Emotionally Naked. Anne Moss Rogers

approach that has had devastating consequences on our youth. If we don't educate kids, drug dealers and disreputable Internet resources will fill that void.

      Of course, other unhealthy coping strategies have also flourished, such as non-suicidal self-harm (e.g. cutting), eating disorders, gambling, retail therapy (buying stuff to feel better), pornography, and promiscuity.

So how can you tell who might be feeling unwell emotionally? Keep an eye out for the kids who are always going to the school nurse with complaints of headaches and stomachaches, who struggle with concentration and motivation or fall asleep in class. A drop in grades or a no-care attitude from a student who used to engage are signs that something isn't right. Other behaviors we don't always associate with depression, anxiety, and other mental illnesses include outbursts of anger, irritability, and aggression such as fighting and bullying. In the past, and sometimes even now, educators label these kids as being lazy, mean, or combative when in fact they are merely acting in response to how they are feeling.

      Teen Depression

      What does it look like when friends are feeling really down?

       Showing up in sweatpants and messy hair—a sign that something might be wrong.

       If a person is isolating themselves from a group.

      Source: Signs of Suicide Youth Focus Group.

      The Impact of Increased Screen Time

Studies have found that spending less than two hours per day of recreational screen time such as browsing the Internet playing games, watching videos, and using social media was associated with higher levels of life satisfaction and optimism, and lower levels of anxiety and depressive symptoms, especially among girls.¹³ While there is not enough definitive data specific to remote learning and its impact on student mental health, we do know that high levels of screen time do have an negative impact on a student's mental health.¹⁴

During the pandemic, calls to suicide hotlines went up 47% nationwide in June 2020 in the US, with some crisis lines experiencing a 300% increase.¹⁵ So it's not farfetched to assume that young people were not insulated from the emotional turmoil triggered by the pandemic, including parental job loss and income instability, and being stuck in a toxic home environment, along with the uncertainty and lack of connectedness of not attending school in person and seeing their peers. During online learning, spotting kids at risk and weeding them out for additional support or assessment became a challenge for educators as schools struggled to adapt quickly to a new digital delivery platform for teaching.

“The kids who were the highest risk were not on the Zoom sessions with their faces in class. Many of them tended to either miss class, sleep through class, or not have a picture in class. So it was very hard for us to find the high-risk kids, which is why our school counseling team sent out a survey. We send it out twice a semester and before the start of the year we were able to weed out the kids who were higher on the scale of showing that they were having more depressive and anxiety symptoms. The kids filled it out and there was a scale of how they were doing during COVID-19, how they were doing during remote learning, and we'd send it out a few times. It's always so important that the school counseling team, either guidance counselors, social workers, whomever is communicating with all the students, to be able to assess who is the most high risk. And honestly, as we know, the kids who are the most high risk are not calling us and saying, ‘Hey, I need some help.’ At our school, those kids tend to be on the sidelines, who we don't know. So if they're answering these surveys it's actually helpful, especially for the boys. Because again, boys are not calling their friends and saying, you know, ‘I'm feeling really sad today. Yeah, I'm feeling depressed, today.’”

       Jessica Chock-Goldman, LCSW (She/Her/Hers), Doctoral Candidate, School Social Worker, Stuyvesant High School in Manhattan, New York

      NOTE A copy of the survey mentioned can be found in Chapter 12, “Quizzes, Worksheets, Handouts, Guides, and Scripts.” Worksheet 3: Student Wellness Surveys features one for distance learning and one for in-classroom learning.

      Co-occurring Disorders

      Suicide in teens is often linked to the presence of mental health disorders, which can co-occur and further increase risk:

       Major Depressive Disorder

       Conduct Disorder

       Substance Use Disorders

       Eating Disorders

       Generalized Anxiety Disorders

       Schizophrenia

       Bipolar Disorder

      Source: More Than Sad Presentation from the American Foundation for Suicide Prevention.

MENTAL HEALTH DISORDERS

Suicide is caused by a constellation of risk factors and underlying vulnerabilities, including mental health issues, environmental and cultural factors (psychosocial), and family and health history, in addition to trying to resolve emotional pain with impaired or underdeveloped problem-solving skills. With most mental illnesses there is treatment and the earlier the intervention, the better the outcome.

The following is a brief overview of some of the more widely known mental health disorders that can affect teenagers and increase suicide risk.¹⁶

      Major Depressive Disorder (Depression)

Major depressive disorder is a mood disorder affecting between 20% and 50% of youth that causes a persistent feeling of sadness, and loss of interest and motivation.¹⁷ It's important to recognize that in children and adolescents, the mood may be irritable rather than sad.¹⁸ Depression affects how an individual feels, thinks, and behaves, and can lead to a variety of emotional and physical problems. Normal day-to-day activities take considerable effort and can lead many to feel that life isn't worth living. Depression is more than just the blues; it isn't a weakness and can often require long-term treatment, including therapy and sometimes medication. These are often the kids who appear unmotivated or tired, fall asleep in class, and are frequently absent.

The total number of teenagers who reported experiencing depression increased 59% between 2007 and 2017.¹⁹ While we cannot pinpoint one single reason that mental illnesses such as depression and anxiety took such a significant jump in this age group, we do know the contributing factors. Adverse childhood experiences (trauma also called ACEs, acesconnection.com), increased digital screen time, grief, marginalization, less in-person face time, sexual orientation, bullying, poor sleep, poor diet, relational difficulties, family history, health history, genetics and more all play a part.

      Conduct Disorder

Conduct disorder is diagnosed when children or adolescents show an ongoing pattern of aggression toward others, including property destruction, bullying, fighting, being cruel to animals, and shoplifting. The major characteristic of the disorder is the violation of social norms and the rights of others.²⁰