The clinical psychologist Lisa Damour published her latest best-selling book, “The Emotional Lives of Teenagers,” in February, a week after the Centers for Disease Control and Prevention issued an alarming report on the mental health of adolescents. In the C.D.C.’s survey, three in five teen-age girls reported having felt “persistently sad and hopeless” in the past year, thirty per cent reported that they had seriously considered suicide, and thirteen per cent said that they had attempted suicide. All of these marked significant increases over previous years, and girls also reported increased exposure to sexual violence. Among L.G.B.T.Q.+ kids, the numbers were even worse: two-thirds reported feeling persistent sadness, forty-five per cent had thoughts of suicide, and twenty-two per cent had attempted suicide. Hypotheses about the causes of this apparent mental-health calamity centered on the overuse of social media, the lingering psychological damage wrought by the pandemic, and, for queer kids, an increasingly malignant political climate.
To make sense of the C.D.C.’s shocking numbers, many media outlets turned to Damour, who explores young people’s inner worlds in her popular “Ask Lisa” podcast, in her books (her first two, “Untangled” and “Under Pressure,” homed in on teen-age girls), and in her private psychotherapy practice, in Shaker Heights, Ohio. Damour is herself the mother of two daughters, ages twelve and nineteen, and, although she does not discount the evidence of a post-pandemic surge in anxiety and despair among American teen-agers, she wants to recalibrate the terms of the conversation. “Mental health is not about feeling good or calm or relaxed,” she told me when we spoke on Zoom in May, days after the U.S. Surgeon General issued an advisory about the ill effects of social media on tweens and teens. “It’s about having feelings that fit the circumstances you’re in and then managing those feelings well, even if those feelings are negative or unpleasant.” She went on, “The adolescent mental-health crisis doesn’t end when all teen-agers feel good. It ends when teen-agers have the support they deserve and are able to cope effectively with the distress that they will invariably face.” Our conversation has been condensed and edited.
In “The Emotional Lives of Teenagers,” you take what we often think of as problems to be solved and you reframe them as facts of life—adversity that you just have to deal with, bad feelings that you can’t necessarily extinguish. You write about the value of being comfortable with discomfort and seeing emotions as tools and as data. Why do you think that that kind of work is harder now for your patients—and perhaps for their parents—than it was in the past?
There are combined forces at work here. One may be the commercialization of wellness. There’s marketing that can suggest that an emotional Zen exists, and with the right products or practices we can get ourselves there. That’s not true, but it’s very alluring as an idea, and it has contributed to a rising discomfort with emotional distress.
There’s also the reality of what we’ve all been through. The pandemic hit families in so many different ways. It left us pretty raw and eager to find a place that feels easy. I entirely understand that desire. Unfortunately, development has always been a bumpy road. The pandemic may have had us in a ditch for a couple of years. Now we’re back on the bumpy road that is typical adolescent development, but maybe we’re feeling those bumps in a different way, having been through so much.
Yeah, we’re exhausted and dirty to start with because we had to climb out of the ditch. “The Emotional Lives of Teenagers” was published within a week of a C.D.C. report that revealed troubling data about teen-agers—teen-age girls and L.G.B.T.Q.+ kids in particular. Then the Surgeon General issued an advisory about teen-agers and social media, which pinpoints moments in adolescent brain development when kids are especially vulnerable to negative effects of social media: between ages eleven and thirteen for girls, ages fourteen and fifteen for boys. Do those numbers track with what you’ve observed with patients in your practice?
It’s certainly a particularly vulnerable time for kids for negative influences. A lot of the disparity between girls and boys is driven by the neurological development that is jump-started by puberty, and girls enter puberty as a group earlier than boys do. So that’s why you see those age disparities.
What’s hard about the tweens to the early teens is that kids are often still quite concrete in their thinking. Regardless of how intelligent they are, they’re not always able to stand back from ideas and consider them from a wide range of perspectives. That comes along later in adolescent development. Older teens, as a function of having more fully developed brains, are able to be more skeptical about what they’re exposed to online, to consider what might be the motivation for any given post, as opposed to taking it at face value, as a younger teen is neurologically inclined to do.
The advisory from the Surgeon General seems to suggest that it’s not necessarily Snapchat or Instagram or TikTok in and of themselves that is the problem but, rather, some kids are spending two or three hours a day, or more, on them. Is part of your role as a psychologist to try to get kids to manage how much of their precious brain-developmental time they’re giving to tech companies?
The advisory highlights two things that we really need to focus on. One is harmful content, which we don’t want kids exposed to. The other is problematic use, which is spending so much time online that it disrupts the activities that are essential for healthy development, such as sleep, physical activity, time spent in person with friends, time spent helping around the house or in one’s community. When parents are trying to sort through these recommendations, one thing that they can do is not necessarily to think of themselves as being against technology—that’s probably a losing battle—but being for our kids and teen-agers spending essential time doing the things that will help them grow and thrive.
The other day, I was talking to a friend who said that he has accepted that he cannot persuade his teen-age daughter to spend less time on TikTok—he has given up doing it, even though he feels that it is harming her. What would you say to him?
My first question is whether she takes technology into her room and whether it’s there with her overnight. I will categorize this as a fight worth having with teen-agers. I have long recommended that technology not be allowed in anybody’s bedroom—parents or kids, ideally never, but certainly not when they’re supposed to be sleeping. If a teen-ager has enjoyed having technology in their room, they’re not usually agreeable to having it removed. So a parent can say, “We’re taking it out of our own bedroom because we know it is bad for our physical and mental health to have it in there. And if we take it out of our bedroom, and we leave it in your bedroom, it’s like we got in the car and we put on our seat belts, but we’re not putting on yours.”
Whatever else you can say about technology and how any of us use it, the more it disrupts sleep, the more likely it will be to contribute to mental-health concerns.
So does she spend three hours a day on TikTok in the living room?
The next way to tackle it might be to think in terms of the reality that it’s good for kids to be busy—not too busy, but busy. So another question that I would ask is: What is she doing after school? Does she have an abundance of free time that couldn’t be better spent? Now, I think the part that is hard for parents is that a lot of us, myself included, watched ungodly amounts of television—
Ungodly. Criminal. The amount of MTV I watched at that age—ridiculous.
And this is where we get down to the question of harmful content, and the question of what side of TikTok this kid is on. There are no simple and perfect answers here. But if this dad could get to a place where he says, “Actually, she’s watching two hours a day of goofy dance videos,” then we have to search our own hearts about whether this is better or worse than all of the “Gilligan’s Island” I watched as a kid.
The Parent of a Teen-Ager Is an Emotional-Garbage Collector
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