Happiness is like a butterfly: the more you chase it, the more it will elude you; but if you turn your attention to other things, it will come and sit softly on your shoulder. Henry David Thoreau
Within my media silo, there has been quite a bit of news recently about the mental health crisis amongst adolescent girls in the United States. This uptick in mental health news was largely prompted by the release of the Youth Risk Behaviour Survey (YRBC), by the Centre for Disease Control (CDC). The most startling result is that last year, the rate of high school attending girls who attempted suicide was more than 1 in 8.
One in eight! Imagine a normal high school with 80 girls. On average 10 attempted suicide!
Thankfully, nowhere near that ratio die. The percentage of injuries from suicide rose from 3% in 2011 to 4% in 2021. Still serious, that’s about 3 girls in our 80-girl school.
Suicide looms as a unique threat in our hyper-safe world. It is a great fear for many parents, and youth suicidality has a debilitating effect on families, as well as the teen experiencing them. The threat of suicide typically impacts the whole family greatly. Also, the presence of a previous suicide attempt is a risk factor for a future attempt.
The YRBC shows that suicidal ideation and planning has increased at a much higher rate than attempts and harm:
Girls injured by suicide:
2011: 3%
2021: 4%
Girls who attempted suicide:
2011: 10%
2021: 13%
Girls who made a suicide plan:
2011: 15%
2021: 24%
Girls who seriously considered suicide:
2011: 19%
2021: 30%
What about boys? According to the same study there has not been a significant increase in boys suicidality over this period. Whatever is happening to teens, it seems to be worse amongst girls.
So, why isn’t something being done to address this issue?
Do Something!
Because something is being done.
Rates of mental health treatment attendance have increased over the last 15 year. From 2005-06 to 2017-18 the number of girls seeking treatment for mental health increased from 22.8% to 25.4%. In 2005-2010, 4.5% of girls were using antidepressants. In 2015, 7.3% were using antidepressants. And, in 2019, 10.2% were using these medications.
Girls’ mental health is being treated and medicalised as never before. And in lockstep with these increases in treatment, mental health rates have kept on rising.
Now, there’s no evidence that psychological or psychiatric services and products are making teens depressed or anxious. In fact, quite the opposite. All approved medications and talk-therapy interventions have evidence that testifies that they work.
Much of my early practice was working with adolescents. I have seen multiple cases where medication and therapy have helped. So, why despite the help are things getting worse?
Emotional Contagion of Mental Health
One likely reason for the increase in mental health issues and suicidality amongst girls is emotional contagion. Emotional contagion is the transmission of emotional states via exposure to others with those mental states. Research indicates that females are more susceptible to emotional contagion than males.
It will be pretty clear to those who read my blog that eventually I’ll start blaming the internet and device use for the problem. And there is evidence that online mental health communities are sites of emotional contagion.
The internet is the great contagion site of social and cultural memes. From Me Too, to Muslim Radicalism the internet is where ideas good and bad proliferate, spread and for the lucky few, achieve virality.
So, what if the meme “mental health” is spreading and making teen girls sick?
A simple Google Trends Search of the term mental health in the period from 2004 (when their records start) to now, shows that the term “mental health” has almost doubled over the last 18 years as a search term. As mental health has become more prominent in the minds of the public, are we all a part of the emotional contagion process?
My article led off with a quote by Henry David Thoreau about happiness. It’s a well-established idea amongst many psychologists and philosophers, that the pursuit of happiness leads to anything but. Bestselling psychology author and GP, Russ Harris, has written several books critical of chasing and holding onto happiness, including a personal recommendation of mine, The Happiness Trap.
So, I wonder if Thoreau and Harris would agree:
Good mental health is like a butterfly: the more you chase it, the more it will elude you; but if you turn your attention to other things, it will come and sit softly on your shoulder
Within my clinical life, I’ve witnessed a welcome shift in people away from denial and shame of mental health. This is good. But sometimes it goes further. I sometime see mental health come to mean identity, community and status. This is not good in my opinion.
So, how should we treat mental health?
I would recommend we treat it like any other health complaint. Like a torn ACL, or asthma or an anal fissure. Something that is troublesome, something you wish that you didn’t have. Something that you wouldn’t brag to your friends about having, but on the other hand, no one would blame you for experiencing.
Mental health does not need to be valorised. We do not need to hold the depressed and anxious on a pedestal. Once mental health becomes as boring as physical health, perhaps we’ll be free of socially spread mental health problems.