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While the COVID-19 pandemic has impacted the mental health of a wide range of individuals, its adverse effects have been particularly detrimental to adolescents. In this article, I discuss evidence that shows the effects of the pandemic on adolescent patients, potential reasons for this increased distress, and what types of coping mechanisms adolescents have used to counter these effects.
Increases in multiple measures of psychopathology
Multiple online surveys and other studies have documented the pandemic’s impact on younger individuals. In the United States, visits to emergency departments by pediatric patients increased in the months after the first lockdown period.1 Several studies found increased rates of anxiety and depression among adolescents during the COVID-19 pandemic.2,3 In an online survey of 359 children and 3,254 adolescents in China, 22% of respondents reported that they experienced depressive symptoms.3 In an online survey of 1,054 Canadian adolescents, 43% said they were “very concerned” about the pandemic.4 In an online survey of 7,353 adolescents in the United States, 37% reported suicidal ideation during the pandemic compared to 17% in 2017.5 A Chinese study found that smartphone and internet addiction was significantly associated with increased levels of depressive symptoms during the pandemic.3 In a survey in the Philippines, 16.3% of adolescents reported moderate-to-severe psychological impairment during the pandemic; the rates of COVID-19–related anxiety were higher among girls vs boys.6 Alcohol and cannabis use increased among Canadian adolescents during the pandemic, according to an online survey.7 Adolescents with anorexia nervosa reported a 70% increase in poor eating habits and more thoughts associated with eating disorders during the pandemic.8 A Danish study found that children and adolescents newly diagnosed with obsessive-compulsive disorder (OCD) or who had completed treatment exhibited worsening OCD, anxiety, and depressive symptoms during the pandemic.9 An online survey of 6,196 Chinese adolescents found that those with a higher number of pre-pandemic adverse childhood experiences, such as abuse and neglect, had elevated posttraumatic stress symptoms and anxiety during the onset of the pandemic.10
Underlying causes of pandemic-induced distress
Limited social connectedness during the pandemic is a major reason for distress among adolescents. A review of 80 studies found that social isolation and loneliness as a result of social distancing and quarantining were associated with an increased risk of depression, anxiety, suicidal ideation, and self-harm.11 Parents’ stress about the risks of COVID-19 was correlated with worsening mental health in their adolescent children.12 A Chinese study found that the amount of time students spent on smartphones and social media doubled during the pandemic.13 In an online survey of 7,890 Chinese adolescents, greater social media, internet, and smartphone use was associated with increased anxiety and depression.14 This may be in part the result of adolescents spending time reading COVID-related news.
Coping mechanisms to increase well-being
Researchers have identified several positive coping mechanisms adolescents employed during the pandemic. Although some data suggest that increased internet use raises the risk of COVID-related distress, for certain adolescents, using social media to stay connected with friends and relatives was a buffer for feelings of loneliness and might have increased mental well-being.15 Other common coping mechanisms include relying on faith, volunteering, and starting new hobbies.16 During the pandemic, there were higher rates of playing outside and increased physical activity, which correlated with positive mental health outcomes.16 An online survey of 1,040 adolescents found that those who looked to the future optimistically and confidently had a higher health-related quality of life.17
Continuing an emphasis on adolescent well-being
Although data are limited, adolescents can continue to use these coping mechanisms to maintain their well-being, even if COVID-related restrictions are lifted or reimplemented. During these difficult times, it is imperative for adolescents to get the mental health services they need, and for psychiatric clinicians to continue to find avenues to promote resilience and mental wellness among young patients.
1. Leeb RT, Bitsko RH, Radhakrishnan L, et al. Mental health–related emergency department visits among children aged <18 years during the COVID-19 pandemic—United States, January 1-October 17, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(45):1675-1680. doi:10.15585/mmwr.mm6945a3
2. Oosterhoff B, Palmer CA, Wilson J, et al. Adolescents’ motivations to engage in social distancing during the COVID-19 pandemic: associations with mental and social health. J Adolesc Health. 2020;67(2):179-185. doi:10.1016/j.jadohealth.2020.05.004
3. Duan L, Shao X, Wang Y, et al. An investigation of mental health status of children and adolescents in China during the outbreak of COVID-19. J Affect Disord. 2020;275:112-118. doi:10.1016/j.jad.2020.06.029
4. Ellis WE, Dumas TM, Forbes LM. Physically isolated but socially connected: psychological adjustment and stress among adolescents during the initial COVID-19 crisis. Can J Behav Sci. 2020;52(3):177-187. doi:10.1037/cbs0000215
5. Murata S, Rezeppa T, Thoma B, et al. The psychiatric sequelae of the COVID-19 pandemic in adolescents, adults, and health care workers. Depress Anxiety. 2021;38(2):233-246. doi:10.1002/da.23120
6. Tee ML, Tee CA, Anlacan JP, et al. Psychological impact of COVID-19 pandemic in the Philippines. J Affect Disord. 2020;277:379-391. doi:10.1016/j.jad.2020.08.043
7. Dumas TM, Ellis W, Litt DM. What does adolescent substance use look like during the COVID-19 pandemic? Examining changes in frequency, social contexts, and pandemic-related predictors. J Adolesc Health. 2020;67(3):354-361. doi:10.1016/j.jadohealth.2020.06.018
8. Schlegl S, Maier J, Meule A, et al. Eating disorders in times of the COVID-19 pandemic—results from an online survey of patients with anorexia nervosa. Int J Eat Disord. 2020;53:1791-1800. doi:10.1002/eat.23374.
9. Nissen JB, Højgaard D, Thomsen PH. The immediate effect of COVID-19 pandemic on children and adolescents with obsessive compulsive disorder. BMC Psychiatry. 2020;20(1):511. doi:10.1186/s12888-020-02905-5
10. Guo J, Fu M, Liu D, et al. Is the psychological impact of exposure to COVID-19 stronger in adolescents with pre-pandemic maltreatment experiences? A survey of rural Chinese adolescents. Child Abuse Negl. 2020;110(Pt 2):104667. doi:10.1016/j.chiabu.2020.104667
11. Loades ME, Chatburn E, Higson-Sweeney N, et al. Rapid Systematic Review: The impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. J Am Acad Child Adolesc Psychiatry. 2020;59(11):1218-1239.e3. doi:10.1016/j.jaac.2020.05.009
12. Spinelli M, Lionetti F, Setti A, et al. Parenting stress during the COVID-19 outbreak: socioeconomic and environmental risk factors and implications for children emotion regulation. Fam Process. 2021;60(2):639-653. doi:10.1111/famp.12601
13. Chen IH, Chen CY, Pakpour AH, et al. Internet-related behaviors and psychological distress among schoolchildren during COVID-19 school suspension. J Am Acad Child Adolesc Psychiatry. 2020;59(10):1099-1102.e1. doi:10.1016/j.jaac.2020.06.007
14. Li W, Zhang Y, Wang J, et al. Association of home quarantine and mental health among teenagers in Wuhan, China, during the COVID-19 pandemic. JAMA Pediatr. 2021;175(3):313-316. doi:10.1001/jamapediatrics.2020.5499
15. Janssen, LHC, Kullberg, MJ, Verkuil B, et al. Does the COVID-19 pandemic impact parents’ and adolescents’ well-being? An EMA-study on daily affect and parenting. PLoS One. 2020;15(10):e0240962. doi:10.1371/journal.pone.0240962
16. Banati P, Jones N, Youssef S. Intersecting vulnerabilities: the impacts of COVID-19 on the psycho-emotional lives of young people in low- and middle-income countries. Eur J Dev Res. 2020;32(5):1613-1638. doi:10.1057/s41287-020-00325-5
17. Ravens-Sieberer U, Kaman A, Otto C, et al. Mental health and quality of life in children and adolescents during the COVID-19 pandemic—results of the COPSY study. Dtsch Arztebl Int. 2020;117(48):828-829. doi:10.3238/arztebl.2020.0828
While the COVID-19 pandemic has impacted the mental health of a wide range of individuals, its adverse effects have been particularly detrimental to adolescents. In this article, I discuss evidence that shows the effects of the pandemic on adolescent patients, potential reasons for this increased distress, and what types of coping mechanisms adolescents have used to counter these effects.
Increases in multiple measures of psychopathology
Multiple online surveys and other studies have documented the pandemic’s impact on younger individuals. In the United States, visits to emergency departments by pediatric patients increased in the months after the first lockdown period.1 Several studies found increased rates of anxiety and depression among adolescents during the COVID-19 pandemic.2,3 In an online survey of 359 children and 3,254 adolescents in China, 22% of respondents reported that they experienced depressive symptoms.3 In an online survey of 1,054 Canadian adolescents, 43% said they were “very concerned” about the pandemic.4 In an online survey of 7,353 adolescents in the United States, 37% reported suicidal ideation during the pandemic compared to 17% in 2017.5 A Chinese study found that smartphone and internet addiction was significantly associated with increased levels of depressive symptoms during the pandemic.3 In a survey in the Philippines, 16.3% of adolescents reported moderate-to-severe psychological impairment during the pandemic; the rates of COVID-19–related anxiety were higher among girls vs boys.6 Alcohol and cannabis use increased among Canadian adolescents during the pandemic, according to an online survey.7 Adolescents with anorexia nervosa reported a 70% increase in poor eating habits and more thoughts associated with eating disorders during the pandemic.8 A Danish study found that children and adolescents newly diagnosed with obsessive-compulsive disorder (OCD) or who had completed treatment exhibited worsening OCD, anxiety, and depressive symptoms during the pandemic.9 An online survey of 6,196 Chinese adolescents found that those with a higher number of pre-pandemic adverse childhood experiences, such as abuse and neglect, had elevated posttraumatic stress symptoms and anxiety during the onset of the pandemic.10
Underlying causes of pandemic-induced distress
Limited social connectedness during the pandemic is a major reason for distress among adolescents. A review of 80 studies found that social isolation and loneliness as a result of social distancing and quarantining were associated with an increased risk of depression, anxiety, suicidal ideation, and self-harm.11 Parents’ stress about the risks of COVID-19 was correlated with worsening mental health in their adolescent children.12 A Chinese study found that the amount of time students spent on smartphones and social media doubled during the pandemic.13 In an online survey of 7,890 Chinese adolescents, greater social media, internet, and smartphone use was associated with increased anxiety and depression.14 This may be in part the result of adolescents spending time reading COVID-related news.
Coping mechanisms to increase well-being
Researchers have identified several positive coping mechanisms adolescents employed during the pandemic. Although some data suggest that increased internet use raises the risk of COVID-related distress, for certain adolescents, using social media to stay connected with friends and relatives was a buffer for feelings of loneliness and might have increased mental well-being.15 Other common coping mechanisms include relying on faith, volunteering, and starting new hobbies.16 During the pandemic, there were higher rates of playing outside and increased physical activity, which correlated with positive mental health outcomes.16 An online survey of 1,040 adolescents found that those who looked to the future optimistically and confidently had a higher health-related quality of life.17
Continuing an emphasis on adolescent well-being
Although data are limited, adolescents can continue to use these coping mechanisms to maintain their well-being, even if COVID-related restrictions are lifted or reimplemented. During these difficult times, it is imperative for adolescents to get the mental health services they need, and for psychiatric clinicians to continue to find avenues to promote resilience and mental wellness among young patients.
While the COVID-19 pandemic has impacted the mental health of a wide range of individuals, its adverse effects have been particularly detrimental to adolescents. In this article, I discuss evidence that shows the effects of the pandemic on adolescent patients, potential reasons for this increased distress, and what types of coping mechanisms adolescents have used to counter these effects.
Increases in multiple measures of psychopathology
Multiple online surveys and other studies have documented the pandemic’s impact on younger individuals. In the United States, visits to emergency departments by pediatric patients increased in the months after the first lockdown period.1 Several studies found increased rates of anxiety and depression among adolescents during the COVID-19 pandemic.2,3 In an online survey of 359 children and 3,254 adolescents in China, 22% of respondents reported that they experienced depressive symptoms.3 In an online survey of 1,054 Canadian adolescents, 43% said they were “very concerned” about the pandemic.4 In an online survey of 7,353 adolescents in the United States, 37% reported suicidal ideation during the pandemic compared to 17% in 2017.5 A Chinese study found that smartphone and internet addiction was significantly associated with increased levels of depressive symptoms during the pandemic.3 In a survey in the Philippines, 16.3% of adolescents reported moderate-to-severe psychological impairment during the pandemic; the rates of COVID-19–related anxiety were higher among girls vs boys.6 Alcohol and cannabis use increased among Canadian adolescents during the pandemic, according to an online survey.7 Adolescents with anorexia nervosa reported a 70% increase in poor eating habits and more thoughts associated with eating disorders during the pandemic.8 A Danish study found that children and adolescents newly diagnosed with obsessive-compulsive disorder (OCD) or who had completed treatment exhibited worsening OCD, anxiety, and depressive symptoms during the pandemic.9 An online survey of 6,196 Chinese adolescents found that those with a higher number of pre-pandemic adverse childhood experiences, such as abuse and neglect, had elevated posttraumatic stress symptoms and anxiety during the onset of the pandemic.10
Underlying causes of pandemic-induced distress
Limited social connectedness during the pandemic is a major reason for distress among adolescents. A review of 80 studies found that social isolation and loneliness as a result of social distancing and quarantining were associated with an increased risk of depression, anxiety, suicidal ideation, and self-harm.11 Parents’ stress about the risks of COVID-19 was correlated with worsening mental health in their adolescent children.12 A Chinese study found that the amount of time students spent on smartphones and social media doubled during the pandemic.13 In an online survey of 7,890 Chinese adolescents, greater social media, internet, and smartphone use was associated with increased anxiety and depression.14 This may be in part the result of adolescents spending time reading COVID-related news.
Coping mechanisms to increase well-being
Researchers have identified several positive coping mechanisms adolescents employed during the pandemic. Although some data suggest that increased internet use raises the risk of COVID-related distress, for certain adolescents, using social media to stay connected with friends and relatives was a buffer for feelings of loneliness and might have increased mental well-being.15 Other common coping mechanisms include relying on faith, volunteering, and starting new hobbies.16 During the pandemic, there were higher rates of playing outside and increased physical activity, which correlated with positive mental health outcomes.16 An online survey of 1,040 adolescents found that those who looked to the future optimistically and confidently had a higher health-related quality of life.17
Continuing an emphasis on adolescent well-being
Although data are limited, adolescents can continue to use these coping mechanisms to maintain their well-being, even if COVID-related restrictions are lifted or reimplemented. During these difficult times, it is imperative for adolescents to get the mental health services they need, and for psychiatric clinicians to continue to find avenues to promote resilience and mental wellness among young patients.
1. Leeb RT, Bitsko RH, Radhakrishnan L, et al. Mental health–related emergency department visits among children aged <18 years during the COVID-19 pandemic—United States, January 1-October 17, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(45):1675-1680. doi:10.15585/mmwr.mm6945a3
2. Oosterhoff B, Palmer CA, Wilson J, et al. Adolescents’ motivations to engage in social distancing during the COVID-19 pandemic: associations with mental and social health. J Adolesc Health. 2020;67(2):179-185. doi:10.1016/j.jadohealth.2020.05.004
3. Duan L, Shao X, Wang Y, et al. An investigation of mental health status of children and adolescents in China during the outbreak of COVID-19. J Affect Disord. 2020;275:112-118. doi:10.1016/j.jad.2020.06.029
4. Ellis WE, Dumas TM, Forbes LM. Physically isolated but socially connected: psychological adjustment and stress among adolescents during the initial COVID-19 crisis. Can J Behav Sci. 2020;52(3):177-187. doi:10.1037/cbs0000215
5. Murata S, Rezeppa T, Thoma B, et al. The psychiatric sequelae of the COVID-19 pandemic in adolescents, adults, and health care workers. Depress Anxiety. 2021;38(2):233-246. doi:10.1002/da.23120
6. Tee ML, Tee CA, Anlacan JP, et al. Psychological impact of COVID-19 pandemic in the Philippines. J Affect Disord. 2020;277:379-391. doi:10.1016/j.jad.2020.08.043
7. Dumas TM, Ellis W, Litt DM. What does adolescent substance use look like during the COVID-19 pandemic? Examining changes in frequency, social contexts, and pandemic-related predictors. J Adolesc Health. 2020;67(3):354-361. doi:10.1016/j.jadohealth.2020.06.018
8. Schlegl S, Maier J, Meule A, et al. Eating disorders in times of the COVID-19 pandemic—results from an online survey of patients with anorexia nervosa. Int J Eat Disord. 2020;53:1791-1800. doi:10.1002/eat.23374.
9. Nissen JB, Højgaard D, Thomsen PH. The immediate effect of COVID-19 pandemic on children and adolescents with obsessive compulsive disorder. BMC Psychiatry. 2020;20(1):511. doi:10.1186/s12888-020-02905-5
10. Guo J, Fu M, Liu D, et al. Is the psychological impact of exposure to COVID-19 stronger in adolescents with pre-pandemic maltreatment experiences? A survey of rural Chinese adolescents. Child Abuse Negl. 2020;110(Pt 2):104667. doi:10.1016/j.chiabu.2020.104667
11. Loades ME, Chatburn E, Higson-Sweeney N, et al. Rapid Systematic Review: The impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. J Am Acad Child Adolesc Psychiatry. 2020;59(11):1218-1239.e3. doi:10.1016/j.jaac.2020.05.009
12. Spinelli M, Lionetti F, Setti A, et al. Parenting stress during the COVID-19 outbreak: socioeconomic and environmental risk factors and implications for children emotion regulation. Fam Process. 2021;60(2):639-653. doi:10.1111/famp.12601
13. Chen IH, Chen CY, Pakpour AH, et al. Internet-related behaviors and psychological distress among schoolchildren during COVID-19 school suspension. J Am Acad Child Adolesc Psychiatry. 2020;59(10):1099-1102.e1. doi:10.1016/j.jaac.2020.06.007
14. Li W, Zhang Y, Wang J, et al. Association of home quarantine and mental health among teenagers in Wuhan, China, during the COVID-19 pandemic. JAMA Pediatr. 2021;175(3):313-316. doi:10.1001/jamapediatrics.2020.5499
15. Janssen, LHC, Kullberg, MJ, Verkuil B, et al. Does the COVID-19 pandemic impact parents’ and adolescents’ well-being? An EMA-study on daily affect and parenting. PLoS One. 2020;15(10):e0240962. doi:10.1371/journal.pone.0240962
16. Banati P, Jones N, Youssef S. Intersecting vulnerabilities: the impacts of COVID-19 on the psycho-emotional lives of young people in low- and middle-income countries. Eur J Dev Res. 2020;32(5):1613-1638. doi:10.1057/s41287-020-00325-5
17. Ravens-Sieberer U, Kaman A, Otto C, et al. Mental health and quality of life in children and adolescents during the COVID-19 pandemic—results of the COPSY study. Dtsch Arztebl Int. 2020;117(48):828-829. doi:10.3238/arztebl.2020.0828
1. Leeb RT, Bitsko RH, Radhakrishnan L, et al. Mental health–related emergency department visits among children aged <18 years during the COVID-19 pandemic—United States, January 1-October 17, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(45):1675-1680. doi:10.15585/mmwr.mm6945a3
2. Oosterhoff B, Palmer CA, Wilson J, et al. Adolescents’ motivations to engage in social distancing during the COVID-19 pandemic: associations with mental and social health. J Adolesc Health. 2020;67(2):179-185. doi:10.1016/j.jadohealth.2020.05.004
3. Duan L, Shao X, Wang Y, et al. An investigation of mental health status of children and adolescents in China during the outbreak of COVID-19. J Affect Disord. 2020;275:112-118. doi:10.1016/j.jad.2020.06.029
4. Ellis WE, Dumas TM, Forbes LM. Physically isolated but socially connected: psychological adjustment and stress among adolescents during the initial COVID-19 crisis. Can J Behav Sci. 2020;52(3):177-187. doi:10.1037/cbs0000215
5. Murata S, Rezeppa T, Thoma B, et al. The psychiatric sequelae of the COVID-19 pandemic in adolescents, adults, and health care workers. Depress Anxiety. 2021;38(2):233-246. doi:10.1002/da.23120
6. Tee ML, Tee CA, Anlacan JP, et al. Psychological impact of COVID-19 pandemic in the Philippines. J Affect Disord. 2020;277:379-391. doi:10.1016/j.jad.2020.08.043
7. Dumas TM, Ellis W, Litt DM. What does adolescent substance use look like during the COVID-19 pandemic? Examining changes in frequency, social contexts, and pandemic-related predictors. J Adolesc Health. 2020;67(3):354-361. doi:10.1016/j.jadohealth.2020.06.018
8. Schlegl S, Maier J, Meule A, et al. Eating disorders in times of the COVID-19 pandemic—results from an online survey of patients with anorexia nervosa. Int J Eat Disord. 2020;53:1791-1800. doi:10.1002/eat.23374.
9. Nissen JB, Højgaard D, Thomsen PH. The immediate effect of COVID-19 pandemic on children and adolescents with obsessive compulsive disorder. BMC Psychiatry. 2020;20(1):511. doi:10.1186/s12888-020-02905-5
10. Guo J, Fu M, Liu D, et al. Is the psychological impact of exposure to COVID-19 stronger in adolescents with pre-pandemic maltreatment experiences? A survey of rural Chinese adolescents. Child Abuse Negl. 2020;110(Pt 2):104667. doi:10.1016/j.chiabu.2020.104667
11. Loades ME, Chatburn E, Higson-Sweeney N, et al. Rapid Systematic Review: The impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19. J Am Acad Child Adolesc Psychiatry. 2020;59(11):1218-1239.e3. doi:10.1016/j.jaac.2020.05.009
12. Spinelli M, Lionetti F, Setti A, et al. Parenting stress during the COVID-19 outbreak: socioeconomic and environmental risk factors and implications for children emotion regulation. Fam Process. 2021;60(2):639-653. doi:10.1111/famp.12601
13. Chen IH, Chen CY, Pakpour AH, et al. Internet-related behaviors and psychological distress among schoolchildren during COVID-19 school suspension. J Am Acad Child Adolesc Psychiatry. 2020;59(10):1099-1102.e1. doi:10.1016/j.jaac.2020.06.007
14. Li W, Zhang Y, Wang J, et al. Association of home quarantine and mental health among teenagers in Wuhan, China, during the COVID-19 pandemic. JAMA Pediatr. 2021;175(3):313-316. doi:10.1001/jamapediatrics.2020.5499
15. Janssen, LHC, Kullberg, MJ, Verkuil B, et al. Does the COVID-19 pandemic impact parents’ and adolescents’ well-being? An EMA-study on daily affect and parenting. PLoS One. 2020;15(10):e0240962. doi:10.1371/journal.pone.0240962
16. Banati P, Jones N, Youssef S. Intersecting vulnerabilities: the impacts of COVID-19 on the psycho-emotional lives of young people in low- and middle-income countries. Eur J Dev Res. 2020;32(5):1613-1638. doi:10.1057/s41287-020-00325-5
17. Ravens-Sieberer U, Kaman A, Otto C, et al. Mental health and quality of life in children and adolescents during the COVID-19 pandemic—results of the COPSY study. Dtsch Arztebl Int. 2020;117(48):828-829. doi:10.3238/arztebl.2020.0828
