Recently I was presented with the challenge of addressing a group of parents and teachers of a cluster of schools in a midlands town – primary and secondary around the whole area of mental health and young people. This prompted me to investigate some of the major issues driving the growth in incidence of youth mental health issues.

​Poor mental health is a huge issue among young people across Ireland and at the extreme end of this continuum; we continue to lose too many young people to suicide on a weekly basis – often a permanent solution to a temporary problem.

While the problem of suicide is vast, it is the end point of a continuum that often begins with stress, anxiety and depression. In young people, these symptoms and presentations are increasing exponentially and is something that should concern us all. In my opinion, it has reached epidemic proportions and the statistics will support my view.

Recently, a “Young Lives in Ireland” study – a school-based study of mental health and suicide prevention within 17 mainstream schools in Cork and Kerry was carried out by the National Suicide Research Foundation. The study – carried out on over 1,000 children with an average age of 13 – 16 found that 14% of teenagers had depressive symptoms, 24% had anxiety and up to 20% had attempted self-harm.

Scarily, it stated that the rate of attempted suicide among school-age teenagers could be as high as one child per class with findings suggesting that up to 7% of participants having suicidal thoughts. Significantly, in this study, 4% had attempted suicide.

This is not an isolated study and in 2012, similar figures were found by Dr Barbara Dooley of UCD in the “My World Survey” conducted with Irish students between 12 and 25. Here it was found also that 21% had depression and or anxiety and that the suicidal attempt rate was higher at 7%. This suggests that the rate of suicide increases as young people progress through their teens and into their early twenties.

In my current role as a home school community liaison, I regularly see the pain and anguish this is having on families’. Like many front line workers on too many occasions, I have met with parents distraught with worry over their teenage children’s unhappiness, self harm, suicidal ideation and low self worth while the mental health services are creaking at the seams!

The problem is complex but we must ask ourselves why it is occurring in such huge proportions.

So what are the contributory factors?

1.     Obesity

Childhood Obesity in the EU

I have a theory and it is multi-faceted. We are in the midst of an obesity epidemic. We are projected to be the most obese country in the world by 2030 at current rates of growth. In fact obesity rates have quadrupled across Europe in the last 30 years with the current rate in Ireland over 25%.

 

 EU obesity
Childhood Obesity in the EU
At exactly the same time, the world has developed social media and young people all over the country are becoming addicted to their technology. No problem here you say? You could not be more wrong!

Comparatively on average, a youth today doesn’t move as much as one used to. Our society of convenience sees that they no longer have to. Communication with friends occurs through a different medium than previous – often through social media groups from the comfort of their own home. Where previously, “hanging out”, involved some form of physical effort; with the development of Wifi, Skype, FaceTime and other social media communications, we can remain seated and “hang out” with anybody in the western world and most of the eastern world with the click of a button.

Some platforms can even facilitate 3 or four in live screen conversation while Whatsapp, Snapchat, Facebook and Instagram among others allow us to communicate with bigger numbers in private conversations! Video gamers communicate and play each other through the internet from the comfort of their own homes. Worse still, children and adolescents anonymously send picture messages and text each other through social media apps such as Kik and Sarahah – a legal minefield for bullying that in extreme cases, requires laborious manual labour on the part of An Garda Siochana to sort out. We can travel the world on our phone and meet who we want from the comfort of our own sofa and as a result, children and young people meet less to interact in fun, sweat inducing and memory forming activities or minor games like their predecessors. Social media in it’s essence is isolating people from each other – so much so that some mental health professionals have even labeled it anti-social media!

In a recent conversation with youth mental health professionals from the Rutland Centre who deal with all sorts of addictions, I was informed of a new phenomenon of mobile phone / social media addiction / gaming where teenagers stay up half the night to tend to “snap-chat streaks”, social media group interactions and gaming. With tens and even hundreds of people in some groups, the mobile phone doesn’t stop at night with many teenagers losing out on sleep. As we all know, lack of sleep and poor sleep quality leaves people agitated and contributes to elevated levels of anxiety. Even those who do not comment have interrupted sleep through regular alerts and notifications. Social media devices also emit a blue light that has a different wavelength of Gama rays than regular light. Long exposure to this blue light results in restriction of the release of melatonin – a sleep inducing neuro-transmitter that is naturally released by the brain to help facilitate sleep. As a result, people who use social media or gaming devices late at night struggle to get the quality sleep they once got naturally, adding to levels of anxiety the next day.

These professionals have also reported various degrees of separation anxiety initially after phones are first restricted by concerned parents but this dissipates after a few days. Physiotherapists too are seeing the fruit of social media addiction with a huge increase in volume of thumb and hand tendon overuse injuries due to excessive use of mobile phone.

The impact of technology has had a phenomenal effect on our social and physical landscape – notably, meaningful relationships, communication skills, energy levels, sleep patterns and our average daily release of a neuro-transmitter called serotonin.

Reduction in release of serotonin
A natural side effect of exercise participation or strenuous manual labour is the release of a neuro-transmitter or “good mood” juice called serotonin. After exercise, serotonin is released from the brain and seeps into our muscles through our blood stream allowing our muscles to relax, helping us feel good about ourselves while increasing the quality of our sleep. To best describe it’s effect is to consider how one might feel after exerting oneself physically in a swimming pool after which, a deep sense of relaxation is felt. This sense of relaxation can only occur through physical activity and movement. When we don’t exert energy, we don’t release it and tend to feel less relaxed and are more easily stressed and anxious. With the increased use of mobile phone technology and virtual gaming, children move a lot less than they used to.

What many don’t realise is that lack of serotonin release from the brain is one of the major causes of depression and anxiety. We need to move more to feel better!
Teenagers hanging out in 1998

Teenagers hanging out in 2018

 gaming 1997  Cell Phone Use Hazards, Specially for Teens

Gaming 1998

Gaming 2018

 gaming 2 1997  child gaming 17

 

  1. Peer Pressure
Peer pressure always caused issues for parents and teenagers. It is just part of growing up but social media has changed the whole dynamic of peer pressure. Social media has a powerful effect on how people think about themselves. For many, social media can derive feelings of inadequacy as many users concern themselves with comparing their lives with how others live theirs – or how others portray theirs through social media.

The psychological reasons behind such feelings of inadequacy are deep rooted in accepted core psychology principles. Carl Rogers (1902-1987) a humanistic psychologist developed a model to explain it and labelled it the Congruence Hypothesis.

Rogers categorised one’s existing social status or level of achievement as one’s “Real Self” and what we would like to achieve as our “Ideal Self”. The closer these are together (congruence), the higher the level of happiness! Though he did suggest that it was rare, if ever that a total state of congruence existed, all people experience a certain amount of incongruence. The Congruence Hypothesis suggests that the further these (Real Self V Ideal Self) are apart (in-congruence), the lower the level of one’s happiness (right hand side below).

Real v Ideal self

The happiness factor is the level of overlap in the middle. The more congruent they are, the happier we are. Our feelings of self-worth are developed in early childhood and are formed through interactions of the child with parents. However, as a child grows older, interactions with significant others will affect feelings of self-worth. People need to be regarded positively by others including their peers beyond their immediate family to feel valued and respected as they grow through life.

However, social media has driven a wedge between where we currently are (real self) and where we want to be (ideal self). Through social media, thousands of young people compare themselves to others in a way that has never happened before. Social media lets us see how those around us live. Many if not most portray them-selves in a false light, showing off their “wonderful” lives, parties, friends and social engagements through social media! We are pretty much told when we are left out of the party as the “great night” is relived online.

For young people, everyone in their circle is a journalist with a camera and a comment – and even if they don’t realise it; the pressure this brings is vast. There is now a science in the art of the photograph, where a girl (or boy) turns sideways, sticks out her backside (or tucks it in as the case may be), pushes out his/her chest, sucks in cheeks and pouts their lips simultaneously. If the figure on the screen doesn’t fit their owner’s desire, then the feelings of inferiority, insecurity and self doubt increase. The tall girls want to be smaller, the small girls want to be taller. The heavier girls want to be skinnier and the skinny girls are not voluptuous enough! There is a social cost to the narcissistic nature of the “selfie”. Everyone has something they are not happy about and the current fashion trends of skinny jeans and tight tops are not helping the peer pressure and induced social physique anxiety (SPA).

 

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How often do we see girls rush to a camera after a photo to see if there is a retake required as they seek a portrayal of perfection to help garner peer approval through “Likes” and “approving comments” on social media – “lookin fab”, “Absolutely gorgeous” etc. No matter how many “likes” they get, somebody has more or looks better and nothing is good enough; especially for self conscious kids seeking confidence from often unattainable peer approval.

In previous times, a photo was rarely taken outside of a family event and if taken, it was taken once – one didn’t want to waste the camera film – there was limited supply of film, money wasn’t plentiful and the facility didn’t exist to review,  delete and retake.

Weren’t we all better off!

 

Mean-Girls

There are other forces at play too. Large multinational companies in the beauty industry feed this pressure by “sponsoring” or advertising products through self proclaimed social media influencers. These new “stars” / influencers may not realise the pressure and anxiety they create further down the chain as most  show little understanding or social responsibility to their followers and wider society as trend setters, setting the bar way too high for way too many.

Lest we forget, the airbrushed pouting and sexualised images presented by influencers have a social cost too with ever increasing levels of anorexia, bulimia, body dis-morphic disorder and social physique anxiety among other mental health issues in our youth population.

There is a distinct lack of honesty among social media influencers with their airbrushed photos and vanity. Mental health professionals have reported that this is having impact on girls as young as 7 and 8 as they become product aware through social media, inducing a pressure to consume cosmetic and “health” based products, feeding a pressure and anxiety to look good. Some naive parents even “market” children’s products by indulging their children on social media for financial gain which is nothing short of abuse!

The discrepancy between an airbrushed profile picture and the actual reality is often staggering but the pressure is on young people to portray themselves in a way that “allows” them to “fit in”, even if they feel totally inadequate afterwards. It has unfortunately got to the stage where many professional photographers can provide an “airbrushing service” of photographs for a small extra fee. This is now considered almost a social norm. For many children and adolescents, just being yourself is no longer good enough. Gone are the days when it was normal to be a hormonal, spotty teenager like everybody their age. Unfortunately, the feelings of inadequacy and anxiety induced by social media pressure multiply as the years of childhood and innocence are sucked away!

This is amplified by the developing incidence of the obesity epidemic where many youngsters feel inadequate as their “Real Self” is further removed from their unattainable perceived “Ideal Self”. This is all before we get started on the Leaving Cert and CAO points race pressure. Many young people just give up, falling into a regular state of anxiety and depression – one I unfortunately see on an almost daily basis.

Certain mobile phone producers favoured by many teens have even designed a filtered hazy camera mode for their phones and some have tied down multi-million dollar deals with social media companies to enhance sexualised imaging through their phones. Some mobile phone app companies have employed psychologists to design interactions in such a way that naive adolescents become addicted to using their app where higher app use means increased revenue and increased share value! Sure what harm! Money talks and the mobile phone, cosmetic and fashion multinationals get wealthy!

Adults unfortunately are just as guilty and are often the ones normalising this behaviour! Our Facebook pages tell of our acquaintances extravagant holiday adventures and lavish family events! We can see how the wealthy live and worse still, how the perception presented by our “perceived successful” peers makes us feel totally inadequate, increasing self doubt and decreasing our levels of social self worth. Many adults are just as guilty with the pouting, sexualised imaging and airbrushing and you will often see very young children following suit, with increasing levels of body conscious pressure being received as they grow older!

The age of consent for traditional media with anything involving a child is 16 but for social media in Ireland it is 13. Most parents are ignorant of this and facilitate their online persona development with hi tech mobile phones delivered from Santa Clause at a much younger age. Digital parenting is easy parenting!

As adults, we should really look at the example we set! Some adults are just as bad – some even worse. Beyond that, we all seem to want more in a never ending race to a perceived happiness. Many want the extra promotion, the nicer car, the bigger house and salary. The lad with the bike wants a car, the person with the car wants a BMW and the person with the BMW wants a summer house on the beach. On it goes – the masses chasing a perceived happiness that will never exist with acquisition of material wealth.

Mainstream media are not faultless either and understand the psychology of it all. Huge volumes of newspapers and advertising based on understanding the whole principal. Ireland’s Rich List is published to sell newspapers and TV advertising and everyone gets further sucked in to a dream that exists at the top of the next hill – only to find that when you get there, that you are at the bottom of another.

Mind your mental health. You were born naked and most will end up in a wooden box! You can’t take your wealth with you! Do real things, facilitating the making of real memories for your kids and keep precious moments to yourself, your families and close friends and you might just retain some confidence and have some fun and a laugh along the way!

Keith Begley is an Irish based sport psychologist accredited with the Irish Institute of Sport.

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