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Colleen’s 15-year-old daughter wasn’t eating. Her grades were dropping, and she was noticeably detaching from the world around her.
These classic signs of depression were troubling enough. Then, months later, came a confession: the girl approached her mother one night and revealed her wrists. She had been cutting herself. The teenager had already been seeing a therapist for obsessive-compulsive disorder, anxiety, and depression. Now, Colleen began sleeping on her daughter’s bedroom floor—not necessarily for her daughter’s comfort, but for her own peace of mind, she says.
Meanwhile, Colleen’s oldest daughter was suffering in her own way. The 17-year-old lacked her typical appetite and began to withdraw from friends and family during the early stages of the pandemic. The teen’s anxiety was compounded by struggles with distance learning, but a return to in-person schooling only seemed to make things worse. The setting and social situations felt unfamiliar after so much time away. Eventually, the waves of anxiety took a toll on the girl. She was having thoughts of suicide, according to Colleen, and required a trip to the hospital.
“It was very isolating for us, as parents, to be going through something like that when you know everything looks very normal on the outside,” says Colleen. “And yet everything is just crumbling, and you’re worried about safety inside your house.”
For a growing number of families across the St. Louis region and beyond, parents and adolescents are grappling with a mental health crisis. In many cases, the pandemic has exacerbated existing challenges. Last October, the American Academy of Pediatrics declared a national emergency in children’s mental health, citing “dramatic increases in emergency department visits for all mental health emergencies, including suspected suicide attempts.” Two months later, Surgeon General Vivek Murthy issued an advisory underscoring the need to address the crisis facing children in the United States. Murthy continued to sound the alarm well into the new year, testifying before a Senate committee in February 2022 about the urgent need to act.
Parents have been devastated, too, as they’ve watched their children suffer. It sometimes feels like all they can do is wonder: How did we get here, and how do we find our way out?
Bullying and the effects of social media on impressionable minds were already long-standing causes for concern. With the onset of the pandemic, social circles have also been broken, routines have been dramatically altered, and weighty concerns have been thrust front and center in everyday life.
Globally, symptoms of anxiety and depression have doubled since the onset of the pandemic, according to a report published last August in JAMA (Journal of the American Medical Association) Pediatrics. What’s more alarming, according to data compiled by the Children’s Hospital Association, is that the U.S. saw a 45 percent spike in the number of self-injury and suicide cases during the first six months of 2021 compared to the same period in 2019.
“We’re seeing a lot of anxiety disorders,” says Tom Duff, executive director of Saint Louis Counseling. “COVID has only impacted it. We were seeing it beforehand, too. But since the onset of COVID, there have been feelings of hopelessness, helplessness, and fear. When those are prolonged over time, it becomes toxic stress, where all of a sudden it’s impacting a kid’s daily functioning. Their stomachs might be more upset; they might have more headaches; they might want to avoid certain aspects of their day, or school in general.”
In Colleen's case, her 15-year-old daughter's grade drops clued her into the problem, illustrating the role that schools can play in helping assess a child’s mental health. At the same time, school routines have been significantly disrupted, causing additional challenges for students’ academic and social lives. When the pandemic forced a shift to virtual learning, for example, many students came to rely on social media even more to communicate with their peers. It also made bullying, another preexisting stressor, harder to recognize. Social media apps such as Instagram can have a dramatic influence on impressionable adolescents, especially girls. One study published in early 2021 in the Journal of Youth and Adolescence shows a correlation between increased use of social media and a higher clinical risk for suicide among teen girls. Regardless of the cause, the number of emergency room visits for suspected suicide attempts among 12- to 17-year-old girls rose by 51 percent from February 2019 to March 2021, according to the Centers for Disease Control and Prevention; during the same period, suspected suicide attempts resulting in ER trips among teen boys jumped 3.7 percent.
How can parents help? Dr. Shannon Farris oversees the Signs of Suicide program at the CHADS Coalition, a St. Louis—based nonprofit focused on suicide prevention programming and counseling services. He advises that parents dealing with a child in crisis “lean in with curiosity.” Kids want to be heard and seen, says Farris, adding that one of the biggest mistakes that parents can make is comparing their own crises to those experienced by their child or minimizing a child’s situation.
“If a kid is talking about something that is happening to them, and they feel that the adult…is saying it’s not a crisis at all, they’re not going to feel supported,” Farris says. “When parents, guardians, and trusted adults ask questions like, ‘What’s happening?’ or ‘How are you mentally?’—that can get to the heart of what’s going on. A child might take a risk and tell them what’s going on, and that saves lives. It can just be a two-minute conversation and still be impactful. Put the phone down, step away from the desk or TV, square up with that child, and lean in and be curious.”
Two years into the pandemic, listening closely to children is especially important now. The small things that can add up to a tough day for a kid—encountering a bully, hearing arguments at home, or not knowing whether they’ll have enough to eat—have been much more difficult to avoid. Where before there might have been a reprieve in the form of a sympathetic teacher, escaping the tension of home, or even a hot school lunch, there have been fewer moments for solace.
“That’s what has made this a real trauma,” Farris says, “and we are going to see the impact of this for many, many years. It is sad, it is brutal, and it’s ugly. It doesn’t mean there isn’t hope, but we have a long way to go on the healing journey.”
On the other end of the phone, Colleen’s voice goes quiet. During a conversation about the worst of her daughters’ struggles, she pauses to think. “My middle one, she’s doing so well now,” Colleen says. “I don’t think that often about what transpired.”
Therapy has helped her 15-year-old cope with obsessive-compulsive disorder, anxiety, and depression. And while Colleen’s 17-year-old still seems to be in the thick of her malaise, Colleen says regular counseling and a steadfast commitment to taking care of controllable objectives have helped her 17-year-old make progress. On rough days, for instance, they’ll choose three things that they can accomplish, such as walking outside, drawing, or dancing—intentional actions to foster positive thoughts.
Watching their children struggle can make a parent feel helpless, Colleen says, but she adds that there is some comfort in knowing that she and her family have found support and more ways of coping. One of those coping mechanisms is a town hall-style virtual meeting hosted by the CHADS Coalition. And more families will soon get the care they need thanks to a recent $15 million donation that will allow St. Louis Children’s Hospital and Washington University School of Medicine to create the Hermann Center for Child and Family Development, providing support not only to the children who are struggling but also the parents who want to help them.
“It is very scary to be a parent who has a child with any mental illness, particularly somebody who has a child with suicidal ideation,” Colleen says. “It’s terrifying. But I hope they know that they are not alone, and it’s not their fault.”
If you or your child are having thoughts of suicide, confidential help is available for free at the National Suicide Prevention Lifeline. Call 1-800-273-8255. The line is available 24 hours a day, seven days a week.
