reported using alcohol and other drugs more during the pandemic.

Psychiatrists say the struggle teens are facing may be greater than many people realize.

“I’m seeing the effects of these government shutdowns, lockdowns, closures, social distancing measures, quarantines, masking, shutting down schools, just now coming to fruition,” Dr. Mark McDonald, a child and adolescent psychiatrist and author of “United States of Fear: How America Fell Victim to a Mass Delusional Psychosis,” said on a recent The Defender Podcast hosted by Robert F. Kennedy Jr.

“My concerns now are actually worse than they were a year and a half ago. I just saw it as a temporary disaster. We’re now seeing this as an ongoing problem.”

Can the long-term effects of COVID-19 countermeasures be considered a full-blown mental health crisis?

A poll conducted by Ipsos in mid-March found that one in four Americans said they’ve returned to their normal, “pre-COVID life,” but the long-term effects of the lockdown and the way it reshaped some of our core ideas as a society remain largely unknown, including its lasting effects on children. McDonald isn’t optimistic.

“We’re going to start to see more and more evidence and reports of lingering chronic trauma, injuries, ongoing abuse of children just like now we’re seeing with the speech problems, like we’re seeing with the drug problems, like we’re seeing with the lack of socialization with children—anxiety and depressive disorders—all these problems that we just ignored ... are now coming back and rebounding much, much worse than they were in 2020,” he said.

Studies confirm McDonald’s warning. A recent JAMA systematic review of 36 studies from 11 countries found that “school closures and social lockdowns during the first COVID-19 wave were associated with adverse mental health symptoms (such as distress and anxiety) and health behaviors (such as higher screen time and lower physical activity) among children and adolescents.”

The review found that 18 to 60 percent of children and adolescents scored above risk thresholds for distress—particularly anxiety and depressive symptoms—and two studies reported greater social media use.

An August 2021 global meta-analysis of 29 studies published in JAMA found estimates of elevated adolescent depression in Europe to be 20.5 percent, as the prevalence of depression and anxiety had doubled compared to pre-pandemic estimates.

A University of Manchester analysis of the teen experience during COVID-19 suggests that parents and educators need to be talking to their teens. Not all mental illness problems will lead to an impairment, the study suggests. Yet because of the fact that “most youngsters do not misbehave, and instead hide their feelings,” the internalized feelings can be easily overlooked and can develop into full-blown disorders.

The effects of COVID-19 on teens come amid a broader social trend of social isolation in the entire culture that’s occurring alongside a rising tide of stress, depression, anxiety, and mental illness.

Isolation

There’s no meme in the virtual universe that encompasses the kind of disappointment teens faced when their schools remained closed.

“It’s just devastating,” McDonald said. “I have so many children in my practice who are unable to spend time with their friends at sleepovers because they can’t separate from their mothers. I have children who have punched through plate glass windows with their fists at age 8 out of frustration because they can’t go outside.

“I have autistic children who were completely fine psychologically. They have autism, but that doesn’t mean that they’re mentally ill, and these autistic children, by and large, have suffered the most.”

An October 2020 study by Bellwether Education Partners estimated as many as 3 million K–12 students were “missing” in one way or another. The study noted, for instance, that 15 to 20 percent of Los Angeles English learners, students in foster care, students with disabilities, and homeless students didn’t access any of the district’s online educational materials from March through May of 2020.

In Washington, back-to-school family surveys found that 60 percent of students lacked the devices and 27 percent lacked the high-speed internet access needed to successfully participate in virtual school.

In Miami-Dade County, Florida, 16,000 fewer students enrolled in the fall of 2020 compared to the previous year.

The BBC reported almost 2 million pupils are regularly missing school in the UK, saying that “almost 1.8 million children missed at least 10 percent of school in the autumn [of 2022] term in England,” which is a rate almost twice as high as before the pandemic, according to National Health Service numbers.

The scale of missing students is massive, according to the Bellwether study.

“The pandemic has also isolated children and youth experiencing abuse, neglect, or acute mental health needs, cutting them off from teachers and other school staff trained to spot warning signs,” the study reads. “Early local reporting suggests widespread decreases in child abuse reporting, increases in child deaths, and more older children being killed.”

Excluded

One senior from central California (who wished to remain anonymous) transitioned to homeschooling when his public high school went virtual.

“It was boring because there was nothing to do, and my mom took me out of school, so I couldn’t be there with my friends,” he said.

The teen worked more than usual at the local surf shop. He spent more time at the beach.

But when his friends said most teachers weren’t enforcing the masks, his parents tried to re-enroll him in high school, but the school flagged his incomplete vaccine record, which was acceptable in seventh grade, but not in high school.

He said the only thing that would make his life better again is “going back to school,” yet California’s strict school vaccine laws won’t allow him to do so. His mother worries that the damage to his social life may be more than just boredom and stress.

A YouTube interview posted by Melbourne Ground described the escalation of boredom and stress in Australia.

Two Melbourne teens who had lived through six COVID-19 lockdowns in two years said they felt deeply affected by stay-at-home orders, including losing the motivation for homeschooling and overdoing their social media and phone usage.

“I have lots of friends who I’ve seen turn to drugs and alcohol over lockdown. I’ve really seen a change in people. They’ve got nothing,” one teen said. “When we were at school two or so years ago ... that’s what [people would] do for the day; they’d go home and sleep and go to school the next day. When they’re at home all day, it’s not healthy, you know.”

The other teen said, “I’ve never been a person who gets depressed much, but recently, I’ve begun to feel the effects of the lockdown. I’ve started to feel depressed. We shouldn’t feel like that—we’re just kids.”

Drugs

McDonald said he’s personally seen an increase in drug use among his clients.

“I lost two patients for the first time in my career, “ he said in The Defender interview, choking up.

“Two patients, underaged, due to fentanyl overdoses. One of them took the Fentanyl when he was at home because he couldn’t go to school, because he was under [Los Angeles Mayor] Eric Garcetti’s ‘Safer at Home’ policy. Safer at home and he died, and his parents were right there in the house when he died. They didn’t know he had taken the fentanyl until they found him face down, green, in a pile of his own vomit, not breathing.

“These problems I have never seen in my career. Not to this degree. Anxiety up 300 percent. Depression: 400 percent. ... Every single mental illness, every behavioral problem, including substance abuse in the older kids, is going through the roof.”

Suicide Attempts

Communities were shocked when 15-year-old Stockton, California, teenager Jo'Vianni Smith committed suicide by hanging herself because of what her mother, Danielle Hunt, said were the circumstances presented by the COVID-19 pandemic. Hunt told local station KTXL that her daughter showed no signs of wanting to take her life, but may have had difficulty dealing with the state’s stay-at-home order, which had only been in place for a few weeks into the U.S. lockdowns.

Isolated stories made it sound as though suicides were on the rise during the pandemic, but statistically speaking, the numbers have been consistent. Global suicide trend data from 21 countries didn’t see an increase in suicide rates during the early months of the pandemic.

Suicide attempts have risen, however. The National Vital Statistics System lists suicide as the third leading cause of death among U.S. adolescents aged 15 to 19, which means that stagnant suicide rates don’t make teen suicide less of a risk.

In an article, a University of California–Davis doctor said in 2021 that youth suicide was already at a record high and that parents should be vigilant as the challenges “teens normally face have been amplified by isolation and distancing during the pandemic.”

CDC data reveals that emergency department (ED) visits for adolescent suicide attempts soared during the summer and winter of 2021, especially among girls. There was a 31 percent spike in suspected suicides by children aged 12 to 17 in the summer of 2020 compared to 2019.

“During February 21 [to] March 20, 2021, suspected suicide attempt ED visits were 50.6 percent higher among girls aged 12–17 years than during the same period in 2019; among boys aged 12–17, suspected suicide attempt ED visits increased 3.7 percent,” The report reads.

As the suicide and suicide attempt data continue to be scrutinized, the teen response to COVID-19 will continue to be examined.

“I think we do need to treat some teens for trauma,” said Jennifer Thomas, a licensed marriage and family therapist. “Teens were left out and told what to do. No one is asking what it’s like for them. Some were doing okay, but some on the other end were consumed with worry. Some committed suicide.

“Because I’m in this field, I know these tragedies were happening before, and I don’t mean to minimize it, but it wasn’t being paid attention to. Now that mental health issues have escalated for some teens, we can be more aware.”

Thomas said the best word to describe the effect of COVID-19 fallout on teen development is “stunted.”

Thomas said her Sacramento, California, practice has grown since the pandemic—in fact, the calls are overflowing. She said it’s been difficult and gut-wrenching keeping up with all the people who need help, especially when she hears of their hardships—parents losing jobs, teens forced to come home from college, increases in anxiety disorders, and obsessive-compulsive disorder.

A part of the problem teens face is that the people that they rely on are also suffering amid the fallout of the pandemic.

“Adults are going through their struggles. Teachers are going through their struggles, too,” Thomas said.

How to Move On

Should certain teens be treated for trauma? According to the joint statement by the American Academy of Pediatrics et al., the answer is an urgent yes.

Thomas thinks that many teens do need help and that it’s the parent or caregiver’s job to learn how to best communicate with them. Sometimes she reserves sessions just for that purpose. Hussong reserves hope for teens as we come out of the pandemic. While COVID-19 upended their teen life, life continues, even if it does so differently.

“Development is not so much delayed by the pandemic but reshaped by it. Rather than asking high school seniors to ‘go back to normal’—which returns them to their sophomore years—we need to ask them and the systems that serve them to recognize their new development path,” Hussong said.

For his part, McDonald has been going out of his way to alert the public that teenagers need more help. In an interview with Jesse Lee Peterson, he said parents need to do much more than recognize their teens’ reshaped path: They need to call for a return to normalcy.

“It’s up to us adults to fix this, because children are not going to be able to fix this themselves,” McDonald said.