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Stress in Teenagers

Contributor(s): Gene Beresin, MD, MA
12 minute read
A mother and daughter discuss coping with stress

Content warning: Suicide, gun violence

 

Ask any one of the millions of preteen and teenage students heading back to school and they’ll confirm: The stresses of school in 2024 extend far beyond class schedules, homework, and a lack of time with friends.

In fact, things are so stressful that the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association have declared a national state of emergency in children’s mental health. This was echoed by the extensive 2021 U.S. Surgeon General’s report, Protecting Youth Mental Health. This Advisory noted that rates of depression, anxiety, stress, loneliness and suicide have been skyrocketing long before the COVID pandemic.

In May 2023, the U.S. Surgeon General released an Advisory indicating that we are amid a loneliness epidemic and the largest sector of the population affected are Gen Z youth, ages 16 to 24.  This has been increasing consistently since 1976 and 2019. 

“Preteens and teenagers are in a perfect storm,” explains Gene Beresin, MD, MA, a child and adolescent psychiatrist at Mass General Brigham. “They are worried about their future and are concerned about mass shootings, gun control, climate change, economic instability, sexual assaults, marginalization of people of color, immigrants, and LGBTQ individuals, war in Ukraine and the Middle East, and a seriously polarization of our population with difficulty if not inability to have civilized conversations and resolve conflict. In short, many feel deep anger, depression, and anxiety about the world they are inheriting.”

Dr. Beresin is the executive director of the Clay Center for Young Healthy Minds at Massachusetts General Hospital. Dr. Beresin holds over 40 years of experience working with youth, with a particular focus on prevention, early intervention, and treatment for teens and young adults. In this article, Dr. Beresin discusses back-to-school stress, shares the best coping skills for teens and preteens to use in times of stress, and explores ways parents and guardians can help.

How does loneliness affect young people?

Loneliness has a devastating impact on young people, including:

  • Sleep deprivation
  • Inability to self-regulate emotions and behavior
  • Increases in medical illnesses
  • Weakened immune system

What causes loneliness in teens?

Its potential causes (though we do not know for sure which are most important) include: loss or detachment from a loved one or friends; overuse and misuse of social media, and possibly of greatest importance is that preteens and teens today are overscheduled. They are pressured to perform in academics, sports, community service, internships, play a musical instrument, and much more — in fact, they are booked solid 24/7, 7 days a week. 

Teens need time to hang out with each other, to process their social and emotional experiences, and to have the space to develop a personal and social identity. Ways to help loneliness are noted below.

Social media and mental health: Cyberbullying and other potential harms

Most recently, the U.S. Surgeon General released a new Advisory on Social Media and Mental Health in youth. While there are potential benefits of social media for some young people, there are clear dangers that require further research.

It is one more constant pressure they feel that derails them from developmental goals, and is potentially harmful for their identity, self-image, self-esteem and isolation from others in real time. Moreover cyberbullying is a clear and present danger, and may have life-long impact.

Uncertainty about the future

Another major stress factor is the significant concern our preteens, teens and young adults have about their future. They are living in an age of uncertainty. 

Watch Dr. Beresin discuss the growing problem of teen loneliness on Boston25.

Why may adolescence be a stressful time for many teenagers?

Adolescence is an incredibly stressful time of life. In adolescence, children’s brains are maturing. They’re looking for (and developing) independence. Their relationships and social experiences begin to stand out against the backdrop of their lives. And all these changes cause them to consider, and care about, different issues in more complex ways.

“A school-aged child is more worried about being liked and fitting in,” explains Dr. Beresin. “An adolescent is struggling with questions like, ‘How do I fit in while being separate and autonomous and my own person?’ When you can see all the nuances that adolescents can in their developmental stage, you can get wrapped up in the weeds. They need precious time and experiences with peers, teachers, parents, caregivers, and others to sort out their identity and the role they play with others. They also need to learn social emotional skills, that have a deep impact on their sense of self, mental health, and healthy interaction with others.”

According to Dr. Beresin, adolescents’ fears and anxieties about the state of the world, their families, and their lives are major contributors to the mental health conditions students face today. They commonly worry about the world they shall inherit as noted above, and to complicate matters, the American school system overschedules and overburdens its students—and that makes things even worse. There is simply no down time to process all they are going through. Mindful reflection is crucial for health biological, social, and emotional development. 

“Adolescents need 8 to 10 hours of sleep a night—they never get that. Their demands for performance, high achievement, and overscheduling is a major contributor to sleep deprivation and loneliness.” 

Back-to-school time is an especially stressful time for teenagers. As Dr. Beresin explains, “For [most] young adults, the background of their life is mostly school, family, friends, and recreation. And their recreation is largely school based — or at least that’s the environment within which recreation occurs. So, most of their life is embedded in school.”

“School is so important because it’s not only where students learn, but also where they build friendships,” says Dr. Beresin. “It’s where they develop athletic skills, where they do extracurricular activities. They learn how to function in classroom settings. And it’s also the basis for how they develop a sense of inclusion, identity, autonomy… and it’s where they deal with how they’re treated. They also learn, sometimes the hard way, about resolving conflict that naturally occurs in their lives.”

I don’t have a single conversation with a young person where we don’t talk about worries about the planet, worries about the world they’re inheriting: viruses, climate change, economic downturn, marginalization, being shot or assaulted.
Gene Beresin, MD, MA
Child/Adolescent Psychiatrist
Mass General Brigham

What are common cognitive stressors for teens?

Teenagers face a lengthy list of stressors that includes:

School stressors

  • Pressure to do well in school
  • Living in a culture that fosters unhealthy competition vs. collaboration
  • After-school and extracurricular activities
  • Demands for community service
  • Public health and safety concerns (such as school shootings)

Social stressors

  • Changes in platonic and romantic relationships
  • Bullying
  • For some, pressures to engage in use of substances and risky behavior
  • Pressure to change or control physical appearance
  • The need to continually focus on digital and social media

Family and home stressors

  • Family stress, such as conflict, illness, economic hardship, and/or divorce
  • Parental pressures for academic achievement and/or help in supporting the family
  • Changes in familial relationships
  • Jobs and career decisions
  • A lack of unstructured/free time
  • A lack of unstructured/free time both alone, learning to engage in hobbies, or with others in activities of they chose to do together 

Students are re-entering traditional schooling for the first time in years. And that brings its own set of stressors to the table.

“Students are going back to school in this era of uncertainty, divisiveness, and polarity,” says Dr. Beresin. “And they’re worried: ‘Am I going to fit in? Will other kids like me? Will I be able to keep up with the work, or have I fallen too far behind? Am I still as good as I used to be in athletics and other activities?”

And it’s not only stress about academics, extracurriculars, and social standing that impact teens. Many of today’s students are also coping with fears about their lives and their families’ well-being. This is particularly on the front burner with the increase in mass shootings.

Dr. Beresin says, “I don’t have a single conversation with a young person without talking about worries about the planet, worries about the world they’re inheriting, viruses, climate change, economic downturn, marginalization, being shot or assaulted.”

Many parents wonder about digital and social media as potential stressors for adolescents. According to Dr. Beresin, while these devices and apps certainly need better management techniques, they’re not solely responsible.

“We’re hostages to digital media,” Dr. Beresin says. “And we haven’t learned how to use it productively and sparingly. It’s complicated, and it complicates our lives. Does it cause more stress, anxiety, depression, and loneliness? Sure. But it’s just one of many factors that contribute to the back-to-school situation.”

How does stress affect teenagers?

Back-to-school stress can be overwhelming for teenagers. And they may not be able to recognize or articulate their needs.

Adolescents who are stressed out may show some of the following signs:

  • Moodiness and irritability
  • Increased anxiety and worries
  • Sometimes oppositional or defiant behavior or shutting down and isolating themselves
  • Trouble sleeping
  • Reduced interests in ones they previously had
  • Reduced energy or more tiredness than usual
  • Difficulty focusing and academic decline
  • Lack of motivation
  • Withdrawal from friends or favorite activities
  • Reduced or increased appetite
  • Headaches, stomach aches, jaw tightness, and/or teeth grinding

What are some good coping techniques for teens?

There’s no easy way to adjust the demands and stressors today’s preteens and teens face. But there are ways for teens and preteens to manage their emotions so the stress doesn’t become intolerable.

Dr. Beresin says preteens and teens can manage stress in several ways. “I believe students can, and should, be activists. I want them to look, with guidance from teachers, at their curriculum and extracurricular activities.”

He explains that activism is not only an excellent way for teens to establish identity and connect with a group, but it’s also a creative outlet, a positive form of rebellion, and a channel for abstract thinking. Most importantly, it’s a means to enact change in the system that is causing such severe mental health challenges.

But activism alone won’t help manage stress. “It’s no substitute for good sleep hygiene, exercise, diet, meditation—which every child should do—yoga, and use of cognitive behavioral therapy. And the same process of self-care should be practiced by parents.”

Additional coping skills include self-care, such as:

  • Setting boundaries
  • Choosing activities that reenergize or relax you
  • Changing your environment
  • Engaging in gentle activity

How can parents help?

Here’s how parents can help their children manage stress:

  • Control your own anxiety by taking care of yourself. You are in the best position to help if your mental state is calm.
  • Ask them what they are concerned about: What bothers you the most? What troubles you? Open-ended questions are always best as they can provide key information about how to address children’s issues.
  • Listen to, and validate, their feelings.
  • Have frequent conversations.
  • Encourage them to use creative arts to express themselves.
  • Talk with them about family narratives, and how we have gotten through hard times before. Let them know: We can manage this.
  • Watch media with them and use this to discuss important issues.
  • Support others in your community who may be struggling. Send them an upbeat note, a YouTube video, make them a meal. Giving to others always feels good — and better than receiving.

According to Dr. Beresin, “Parents and caregivers could advocate for more free time, for less demands, for less teaching to the test, for changing the school system and school policies, and looking at what works, for more socio-emotional learning. I think that’s more important as a life skill than the three Rs.”

There are several resources available to help parents and students seeking support for back-to-school stress and mental health. These include:

  • Massachusetts General Hospital’s Clay Center for Young Healthy Minds: A free, practical, online educational resource dedicated to promoting and supporting the mental, emotional, and behavioral well-being of children, teens, and young adults
  • Newton-Wellesley Hospital’s Resiliency Project: An innovative, community-based initiative designed to promote the mental health and well-being of adolescents
  • CASEL: The Collaborative for Academic, Social, and Emotional Learning resources
  • The book Ways to Help Your Lonely Teen, authored by Dr. Beresin, and based on the recommendations for parents and caregivers by the U.S. Surgeon General in his Advisory
Eugene Beresin, MD, MA headshot

Contributor

Child and Adolescent Psychiatrist