Southwest Florida families are finding themselves in the middle of a national trend - a rise in mental health challenges for a new generation. A number national medical journals and other publications have identified a rise in anxiety and depressionamong teenagers and young adults.
"I was struggling with anxiety and depression," says 29 year-old Southwest Floridian Elle Denning.
She says it was difficult to process because her outside world - like her marriage and career - were going so well.
"I felt like everything externally in my life seemed like it was checking all of the boxes," "It felt like 'I'm accomplishing things, I'm doing things but my inside world doesn't feel like it.'" Since everything seemed OK on the outside, she had trouble accepting that her internal world needed support.
"I think that type of thinking kept me from reaching out for help for a very long time," says Elle. Like many young people, the she tried to cope with "feeling bad about feeling bad" which made everything worse.
"Part of that thinking of, 'I shouldn't be worried about this,' or "I shouldn't have this anxiety,' almost creates this snowball effect." Her medical provider at the non-profit, Samaritan Health suggested she get mental health counseling.
"The counseling has helped me tremendously - more than the years of reading self help books or blog articles," says Elle. Elle's counselor at Samaritan, Elizabeth Martin, says her case is not unusual.
"Younger clients are coming in that have a lot of anxiety," says Elizabeth, who holds a Master's degree in Mental Health counseling. She says in many cases, the young people she sees are leading "outwardly successful" lives and maintaining that "success" takes a toll.
"They don't sleep, they have these rigorous schedules, and they try to keep up," says Elizabeth who adds young people are dealing with high expectations from themselves and others.
"The pressure for the grades, the pressure for themselves to be perfect," she says. And Elizabeth says that pressure can eventually make itself known in changes of behavior. "The behavioral changes, the acting out, the not listening to the parents," she says, can be signs a young person is overwhelmed.
She says social media can amplify feelings of anxiety and depression. And she says some young people may use a toxic substance as a way to cope.
"Lots of kids are smoking marijuana and vaping," she says. "And that I believe has added to some type of de-motivation for kids." 17 year-old Freya Turner of Lee county is painfully familiar with where self-medicating drug use can lead.
"I lost my sister about 4 years ago to a heroin overdose," says Freya. And she says her sister, who was eight years older, isn't the only young person in her life she has seen take drastic steps in the attempt to end mental anguish.
"I've seen people try to cut their own throat," says Freya. Freya says she eventually found herself in a state of despair. "I hit rock bottom," says Freya. "I was hurting myself." "I was doing everything I could to not feel the way I was feeling," she adds.
Like Elle, Freya found help through counseling at Samaritan Health in Cape Coral. Freya found she felt better from seeing a professional face to face. But she says, initially, she didn't like the idea. And she says many others of her generation may feel the same at first.
"When they're told they need counseling, they think something's wrong with them and that's what I thought," she says. Freya says what she's learned through counseling helps her when she needs it most.
"Like when I'm having anxiety attacks, I take a second look at my surroundings and see the things I'm currently controlling and what I can control," she says. "And slowly, (I) take my deep breaths and baby steps to being functional and calm."
Elle says her counselor, Elizabeth, has given her "homework" that has helped. She keeps a gratitude journal, exercises (usually a brisk walk around her neighborhood) every morning and volunteers (with horses in Punta Gorda.)
So how can you - or the young person your life - know when it's time to get professional help as opposed to handling things at the family level without outside support? We put that question to Dan Simmons, a counselor with the Betty Ford Hazelden Foundationin Naples.
"To know when the adolescent is going through 'normal anxiety' for an adolescent is not an easy thing to do," says Dan. "Difficulty with school, that's not unusual," he says. "Difficulty with school that has behavioral acting out kind of things, that's usually a cry for help."
"If there's any question or concern, you might want to consult a professional," adds Dan. He says it's can be difficult for the older adults in young people's lives to know where to start.
He says, often times, parents "use their own adolescence to measure what kids should or shouldn't be doing today."
"And it’s a different world than it was," he says.
He says it begins with allowing young people to speak about what they're feeling - even if that involves conflicting thoughts and emotions.
"For parents to understand their adolescents, they need to listen - a lot," says Dan.
"Adolescents are overwhelmed."
"They are really struggling at this point," he adds.
He suggests parents talk about their own process with dealing with anxiety - both when they were younger and now.
"They might give examples of how they struggle with an authority figure like a boss" says Dan.
He says seeking professional support might start at a place where young people spend the most time away from home.
"I would start by seeing if i can have a personal connection with a professional at the school," says Dan who adds there usually are not enough school counselors and psychologists to go around.
But he adds, "Even if they can't provide the services, they often know the resources in the area."
Dan says it's important to remember maintaining good mental health is a dynamic process with ups and downs.
"All of us have issues," he says.
"We all struggle time to time."
"And we need to take the stigma out of asking for help."
To find out more for you, we submitted a series of questions to Sue Hook who is an Advanced Registered Nurse Practitioner (ARNP.)
Sue is also the executive director of Samaritan Health in Cape Coral where Elle and Freya have found support.
Below are our questions and Sue's responses.
- Have you seen a shift in demand for mental health care among young people in recent years? if so, what do you suspect is driving that?
What I’ve seen is a growing awareness of the need for mental health care among young people. The need has always been there, but with the stigma associated with mental illness, many people found it hard to ask for help. More parents are seeking help for their children, and more youth are speaking out about their emotions, stress, etc. Social media and technology (Facebook, Instagram, Snap Chat, gaming, etc.) are major contributors to mental health problems in youth especially. Children, even in preschool and elementary school, have access to cell phones, which, when connected to the internet, open doors that should remain closed. Children have access to a barrage of images and voices telling them how they should look, what they should wear…they compare themselves to each other via social media. I’ve seen young people so distraught over these things that they’ve developed eating disorders, suicidal ideation, depression, anxiety, insomnia, etc.
Drug and alcohol use in adolescents is rampant. Marijuana, alcohol, over-the-counter medications (DXM, Triple C)…they are all being used, and most parents are unaware. Self-medicating...they are numbing themselves to their reality to “feel better.” Marijuana, to many teens as well as adults, is just an “herb…a natural medication.” Another media deception, which is becoming another addiction. These dangerous habits damage brains, and in children and adolescents, inhibit intellectual and emotional growth and development. This damage carries over into adulthood and leads to depression, anxiety, drug-induced psychosis, and a myriad of other mental and physical health problems.
We are also seeing young people who’ve started to “self-harm,” which manifests itself, for example, in the practice of “cutting.” In the past, nearly 20 years ago, I had a teen tell me that her lip piercing was “just another way I could hurt myself.” Now it’s cutting.
- Is there a particular age where kids and parents really need to pay attention?
Parents should be aware of their children’s mental and emotional state from the time they are born! As children grow, and life stressors begin, parents and care givers need to be cognizant of changes in behaviors, mood, sleep and eating habits, socialization, etc. When children go to school, again, grades and behaviors with peers and teachers can be indicators of their mental and emotional health. Grades drop, the child acts out by hitting or disrupting the class, etc. These are indicators of problems and should alert the parents that something is up with their child. In adolescent years, with the onset of puberty, there are often emotional upheavals in the lives of kids. Peers become much more important at this point in young peoples’ lives, and children are often brutal to one another (bullying, comparing, etc.). At this point, and throughout high school, parents should watch for changes in behavior that could indicate depression, anxiety, risky sexual behaviors, and drug and alcohol use, all of which can be initiated by peer pressure through peer groups directly and through social media.
Parents need to stay involved at all stages of their children’s growth and development, but as noted, adolescence is a tumultuous time where parents need to be parents and not “friends” to their children…vigilance is key.
- Is there a most common condition for that age group? anxiety? depression?
- any things in young people's world that may exacerbate (e.g. elizbeth mentioned the marijuana epidemic ..I wondered about social media and phones etc)
- Samaritan seems like a great resource..how should we tell folks payment is determined? is there a range we can mention depending on insurance? other resources young people should know about?
As you know, Samaritan Health and Wellness Center is an integrated primary care behavioral health clinic, which is funded by the small amount the patients pay for service along with donations from the community. Integrated care involves medical providers (i.e. nurse practitioners) and masters prepared mental health counselors working together as a team to take care of the body, mind, and spirit of each patient.
Fees for service: a new patient visit (medical or mental health counseling) is $65. Follow up medical visits are $45. A counseling session (1 hour) is $50. Samaritan does not bill any insurance because the mission of the organization is to provide affordable healthcare for the uninsured and under insured. We are a Christ-centered practice, but “religion” is not pushed on anyone, and everyone is welcome to come for care.
As an organization, we currently partner with Valerie’s House where children and families grieving the loss of a loved one, go for support and peer counseling. We refer our patients to them as needed, and they in turn refer children and families to Samaritan who need individual or family counseling.
In regard to other resources there are multiple agencies that can be found online as well as National Association for Mental Illness (NAMI) who has great resources. The Suicide Hotline, Partners for Drug Free America, Substance Abuse and Mental Health Services Administration (SAMHSA) are examples of resources that can be accessed by parents and youth.