Anxiety and depression among US children today is epidemic and getting worse according to the experts.

The Centers for Disease Control and Prevention reports that “1 in 5 American children ages 3 through 17 — about 15 million — have a diagnosable mental, emotional or behavioral disorder in any given year. Worse still is the fact that only 20 percent of these children are ever diagnosed or receive treatment. In other words 80 percent — about 12 million young people — aren\’t receiving treatment for serious and often life-threatening emotional disorders.” Wow!

This is even more concerning when you consider the suicide statistics on the following chart put out by the Centers for Disease Control.

How do teens view this issue? 

According to the PEW Research Center, when asked how they see problems among their peers 70% felt that anxiety and depression was a major problem with bullying coming in next at 55%, drug addiction at 51%, alcohol consumption at 45%, poverty at 40%, teen pregnancy at 34% and gangs at 33%.

Recent research indicates that serious depression Is getting worse among teens, especially girls and that the suicide rate among girls reached an all-time 40 year high in the year 2015 according to the Centers for Disease Control Report released this August. 

That is a terrifying statistic. In my practice, where I specialize in the treatment of eating disorders, I have seen a significant uptick in the number of individuals presenting with eating disorders in general, but especially anorexia. The cases including males are climbing rapidly.

According to the Center for Disease Control: 

• Males make up 25% of people with anorexia. Because they are often diagnosed later than females, they are at higher risk of dying. 

• Men are likely under-diagnosed with eating disorders because clinical assessment tools emphasize a desire to lose weight as opposed to building muscle and because loss of menses is often the most important symptom after weight loss in women.

• Disordered eating has increased across all different demographics but at an even faster rate for older people, males, and people with a lower socioeconomic status. 

What has anxiety got to do with Anorexia? I believe that Anorexia is simply a way the individual suffering from unbearable anxiety has of managing the anxiety. In my experience, anxiety is a terrible thing to experience as it isn’t focused. No cause, no cure. Instead, it just seems to envelop us and surround us such that we can’t get away from it. 

Fear, on the other hand, is easier to deal with because it does have a focus. In the case of an eating disorder, such as anorexia for example, the fear is of gaining weight. The solution then is simple: don\’t eat. Not only does this “solution “ work, it has the added benefit of getting a lot of reinforcement especially in the initial phases. Often the patient is complimented on having lost the weight by family and friends. This positive reinforcement continues until it becomes obvious that the weight loss is uncontrolled and that the individual losing the weight is psychologically and medically in jeopardy. By that time it is too late to stop it at least from the patient’s point of  view. It is as if they are addicted to restricting, and checking to see how much weight they have lost. Sometimes the checking takes place dozens of times a day because it is so reinforcing.

The worst cases I see though are the ones where no one notices the weight loss for an extended period of time. For those individuals being anorexic becomes a way of life and giving it up is even more difficult. Now what started as an anxiety disorder ends up as a life-threatening eating disorder on top of the anxiety disorder.

There are many things contributing to anxiety and depression among our children today. Perhaps the best example, and the most recent example, is the impact that COVID had on young people. Like many practitioners during the COVID pandemic I saw an uptick in a population that I have been treating for 30 years with no other significant changes except a drastic increase in the number of individuals suffering from eating disorders, particularly anorexia. I don’t think that was a coincidence.

The reason for this shift was that COVID created a whole new opportunity for young people to feel anxious as it isolated them from their peers and from the teachers and adults that supported them. As a result, I saw a significant increase in both the number of individuals presenting with eating disorders as well as the severity of the symptoms accompanying the eating disorders, during the COVID pandemic.

Stay tuned for the other variables that seem to be isolating our teens and jeopardizing their mental health.