“Today’s adolescents and young adults are growing up in an age of anxiety,” says Patrice Harris, MD, a psychiatrist and Everyday Health’s medical editor in chief at large. “They’re living in an age of active shooter drills at school, bullying, ‘fear of missing out,’ and success measured by the number of likes — along with pressure, often from peers — that comes with social media use. And when your peers are not just your classmates, but millions of people, as with Olympians, there’s even greater pressure.” This group, ranging from the youngest millennials (starting at age 24) to Generation Z (up to age 24), is coming of age in an era of tumultuous sociopolitical issues — including constant pandemic uncertainty, gun violence, climate change, rapidly shifting social norms, and a reckoning with systemic racism and sexual assault — that are proven to take a toll on mental health, according to the American Psychological Association’s (APA) “Stress in America: Generation Z” report. As a result, symptoms of anxiety and depression in this generation are on the rise and have been reported by more than half of 18- to 29-year-olds, as reported in the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report in April 2021. “Youth are growing up under a microscope in a way that’s never happened before,” says Anne Marie Albano, PhD, a clinical psychologist and director of the Columbia University Clinic for Anxiety and Related Disorders in New York City who specializes in anxiety and mood disorders in children, adolescents, and young adults. “From birth, parents are sharing pictures and videos of their kids on Instagram, YouTube, you name it. Kids’ lives are now public.” The Pew Research Center reports that 48 percent of young adults ages 18 to 29 are online almost constantly, and a study published in Creative Education in July 2021 showed that gadget addiction among Gen Z can be a contributor to mental health issues. In addition, those who use social media often are more likely to be involved in cyber-bullying, which is linked to depression, self-harm, and suicidal thoughts, according to research published in 2019 by the APA in the Journal of Abnormal Psychology. RELATED: The Top Mental Health TikTok Influencers — and Why They’re Important “There’s tremendous pressure on how kids appear to others on social media,” says Dr. Albano. “On one hand, they’ve got to be the coolest and get the most likes from their friends. At the same time, they have to balance not crossing a line for parents and other adults who are saying, ‘Colleges and future employers will see what you post on TikTok.’” This all adds up to a stressful and confusing picture to navigate for an age group that’s already grappling with other pressures such as exploring their identities. RELATED: 5 Tips for Kick-Starting a ‘Mindful Tech’ Self-Care Habit This rise in inclusivity and awareness of LGBTQ+ identities has resulted in more youths coming out at younger ages, which has contributed to more positive resources and protective school environments for some. But because this demographic is still likelier to face discrimination, bullying, and a lack of interpersonal support, they’re also at higher risk of mental health issues like depression, anxiety, alcohol misuse, suicide attempts, PTSD, and mood disorders, according to research published in May 2016 in the Annual Review of Clinical Psychology. RELATED: LGBTQ+ Emotional Resources “Our school has seen a higher percentage of students come out and be up front and proud of their identities,” says Kristin Reeder, president of the New Mexico School Counselor Association and head counselor at Digital Arts and Technology Academy, a public charter school in Albuquerque, New Mexico. “These students have begun to feel more accepted, and when they have a sense of belonging, classroom engagement and learning increases. But being open about identity depends on school and family support; it’s just not safe for all students to be open yet.” Alcohol aside, marijuana is by far the most-used drug among young adults, reports the National Institute on Drug Abuse, and substances like amphetamines and prescription painkillers are also an issue. According to report published in May 2020 in Pediatrics, there’s been an 80 percent spike since 2008 in high school–age youths who use marijuana daily or nearly every day — a statistic of concern given that marijuana use before the mid-twenties is linked to increased risk of depression, anxiety, and psychosis, among other adverse effects, according to CDC. Despite this uptick in use, some experts are encouraged by one of the side effects: The stigma around substances is slowly dissipating, in part because broader use and marijuana legalization is inviting more education and open conversation. “Drug use with friends or families isn’t as secretive as it once was,” says Reeder. “Many teens I work with have been impacted directly or indirectly by the opioid crisis, losing a family member or friend, or knowing someone that’s struggling with addiction. As a result, I’ve noticed more people are talking about substance use, which has led to an increase in awareness of the risks.” Since the onset of COVID-19, 56 percent of young adults ages 18 to 24 report symptoms of anxiety or depression, according to a report from the Kaiser Family Foundation (KFF), with Gen Z members reporting the highest levels of stress compared to other generations, reports the APA. And while the pandemic may have temporarily restricted youths’ access to some substances, the KFF report says young adults are also 12 percent likelier than other age groups to report substance abuse. “The pandemic has shaken up teens’ and young adults’ ability to individualize and develop,” says Courtney Tracy, PsyD, a 31-year-old licensed clinical social worker, psychologist, and social media influencer based in Laguna Beach, California. “Without this ability, all kinds of mental health struggles come up, like shame, anxiety, depression, low self-esteem, anger, and confusion.” These challenges emphasize how crucial it is for youths to have a strong support network to strengthen their self-esteem and help them cope, but research also shows that today’s young adults, more than other age groups, struggle to find community: A 2020 Cigna survey found that 73 percent of Gen Z respondents sometimes or always feel alone. “The rise of loneliness is a big stressor that has impacted this generation,” says Kojo Sarfo, DNP, a 28-year-old psychiatric mental health nurse practitioner and social media influencer based in Los Angeles. “A lot of us are isolated away from our loved ones. It’s challenging to have a sense of community and feel connected when we rely exclusively on technology for that connection.” RELATED: Protecting Our Mental Health While We Ride Out the COVID-19 Pandemic Dr. Tracy adds that the pressure to appear “okay” on social media has fortunately not been too intense during the pandemic — in fact, young people found community in struggle — but other challenges have emerged. “New pressures include developing a sense of self while locked in your home, maintaining an interest in education, and keeping up grades while shifting from online to in-person instruction,” she says. “This generation will never be what they would have been had the pandemic not happened, for better or worse.” RELATED: 69 Top Self-Care Tips for Taking Care of You During the Coronavirus Pandemic “While many college students are excited about getting back to their campuses, many are having mixed emotions and experiencing reentry anxiety,” says Carmen Bell, PsyD, a psychologist in the department of counseling, psychological services, and disability services at the University of Michigan in Dearborn. “For some, the wide range of emotions can be stressful and have a great impact on their academic success and social relationships.” RELATED: An Introvert’s Guide to Socializing Again in a Partially Vaccinated World “Everyone experiences stress and anxiety, but for BIPOC communities, the stressors might be different or additive, especially during the last year-and-a-half, as issues of racial justice have been amplified,” says Harris. “Additional pressures include bias and racism. Parents and guardians of African American children have to have conversations with their children about race and police violence that white parents and guardians don’t need to have. We don’t have enough mental health resources in general, and the data shows that communities of color have even less access to those resources — and they may face additional stigma in seeking help.” RELATED: Mental Health Resources for Black Americans Shortages are more common in rural areas due to lack of funding and infrastructure, and some specializations are more at risk than others; GoodTherapy says the United States is predicted to have a shortage of 78,000-plus school counselors by 2025, for example. But even in highly-staffed urban areas, financial and educational factors can prevent people from seeking help. If their insurance doesn’t cover mental health services or if they’re not aware of their treatment options, they may simply not get any. The increased awareness and discussions surrounding mental health may be helping, however: According to the 2019 SAMHSA survey, the percentage of young adults ages 18 to 25 who received mental health services increased from 10.5 percent in 2002 to 17.2 percent in 2019 — only slightly less than the 17.8 percent of adults ages 26 to 49 who received care in 2019. But for those who have acknowledged any mental illness, 18- to 25-year-olds are almost 7 percent less likely to receive care than 26- to 49-year-olds. The lower rates of care among younger adults is partly due to factors including lack of knowledge about services, barriers to access, and stress associated with the help-seeking process. Their transitional life stage also makes young adults particularly vulnerable to a drop-off phenomenon in which they stop treatment or care prematurely, perhaps due to a move or insurance coverage change, according to research published in April 2020 in The Journal of Behavioral Health Sciences and Research. “The mental health infrastructure has been woefully underfunded and under-resourced for decades,” Harris adds. “In order to increase access, funding, resources, and workforce issues must be a priority. And the availability of a sustained continuum of care from prevention to treatment should be the norm, not the exception.” Albano points to specific kinds of treatment that can be especially effective for young adults, including group therapy, dialectical behavior therapy, exposure therapy, and behavioral activation. All the experts reiterate the importance of everyday activities like exercise, hydration, and social connections (including peers and mentors), which are proven to support mental health. RELATED: Why Friendships Are So Important for Health and Well-Being On Sarfo’s own mental health journey, in his mid-twenties, he was diagnosed with attention deficit hyperactivity disorder (ADHD), a mental disorder that affects 4.5 percent of adults ages 18 to 24, according to the National Institute of Mental Health. For him, getting a formal diagnosis and taking up rituals like mindfulness was a life-changing combination. “The hardest part of our mental health is to start the conversation,” he says. “By talking about it, not only do we eliminate the stigma, but we also create a sense of community where people feel accepted and vulnerable enough to be their most authentic selves.”
The Jed FoundationNational Alliance on Mental IllnessYouth.govAmerican Psychiatric Association FoundationMental Health AmericaAmerican College Health AssociationAakoma ProjectRECLAIMBlack Mental Health AllianceInclusive TherapistsLee Thompson Young’s Youth Mental Health First Aid ProgramAnxiety and Depression Association of America’s approved mental health appsSociety for Adolescent Health and Medicine
