# data[].attributes.body
As moast teens have low self estem its sometimes because we would damage our selves to "fit in".

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An eating disorder is when people are given food they dont eat or there not hungry. Its also when people starve themselfs cause they would want to be skinny.

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PTSD is somthing people have and its from when people rember there trama from the past.

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Yes teens strugle with mental health cause as some of us do its cause moast of us try to fit in.

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Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD.

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How Common is PTSD in Children and Teens?

Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors.

What Events Cause PTSD in Children?

Children and teens could have PTSD if they have lived through an event that could have caused them or someone else to be killed or badly hurt. Such events include sexual or physical abuse or other violent crimes. Disasters such as floods, school shootings, car crashes, or fires might also cause PTSD. Other events that can cause PTSD are war, a friend's suicide, or seeing violence in the area they live.

Child protection services in the U.S. get around three million reports each year. This involves 5.5 million children. Of the reported cases, there is proof of abuse in about 30%. From these cases, we have an idea how often different types of abuse occur:

65% neglect

18% physical abuse

10% sexual abuse

7% psychological (mental) abuse

Also, three to ten million children witness family violence each year. Around 40% to 60% of those cases involve child physical abuse. (Note: It is thought that two-thirds of child abuse cases are not reported.)

What Are the Risk Factors for PTSD?

Three factors have been shown to raise the chances that children will get PTSD. These factors are:

How severe the trauma is

How the parents react to the trauma

How close or far away the child is from the trauma

Children and teens that go through the most severe traumas tend to have the highest levels of PTSD symptoms. The PTSD symptoms may be less severe if the child has more family support and if the parents are less upset by the trauma. Lastly, children and teens who are farther away from the event report less distress.

Other factors can also affect PTSD. Events that involve people hurting other people, such as rape and assault, are more likely to result in PTSD than other types of traumas. Also, the more traumas a child goes through, the higher the risk of getting PTSD. Girls are more likely than boys to get PTSD. It is not clear whether a child's ethnic group may affect PTSD. Some research shows that minorities have higher levels of PTSD symptoms. Other research suggests this may be because minorities may go through more traumas.

Another question is whether a child's age at the time of the trauma has an effect on PTSD. Researchers think it may not be that the effects of trauma differ according to the child's age. Rather, it may be that PTSD looks different in children of different ages.

# data[].attributes.attachment_link.description
Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors.

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Overview

Teen depression is a serious mental health problem that causes a persistent feeling of sadness and loss of interest in activities. It affects how your teenager thinks, feels and behaves, and it can cause emotional, functional and physical problems. Although depression can occur at any time in life, symptoms may be different between teens and adults.

Issues such as peer pressure, academic expectations and changing bodies can bring a lot of ups and downs for teens. But for some teens, the lows are more than just temporary feelings - they're a symptom of depression.

Teen depression isn't a weakness or something that can be overcome with willpower - it can have serious consequences and requires long-term treatment. For most teens, depression symptoms ease with treatment such as medication and psychological counseling.

Symptoms

Teen depression signs and symptoms include a change from the teenager's previous attitude and behavior that can cause significant distress and problems at school or home, in social activities, or in other areas of life.

Depression symptoms can vary in severity, but changes in your teen's emotions and behavior may include the examples below.

Emotional changes

Be alert for emotional changes, such as:

Feelings of sadness, which can include crying spells for no apparent reason

Frustration or feelings of anger, even over small matters

Feeling hopeless or empty

Irritable or annoyed mood

Loss of interest or pleasure in usual activities

Loss of interest in, or conflict with, family and friends

Low self-esteem

Feelings of worthlessness or guilt

Fixation on past failures or exaggerated self-blame or self-criticism

Extreme sensitivity to rejection or failure, and the need for excessive reassurance

Trouble thinking, concentrating, making decisions and remembering things

Ongoing sense that life and the future are grim and bleak

Frequent thoughts of death, dying or suicide

Behavioral changes

Watch for changes in behavior, such as:

Tiredness and loss of energy

Insomnia or sleeping too much

Changes in appetite - decreased appetite and weight loss, or increased cravings for food and weight gain

Use of alcohol or drugs

Agitation or restlessness - for example, pacing, hand-wringing or an inability to sit still

Slowed thinking, speaking or body movements

Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse

Social isolation

Poor school performance or frequent absences from school

Less attention to personal hygiene or appearance

Angry outbursts, disruptive or risky behavior, or other acting-out behaviors

Self-harm - for example, cutting or burning

Making a suicide plan or a suicide attempt

What's normal and what's not

It can be difficult to tell the difference between ups and downs that are just part of being a teenager and teen depression. Talk with your teen. Try to determine whether he or she seems capable of managing challenging feelings, or if life seems overwhelming.

When to see a doctor

If depression signs and symptoms continue, begin to interfere in your teen's life, or cause you to have concerns about suicide or your teen's safety, talk to a doctor or a mental health professional trained to work with adolescents. Your teen's family doctor or pediatrician is a good place to start. Or your teen's school may recommend someone.

Depression symptoms likely won't get better on their own - and they may get worse or lead to other problems if untreated. Depressed teenagers may be at risk of suicide, even if signs and symptoms don't appear to be severe.

If you're a teen and you think you may be depressed - or you have a friend who may be depressed - don't wait to get help. Talk to a health care provider such as your doctor or school nurse. Share your concerns with a parent, a close friend, a spiritual leader, a teacher or someone else you trust.

Symptoms

Suicide is often associated with depression. If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

Also consider these options if you're having suicidal thoughts:

Call your mental health professional.

Contact a suicide hotline.

In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. The Spanish language phone line is 1-888-628-9454 (toll-free). Services are free and confidential.

Or contact a crisis service for teenagers in the U.S. called TXT 4 HELP: Text the word "safe" and your current location to 4HELP (44357) for immediate help, with the option for interactive texting.

Seek help from your primary care doctor or other health care provider.

Reach out to a close friend or loved one.

Contact a minister, spiritual leader or someone else in your faith community.

If a loved one or friend is in danger of attempting suicide or has made an attempt:

Make sure someone stays with that person.

Call 911 or your local emergency number immediately.

Or, if you can do so safely, take the person to the nearest hospital emergency room.

Never ignore comments or concerns about suicide. Always take action to get help.

Causes

It's not known exactly what causes depression, but a variety of issues may be involved. These include:

Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of your brain and body. When these chemicals are abnormal or impaired, the function of nerve receptors and nerve systems changes, leading to depression.

Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression.

Inherited traits. Depression is more common in people whose blood relatives - such as a parent or grandparent - also have the condition.

Early childhood trauma. Traumatic events during childhood, such as physical or emotional abuse, or loss of a parent, may cause changes in the brain that increase the risk of depression.

Learned patterns of negative thinking. Teen depression may be linked to learning to feel helpless - rather than learning to feel capable of finding solutions for life's challenges.

Risk factors

Many factors increase the risk of developing or triggering teen depression, including:

Having issues that negatively impact self-esteem, such as obesity, peer problems, long-term bullying or academic problems

Having been the victim or witness of violence, such as physical or sexual abuse

Having other mental health conditions, such as bipolar disorder, an anxiety disorder, a personality disorder, anorexia or bulimia

Having a learning disability or attention-deficit/hyperactivity disorder (ADHD)

Having ongoing pain or a chronic physical illness such as cancer, diabetes or asthma

Having certain personality traits, such as low self-esteem or being overly dependent, self-critical or pessimistic

Abusing alcohol, nicotine or other drugs

Being gay, lesbian, bisexual or transgender in an unsupportive environment

Family history and issues with family or others may also increase your teenager's risk of depression, such as:

Having a parent, grandparent or other blood relative with depression, bipolar disorder or alcohol use problems

Having a family member who died by suicide

Having a family with major communication and relationship problems

Having experienced recent stressful life events, such as parental divorce, parental military service or the death of a loved one

Complications

Untreated depression can result in emotional, behavioral and health problems that affect every area of your teenager's life. Complications related to teen depression may include, for example:

Alcohol and drug misuse

Academic problems

Family conflicts and relationship difficulties

Suicide attempts or suicide

Prevention

There's no sure way to prevent depression. However, these strategies may help. Encourage your teenager to:

Take steps to control stress, increase resilience and boost self-esteem to help handle issues when they arise

Practice self-care, for example by creating a healthy sleep routine and using electronics responsibly and in moderation

Reach out for friendship and social support, especially in times of crisis

Get treatment at the earliest sign of a problem to help prevent depression from worsening

Maintain ongoing treatment, if recommended, even after symptoms let up, to help prevent a relapse of depression symptoms

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This serious mental health problem affects how your teenager thinks, feels and behaves, and can cause emotional, functional and physical problems.

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94% of teens suffer from mood disorders.

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30% of teen girls and 25% of teen boys reported being teased about their weight by their peers.

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Yes because the stats show that teens really struggle with mental health

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Yes, I think teens struggle with mental health because of emotional, physical, or social changes.

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I think teens struggle with mental health because it's easier to do that. 1 in 5 teens struggle with this

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An estimated 3.6% of U.S. adults had PTSD in the past year.

https://www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd

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National Institute of Mental Health (NIMH)

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Definition

Post-traumatic stress disorder (PTSD) can develop after exposure to a potentially traumatic event that is beyond a typical stressor. Events that may lead to PTSD include, but are not limited to, violent personal assaults, natural or human-caused disasters, accidents, combat, and other forms of violence. Exposure to events like these is common. About one half of all U.S. adults will experience at least one traumatic event in their lives, but most do not develop PTSD. People who experience PTSD may have persistent, frightening thoughts and memories of the event(s), experience sleep problems, feel detached or numb, or may be easily startled. In severe forms, PTSD can significantly impair a person's ability to function at work, at home, and socially.

Additional information about PTSD can be found on the NIMH Health Topics page on Post-Traumatic Stress Disorder.

Prevalence of Post-Traumatic Stress Disorder Among Adults

Based on diagnostic interview data from National Comorbidity Survey Replication (NCS-R), Figure 1 shows past year prevalence of PTSD among U.S. adults aged 18 or older.1

An estimated 3.6% of U.S. adults had PTSD in the past year.

Past year prevalence of PTSD among adults was higher for females (5.2%) than for males (1.8%).

The lifetime prevalence of PTSD was 6.8%.²

Figure 1

Post-Traumatic Stress Disorder with Impairment Among Adults

Of adults with PTSD in the past year, degree of impairment ranged from mild to serious, as shown in Figure 2. Impairment was determined by scores on the Sheehan Disability Scale.³

Impairment was distributed evenly among adults with PTSD. An estimated 36.6% had serious impairment, 33.1% had moderate impairment, and 30.2% had mild impairment

Figure 2

Prevalence of Post-Traumatic Stress Disorder Among Adolescents

Based on diagnostic interview data from National Comorbidity Survey Adolescent Supplement (NCS-A), Figure 3 shows lifetime prevalence of PTSD among U.S. adolescents aged 13-18.⁴

An estimated 5.0% of adolescents had PTSD, and an estimated 1.5% had severe impairment. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria were used to determine impairment.

The prevalence of PTSD among adolescents was higher for females (8.0%) than for males (2.3%).

Figure 3

Data Sources

References

1. Harvard Medical School, 2007. National Comorbidity Survey (NCS). (2017, August 21). Retrieved from https://www.hcp.med.harvard.edu/ncs/index.php. Data Table 2: 12-month prevalence DSM-IV/WMH-CIDI disorders by sex and cohort.

2. Harvard Medical School, 2007. National Comorbidity Survey (NCS). (2017, August 21). Retrieved from https://www.hcp.med.harvard.edu/ncs/index.php. Data Table 1: Lifetime prevalence DSM-IV/WMH-CIDI disorders by sex and cohort.

3. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005 Jun;62(6):617-27. PMID: 15939839

4. Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):980-9. PMID: 20855043

Statistical Methods and Measurement Caveats

National Comorbidity Survey Replication (NCS-R)

Diagnostic Assessment and Population:

The NCS-R is a nationally representative, face-to-face, household survey conducted between February 2001 and April 2003 with a response rate of 70.9%. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview (WMH-CIDI), a fully structured lay-administered diagnostic interview that generates both International Classification of Diseases, 10th Revision, and DSM-IV diagnoses. The DSM-IV criteria were used here. The Sheehan Disability Scale (SDS) assessed disability in work role performance, household maintenance, social life, and intimate relationships on a 0-10 scale. Participants for the main interview totaled 9,282 English-speaking, non-institutionalized, civilian respondents. Post-traumatic stress disorder (PTSD) was assessed in a subsample of 5,692 adults. The NCS-R was led by Harvard University.

Unlike the DSM-IV criteria used in the NCS-R and NCS-A, the current DSM-5 no longer places PTSD in the anxiety disorder category. It is listed in a new DSM-5 category, Trauma- and Stressor-Related Disorders.

Survey Non-response:

In 2001-2002, non-response was 29.1% of primary respondents and 19.6% of secondary respondents.

Reasons for non-response to interviewing include: refusal to participate (7.3% of primary, 6.3% of secondary); respondent was reluctant- too busy but did not refuse (17.7% of primary, 11.6% of secondary); circumstantial, such as intellectual developmental disability or overseas work assignment (2.0% of primary, 1.7% of secondary); and household units that were never contacted (2.0).

For more information, see PMID: 15297905 and the NIMH NCS-R study page.

National Comorbidity Survey Adolescent Supplement (NCS-A)

Diagnostic Assessment and Population:

The NCS-A was carried out under a cooperative agreement sponsored by NIMH to meet a request from Congress to provide national data on the prevalence and correlates of mental disorders among U.S. youth. The NCS-A was a nationally representative, face-to-face survey of 10,123 adolescents aged 13 to 18 years in the continental United States. The survey was based on a dual-frame design that included 904 adolescent residents of the households that participated in the adult U.S. National Comorbidity Survey Replication and 9,244 adolescent students selected from a nationally representative sample of 320 schools. The survey was fielded between February 2001 and January 2004. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview.

Survey Non-response:

The overall adolescent non-response rate was 24.4%. This is made up of non-response rates of 14.1% in the household sample, 18.2% in the un-blinded school sample, and 77.7% in the blinded school sample. Non-response was largely due to refusal (21.3%), which in the household and un-blinded school samples came largely from parents rather than adolescents (72.3% and 81.0%, respectively). The refusals in the blinded school sample, in comparison, came almost entirely (98.1%) from parents failing to return the signed consent postcard.

For more information, see PMID: 19507169 and the NIMH NCS-A study page.

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Post-traumatic stress disorder (PTSD) can develop after exposure to a potentially traumatic event that is beyond a typical stressor. Events that may lead to PTSD include, but are not limited to, violent personal assaults, natural or human-caused disasters, accidents, combat, and other forms of violence. Exposure to events like these is common.

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Rates of PTSD are higher for certain types of trauma survivors.

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How Common is PTSD in Children and Teens?

Trauma can happen at any age. When children or teenagers experience trauma, they can develop PTSD. Certain types of trauma are more likely to lead to PTSD. Learn how many children and teenagers have PTSD.

Reading time: minutes

Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors.

What Events Cause PTSD in Children?

Children and teens could have PTSD if they have lived through an event that could have caused them or someone else to be killed or badly hurt. Such events include sexual or physical abuse or other violent crimes. Disasters such as floods, school shootings, car crashes, or fires might also cause PTSD. Other events that can cause PTSD are war, a friend's suicide, or seeing violence in the area they live.

Child protection services in the U.S. get around three million reports each year. This involves 5.5 million children. Of the reported cases, there is proof of abuse in about 30%. From these cases, we have an idea how often different types of abuse occur:

65% neglect

18% physical abuse

10% sexual abuse

7% psychological (mental) abuse

How severe the trauma is

How the parents react to the trauma

How close or far away the child is from the trauma

# data[].attributes.attachment_link.description
Trauma can happen at any age. When children or teenagers experience trauma, they can develop PTSD. Certain types of trauma are more likely to lead to PTSD. Learn how many children and teenagers have PTSD. Reading time: minutes Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma.

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Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors.

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If your teen has survived a traumatic experience, they may have PTSD. Let’s look at the causes, signs and symptoms, and treatment options.

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2.7% of teens have some sort of eating disorder.

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Yes, because many teens go through troubles and are surrounded by influences on their mental health.

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Young people between the ages of 15 and 24 with anorexia have 10 times the risk of dying compared to their same-aged peers. https://www.nationaleatingdisorders.org/statistics-research-eating-disorders

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5/100 people have ptsd

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How Common is PTSD in Children and Teens?

Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors.

What Events Cause PTSD in Children?

Children and teens could have PTSD if they have lived through an event that could have caused them or someone else to be killed or badly hurt. Such events include sexual or physical abuse or other violent crimes. Disasters such as floods, school shootings, car crashes, or fires might also cause PTSD. Other events that can cause PTSD are war, a friend's suicide, or seeing violence in the area they live.

Child protection services in the U.S. get around three million reports each year. This involves 5.5 million children. Of the reported cases, there is proof of abuse in about 30%. From these cases, we have an idea how often different types of abuse occur:

65% neglect

18% physical abuse

10% sexual abuse

7% psychological (mental) abuse

Also, three to ten million children witness family violence each year. Around 40% to 60% of those cases involve child physical abuse. (Note: It is thought that two-thirds of child abuse cases are not reported.)

What Are the Risk Factors for PTSD?

Three factors have been shown to raise the chances that children will get PTSD. These factors are:

How severe the trauma is

How the parents react to the trauma

How close or far away the child is from the trauma

Children and teens that go through the most severe traumas tend to have the highest levels of PTSD symptoms. The PTSD symptoms may be less severe if the child has more family support and if the parents are less upset by the trauma. Lastly, children and teens who are farther away from the event report less distress.

Other factors can also affect PTSD. Events that involve people hurting other people, such as rape and assault, are more likely to result in PTSD than other types of traumas. Also, the more traumas a child goes through, the higher the risk of getting PTSD. Girls are more likely than boys to get PTSD. It is not clear whether a child's ethnic group may affect PTSD. Some research shows that minorities have higher levels of PTSD symptoms. Other research suggests this may be because minorities may go through more traumas.

Another question is whether a child's age at the time of the trauma has an effect on PTSD. Researchers think it may not be that the effects of trauma differ according to the child's age. Rather, it may be that PTSD looks different in children of different ages.

# data[].attributes.attachment_link.description
Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors.

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People have an obsession to thiness

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What Is Anorexia Nervosa? 5 Myths and 5 Facts

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Stereotypes about anorexia nervosa can blur the lines between fact and fiction — and may even make it hard to tell if you or a loved one is showing signs of this disorder.

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Yes. Teens are surrounded by triggers that can cause mental health issues. It could be their home environment, social media, or their friend group. There are other things that cause mental health issues.

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2.7% of teens have eating disorders

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Prevention tips for teen eating disorders

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How to talk to your teen about eating disorders and promote a healthy lifestyle for the entire family.

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In 2017, 13% of U.S. teens ages 12 to 17 (or 3.2 million) said they had experienced at least one major depressive episode in the past year, up from 8% (or 2 million) in 2007, according to a Pew Research Center analysis of data from the 2017 National Survey on Drug Use and Health.

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Depression has become increasingly common among American teenagers - especially teen girls, who are now almost three times as likely as teen boys to have had recent experiences with depression.

In 2017, 13% of U.S. teens ages 12 to 17 (or 3.2 million) said they had experienced at least one major depressive episode in the past year, up from 8% (or 2 million) in 2007, according to a Pew Research Center analysis of data from the 2017 National Survey on Drug Use and Health.

One-in-five teenage girls - or nearly 2.4 million - had experienced at least one major depressive episode (the proxy measure of depression used in this analysis) over the past year in 2017. By comparison, 7% of teenage boys (or 845,000) had at least one major depressive episode in the past 12 months.

The total number of teenagers who recently experienced depression increased 59% between 2007 and 2017. The rate of growth was faster for teen girls (66%) than for boys (44%).

While teenage girls are more likely to have faced depression than their male peers, they are also more likely to have received treatment by seeing a professional or taking medication. Among teen girls who had recent depressive episodes, 45% received treatment for depression over the past year. By comparison, 33% of teen boys with recent depressive episodes received treatment.

The number of adults who had experienced depression also increased from 14.8 million in 2007 to 17.3 million in 2017, though the share remained the same (7%). Adults also differed by gender in their experiences with depression (9% of women vs. 5% of men).

Adults who have experienced depression are treated at higher rates than teens. Among adults who had recent depressive episodes, about two-thirds (67%) received treatment. Again, women who had a recent experience with depression (72%) were more likely than men (58%) to receive treatment.

Teens express concern about anxiety and depression among peers, feel day-to-day pressures

Seven-in-ten U.S. teens said anxiety and depression is a major problem among people their age in the community where they live, according to a Pew Research Center survey of teenagers ages 13 to 17 conducted in fall 2018. An additional 26% cited anxiety and depression as a minor problem.

About three-in-ten teens (29%) said they felt tense or nervous about their day every or almost every day, and 45% said they felt tense or nervous sometimes. About a third of teen girls (36%) reported feeling this way every day or almost every day, compared with 23% of teen boys.

Academic and social pressures are among the reasons cited by experts who have studied teen depression. The Center's survey asked about some of those pressures teens face in their daily lives. About six-in-ten teens (61%) said they personally felt a lot of pressure to get good grades, while roughly three-in-ten reported a lot of pressure to look good and fit in socially (29% and 28%, respectively).

This analysis uses data from the 2017 National Survey on Drug Use and Health (NSDUH), which is directed by the U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration and overseen by the Center for Behavioral Health Statistics and Quality.

"Major depressive episode" is used throughout this analysis as a proxy measure of depression; as such, that term and "depression" are used interchangeably. A " major depressive episode " is defined as a period of at least two weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specific depression symptoms in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). "Treatment" of depression is defined in the NSDUH survey as seeing or talking to a health or alternative service professional or using prescription medication for depression in the past year.

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A growing number of American teenagers - particularly girls - are facing depression

# data[].attributes.attachment_link.description
Depression has become increasingly common among American teenagers - especially teen girls, who are now almost three times as likely as teen boys to have had recent experiences with depression. In 2017, 13% of U.S.

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yes i do think teens struggle with mental health because 20% of teens experience depression before they became a adult

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https://www.mayoclinic.org/healthy-lifestyle/tween-and-teen-health/in-depth/teen-eating-disorders/art-20044635

# data[].attributes.attachment_link.title
Prevention tips for teen eating disorders

# data[].attributes.attachment_link.description
How to talk to your teen about eating disorders and promote a healthy lifestyle for the entire family.

# data[].attributes.body
Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma.

# data[].attributes.attachment_link.readable_text
How Common is PTSD in Children and Teens?

Trauma can happen at any age. When children or teenagers experience trauma, they can develop PTSD. Certain types of trauma are more likely to lead to PTSD. Learn how many children and teenagers have PTSD.

Reading time: minutes

Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors.

What Events Cause PTSD in Children?

Children and teens could have PTSD if they have lived through an event that could have caused them or someone else to be killed or badly hurt. Such events include sexual or physical abuse or other violent crimes. Disasters such as floods, school shootings, car crashes, or fires might also cause PTSD. Other events that can cause PTSD are war, a friend's suicide, or seeing violence in the area they live.

Child protection services in the U.S. get around three million reports each year. This involves 5.5 million children. Of the reported cases, there is proof of abuse in about 30%. From these cases, we have an idea how often different types of abuse occur:

65% neglect

18% physical abuse

10% sexual abuse

7% psychological (mental) abuse

How severe the trauma is

How the parents react to the trauma

How close or far away the child is from the trauma

# data[].attributes.attachment_link.description
Trauma can happen at any age. When children or teenagers experience trauma, they can develop PTSD. Certain types of trauma are more likely to lead to PTSD. Learn how many children and teenagers have PTSD. Reading time: minutes Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma.

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Eating disorders affect at least 9% of the population worldwide. 9% of the U.S. population, or 28.8 million Americans, will have an eating disorder in their lifetime. Less than 6% of people with eating disorders are medically diagnosed as “underweight.”

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What Are Eating Disorders?

Eating disorders are problems that affect a person's eating behaviors as well as their attitudes and feelings about food - and about their body.

Eating disorders affect a person's mental health and can cause serious harm to a person's physical health.

There are several types of eating disorders.

What Are the Different Types of Eating Disorders?

Common types of eating disorders are anorexia, bulimia, binge eating, and avoidant/restrictive food intake disorder (ARFID).

Anorexia. People with anorexia:

eat very little on purpose, leading to a very low body weight

have an intense fear of weight gain and fear looking fat

have a distorted body image and see themselves as fat even when they are very thin

People with anorexia are very strict about what and how much they will eat. They may think about food or calories almost all the time.

To lose weight, some people with anorexia fast or exercise too much. Others may use laxatives, diuretics (water pills), or enemas.

Bulimia. People with bulimia:

overeat and feel out of control to stop, called binge eating

do things to make up for overeating, such as:

make themselves throw up on purpose after overeating, called purging

use laxatives, diuretics, weight loss pills, fast, or exercise a lot to prevent weight gain

judge themselves based on body shape and weight

People with bulimia eat much more (during a set period of time) than most people would. If a person regularly binges and purges, it may be a sign of bulimia. Unlike people with anorexia who are very low weight, people with bulimia may be thin, average weight, or overweight. People with bulimia often hide their eating and purging from others.

Binge eating. People with binge eating disorder:

overeat and feel out of control to stop

eat large amounts even when they are not hungry

may feel upset or guilty after binge eating

often gain weight and may become very overweight

Many people with binge eating disorder eat faster than normal. They may eat alone so others don't see how much they are eating. Unlike people with bulimia, those with binge eating disorder do not make themselves throw up, use laxatives, or exercise a lot to make up for binge eating. If a person binge eats at least once a week for 3 months, it may be a sign of binge eating disorder.

ARFID. People with avoidant/restrictive food intake disorder:

are not interested in food or avoid foods

lose weight, or don't gain expected amount of weight

are not afraid of gaining weight

don't have a poor body image

People with ARFID don't eat because they are turned off by the smell, taste, texture, or color of food. They may be afraid that they will choke or vomit. They don't have anorexia, bulimia, or another medical problem that would explain their eating behaviors.

How Do Eating Disorders Affect Health and Emotions?

Eating disorders can cause serious problems throughout the body.

Anorexia can lead to health problems caused by undernutrition and low body weight, such as:

low blood pressure

slow or irregular heartbeats

feeling tired, weak, dizzy, or faint

constipation and bloating

irregular periods

weak bones

delayed puberty and slow growth

People with anorexia may find it hard to focus and have trouble remembering things. Mood changes and emotional problems include:

feeling alone, sad, or depressed

anxiety and fears about gaining weight

thoughts of hurting themselves

Bulimia can lead to health problems caused by vomiting, laxatives, and diuretics, such as:

low blood pressure

irregular heartbeats

feeling tired, weak, dizzy, or faint

blood in vomit or stool (poop)

tooth erosion and cavities

swollen cheeks (salivary glands)

People with bulimia may have these emotional problems:

low self-esteem, anxiety, and depression

alcohol or drug problems

thoughts of hurting themselves

Binge eating can lead to weight-related health problems, such as:

diabetes

high blood pressure

high cholesterol and triglycerides

fatty liver

sleep apnea

People with binge eating disorder may:

have low self-esteem, anxiety, or depression

feel alone, out of control, angry, or helpless

have trouble coping with strong emotions or stressful events

ARFID may lead to health problems that stem from poor nutrition, similar to anorexia. People with ARFID may:

not get enough vitamins, minerals, and protein

need tube feeding and nutrition supplements

grow poorly

People with ARFID are more likely to have:

What Causes Eating Disorders?

There's no one cause for eating disorders. Genes, environment, and stressful events all play a role. Some things can increase a person's chance of having an eating disorder, such as:

poor body image

too much focus on weight or looks

dieting at a young age

playing sports that focus on weight (gymnastics, ballet, ice skating, and wrestling)

having a family member with an eating disorder

mental health problems such as anxiety, depression, or OCD

How Are Eating Disorders Diagnosed?

Health care providers and mental health professionals diagnose eating disorders based on history, symptoms, thought patterns, eating behaviors, and an exam.

The doctor will check weight and height and compare these to previous measurements on growth charts. The doctor may order tests to see if there is another reason for the eating problems and to check for problems caused by the eating disorder.

How Are Eating Disorders Treated?

Eating disorders are best treated by a team that includes a doctor, dietitian, and therapist. Treatment includes nutrition counseling, medical care, and talk therapy (individual, group, and family therapy). The doctor might prescribe medicine to treat binge eating, anxiety, depression, or other mental health concerns.

The details of the treatment depend on the type of eating disorder and how severe it is. Some people are hospitalized because of extreme weight loss and medical complications.

What if I Have an Eating Disorder?

If you think you may have an eating disorder:

Tell someone. Tell a parent, teacher, counselor, or an adult you trust. Let them know what you're going through. Ask them to help.

Get help early. When an eating disorder is caught early, a person has a better chance of recovery. Make an appointment with your doctor or an eating disorders specialist.

Go to all appointments. Treatment takes time and effort. Work hard to learn about yourself and your emotions. Ask questions any time you have them.

Be patient with yourself. There's so much to learn, and change happens a little at a time. Take care of yourself and be with people who support you.

Where Can I Learn More About Eating Disorders?

For more information on eating disorders, visit the National Eating Disorders Association (NEDA).

For more help and support, the National Association of Anorexia Nervosa and Associated Disorders (ANAD) offers these free resources:

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Eating disorders are problems that affect a person's eating behaviors as well as their attitudes and feelings about food - and about their body. Eating disorders affect a person's mental health and can cause serious harm to a person's physical health. There are several types of eating disorders.

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75% of girls with low self esteem have admitted to doing harmful things to their bodies.

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As children grow older, they will go through numerous changes. Their bodies will grow, and their minds will develop. However, as they reach adolescence, they will experience monumental developments, which change their entire life. Puberty and hormonal shifts often lead to many teenagers feeling insecure about their bodies and themselves. On top of these bodily changes, teenagers also face social changes, new emotions, and much more. Many teens struggle to maintain positive self-esteem and self-worth during these formative years.

While growing up and going through adolescence is hard for all teens in different ways, all parents, guardians, and those in leadership or mentor positions must do what they can to help these young people understand the importance of knowing one's worth. There is no better time than now to inspire young people and to help them create and maintain their own sense of self than National Teen Self-Esteem Month. Every May, we take the time to ensure our youth are aware of the importance of one's self-esteem and to combat self-worth and self-image issues teenagers face daily.

Lifework Counseling Center understands how difficult being a teenager can be. After all, not only do they have to deal with the changes in their bodies, but they are faced with changes to their social lives, new expectations, and more. Join us in celebrating National Teen Self-Esteem Month by helping young people understand their self-worth.

What is National Teen Self-Esteem Month?

Every May, we celebrate National Teen Self-Esteem Month. Sponsored by I Am Worth More, a nonprofit organization that helps teens find resources and presents them with positive entertainment, May is a time to combat the self-worth and self-image issues that plague all teenagers across the country.

National Teen Self-Esteem Month is a time where teens, parents, and teachers across the country come together to focus on supporting teens by providing them with a space to voice their needs and concerns, building a positive outlook of themselves, and ensuring they are self-aware and confident.

A teen's self-esteem can impact their physical and mental health dramatically, so you must support it. Self-esteem refers to an individual's confidence in themselves, their abilities, and their worth. It's often referred to as self-worth and self-respect. When a teen has little self-esteem, it can lead to serious mental health problems that plague them for the rest of their lives.

Along with their hormonal shifts and developing body, teens are faced with social changes, new relationships, increased academic and professional expectations, peer pressure, impossible standards pushed by media, and so much more. Millions of teenagers across the country suffer from low self-esteem.

Statistics to Know

As we said earlier, when a child's self-esteem is low, it can affect their physical and mental wellbeing. Many teenagers with low self-esteem believe that they are unlovable, undesirable, worthless, and more. As you can imagine, this can affect a child's mental health considerably, which, in turn, impacts their physical health.

To highlight the importance of National Teen Self-Esteem Month, we have compiled a list of statistics that shed light on the issues plaguing teens self-worth:

Nearly 20% of teens experience depression before they reach adulthood

Only 30% of teens receive treatment for their depression

75% of girls with low self-esteem admitted to engaging in self-destructive behaviors, such as cutting, bullying, drinking, smoking, and eating disorders

Seven out of ten girls believed that they were not good enough or did not measure up to others, whether in looks, relationships, or academic performance

Suicide is the third leading cause of death among young people ages 15-24

Over 5% of teenagers reported substance abuse or alcohol use

40% of teenage boys reported exercising regularly to increase muscle mass

38% of teenage boys reported using protein supplements, and 6% admitted to steroid use to improve their physique

50% mental health disorders are established by the age of 14, while 75% are established by age 24

A teen commits suicide every 100 minutes

As you can see, low self-esteem can lead to drastic effects that not only affect a child's mental health but their physical health, as well. Teenagers will go to great lengths to improve their looks if they feel that they do not match up to their peers. This shows why National Teen Self-Esteem is so significant. It provides teens, parents, and teachers a chance to combat self-worth issues teens face daily.

How You Can Help

National Teen Self-Esteem Month provides everyone an opportunity to help support teens, their self-esteem, and their mental health. There is a handful of fun and positive activities held throughout the month that can help boost a teen's self-esteem. You can help by:

Writing a positive note to a teen you know. If you have a teen family member or friend, write them a heartfelt note full of words of support and affirmation, letting them know why they are loved.

Take the "I Am Worth More" social media challenge. Every day throughout May, encourage teens to write something about themselves that they love on their social media accounts.

Share ideas. There are plenty of ways teens can boost their self-esteem. Encourage them to eat healthy, , accept themselves, practice self-love, and love those around them.

Ensure you offer open lines of communication. Many teens feel that they cannot talk to their parents or peers and share how they feel. Make sure that you offer teens a chance to communicate and share how they feel and think.

Lead by example. Teens still follow by example, so they are always watching their parents, teachers, and other mentors for guidance. Avoid negative self-talk. Be mindful of the criticisms you give yourself and the others around you. Your teen is always listening, whether you think they are or not.

Join Lifeworks Counseling Center throughout May in celebrating National Teen Self-Esteem Month by teaching teenagers the importance of knowing one's self-worth while combating the problems that teens face daily. If your teen is suffering from low self-esteem or other mental health disorders, do not hesitate to contact Lifeworks today.

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May is National Teen Self-Esteem Month | Lifeworks Counseling Center

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As children grow older, they will go through numerous changes. Their bodies will grow, and their minds will develop. However, as they reach adolescence, they will experience monumental developments, which change their entire life. Puberty and hormonal shifts often lead to many teenagers feeling insecure about their bodies and themselves.

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1 in 14 tenagers have self esteem issues

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Abstract

Objective

Low self-esteem in adolescents has been associated with a number of risk and protective factors in previous studies, but results have been mixed. Our objective was to examine characteristics associated with low self-esteem in a large national sample of young adolescents.

Design/Methods

Population-based correlational study. A sample of 6522 adolescents, aged 12-16 years, was surveyed by phone as part of a national study of media and substance use. Self-esteem was measured with three questions that assessed global self worth and physical appearance. Multivariate logistic regression was used to examine the relation between self-esteem and socio-demographics, child personality characteristics, weight status, daily TV time, parenting style, school performance and team sports participation. Interactions among gender, race, and weight status were examined.

Results

In multivariate analysis, female gender, Hispanic race, overweight and obesity, sensation seeking, rebelliousness, and daily TV time were each independently associated with lower self-esteem. Teens of Black race, with higher parental responsiveness and demandingness, better school performance or involvement in team sports were less likely to report low self-esteem. Black females were at lower risk and Hispanic males were at higher risk for low esteem than peers of similar gender of other races.

Conclusions

Low self-esteem was associated with a number of modifiable risk factors including obesity, television time, team sports participation, school performance and parenting style that should be discussed with teens and parents at health supervision visits. Further research examining race and gender-specific factors that serve to moderate risk for poor self-esteem in adolescents is warranted.

Keywords: Adolescent, self-esteem, obesity

Introduction

Self-esteem, as an overall reflection of an individual's self-worth, encompasses beliefs about oneself as well as an emotional response to those beliefs. Representing the capacity to feel worthy of happiness and be able to successfully address life challenges, self-esteem is an important determinant of adolescent mental health and development. , Accordingly, low self-esteem has been associated with a number of psychological, physical, and social consequences that may influence successful adolescent development and the transition to adulthood, including depression, anxiety, suicide and disordered eating, ⁻ violent behavior, earlier initiation of sexual activity (in girls), and substance use. Recent research also suggests that low self-esteem in adolescence may be a harbinger for poor longer-term outcomes, such as fewer years of post-secondary education, greater likelihood of joblessness and financial difficulties,, as well as poorer mental/physical health and higher rates of criminal behavior. Identification of modifiable risk factors for low self-esteem in adolescents is important in developing interventions to prevent and to enhance adolescents' self-esteem.

Self-esteem research has been conducted for several decades, but researchers have yet to reach a consensus on a definition for this construct. Several comprehensive assessment scales have been reported including Rosenberg's self-esteem scale, the Piers-Harris Children's Self-Concept Scale, and Harter's Self-Perception Profile. The former focuses on a global measure, while the latter two scales evaluate specific dimensions of self-esteem (i.e. physical appearance) and then aggregate scores to form a global score. The current study utilizes an abbreviated version of Harter's Self-Perceptions Profile for Children and incorporates those domains that capture global self-worth and comfort with one's appearance.

Many publications have explored risk and protective factors for the development of low self-esteem during adolescence, but much of the research is limited by small sample sizes, regional populations and inconsistent inclusion of covariates. Reported risk factors include older age, female gender,, ⁻ low socioeconomic status, nontraditional family structure, having special health care needs, exposure to school violence, parental aggravation or family stress, and higher TV viewing. A relationship between weight status (overweight and obesity) and low self-esteem has also been demonstrated, however results have been mixed with some studies showing lower self-esteem among obese adolescents, , , and others finding associations only among subgroups based on age or race,, or for a particular domain of self-esteem., ⁻ Wang and Vuegelers identified both risk and protective factors with complex relations between self-esteem, body mass index (BMI), school performance and a number of socio-demographic risk factors. Elevated BMI and sedentary behavior were risks for low esteem, but greater parent education, higher household income, greater physical activity and better school performance were protective. Other protective factors include physical activity, better health, positive family communication and closeness, more authoritative parenting, perceived teacher support, feeling safe in school and being part of a religious community.

Additional complexity has been identified when researchers have assessed interactions between self-esteem and race/gender. A number of longitudinal studies have demonstrated that Black adolescents are less likely to have low self-esteem compared with their White counterparts; the association between Hispanic race and self-esteem has been less studied and offers mixed results. In a national longitudinal sample, Black and Hispanic race both predicted higher self-esteem among female adolescents. This finding confirmed earlier work by Brown et al demonstrating greater stability of self-esteem and satisfaction with physical appearance among Black adolescent girls as well as a study by Youngblade et al that showed Hispanic ethnicity (both genders) to be protective in a large national sample of US adolescents using a single item measure of self-esteem. In contrast, other studies, including a meta-analysis, demonstrated lower self-esteem among Hispanics when compared to Black and White peers., This heterogeneity of results has been attributed, in part, to study design (sample, esteem scale used, definition of race/ethnicity, analyses) but also to variation in ethnic identity over time and among populations., , , Ethnic identity has been shown to be an important predictor of self-esteem in adolescents and may mediate the complex associations between race, gender and other predictors of esteem that put adolescents at risk for poor health outcomes.

As briefly reviewed above, the literature to date suggests a number of risk and protective factors for low self-esteem with potentially important differences across gender and race. Results have been mixed, however, in part because few studies have included a broad range of covariates simultaneously in a large sample. This population-based correlational study aims to advance the current understanding of risk factors for low self-esteem in adolescents by assessing, in a large national sample of US adolescents, a number of intrinsic and extrinsic factors associated with low self-esteem as defined by perception of physical appearance and self-worth. The current study adds to previous research by utilizing a large, nationally representative sample of adolescents, and by employing a multivariate approach that controls for multiple relevant covariates. This work extends previous research by examining complex interactions between self-esteem, gender, race, and weight status in this national sample. Identifying modifiable risk factors and better understanding the multiple influences at play may guide efforts to bolster self-esteem among adolescents.

Methods

Recruitment

A detailed description of recruitment methods has been previously published. Briefly, a national random-digit-dial (RDD) telephone survey recruited 6522 10 to 14 year old US adolescents for a national study of media and substance use. Westat, a national research organization, conducted baseline and follow-up surveys using computer assisted telephone interviews. The baseline survey was conducted in 2003 with three follow up surveys at 8 month intervals. Parental consent and adolescent assent were obtained verbally by Westat staff prior to each interview: parents were asked "Do you give your permission for ≪NAME/AGE/SEX≫ to participate in this Dartmouth Medical School study?" Adolescents were informed that their parent had given permission for them to participate in the study and they were then asked whether they were willing to go ahead with survey items. To protect confidentiality, adolescents entered responses to all sensitive questions (e.g. tobacco, alcohol use) using the telephone touch pad. The survey was approved by the Human Subjects Protection Committees at Dartmouth Medical School and Westat. The survey response rate (as determined by the Council of American Survey Research Organizations' standard) was 32% and the cooperation rate (completed interviews divided by eligible households) was 66%, which is typical for RDD surveys. The un-weighted baseline sample was representative of 2000 US Census data for age, gender, region of the country and family income. Compared with census, there was slight under-representation of Blacks and over-representation of Hispanics. Reliability coefficients (Cronbach's alpha) were computed for all derived measures. Data for this analysis was collected from June to October of 2003. In addition, BMI was assessed from June to October of 2005, in a later survey wave.

Measures

[see appendix table for detailed survey items]

Outcome measure

Self-esteem was the primary outcome measure, assessed using selected measures from the Harter Self Perception Profile for Children. A composite score was derived from three survey items that assessed domains of global self-worth and physical appearance. Survey items included "I like myself the way I am", "I am happy with the way I look", and "I wish I were someone else". Participants were asked to respond whether they felt the descriptor was like them using a 4 point Likert scale, and values were summed into a scale (Cronbach's alpha= 0.64). For this study, we defined low self-esteem as the lowest quintile of the distribution.

Predictor variables

Demographics were assessed at baseline, including age, gender, race and socioeconomic status (SES). For race and ethnicity, parents were first asked about their child's ethnicity: "Is s/he Spanish, Hispanic, or Latino?" They were then asked about race and could choose from eight categories: White, Black, Hispanic, Pacific Islander, American Indian/Alaskan Native, more than one race, and other/mixed-race. For analysis purposes, if a parent indicated that their child was Hispanic, the child was categorized as Hispanic regardless of parent response to the question about race. SES was measured using a standardized derived variable that combined parent-reported education and household income (Cronbach's alpha=0.71). We examined a number of baseline variables, in addition to demographics, that have been associated with self-esteem in other studies. These included weight status (classification of BMI percentile), child personality characteristics (sensation seeking and rebelliousness), daily TV use, parenting style (maternal responsiveness and demandingness), school performance, and participation in team sports.

Body mass index was derived from self-report and/or parent-report of height and weight at a 24-month follow-up (70% retention rate), calculated by converting (if appropriate) height from inches to meters and weight from pounds to kilograms and then dividing weight by height squared. Algorithms available from the Centers for Disease Control (CDC) were then used to convert measurements to age and gender-specific BMI z-scores, relative to the US population. Quality-assurance checks used by the CDC were applied to the data to eliminate implausible height and weight responses. Similar to the cut-offs used in the Pediatric Nutrition Surveillance System (PedNSS) study, weights that corresponded with the 2000 CDC weight-for-age z-scores that were less than -5 or greater than 5, and BMI scores that corresponded with the 2000 BMI-for-age z-scores that were less than −4 or greater than 5 were deemed biologically implausible. Different from the PedNSS, we deemed heights implausible if they corresponded with the 2000 CDC height-for-age z-scores that were less than −5 or greater than 4 (PedNSS considered z-scores >3 as implausible). As both parent and subjects reported height and weight, we averaged the BMIz unless implausible or missing values were found. If parent values were flagged by the above conditions as biologically implausible, the subject's report was used; if subject values were implausible, the parent's report was used. Correlation between subject and parent report for BMI was 0.83. For the analysis, CDC definitions were followed for classifying weight status by BMI: obesity (95%ile or higher), overweight (85 to 95%ile), normal weight (5 to 85%ile) and underweight (<5%ile). Underweight and healthy weight categories were combined for the purposes of this analysis.

Rebelliousness, sensation seeking, and maternal demandingness and responsiveness were scaled variables that were dichotomized into high and low categories using a median split. TV time was categorized as <1 hours/day, 1 to 2 hours/day, or >=3 hrs/day. Team sports participation was dichotomized as "almost every day to a few times a week" versus "a few times a month or never."

Statistical Analysis

All analyses were completed using STATA statistical software. Chi-square tests were used to compare differences in proportions. Multivariate logistic regression analyses were conducted to determine the independent association between predictor variables and self-esteem. The multivariate model included demographics (age, gender, race, SES), weight status, child personality characteristics (sensation seeking and rebelliousness), hours of TV per day, measures of parenting style (maternal responsiveness and demandingness), school performance, and team sports participation. Finally, interactions between weight status and gender, weight status and race, and gender and race were examined. All statistical tests were two-tailed and significance was set at p<0.05.

Results

Sample Characteristics ()

TABLE 1

The study sample is described in .

Factors associated with low self-esteem: Bivariate analysis

lists characteristics associated with low self-esteem in bivariate (chi-squared) analysis. The percent of teens with our definition of low self-esteem was greater in older adolescents and in females. Differences were found by race, with proportionally fewer Black teens having low self-esteem compared with Whites, and Hispanic teens having a higher rate of low self-esteem. Obese teens had particularly high rates of low self-esteem (30%). Teens with greater sensation seeking and rebelliousness had higher rates of low self-esteem, as did those who reported higher TV use. Adolescents whose parents were more responsive and demanding also had lower rates of poor self-esteem, as did those who had better grades in school and regularly participated in team sports.

TABLE 2

Factors associated with low self-esteem: Multivariate analysis

In multivariate analysis (), females were twice as likely to have low self-esteem as males [OR 2.01, (95% CI 1.71-2.36)]. Those of Hispanic race were more likely to have low self-esteem [OR 1.32 (1.05-1.67)] whereas Black adolescents were less likely to have low self-esteem [OR 0.68 (0.50-0.92)] when compared with Whites. Weight status was associated with low self-esteem, with teens in the obese category being twice as likely to have low self-esteem, and those in the overweight category 1.3 times as likely [OR 2.05 (1.63-2.57) and OR 1.26 (1.02-1.56) respectively] than normal weight youth. Low self-esteem was also associated both with higher sensation seeking and with rebelliousness [OR 1.53 (1.29-1.82) and OR 1.48 (1.23-1.79) respectively]. Teens with higher sensation seeking or rebelliousness were 50% more likely to have low self-esteem [OR 1.53 (1.29-1.82) and OR 1.48 (1.23-1.79) respectively]. Importantly, a number of factors were associated with a lower risk for low self-esteem (in addition to Black race, as above). More responsive and demanding parenting [OR 0.53 (0.44-0.63) and OR 0.7 (0.58-0.84) respectively] and either good [OR 0.82 (0.68-0.99)] or excellent [OR 0.74 (0.59-0.92)] school performance decreased the likelihood of low esteem, as did involvement in team sports [OR 0.68 (0.58-0.80)].

TABLE 3

Interaction effects

In main effects analysis, both male gender and Black race were associated with lower risk of low self-esteem. We further explored these associations by examining theoretically important interaction effects including gender, race, and obesity. No statistically significant interactions were found between overweight/obesity and gender or overweight/obesity and race. However, a significant interaction was found between gender and race (p= 0.015), showing that Black female adolescents did not have the higher risk for low self-esteem that was conferred to females in other race/ethnicity categories. illustrates this interaction effect and shows that risk for low self-esteem in Black females was similar to that of White, Black or mixed-race males. For example, the risk of low self-esteem in White, Hispanic and mixed-race females was 2.5 to 3 times higher than for Black females but not significantly different than White, Black or mixed-race males. Interestingly, Hispanic males, like White, Black and mixed-race females, were at higher risk for low self-esteem [OR 1.94 (1.17, 3.24)] when compared to Black females, thus the finding of Hispanic race being associated with low self-esteem was not due to being female.

Table 4

Discussion

This population-based correlational study examines multiple factors associated with low self-esteem, identifying important modifiable variables. This study furthers previous research by utilizing a large national sample and assessing multiple covariates concurrently, allowing for multivariate and subgroup analyses and better control of possible confounding. Our findings confirm that while there are a number of socio-demographic risk factors that are associated with low self-esteem including female gender and Hispanic race, there are also a number of potentially modifiable factors. One such factor is obesity, which is strongly associated with low self-esteem in this study. This highlights the importance of efforts to prevent and manage childhood obesity, as well as counseling strategies to help overweight teens maintain healthy self-esteem. Higher TV viewing is perhaps the most easily modifiable risk factor for low self-esteem, warranting specific attention from parents and clinicians. Our results further demonstrate that adolescents with stronger school performance and participation in team sports have lower risk for poor self-esteem. Within the present study, less than half of teens reported participation in any team sport, highlighting an additional opportunity for school and community sports programs to promote self-esteem and prevent obesity. Finally, adolescents who perceive their parents to be more responsive and better at setting limits also appear to have lower risk for poor self-esteem.

Our findings are consistent with previous literature examining modifiable risk factors for low self-esteem. Wang et al examined obesity, school performance, self-esteem and a number of socio-demographic factors concurrently, and found that obesity and sedentary activity (such as media time) had an independent negative effect on self-esteem while school performance and physical activity were protective. While the link between physical activity and higher self-esteem has been demonstrated previously, this is the first large study to demonstrate lower risk for poor self-esteem among adolescents who participate regularly in team sports. Our findings are also consistent with several national studies demonstrating a positive association between parenting style and self-esteem., , These studies suggest that parents have a great deal of influence on their children's psychological development, even during a time when adolescents move towards a peer-dominated environment. These findings have obvious implications for public health interventions and for health counseling. Pediatricians can encourage healthy self-esteem by counseling parents and teens on the importance of limiting TV time, promoting physical activity/team sports involvement and supporting academic endeavors. Their efforts to support parents in setting limits and to be responsive to their adolescents could also improve adolescents' sense of self-worth.

The observed interaction between race and gender suggests that Black females are protected against low self-esteem. This finding is consistent with previous studies that have demonstrated a self-esteem advantage for Black youth, females in particular., , , , , Higher self-esteem among Black youth has been explained in a mediation analysis that demonstrated that self-esteem was more internally motivated and less contingent on external motivators, such as other's approval, physical appearance and competition with others compared with White adolescents. This suggests that race and gender cannot be examined in isolation when assessing self-esteem. Ethnic identity, as a means through which people of common traits distinguish themselves from others, has also been associated with more stable self-esteem among adolescents and tends to be stronger among Black and Hispanic than White adolescents. , , This may in part explain the differences in self-esteem among racial groups. While ethnic identity was not measured within our study, this may be a modifiable aspect of race that parents, family and community can influence; this warrants further study.

Our finding that low self-esteem is associated with Hispanic race is consistent with previous literature including a meta-analysis of race and self-esteem, with the exception of a recent longitudinal national study by Birndorf et al, that pointed to higher self-esteem among Hispanic females. Our finding of increased risk of low self-esteem among Hispanic males, compared to males of other races, was unexpected and has not been previously reported. The heterogeneity of findings among studies may be explained by temporal trends over time, different classification strategies for race / ethnicity, or different measures of self-esteem. It has also been suggested that ethnic differences in global self-esteem may be explained by variation in response to specific domains of self-esteem; , , this hypothesis could only be explored with a comprehensive measure of the different self-esteem domains.

These findings suggest that interactions between race, gender and self-esteem may be more complex than previously described. Further elucidation of the mechanisms through which race/ethnicity and gender characteristics modify self-esteem will be necessary to guide families, clinicians and public health workers in their efforts to preserve healthy self-esteem levels during adolescence and ensure a successful transition to adulthood.

Limitations

This study has a number of limitations. Reporting bias may exist as all responses were self-reported by teens or parents. In addition, BMI was not measured concurrently with other variables, as this survey item was assessed at the 24 month survey. While it is possible that weight status may have changed during this time period, BMIz has been shown be relatively stable within respective weight categories over time, thus would not be expected to alter these findings. Nevertheless, we recognize that BMI could have changed over time, at least for some. If changes were correlated with baseline self-esteem, this would suggest that self-esteem affects change in BMI. Although we consider this unlikely, this phenomenon would serve to inflate our estimates of the cross-sectional association. More likely, BMI influences contemporaneous measures of self-esteem. If this is the case, changes in BMI over time would cause us to under estimate the cross-sectional correlation between BMI and self-esteem.

Because these data are not longitudinal, causality cannot be determined. Additional studies are needed to determine if risk factors such as obesity and TV viewing lead to low self-esteem, or if perhaps lower self-esteem contributes to the development and persistence of obesity. With such complex relationships, multiple directions of influence can be hypothesized. Finally, for our assessment of self-esteem, we used a limited rather than a comprehensive scale of self-esteem, so our results may not be fully comparable to other measures of self-esteem and may not be as internally valid. However, a lower reliability would be expected to weaken the strength of our findings so it is reassuring that our findings are generally consistent with the literature.

Conclusion

Results of this study identified specific factors that are associated with low self-esteem in adolescents. More importantly, these results increase understanding for how various risk and potentially protective factors for self-esteem differ across race and gender. Several of these factors are modifiable (e.g. obesity, TV time, school performance, team sports participation), and therefore the results of this study could guide public health interventions and counseling for parents in health supervision visits in an attempt to protect adolescents from the deleterious psychological, physical, and social outcomes associated with low self-esteem.

Acknowledgments

This study is funded by a National Institute on Alcohol Abuse and Alcoholism grant ( AA015591)

All investigators had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Funding: National Institute on Alcohol Abuse and Alcoholism grant # AA015591B

Appendix

Footnotes

Conflict of interest: The above authors report no conflict of interest

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

References

12. Harter S. The Self-Perception Profile for Children. University of Denver; 1985. Un-published manual. [ Google Scholar]

31. Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, et al. 2000 CDC Growth Charts for the United States: methods and development. Vital Health Stat 11. 2002;(246):1-190. [[ PubMed] Google Scholar]

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Characteristics Associated with Low Self-esteem among U.S. Adolescents

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Low self-esteem in adolescents has been associated with a number of risk and protective factors in previous studies, but results have been mixed. Our objective was to examine characteristics associated with low self-esteem in a large national sample of ...

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studies have shown that over 85% of teens have low self esteem

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While it can be normal for a teenager to lack confidence at times, people with self-esteem issues normally view themselves differently to how others view them.

Low self-esteem can be particularly hard for young people especially when they're doing things like starting high school or work, and forming new friendships and relationships. Keep reading to understand self-esteem issues that may come up for your teenager and ways to help your child feel better about themselves and their capabilities.

This can help if you:

suspect your child is suffering from low self-esteem

want to learn how to build your child's self-esteem

would like to identify the causes of your child's low self-esteem.

Why your child's self-esteem is important

Positive self-esteem for teens is important as it allows them to try new things, take healthy risks and solve problems. In turn, their learning and development will be productive and will set them up for a healthy and positive future. A young person with healthy self-esteem is more likely to display positive behavioural characteristics, such as:

acting independent and mature

taking pride in their accomplishments/acheivements

accepting frustration and dealing with it responsibly

trying new things and challenges

helping others when possible

How can low self-esteem affect my child?

When someone has low self-esteem they tend to avoid situations where they think there's risk of failure, embarrassment or making mistakes. These can involve school work, making friends, and trying new activities, which are all important parts of a healthy teenage life.

If the low self-esteem is not identified and treated, then it can lead to problems such as:

relationship troubles or difficulty making friends

- negative moods such as feeling sad, anxious, ashamed or angry

low motivation

poor body image

earlier sexual activity

drinking alcohol and/or taking drugs to feel better

What can cause low self-esteem?

How a person feels about themselves is a result of their experiences and how they deal with situations. The most common causes of low self-esteem in teenagers are:

unsupportive parents, carers or others that play an influential role in their life

friends who are bad influences

stressful life events such as divorce or moving houses

trauma or abuse

poor performance at school or unrealistic goals

mood disorders such as depression

bullying or loneliness

ongoing medical issues

Signs of low self-esteem

A child with low self-esteem will more than likely be having negative thoughts about their worth and value as a person. Some general signs that your child has low self-esteem include:

avoiding new things and not taking up opportunities

feeling unloved and unwanted

blaming others for their own mistakes

- not being able to deal with normal levels of frustration

- negative self-talk and comparisons to others

fear of failure or embarrassment

difficulty making friends

low levels of motivation and interest

can't take compliments and shows mixed feelings of anxiety or stress.

There are things you can do to support your child to have positive self-esteem, but it's also important to remember that teenage self-esteem develops and changes quite frequently overtime. If your child doesn't show signs of positive self-esteem immediately, it doesn't necessarily mean you're doing something wrong!

You can help your child develop positive self-esteem with tips here.

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Self-esteem and teenagers - ReachOut Parents

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While it can be normal for a teenager to lack confidence at times, people with self-esteem issues normally view themselves differently to how others view them. Low self-esteem can be particularly hard for young people especially when they're doing things like starting high school or work, and forming new friendships and relationships.

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yes, due to rapid change in hormones in the brain

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More than 40% of boys in middle school and high school regularly exercise with the goal of increasing muscle mass. https://www.dosomething.org/us/facts/11-facts-about-teens-and-self-esteem

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The majority of U.S. teens have self-esteem issues that will follow them into adulthood.

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Adolescent eating disorder statistics show 2.7% of teens in the U.S. between 13 and 18 years old have an eating disorder.

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Polaris Teen Center: Premier Adolescent Treatment Center in Los Angeles

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The adolescent and teenage years are a time of growth and transformation, physically, mentally and biologically. In moving towards adulthood, young people begin to discover who they are. Independent of parents, they begin to establish friendships and go through puberty. There are obvious physical changes associated with adolescence and puberty. But a large amount of internal change also occurs. Adolescent eating disorder statistics show 2.7% of teens in the U.S. between 13 and 18 years old have an eating disorder. For many teenagers, entering into puberty can be a time wrought with intense emotions, confusion, and stress. This period of change is what makes teens susceptible to developing eating disorders.

Adolescent eating disorders (such as anorexia, bulimia, binge eating disorder, and compulsive overeating) are concerns every parent hopes to avoid. Yet, because so many young people struggle with eating disorders, it is important to know the facts.

4% of adolescents and teens, ages 13 to 18, suffer from an anorexia, bulimia, or binge eating disorder.

Anorexia is a serious, life-threatening eating disorder affecting many teenagers. Those who suffer from anorexia go to extreme lengths to control their food intake. Or, worse, they avoid eating altogether. Additionally, those with anorexia also have a distorted body image. They still feel "fat," regardless of how thin they become.

Teenagers with bulimia typically binge (periods of uncontrollable overeating) and purge (self-induce vomiting). Inducing vomiting is the most common compensatory behavior. But there are others, such as laxatives or excessive exercise.

Binge-eating disorder is characterized by excessive eating. Many teens who suffer from binge-eating disorder describe feeling like they have no control over their behavior. They also experience intense guilt and shame following a binge.

50% of teens with anorexia will develop bulimia or binge-eating disorder

Anorexia is an eating disorder marked by significantly restricting caloric intake due to intense fear of weight gain. Teens with anorexia engage in some level of self-starvation. This extreme dietary restriction often leads to another eating disorder, such as bulimia or binge-eating disorder. Long periods of malnutrition take a toll on the body's systems and organs. This, along with experiencing hunger cues and pains, can eventually lead a teen to "giving in" to the desire for food. And like the extreme nature of the restricting, once a teenager begins to eat again, it can be extreme as well (such as binging).

90% of teens with anorexia are female

Anorexia most commonly emerges in the adolescent and teenage years. This eating disorder develops from a number of factors including, for some, the onset of dieting, converge. While dieting does not cause anorexia, the reduction in calories dieting entails often triggers the disorder. Especially in those who are genetically predisposed to it.

The average amount spent on eating disorder research per affected individual is .93¢

In comparison, $44 per affected individual is spent on autism research. Schizophrenia research spends $81 per affected individual. Lastly, $88 is spent on Alzheimer's disease research per affected individual.

Young women with anorexia are 12 times more likely to die than women the same age who do not have anorexia.

Anorexia nervosa is the third most common chronic illness among adolescent and teenage girls. Anorexia also has the highest mortality rate of any psychiatric disorder.

50% of teenage girls and 30% of teenage boys use unhealthy weight control behaviors.

Some of these behaviors include skipping meals, fasting, smoking cigarettes, purging (throwing up), taking laxatives, over-exercising, taking diet pills, hiding food, and drinking highly caffeinated energy drinks.

50% of teens with an eating disorder also suffer from depression

Depression may lead to eating disorders in teenagers, but in many cases, the eating disorder itself is what triggers depression. Malnourishment causes physiological changes in the brain that can affect emotion regulation and mood.

69% of females (ages 10 to 18) state that photographs of models and celebrities in the media motivated their "ideal" body shape.

The rate at which teens are becoming aware of their body shape and size is getting younger and younger, and media plays a big part in this. Many teenagers site media as being on of the biggest influencers when it comes to body image (how one perceives his or her body when looking in the mirror). In the United States, media and overall popular culture strongly idealize thinness, and adolescents and teens are amongst the population most strongly influenced, especially with the popularity of social media. Unfortunately, the substantial influence the media plays in teenagers lives leads many (even teens with a normal body weight), are still susceptible to viewing themselves as "overweight" or "fat". The importance placed on thinness in the media can create a desire to achieve the impossible in terms of body shape and size, and can obviously become a trigger to dieting and weight loss.

In this day and age, being concerned with weight and body size is incredibly common, especially amongst adolescent and teenaged girls. Adolescence is when bodies begin to change, and there is an increased awareness of media and peer pressures. Couple this with a lack of knowledge around nutrition, and many teenage girls are engaging in some very risky dietary behaviors as a way to cope with body dissatisfaction. Although all teenage girls are susceptible, there are certain risk factors that make some more likely to use dangerous diets including:

Family factors - low family connectedness, absent or neglectful parents, or dieting amongst parents can all contribute to increasing a teenage girl's risk of engaging in dieting behavior.

Environmental factors - poor school involvement, bullying/teasing by peers (especially around weight-related issues), or participation in a sport that is weight-focused will likely make a teen more prone to using diets.

Individual factors - being female alone increasing one's inclination towards dieting. Other individual factors include low self-esteem, early puberty, being overweight or obese, or practicing vegetarianism.

How many teen boys actually have eating disorders? Boys make up approximately 10 to 15% of the adolescent and teenage population with eating disorders, but are much less likely to seek treatment due to the gender stereotypes surrounding the disorders.

Many people believe that an eating disorder is a "female" problem. And while more common in girls and women, eating disorders do affect males as well. Because there is far more discussion about teenage girls and eating disorders, many teen boys are reluctant to discuss their symptoms or admit they have a problem. For some, there may be fear of appearing less masculine, or being judged by friends and peers. This unfortunately prevents many male teenagers from getting the help they need.

Involvement in certain athletic activities - such as bodybuilding, wrestling, swimming, and gymnastics all increase a teenage boy's chances of developing an eating disorder. This is because these are sports where weight control can influence performance, and coaches often encourage maintaining a certain weight range.

Sexual orientation - homosexual males or males questioning their sexual identity are at an increased risk of struggling with an eating disorder.

Being overweight - teenage boys who are currently overweight, or were overweight as children are more prone to eating disorders. This is especially true if a bullying and/or teasing is involved.

Parental dieting - parents model behaviors to their children, whether they intend to or not. Thus, teenage boys who see one or both parents using restrictive diets to lose weight may begin to practice similar behavior.

While it is possible for any boy to develop an eating disorder throughout his adolescent and teenage years, there are certain factors that increase one's likelihood including:

If you think your teen may be struggling with an eating disorder, contact Polaris Teen at (844) 836-0222 to find out more about residential treatment options for your son or daughter.

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10 Statistics of Teenage Eating Disorders

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Many young people struggle with eating disorders. If you think your teen falls into this category, discover how you can help support them. Read here

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Yes, teens have many problems in life like bad family lives, and bullying, this leads to teens developing things like depression, low self esteem, eating disorders, and PTSD

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https://www.cdc.gov/childrensmentalhealth/data.html

Mental health is an important part of children’s overall health and well-being. Mental health includes children’s mental, emotional, and behavioral well-being. It affects how children think, feel, and act. It also plays a role in how children handle stress, relate to others, and make healthy choices.

Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, causing distress and problems getting through the day.¹ Among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety, and behavior disorders.

There are different ways to assess mental health and mental disorders in children. CDC uses surveys, like the National Survey of Children’s Health, to describe the presence of positive indicators of children’s mental health and to understand the number of children with diagnosed mental disorders and whether they received treatment. In this type of survey, parents report on indicators of positive mental health for their child and report any diagnoses their child has received from a healthcare provider.  The information on this page provides data about indicators of positive mental health in children and mental health disorders that are most common in children.

Facts about mental health in U.S. children

National data on positive mental health indicators that describe mental, emotional, and behavioral well-being for children are limited. Based on the data we do have:

Indicators of positive mental health are present in most children. Parents reported in 2016-2019 that their child mostly or always showed:

Affection (97.0%), resilience (87.9%), positivity (98.7%) and curiosity (93.9%) among children ages 3-5 years²

Curiosity (93.0%), persistence (84.2%), and self-control (73.8%) among children ages 6-11 years²

Curiosity (86.5 %), persistence (84.7%), and self-control (79.8%) among children ages 12-17 years²

Facts about mental disorders in U.S. children

ADHD, anxiety problems, behavior problems, and depression are the most commonly diagnosed mental disorders in children. Estimates for ever having a diagnosis among children aged 3-17 years, in 2016-19, are given below.

ADHD 9.8% (approximately 6.0 million)²

Anxiety 9.4% (approximately 5.8 million)²

Behavior problems 8.9% (approximately 5.5 million)²

Depression 4.4% (approximately 2.7 million)²

Some of these conditions commonly occur together. For example, among children aged 3-17 years in 2016:

Having another mental disorder was most common in children with depression: about 3 in 4 children with depression also had anxiety (73.8%) and almost 1 in 2 had behavior problems (47.2%).³

For children with anxiety, more than 1 in 3 also had behavior problems (37.9%) and about 1 in 3 also had depression (32.3%).³

For children with behavior problems, more than 1 in 3 also had anxiety (36.6%) and about 1 in 5 also had depression (20.3%).³

Depression and anxiety have increased over time

“Ever having been diagnosed with either anxiety or depression” among children aged 6–17 years increased from 5.4% in 2003 to 8% in 2007 and to 8.4% in 2011–2012.⁴

“Ever having been diagnosed with anxiety” increased from 5.5% in 2007 to 6.4% in 2011–2012.⁴

“Ever having been diagnosed with depression” did not change between 2007 (4.7%) and 2011-2012 (4.9%).⁴

For adolescents, depression, substance use and suicide are important concerns. Among adolescents aged 12-17 years in 2018-2019 reporting on the past year:

15.1% had a major depressive episode.²

36.7% had persistent feelings of sadness or hopelessness.²

4.1% had a substance use disorder.²

1.6% had an alcohol use disorder.²

3.2% had an illicit drug use disorder.²

18.8% seriously considered attempting suicide.²

15.7% made a suicide plan.²

8.9% attempted suicide.²

2.5% made a suicide attempt requiring medical treatment.²

Learn more about high-risk substance use among youth. Learn more about suicide.

Treatment rates vary among different mental disorders. Among children aged 3-17 years, in 2016:

Nearly 8 in 10 children (78.1%) with depression received treatment.³

6 in 10 children (59.3%) with anxiety received treatment.³

More than 5 in 10 children (53.5%) with behavior disorders received treatment.³

Mental, behavioral, and developmental disorders begin in early childhood

1 in 6 U.S. children aged 2–8 years (17.4%) had a diagnosed mental, behavioral, or developmental disorder.⁵

Prevalence of mental disorders change with age

Diagnoses of ADHD, anxiety, and depression become are more common with increased age.³

Behavior problems are more common among children aged 6–11 years than younger or older children.³

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Centers for Disease Control and Prevention

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Mental health is an important part of children's overall health and well-being. Mental health includes children's mental, emotional, and behavioral well-being. It affects how children think, feel, and act. It also plays a role in how children handle stress, relate to others, and make healthy choices.

Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, causing distress and problems getting through the day. Among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety, and behavior disorders.

There are different ways to assess mental health and mental disorders in children. CDC uses surveys, like the National Survey of Children's Health, to describe the presence of positive indicators of children's mental health and to understand the number of children with diagnosed mental disorders and whether they received treatment. In this type of survey, parents report on indicators of positive mental health for their child and report any diagnoses their child has received from a healthcare provider. The information on this page provides data about indicators of positive mental health in children and mental health disorders that are most common in children.

Facts about mental health in U.S. children

National data on positive mental health indicators that describe mental, emotional, and behavioral well-being for children are limited. Based on the data we do have:

Facts about mental disorders in U.S. children

ADHD, anxiety problems, behavior problems, and depression are the most commonly diagnosed mental disorders in children. Estimates for ever having a diagnosis among children aged 3-17 years, in 2016-19, are given below.

ADHD 9.8% (approximately 6.0 million)

Anxiety 9.4% (approximately 5.8 million)

Behavior problems 8.9% (approximately 5.5 million)

Depression 4.4% (approximately 2.7 million)

Some of these conditions commonly occur together. For example, among children aged 3-17 years in 2016:

Having another mental disorder was most common in children with depression: about 3 in 4 children with depression also had anxiety (73.8%) and almost 1 in 2 had behavior problems (47.2%).

For children with anxiety, more than 1 in 3 also had behavior problems (37.9%) and about 1 in 3 also had depression (32.3%).

For children with behavior problems, more than 1 in 3 also had anxiety (36.6%) and about 1 in 5 also had depression (20.3%).

For adolescents, depression, substance use and suicide are important concerns. Among adolescents aged 12-17 years in 2018-2019 reporting on the past year:

Learn more about high-risk substance use among youth. Learn more about suicide.

Mental, behavioral, and developmental disorders begin in early childhood
1 in 6 U.S. children aged 2-8 years (17.4%) had a diagnosed mental, behavioral, or developmental disorder.

Prevalence of mental disorders change with age

Diagnoses of ADHD, anxiety, and depression become are more common with increased age.

Behavior problems are more common among children aged 6-11 years than younger or older children.

Adverse childhood events (ACEs) are associated with children's physical and mental health. In 2016-2019, among children aged 6-17 years:

Children who were discriminated against based on race or ethnicity had higher percentages of one or more physical health conditions (37.8% versus 27.1%), and one or more mental health conditions (28.9% versus 17.8%).

Racial/ethnic discrimination was almost seven times as common among children with three other ACEs compared to those with no other ACEs.

Note: The estimates reported on this page are based on parent report, using nationally representative surveys. This method has several limitations. It is not known to what extent children receive these diagnoses accurately. Estimates based on parent-reported diagnoses may match those based on medical records, but some children may also have mental disorders that have not been diagnosed, or receive diagnoses that may not be the best fit for their symptoms. Limited information on measuring children's mental health nationally is available.

Read more about children's mental health from a community study.

Access to mental health treatment

Early diagnosis and appropriate services for children and their families can make a difference in the lives of children with mental disorders. Access to providers who can offer services, including screening, referrals, and treatment, varies by location. CDC is working to learn more about access to behavioral health services and supports for children and their families.
View information by state describing the rates of different types of providers who can offer behavioral health services providers by county. Read a recent report describing shortages of services, barriers to treatment, and how integration of behavioral health care with pediatric primary care could address the issues. Read a policy brief on potential ways to increase access to mental health services for children in rural areas
Data sources for mental health and related conditions

There are many different datasets which include information on children's mental health and related conditions for children living in the United States.

Healthy People 2030
Healthy People 2030 sets data-driven national objectives to improve health and well-being over the next decade, including children's mental health and well-being.

National Survey of Family Growth (NSFG)
NSFG gathers information on family life, marriage and divorce, pregnancy, infertility, use of contraception, and general and reproductive health.

National Health and Nutrition Examination Survey (NHANES)
NHANES assesses health and nutritional status through interviews and physical examinations, and includes conditions, symptoms, and concerns associated with mental health and substance abuse, as well as the use and need for mental health services.

National Health Interview Survey (NHIS)
NHIS collects data on children's mental health, mental disorders, such as ADHD, autism spectrum disorder, depression and anxiety problems, and use and need for mental health services.

National Survey of Children's Health (NSCH)
NSCH examines the health of children, with emphasis on well-being, including medical homes, family interactions, the health of parents, school and after-school experiences, and safe neighborhoods. This survey was redesigned in 2016.

For previous versions of this survey, see also:
National Survey of Children's Health (NSCH 2003, 2007, 2011-12)
National Survey of Children with Special Healthcare Needs (NS-CSHCN 2001, 2005-6, 2009-10)

National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (NS-DATA)
NS-DATA collects information about children, 2-15 years old in 2011-2012, who had ever been diagnosed with ADHD and/or Tourette syndrome (TS), with the goal of better understanding diagnostic practices, level of impairment, and treatments for this group of children.

National Survey on Drug Use and Health (NSDUH)
NSDUH, administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), provides national- and state-level data on the use of tobacco, alcohol, and illicit drugs (including non-medical use of prescription drugs), as well as data on mental health in the United States.

National Vital Statistics System (NVSS)
NVSS contains vital statistics from the official records of live births, deaths, causes of death, marriages, divorces, and annulment recorded by states and independent registration areas

National Youth Tobacco Survey (NYTS)
NYTS is a nationally representative school-based survey on tobacco use by public school students enrolled in grades 6-12.

School Associated Violent Death Study (SAVD)
SAVD plays an important role in monitoring trends related to school-associated violent deaths (including suicide), identifying the factors that increase the risk, and assessing the effects of prevention efforts.

School Health Policies and Programs Study (SHPPS)
SHPPS is a national survey assessing school health policies and practices at the state, district, school, and classroom levels. Collected data includes mental health and social service policies.

Web-based Injury Statistics Query and Reporting System (WISQARS)
WISQARS is an interactive database system that provides customized reports of injury-related data.

Youth Risk Behavior Surveillance System (YRBSS)
The YRBSS monitors health-risk behaviors, including tobacco use, substance abuse, unintentional injuries and violence, sexual behaviors that contribute to unintended pregnancy, and sexually transmitted diseases.

References

1. Perou R, Bitsko RH, Blumberg SJ, Pastor P, Ghandour RM, Gfroerer JC, Hedden SL, Crosby AE, Visser SN, Schieve LA, Parks SE, Hall JE, Brody D, Simile CM, Thompson WW, Baio J, Avenevoli S, Kogan MD, Huang LN. Mental health surveillance among children - United States, 2005-2011. MMWR 2013;62(Suppl; May 16, 2013):1-35. [Read summary]

2. Bitsko RH, Claussen AH, Lichtstein J, Black LJ, Everett Jones S, Danielson MD, Hoenig JM, Davis Jack SP, Brody DJ, Gyawali S, Maenner MM, Warner M, Holland KM, Perou R, Crosby AE, Blumberg SJ, Avenevoli S, Kaminski JW, Ghandour RM. Surveillance of Children's Mental Health - United States, 2013 - 2019 MMWR, , 2022 / 71(Suppl-2);1-42. [Read article]

3. Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, Blumberg SJ. Prevalence and treatment of depression, anxiety, and conduct problems in U.S. children. The Journal of Pediatrics, 2018. Published online before print October 12, 2018 [Read summary]

4. Bitsko RH, Holbrook JR, Ghandour RM, Blumberg SJ, Visser SN, Perou R, Walkup J. Epidemiology and impact of healthcare provider diagnosed anxiety and depression among US children. Journal of Developmental and Behavioral Pediatrics. Published online before print April 24, 2018 [Read summary]

5. Cree RA, Bitsko RH, Robinson LR, Holbrook JR, Danielson ML, Smith DS, Kaminski JW, Kenney MK, Peacock G. Health care, family, and community factors associated with mental, behavioral, and developmental disorders and poverty among children aged 2-8 years - United States, 2016. MMWR, 2018;67(5):1377-1383. [Read article]

6. Hutchins HJ, Barry CM, Valentine V, Bacon S, Njai R, Claussen AH, Ghandour RM, Lebrun-Harris LA, Perkins K, Robinson LR (submitted). Perceived racial/ethnic discrimination, physical and mental health conditions in childhood, and the relative role of other adverse experiences. Adversity and Resilience Science published online May 23, 2022. [Read summary]

7. US Department of Health and Human Services Health Resources and Services Administration & Maternal and Child Health Bureau. Mental health: A report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, and National Institutes of Health, National Institute of Mental Health; 1999. [Read report]

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Data and Statistics on Children's Mental Health | CDC

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Read data highlights about children's mental health.

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15% to 43% of girls and 14% to 43% of boys go through at least one trauma.

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How Common is PTSD in Children and Teens?

Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors.

What Events Cause PTSD in Children?

Children and teens could have PTSD if they have lived through an event that could have caused them or someone else to be killed or badly hurt. Such events include sexual or physical abuse or other violent crimes. Disasters such as floods, school shootings, car crashes, or fires might also cause PTSD. Other events that can cause PTSD are war, a friend's suicide, or seeing violence in the area they live.

Child protection services in the U.S. get around three million reports each year. This involves 5.5 million children. Of the reported cases, there is proof of abuse in about 30%. From these cases, we have an idea how often different types of abuse occur:

65% neglect

18% physical abuse

10% sexual abuse

7% psychological (mental) abuse

Also, three to ten million children witness family violence each year. Around 40% to 60% of those cases involve child physical abuse. (Note: It is thought that two-thirds of child abuse cases are not reported.)

What Are the Risk Factors for PTSD?

Three factors have been shown to raise the chances that children will get PTSD. These factors are:

How severe the trauma is

How the parents react to the trauma

How close or far away the child is from the trauma

Children and teens that go through the most severe traumas tend to have the highest levels of PTSD symptoms. The PTSD symptoms may be less severe if the child has more family support and if the parents are less upset by the trauma. Lastly, children and teens who are farther away from the event report less distress.

Other factors can also affect PTSD. Events that involve people hurting other people, such as rape and assault, are more likely to result in PTSD than other types of traumas. Also, the more traumas a child goes through, the higher the risk of getting PTSD. Girls are more likely than boys to get PTSD. It is not clear whether a child's ethnic group may affect PTSD. Some research shows that minorities have higher levels of PTSD symptoms. Other research suggests this may be because minorities may go through more traumas.

Another question is whether a child's age at the time of the trauma has an effect on PTSD. Researchers think it may not be that the effects of trauma differ according to the child's age. Rather, it may be that PTSD looks different in children of different ages.

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Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors.

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I think a lot of teens struggle with mental health because these four categories show that there are different kinds of mental health problems.

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https://kidshealth.org/en/teens/ptsd.html

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What Is PTSD?

Posttraumatic stress disorder (PTSD) is a mental health condition brought on by a trauma.

Someone with PTSD has been through or witnessed a traumatic event. They have symptoms that last long after the trauma is over. These symptoms can be:

bad memories, called flashbacks, that make it seem like the trauma is still happening

bad dreams or trouble sleeping

avoiding things that remind them of the trauma

changes in mood, such as feeling sad, moody, angry, or detached

not enjoying things like before

feeling more easily scared, anxious, jumpy, sensitive, or startled

Therapy can help people recover from PTSD. They also need understanding, comfort, and support from people in their lives.

Not everyone who has been through a trauma will have PTSD. In fact, most won't. Most people find ways to cope and get past trauma. Therapy and support soon after a trauma can help.

What Is a Trauma?

A trauma is a stressful event that makes a person fear for their or other people's life or safety.

Trauma events that can lead to PTSD include:

physical or sexual abuse, or assault

school or neighborhood violence

natural disasters or fires

car accidents

military combat

sudden or forceful loss of a parent

arrests, evictions

being the target of hate, or threats of harm

An event can be a trauma for someone even if they don't go through the danger themselves. For example, seeing someone else be hurt or die from violence can be a trauma.

Hearing that someone close died by violence or suicide can be a trauma too. The grief can be intense with this type of loss. It is called traumatic grief.

Does Trauma Always Cause PTSD?

Traumas can lead to PTSD, but not always. Not everyone who has been through a trauma will have PTSD. In fact, most young people who go through trauma will not have PTSD.

But most will feel the effects of trauma. It's natural to react to a deeply stressful event. Most people will feel upset, have thoughts of the trauma, and other signs of distress. These may be called PTSD-like symptoms.

Most people do find ways to cope with what they've been through. Some will get past trauma quickly on their own. It helps to have extra comfort and support from people in their lives. Therapy can also help. As people cope and adjust, their symptoms get better.

PTSD develops when a trauma overwhelms a person's ability to cope. The deep stress of trauma keeps the brain's threat sensors too active. That makes it hard for the person to feel safe again. People with PTSD need extra help to move through the coping process. Therapy helps them do that.

Whether or not a person will have PTSD partly depends on:

how severe the trauma was, or how harmful

the help and support they get

if they have a lot of other stress in their life

if they have been through past trauma

if they have depression or anxiety

inherited risks like family history of depression and anxiety

After a trauma, a person may have PTSD-like symptoms that last for a short while, sometimes days or weeks. This may be called a stress reaction. Only if symptoms last longer than a month can it be diagnosed as PTSD.

How Is PTSD Treated?

PTSD doesn't usually go away on its own. Getting treatment and support can make all the difference.

Mental health providers (like psychologists, psychiatrists, and mental health counselors) have the experience to work with patients with PTSD. Treatment for PTSD can include therapy and/or medicines to help with anxiety, mood problems, and sleep issues.

Therapy for PTSD is called trauma-focused cognitive behavioral therapy (TF-CBT). This type of talk therapy uses talking and learning activities, guided by a mental health therapist. It can help anyone who has been through a trauma, not just people with PTSD. Getting therapy soon after a trauma helps them cope well.

PTSD therapy often includes:

cognitive processing therapy (CPT) activities: to help with thoughts and feelings about the trauma

prolonged exposure (PE) activities: to help someone lower anxiety and learn to safely face things they avoid after trauma

eye movement desensitization and reprocessing therapy (EMDR): combined cognitive therapy with directed eye movements to reduce the power and pain of the trauma. This helps the brain reprocess memory of the trauma. There are therapists who specialize in this type of trauma therapy.

Trauma therapists also guide parents on how to listen and show they understand. The support of caring adults helps young people open up, feel safe, and do well.

How Does Therapy Help?

Trauma therapy gives people a way to safely share their feelings, tell their story, and get support. In therapy, they learn coping and calming skills to help them deal with anxiety after a trauma. This makes it easier to talk about what they have been through.

In therapy, people learn how trauma can affect their thoughts, feelings, and actions. They learn ways to adjust some of the difficult thoughts about the trauma. They learn to let go of any guilt or shame about what happened.

Slowly, people learn to face things they used to avoid. Therapy helps them gain courage and confidence. They use their strengths to cope and move forward.

How Can I Help Myself?

If you have been through trauma, or think you might have PTSD, here are things you can do:

Confide in an adult you trust. Reach out to someone who will listen and care. It's OK if you need extra time and support for a while. Pay it forward by being kind or helpful to someone else. Helping makes the helper feel good too.

Get treatment for PTSD or trauma. This can help you cope with what you have been through. It can help you discover strengths you never knew you had. Your parent, doctor, or school counselor can help you find the right person to work with.

Practice ways to relax. Make time every day to take a few slow breaths. If you can, make the exhale just a bit longer than the inhale. Try this: Breathe in while you count to 3. Breathe out while you count to 5. Take 3-4 breaths like this. It seems so simple. But it has a powerful benefit. It helps to reset the brain's threat sensor. The benefit adds up, so practice it often.

Do things that you enjoy. Trauma can make it harder to feel the positive emotions that naturally help you recharge. Play, laugh, enjoy nature, make music or art, cook. These activities can reduce stress, build your resilience. They even help you be a better learner when it's time to focus.

Know that you can do this. Believe in yourself. Everyone has the ability to adapt and grow, even with difficult challenges. It takes patience and effort. And there are people who will help you.

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Sometimes after experiencing a traumatic event, a person has a strong and lingering reaction known as posttraumatic stress disorder (PTSD). Getting treatment and support can make all the difference.

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Yes, i think teens do struggle with metal help, because a lot of teens go through a lot of thinks in their life. They have parents that may abuse them, they have people at school who may pick on them, and all that does is hurt them mentally

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Among high school students, 44% of girls and 15% of guys are attempting to lose weight.

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The majority of U.S. teens have self-esteem issues that will follow them into adulthood.

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An estimated 5.0% of adolescents had PTSD, and an estimated 1.5% had severe impairment.

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National Institute of Mental Health (NIMH)

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Definition

Post-traumatic stress disorder (PTSD) can develop after exposure to a potentially traumatic event that is beyond a typical stressor. Events that may lead to PTSD include, but are not limited to, violent personal assaults, natural or human-caused disasters, accidents, combat, and other forms of violence. Exposure to events like these is common. About one half of all U.S. adults will experience at least one traumatic event in their lives, but most do not develop PTSD. People who experience PTSD may have persistent, frightening thoughts and memories of the event(s), experience sleep problems, feel detached or numb, or may be easily startled. In severe forms, PTSD can significantly impair a person's ability to function at work, at home, and socially.

Additional information about PTSD can be found on the NIMH Health Topics page on Post-Traumatic Stress Disorder.

Prevalence of Post-Traumatic Stress Disorder Among Adults

Based on diagnostic interview data from National Comorbidity Survey Replication (NCS-R), Figure 1 shows past year prevalence of PTSD among U.S. adults aged 18 or older.1

An estimated 3.6% of U.S. adults had PTSD in the past year.

Past year prevalence of PTSD among adults was higher for females (5.2%) than for males (1.8%).

The lifetime prevalence of PTSD was 6.8%.²

Figure 1

Post-Traumatic Stress Disorder with Impairment Among Adults

Of adults with PTSD in the past year, degree of impairment ranged from mild to serious, as shown in Figure 2. Impairment was determined by scores on the Sheehan Disability Scale.³

Impairment was distributed evenly among adults with PTSD. An estimated 36.6% had serious impairment, 33.1% had moderate impairment, and 30.2% had mild impairment

Figure 2

Prevalence of Post-Traumatic Stress Disorder Among Adolescents

Based on diagnostic interview data from National Comorbidity Survey Adolescent Supplement (NCS-A), Figure 3 shows lifetime prevalence of PTSD among U.S. adolescents aged 13-18.⁴

An estimated 5.0% of adolescents had PTSD, and an estimated 1.5% had severe impairment. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria were used to determine impairment.

The prevalence of PTSD among adolescents was higher for females (8.0%) than for males (2.3%).

Figure 3

Data Sources

References

1. Harvard Medical School, 2007. National Comorbidity Survey (NCS). (2017, August 21). Retrieved from https://www.hcp.med.harvard.edu/ncs/index.php. Data Table 2: 12-month prevalence DSM-IV/WMH-CIDI disorders by sex and cohort.

2. Harvard Medical School, 2007. National Comorbidity Survey (NCS). (2017, August 21). Retrieved from https://www.hcp.med.harvard.edu/ncs/index.php. Data Table 1: Lifetime prevalence DSM-IV/WMH-CIDI disorders by sex and cohort.

3. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005 Jun;62(6):617-27. PMID: 15939839

4. Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):980-9. PMID: 20855043

Statistical Methods and Measurement Caveats

National Comorbidity Survey Replication (NCS-R)

Diagnostic Assessment and Population:

The NCS-R is a nationally representative, face-to-face, household survey conducted between February 2001 and April 2003 with a response rate of 70.9%. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview (WMH-CIDI), a fully structured lay-administered diagnostic interview that generates both International Classification of Diseases, 10th Revision, and DSM-IV diagnoses. The DSM-IV criteria were used here. The Sheehan Disability Scale (SDS) assessed disability in work role performance, household maintenance, social life, and intimate relationships on a 0-10 scale. Participants for the main interview totaled 9,282 English-speaking, non-institutionalized, civilian respondents. Post-traumatic stress disorder (PTSD) was assessed in a subsample of 5,692 adults. The NCS-R was led by Harvard University.

Unlike the DSM-IV criteria used in the NCS-R and NCS-A, the current DSM-5 no longer places PTSD in the anxiety disorder category. It is listed in a new DSM-5 category, Trauma- and Stressor-Related Disorders.

Survey Non-response:

In 2001-2002, non-response was 29.1% of primary respondents and 19.6% of secondary respondents.

Reasons for non-response to interviewing include: refusal to participate (7.3% of primary, 6.3% of secondary); respondent was reluctant- too busy but did not refuse (17.7% of primary, 11.6% of secondary); circumstantial, such as intellectual developmental disability or overseas work assignment (2.0% of primary, 1.7% of secondary); and household units that were never contacted (2.0).

For more information, see PMID: 15297905 and the NIMH NCS-R study page.

National Comorbidity Survey Adolescent Supplement (NCS-A)

Diagnostic Assessment and Population:

The NCS-A was carried out under a cooperative agreement sponsored by NIMH to meet a request from Congress to provide national data on the prevalence and correlates of mental disorders among U.S. youth. The NCS-A was a nationally representative, face-to-face survey of 10,123 adolescents aged 13 to 18 years in the continental United States. The survey was based on a dual-frame design that included 904 adolescent residents of the households that participated in the adult U.S. National Comorbidity Survey Replication and 9,244 adolescent students selected from a nationally representative sample of 320 schools. The survey was fielded between February 2001 and January 2004. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview.

Survey Non-response:

The overall adolescent non-response rate was 24.4%. This is made up of non-response rates of 14.1% in the household sample, 18.2% in the un-blinded school sample, and 77.7% in the blinded school sample. Non-response was largely due to refusal (21.3%), which in the household and un-blinded school samples came largely from parents rather than adolescents (72.3% and 81.0%, respectively). The refusals in the blinded school sample, in comparison, came almost entirely (98.1%) from parents failing to return the signed consent postcard.

For more information, see PMID: 19507169 and the NIMH NCS-A study page.

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Post-traumatic stress disorder (PTSD) can develop after exposure to a potentially traumatic event that is beyond a typical stressor. Events that may lead to PTSD include, but are not limited to, violent personal assaults, natural or human-caused disasters, accidents, combat, and other forms of violence. Exposure to events like these is common.

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it is estimated that 85 percent of Americans suffer from low self-esteem.

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While it can be normal for a teenager to lack confidence at times, people with self-esteem issues normally view themselves differently to how others view them.

Low self-esteem can be particularly hard for young people especially when they're doing things like starting high school or work, and forming new friendships and relationships. Keep reading to understand self-esteem issues that may come up for your teenager and ways to help your child feel better about themselves and their capabilities.

This can help if you:

suspect your child is suffering from low self-esteem

want to learn how to build your child's self-esteem

would like to identify the causes of your child's low self-esteem.

Why your child's self-esteem is important

Positive self-esteem for teens is important as it allows them to try new things, take healthy risks and solve problems. In turn, their learning and development will be productive and will set them up for a healthy and positive future. A young person with healthy self-esteem is more likely to display positive behavioural characteristics, such as:

acting independent and mature

taking pride in their accomplishments/acheivements

accepting frustration and dealing with it responsibly

trying new things and challenges

helping others when possible

How can low self-esteem affect my child?

When someone has low self-esteem they tend to avoid situations where they think there's risk of failure, embarrassment or making mistakes. These can involve school work, making friends, and trying new activities, which are all important parts of a healthy teenage life.

If the low self-esteem is not identified and treated, then it can lead to problems such as:

relationship troubles or difficulty making friends

- negative moods such as feeling sad, anxious, ashamed or angry

low motivation

poor body image

earlier sexual activity

drinking alcohol and/or taking drugs to feel better

What can cause low self-esteem?

How a person feels about themselves is a result of their experiences and how they deal with situations. The most common causes of low self-esteem in teenagers are:

unsupportive parents, carers or others that play an influential role in their life

friends who are bad influences

stressful life events such as divorce or moving houses

trauma or abuse

poor performance at school or unrealistic goals

mood disorders such as depression

bullying or loneliness

ongoing medical issues

Signs of low self-esteem

A child with low self-esteem will more than likely be having negative thoughts about their worth and value as a person. Some general signs that your child has low self-esteem include:

avoiding new things and not taking up opportunities

feeling unloved and unwanted

blaming others for their own mistakes

- not being able to deal with normal levels of frustration

- negative self-talk and comparisons to others

fear of failure or embarrassment

difficulty making friends

low levels of motivation and interest

can't take compliments and shows mixed feelings of anxiety or stress.

There are things you can do to support your child to have positive self-esteem, but it's also important to remember that teenage self-esteem develops and changes quite frequently overtime. If your child doesn't show signs of positive self-esteem immediately, it doesn't necessarily mean you're doing something wrong!

You can help your child develop positive self-esteem with tips here.

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Self-esteem and teenagers - ReachOut Parents

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While it can be normal for a teenager to lack confidence at times, people with self-esteem issues normally view themselves differently to how others view them. Low self-esteem can be particularly hard for young people especially when they're doing things like starting high school or work, and forming new friendships and relationships.

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Adolescent eating disorder statistics show that 2.7% of teens in the U.S. between 13 and 18 years old have an eating disorder.

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https://parents.au.reachout.com/common-concerns/everyday-issues/self-esteem-and-teenagers

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While it can be normal for a teenager to lack confidence at times, people with self-esteem issues normally view themselves differently to how others view them.

Low self-esteem can be particularly hard for young people especially when they're doing things like starting high school or work, and forming new friendships and relationships. Keep reading to understand self-esteem issues that may come up for your teenager and ways to help your child feel better about themselves and their capabilities.

This can help if you:

suspect your child is suffering from low self-esteem

want to learn how to build your child's self-esteem

would like to identify the causes of your child's low self-esteem.

Why your child's self-esteem is important

Positive self-esteem for teens is important as it allows them to try new things, take healthy risks and solve problems. In turn, their learning and development will be productive and will set them up for a healthy and positive future. A young person with healthy self-esteem is more likely to display positive behavioural characteristics, such as:

acting independent and mature

taking pride in their accomplishments/acheivements

accepting frustration and dealing with it responsibly

trying new things and challenges

helping others when possible

How can low self-esteem affect my child?

When someone has low self-esteem they tend to avoid situations where they think there's risk of failure, embarrassment or making mistakes. These can involve school work, making friends, and trying new activities, which are all important parts of a healthy teenage life.

If the low self-esteem is not identified and treated, then it can lead to problems such as:

relationship troubles or difficulty making friends

- negative moods such as feeling sad, anxious, ashamed or angry

low motivation

poor body image

earlier sexual activity

drinking alcohol and/or taking drugs to feel better

What can cause low self-esteem?

How a person feels about themselves is a result of their experiences and how they deal with situations. The most common causes of low self-esteem in teenagers are:

unsupportive parents, carers or others that play an influential role in their life

friends who are bad influences

stressful life events such as divorce or moving houses

trauma or abuse

poor performance at school or unrealistic goals

mood disorders such as depression

bullying or loneliness

ongoing medical issues

Signs of low self-esteem

A child with low self-esteem will more than likely be having negative thoughts about their worth and value as a person. Some general signs that your child has low self-esteem include:

avoiding new things and not taking up opportunities

feeling unloved and unwanted

blaming others for their own mistakes

- not being able to deal with normal levels of frustration

- negative self-talk and comparisons to others

fear of failure or embarrassment

difficulty making friends

low levels of motivation and interest

can't take compliments and shows mixed feelings of anxiety or stress.

There are things you can do to support your child to have positive self-esteem, but it's also important to remember that teenage self-esteem develops and changes quite frequently overtime. If your child doesn't show signs of positive self-esteem immediately, it doesn't necessarily mean you're doing something wrong!

You can help your child develop positive self-esteem with tips here.

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Self-esteem and teenagers - ReachOut Parents

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While it can be normal for a teenager to lack confidence at times, people with self-esteem issues normally view themselves differently to how others view them. Low self-esteem can be particularly hard for young people especially when they're doing things like starting high school or work, and forming new friendships and relationships.

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Teens do struggles with mental health because all kids aren't perfect. All people need to let some emotion out

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5% to 43% of girls and 14% to 43% of boys go through at least one trauma.

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How Common is PTSD in Children and Teens?

Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors.

What Events Cause PTSD in Children?

Children and teens could have PTSD if they have lived through an event that could have caused them or someone else to be killed or badly hurt. Such events include sexual or physical abuse or other violent crimes. Disasters such as floods, school shootings, car crashes, or fires might also cause PTSD. Other events that can cause PTSD are war, a friend's suicide, or seeing violence in the area they live.

Child protection services in the U.S. get around three million reports each year. This involves 5.5 million children. Of the reported cases, there is proof of abuse in about 30%. From these cases, we have an idea how often different types of abuse occur:

65% neglect

18% physical abuse

10% sexual abuse

7% psychological (mental) abuse

Also, three to ten million children witness family violence each year. Around 40% to 60% of those cases involve child physical abuse. (Note: It is thought that two-thirds of child abuse cases are not reported.)

What Are the Risk Factors for PTSD?

Three factors have been shown to raise the chances that children will get PTSD. These factors are:

How severe the trauma is

How the parents react to the trauma

How close or far away the child is from the trauma

Children and teens that go through the most severe traumas tend to have the highest levels of PTSD symptoms. The PTSD symptoms may be less severe if the child has more family support and if the parents are less upset by the trauma. Lastly, children and teens who are farther away from the event report less distress.

Other factors can also affect PTSD. Events that involve people hurting other people, such as rape and assault, are more likely to result in PTSD than other types of traumas. Also, the more traumas a child goes through, the higher the risk of getting PTSD. Girls are more likely than boys to get PTSD. It is not clear whether a child's ethnic group may affect PTSD. Some research shows that minorities have higher levels of PTSD symptoms. Other research suggests this may be because minorities may go through more traumas.

Another question is whether a child's age at the time of the trauma has an effect on PTSD. Researchers think it may not be that the effects of trauma differ according to the child's age. Rather, it may be that PTSD looks different in children of different ages.

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Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors.

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50% mental health disorders are established by the age of 14, while 75% are established by age 24

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As children grow older, they will go through numerous changes. Their bodies will grow, and their minds will develop. However, as they reach adolescence, they will experience monumental developments, which change their entire life. Puberty and hormonal shifts often lead to many teenagers feeling insecure about their bodies and themselves. On top of these bodily changes, teenagers also face social changes, new emotions, and much more. Many teens struggle to maintain positive self-esteem and self-worth during these formative years.

While growing up and going through adolescence is hard for all teens in different ways, all parents, guardians, and those in leadership or mentor positions must do what they can to help these young people understand the importance of knowing one's worth. There is no better time than now to inspire young people and to help them create and maintain their own sense of self than National Teen Self-Esteem Month. Every May, we take the time to ensure our youth are aware of the importance of one's self-esteem and to combat self-worth and self-image issues teenagers face daily.

Lifework Counseling Center understands how difficult being a teenager can be. After all, not only do they have to deal with the changes in their bodies, but they are faced with changes to their social lives, new expectations, and more. Join us in celebrating National Teen Self-Esteem Month by helping young people understand their self-worth.

What is National Teen Self-Esteem Month?

Every May, we celebrate National Teen Self-Esteem Month. Sponsored by I Am Worth More, a nonprofit organization that helps teens find resources and presents them with positive entertainment, May is a time to combat the self-worth and self-image issues that plague all teenagers across the country.

National Teen Self-Esteem Month is a time where teens, parents, and teachers across the country come together to focus on supporting teens by providing them with a space to voice their needs and concerns, building a positive outlook of themselves, and ensuring they are self-aware and confident.

A teen's self-esteem can impact their physical and mental health dramatically, so you must support it. Self-esteem refers to an individual's confidence in themselves, their abilities, and their worth. It's often referred to as self-worth and self-respect. When a teen has little self-esteem, it can lead to serious mental health problems that plague them for the rest of their lives.

Along with their hormonal shifts and developing body, teens are faced with social changes, new relationships, increased academic and professional expectations, peer pressure, impossible standards pushed by media, and so much more. Millions of teenagers across the country suffer from low self-esteem.

Statistics to Know

As we said earlier, when a child's self-esteem is low, it can affect their physical and mental wellbeing. Many teenagers with low self-esteem believe that they are unlovable, undesirable, worthless, and more. As you can imagine, this can affect a child's mental health considerably, which, in turn, impacts their physical health.

To highlight the importance of National Teen Self-Esteem Month, we have compiled a list of statistics that shed light on the issues plaguing teens self-worth:

Nearly 20% of teens experience depression before they reach adulthood

Only 30% of teens receive treatment for their depression

75% of girls with low self-esteem admitted to engaging in self-destructive behaviors, such as cutting, bullying, drinking, smoking, and eating disorders

Seven out of ten girls believed that they were not good enough or did not measure up to others, whether in looks, relationships, or academic performance

Suicide is the third leading cause of death among young people ages 15-24

Over 5% of teenagers reported substance abuse or alcohol use

40% of teenage boys reported exercising regularly to increase muscle mass

38% of teenage boys reported using protein supplements, and 6% admitted to steroid use to improve their physique

50% mental health disorders are established by the age of 14, while 75% are established by age 24

A teen commits suicide every 100 minutes

As you can see, low self-esteem can lead to drastic effects that not only affect a child's mental health but their physical health, as well. Teenagers will go to great lengths to improve their looks if they feel that they do not match up to their peers. This shows why National Teen Self-Esteem is so significant. It provides teens, parents, and teachers a chance to combat self-worth issues teens face daily.

How You Can Help

National Teen Self-Esteem Month provides everyone an opportunity to help support teens, their self-esteem, and their mental health. There is a handful of fun and positive activities held throughout the month that can help boost a teen's self-esteem. You can help by:

Writing a positive note to a teen you know. If you have a teen family member or friend, write them a heartfelt note full of words of support and affirmation, letting them know why they are loved.

Take the "I Am Worth More" social media challenge. Every day throughout May, encourage teens to write something about themselves that they love on their social media accounts.

Share ideas. There are plenty of ways teens can boost their self-esteem. Encourage them to eat healthy, , accept themselves, practice self-love, and love those around them.

Ensure you offer open lines of communication. Many teens feel that they cannot talk to their parents or peers and share how they feel. Make sure that you offer teens a chance to communicate and share how they feel and think.

Lead by example. Teens still follow by example, so they are always watching their parents, teachers, and other mentors for guidance. Avoid negative self-talk. Be mindful of the criticisms you give yourself and the others around you. Your teen is always listening, whether you think they are or not.

Join Lifeworks Counseling Center throughout May in celebrating National Teen Self-Esteem Month by teaching teenagers the importance of knowing one's self-worth while combating the problems that teens face daily. If your teen is suffering from low self-esteem or other mental health disorders, do not hesitate to contact Lifeworks today.

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May is National Teen Self-Esteem Month | Lifeworks Counseling Center

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As children grow older, they will go through numerous changes. Their bodies will grow, and their minds will develop. However, as they reach adolescence, they will experience monumental developments, which change their entire life. Puberty and hormonal shifts often lead to many teenagers feeling insecure about their bodies and themselves.

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To promote self-improvement in your teen, help them identify their strengths as well as their weaknesses. Then engage them in goal setting and problem solving so they can work toward improving in areas where they struggle. Make sure the goals they set are attainable and within their control and then map out a plan on how they are going to achieve those goals.

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Kids who seemed confident throughout childhood may struggle to maintain self-assurance during the teen years. For many, adolescence is filled with self-doubt, a questionable body image, and insecurity.

The good news is, you can take steps to help your teen build self-esteem. Here are eight strategies that will instill life-long confidence in your teen.

Promote Self-Improvement

Teens who struggle to master a skill may conclude they're complete failures. A teen who has difficulty with math may decide they're not smart. Or a teen who fails to make the soccer team may decide they'll never be good at sports.

Show your teen that it's possible to accept flaws while also striving to become better. There is a healthy balance between self-acceptance and self-improvement. Rather than label themselves as "stupid," help your teen see that while they're struggling academically, they can still strive to become better.﻿﻿

Praise Effort Instead of Outcome

Rather than praise your teen for getting a good grade on an exam, praise them for all the studying they did. Instead of saying, "Great job scoring those five points in the game," say, "All that practicing you've been doing has been paying off." Show them that it's important to try hard and it's OK if they don't succeed all the time.﻿﻿

Teach Assertiveness Skills

Teens need to know how to speak up for themselves in an appropriate manner.﻿﻿ An assertive teen will be able to ask for help when they don't understand school work, rather than allow themselves to fall behind.

A teen who can speak up is also less likely to be treated poorly by peers. They'll speak up for themselves when they don't like how they're being treated, and they'll be able to ask for what they need in a direct manner.

Encourage Your Teen to Explore New Opportunities

Trying new activities, discovering hidden talents, and challenging themselves can help grow teens' confidence. But many teens are afraid of failure and don't want to embarrass themselves.

Encourage your teen to join a new club, play a musical instrument, engage in volunteer work, or find a part-time job. Mastering new skills will help them feel better about themselves.

Model Confidence

Your teen will learn the most about confidence based on what you do-not what you say. If you're guilty of making critical statements about your body or your abilities, you'll teach your child to do the same.

Role model how to face new situations with courage and confidence and demonstrate the importance of loving yourself.﻿﻿ Talk to your teen about times when you've been brave or things you've done in your life to help build your confidence.

Build Self-Worth on a Healthy Foundation

If your teen only feels good when they get a certain amount of likes on social media or when fit into a certain size pair of pants, they'll struggle to maintain confidence when situations don't suit their needs. Basing self-worth on superficial things, external circumstances, or other people leads to a lack of confidence in the long run.

Help your teen build a healthy and stable foundation for self-worth. Emphasize your values and teach that true self-worth is about living according to those values. For example, help them see that it's more important to be kind and caring rather than thin or attractive.﻿﻿

Balance Freedom with Guidance

Micromanaging your teen's choices will only reinforce that they can't be trusted to make good decisions independently. It's important to balance just the right amount of freedom with plenty of guidance.

Provide your teen with plenty of opportunities to practice the skills you've taught. Let them experience natural consequences and they'll learn from their own mistakes. Over time, they'll develop increased confidence in their ability to make healthy choices.

Help Develop Positive Self-Talk

Your teen's inner monologue will play a major role in how they feels about themselves. If they are always thinking things like, "I'm so ugly," or "No one likes me," they're bound to feel bad about themselves.

Teach your teen to develop healthy self-talk. Point out how many thoughts aren't true and help them see how being overly harsh can be detrimental. Teach her to reframe irrational thoughts like, "I'm going to fail because I'm stupid," with something more realistic like, "I can pass math class if I work hard."

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How Parents Can Help Their Teen Build Self-Confidence

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Kids who seemed confident throughout childhood may struggle to maintain self-assurance during the teen years. For many, adolescence is filled with self-doubt, a questionable body image, and insecurity. The good news is, you can take steps to help your teen build self-esteem. Here are eight strategies that will instill life-long confidence in your teen.

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1. Over 70% of girls age 15 to 17 avoid normal daily activities, such as attending school, when they feel bad about their looks. Brighten someone’s day by posting encouraging messages on your school’s bathroom mirrors. Sign up for Mirror Messages.[3]

https://www.dosomething.org/us/facts/11-facts-about-teens-and-self-esteem

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The majority of U.S. teens have self-esteem issues that will follow them into adulthood.

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In 2017, 13% of U.S. teens ages 12 to 17 (or 3.2 million) said they had experienced at least one major depressive episode in the past year, up from 8% (or 2 million) in 2007, according to a Pew Research Center analysis of data

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National Institute of Mental Health (NIMH)

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Being a teenager can be tough, but it shouldn't feel hopeless. If you have been feeling sad most of the time for a few weeks or longer and you're not able to concentrate or do the things you used to enjoy, talk to a trusted adult about depression.

Do I have depression?

Do you often feel sad, anxious, worthless, or even "empty"?

Have you lost interest in activities you used to enjoy?

Do you get easily frustrated, irritable, or angry?

Do you find yourself withdrawing from friends and family?

Are your grades dropping?

Have your eating or sleeping habits changed?

Have you experienced any fatigue or memory loss?

Have you thought about suicide or harming yourself?

Depression looks different for everyone. You might have many of the symptoms listed above or just a few.
How do I get help for depression?

Talk to a trusted adult (such as your parent or guardian, teacher, or school counselor) about how you've been feeling.

Ask your doctor about options for professional help. Depression can be treated with psychotherapy (also called "talk therapy"), medication, or a combination of medication and talk therapy.

Try to spend time with friends or family, even if you don't feel like you want to.

Stay active and exercise, even if it's just going for a walk. Physical activity releases chemicals, such as endorphins, in your brain that can help you feel better.

Try to keep a regular sleep schedule.

Eat healthy foods.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
NIMH Identification No. OM 22-4321

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The information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy the images in the publication. If you do use our materials, we request that you cite the National Institute of Mental Health. To learn more about using NIMH publications, refer to NIMH's reprint guidelines.

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Teen Depression: More Than Just Moodiness

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This fact sheet is intended for teens and young adults and presents information about how to recognize the symptoms of depression and how to get help.

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Adolescent eating disorder statistics show 2.7% of teens in the U.S. between 13 and 18 years old have an eating disorder

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Polaris Teen Center: Premier Adolescent Treatment Center in Los Angeles

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The adolescent and teenage years are a time of growth and transformation, physically, mentally and biologically. In moving towards adulthood, young people begin to discover who they are. Independent of parents, they begin to establish friendships and go through puberty. There are obvious physical changes associated with adolescence and puberty. But a large amount of internal change also occurs. Adolescent eating disorder statistics show 2.7% of teens in the U.S. between 13 and 18 years old have an eating disorder. For many teenagers, entering into puberty can be a time wrought with intense emotions, confusion, and stress. This period of change is what makes teens susceptible to developing eating disorders.

Adolescent eating disorders (such as anorexia, bulimia, binge eating disorder, and compulsive overeating) are concerns every parent hopes to avoid. Yet, because so many young people struggle with eating disorders, it is important to know the facts.

4% of adolescents and teens, ages 13 to 18, suffer from an anorexia, bulimia, or binge eating disorder.

Anorexia is a serious, life-threatening eating disorder affecting many teenagers. Those who suffer from anorexia go to extreme lengths to control their food intake. Or, worse, they avoid eating altogether. Additionally, those with anorexia also have a distorted body image. They still feel "fat," regardless of how thin they become.

Teenagers with bulimia typically binge (periods of uncontrollable overeating) and purge (self-induce vomiting). Inducing vomiting is the most common compensatory behavior. But there are others, such as laxatives or excessive exercise.

Binge-eating disorder is characterized by excessive eating. Many teens who suffer from binge-eating disorder describe feeling like they have no control over their behavior. They also experience intense guilt and shame following a binge.

50% of teens with anorexia will develop bulimia or binge-eating disorder

Anorexia is an eating disorder marked by significantly restricting caloric intake due to intense fear of weight gain. Teens with anorexia engage in some level of self-starvation. This extreme dietary restriction often leads to another eating disorder, such as bulimia or binge-eating disorder. Long periods of malnutrition take a toll on the body's systems and organs. This, along with experiencing hunger cues and pains, can eventually lead a teen to "giving in" to the desire for food. And like the extreme nature of the restricting, once a teenager begins to eat again, it can be extreme as well (such as binging).

90% of teens with anorexia are female

Anorexia most commonly emerges in the adolescent and teenage years. This eating disorder develops from a number of factors including, for some, the onset of dieting, converge. While dieting does not cause anorexia, the reduction in calories dieting entails often triggers the disorder. Especially in those who are genetically predisposed to it.

The average amount spent on eating disorder research per affected individual is .93¢

In comparison, $44 per affected individual is spent on autism research. Schizophrenia research spends $81 per affected individual. Lastly, $88 is spent on Alzheimer's disease research per affected individual.

Young women with anorexia are 12 times more likely to die than women the same age who do not have anorexia.

Anorexia nervosa is the third most common chronic illness among adolescent and teenage girls. Anorexia also has the highest mortality rate of any psychiatric disorder.

50% of teenage girls and 30% of teenage boys use unhealthy weight control behaviors.

Some of these behaviors include skipping meals, fasting, smoking cigarettes, purging (throwing up), taking laxatives, over-exercising, taking diet pills, hiding food, and drinking highly caffeinated energy drinks.

50% of teens with an eating disorder also suffer from depression

Depression may lead to eating disorders in teenagers, but in many cases, the eating disorder itself is what triggers depression. Malnourishment causes physiological changes in the brain that can affect emotion regulation and mood.

69% of females (ages 10 to 18) state that photographs of models and celebrities in the media motivated their "ideal" body shape.

The rate at which teens are becoming aware of their body shape and size is getting younger and younger, and media plays a big part in this. Many teenagers site media as being on of the biggest influencers when it comes to body image (how one perceives his or her body when looking in the mirror). In the United States, media and overall popular culture strongly idealize thinness, and adolescents and teens are amongst the population most strongly influenced, especially with the popularity of social media. Unfortunately, the substantial influence the media plays in teenagers lives leads many (even teens with a normal body weight), are still susceptible to viewing themselves as "overweight" or "fat". The importance placed on thinness in the media can create a desire to achieve the impossible in terms of body shape and size, and can obviously become a trigger to dieting and weight loss.

In this day and age, being concerned with weight and body size is incredibly common, especially amongst adolescent and teenaged girls. Adolescence is when bodies begin to change, and there is an increased awareness of media and peer pressures. Couple this with a lack of knowledge around nutrition, and many teenage girls are engaging in some very risky dietary behaviors as a way to cope with body dissatisfaction. Although all teenage girls are susceptible, there are certain risk factors that make some more likely to use dangerous diets including:

Family factors - low family connectedness, absent or neglectful parents, or dieting amongst parents can all contribute to increasing a teenage girl's risk of engaging in dieting behavior.

Environmental factors - poor school involvement, bullying/teasing by peers (especially around weight-related issues), or participation in a sport that is weight-focused will likely make a teen more prone to using diets.

Individual factors - being female alone increasing one's inclination towards dieting. Other individual factors include low self-esteem, early puberty, being overweight or obese, or practicing vegetarianism.

How many teen boys actually have eating disorders? Boys make up approximately 10 to 15% of the adolescent and teenage population with eating disorders, but are much less likely to seek treatment due to the gender stereotypes surrounding the disorders.

Many people believe that an eating disorder is a "female" problem. And while more common in girls and women, eating disorders do affect males as well. Because there is far more discussion about teenage girls and eating disorders, many teen boys are reluctant to discuss their symptoms or admit they have a problem. For some, there may be fear of appearing less masculine, or being judged by friends and peers. This unfortunately prevents many male teenagers from getting the help they need.

Involvement in certain athletic activities - such as bodybuilding, wrestling, swimming, and gymnastics all increase a teenage boy's chances of developing an eating disorder. This is because these are sports where weight control can influence performance, and coaches often encourage maintaining a certain weight range.

Sexual orientation - homosexual males or males questioning their sexual identity are at an increased risk of struggling with an eating disorder.

Being overweight - teenage boys who are currently overweight, or were overweight as children are more prone to eating disorders. This is especially true if a bullying and/or teasing is involved.

Parental dieting - parents model behaviors to their children, whether they intend to or not. Thus, teenage boys who see one or both parents using restrictive diets to lose weight may begin to practice similar behavior.

While it is possible for any boy to develop an eating disorder throughout his adolescent and teenage years, there are certain factors that increase one's likelihood including:

If you think your teen may be struggling with an eating disorder, contact Polaris Teen at (844) 836-0222 to find out more about residential treatment options for your son or daughter.

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10 Statistics of Teenage Eating Disorders

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Many young people struggle with eating disorders. If you think your teen falls into this category, discover how you can help support them. Read here

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Depression,social support, and body image causes low self esteem

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Abstract

Purpose: This research has been conducted in order to understand the major factors that affect self-esteem of adolescents.

Methods: Data was collected by questionnaires from 1155 students at middle and high school in Seoul and Kyungkido, Korea. The Instrument tools utilized in this study were self-esteem, body-image, problematic behavior, depression, school adjustment, social support tool and thoroughly modified to verify validity and reliability. The collected data have been analyzed using SPSS 11.0 program. The variable of family harmony and counseling partner was treated as a dummy variable. Seven outliers which were bigger than 3 in absolute value were found, so after taking them off, Multiple Regression was used for further analysis.

Result: The major factors that affect self-esteem of adolescents were depression, social support, body-image, problematic behavior, school adjustment, and family harmony, which explained 54.7% of self-esteem.

Conclusion: It has been confirmed that the regression equation model of this research may serve as a self-esteem prediction factors in adolescents.

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Protective effects of self-esteem and family support on suicide risk behaviors among at-risk adolescents.

Sharaf AY, Thompson EA, Walsh E. Sharaf AY, et al. J Child Adolesc Psychiatr Nurs. 2009 Aug;22(3):160-8. doi: 10.1111/j.1744-6171.2009.00194.x. J Child Adolesc Psychiatr Nurs. 2009. PMID: 19702970

[A Prediction Model of Factors related to Career Maturity in Korean High School Students].

Seo J, Kim M. Seo J, et al. Child Health Nurs Res. 2019 Apr;25(2):95-102. doi: 10.4094/chnr.2019.25.2.95. Epub 2019 Apr 30. Child Health Nurs Res. 2019. PMID: 35004402 Free PMC article. Korean.

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national center for biotechnology information

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[Influencing factors on self-esteem in adolescents] - PubMed

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Purpose: This research has been conducted in order to understand the major factors that affect self-esteem of adolescents. Methods: Data was collected by questionnaires from 1155 students at middle and high school in Seoul and Kyungkido, Korea. The Instrument tools utilized in this study were self-esteem, body-image, problematic behavior, depression, school adjustment, social support tool and thoroughly modified to verify validity and reliability.

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Someone with PTSD has been through or witnessed a traumatic event. They have symptoms that last long after the trauma is over

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What Is PTSD?

Posttraumatic stress disorder (PTSD) is a mental health condition brought on by a trauma.

Someone with PTSD has been through or witnessed a traumatic event. They have symptoms that last long after the trauma is over. These symptoms can be:

bad memories, called flashbacks, that make it seem like the trauma is still happening

bad dreams or trouble sleeping

avoiding things that remind them of the trauma

changes in mood, such as feeling sad, moody, angry, or detached

not enjoying things like before

feeling more easily scared, anxious, jumpy, sensitive, or startled

Therapy can help people recover from PTSD. They also need understanding, comfort, and support from people in their lives.

Not everyone who has been through a trauma will have PTSD. In fact, most won't. Most people find ways to cope and get past trauma. Therapy and support soon after a trauma can help.

What Is a Trauma?

A trauma is a stressful event that makes a person fear for their or other people's life or safety.

Trauma events that can lead to PTSD include:

physical or sexual abuse, or assault

school or neighborhood violence

natural disasters or fires

car accidents

military combat

sudden or forceful loss of a parent

arrests, evictions

being the target of hate, or threats of harm

An event can be a trauma for someone even if they don't go through the danger themselves. For example, seeing someone else be hurt or die from violence can be a trauma.

Hearing that someone close died by violence or suicide can be a trauma too. The grief can be intense with this type of loss. It is called traumatic grief.

Does Trauma Always Cause PTSD?

Traumas can lead to PTSD, but not always. Not everyone who has been through a trauma will have PTSD. In fact, most young people who go through trauma will not have PTSD.

But most will feel the effects of trauma. It's natural to react to a deeply stressful event. Most people will feel upset, have thoughts of the trauma, and other signs of distress. These may be called PTSD-like symptoms.

Most people do find ways to cope with what they've been through. Some will get past trauma quickly on their own. It helps to have extra comfort and support from people in their lives. Therapy can also help. As people cope and adjust, their symptoms get better.

PTSD develops when a trauma overwhelms a person's ability to cope. The deep stress of trauma keeps the brain's threat sensors too active. That makes it hard for the person to feel safe again. People with PTSD need extra help to move through the coping process. Therapy helps them do that.

Whether or not a person will have PTSD partly depends on:

how severe the trauma was, or how harmful

the help and support they get

if they have a lot of other stress in their life

if they have been through past trauma

if they have depression or anxiety

inherited risks like family history of depression and anxiety

After a trauma, a person may have PTSD-like symptoms that last for a short while, sometimes days or weeks. This may be called a stress reaction. Only if symptoms last longer than a month can it be diagnosed as PTSD.

How Is PTSD Treated?

PTSD doesn't usually go away on its own. Getting treatment and support can make all the difference.

Mental health providers (like psychologists, psychiatrists, and mental health counselors) have the experience to work with patients with PTSD. Treatment for PTSD can include therapy and/or medicines to help with anxiety, mood problems, and sleep issues.

Therapy for PTSD is called trauma-focused cognitive behavioral therapy (TF-CBT). This type of talk therapy uses talking and learning activities, guided by a mental health therapist. It can help anyone who has been through a trauma, not just people with PTSD. Getting therapy soon after a trauma helps them cope well.

PTSD therapy often includes:

cognitive processing therapy (CPT) activities: to help with thoughts and feelings about the trauma

prolonged exposure (PE) activities: to help someone lower anxiety and learn to safely face things they avoid after trauma

eye movement desensitization and reprocessing therapy (EMDR): combined cognitive therapy with directed eye movements to reduce the power and pain of the trauma. This helps the brain reprocess memory of the trauma. There are therapists who specialize in this type of trauma therapy.

Trauma therapists also guide parents on how to listen and show they understand. The support of caring adults helps young people open up, feel safe, and do well.

How Does Therapy Help?

Trauma therapy gives people a way to safely share their feelings, tell their story, and get support. In therapy, they learn coping and calming skills to help them deal with anxiety after a trauma. This makes it easier to talk about what they have been through.

In therapy, people learn how trauma can affect their thoughts, feelings, and actions. They learn ways to adjust some of the difficult thoughts about the trauma. They learn to let go of any guilt or shame about what happened.

Slowly, people learn to face things they used to avoid. Therapy helps them gain courage and confidence. They use their strengths to cope and move forward.

How Can I Help Myself?

If you have been through trauma, or think you might have PTSD, here are things you can do:

Confide in an adult you trust. Reach out to someone who will listen and care. It's OK if you need extra time and support for a while. Pay it forward by being kind or helpful to someone else. Helping makes the helper feel good too.

Get treatment for PTSD or trauma. This can help you cope with what you have been through. It can help you discover strengths you never knew you had. Your parent, doctor, or school counselor can help you find the right person to work with.

Practice ways to relax. Make time every day to take a few slow breaths. If you can, make the exhale just a bit longer than the inhale. Try this: Breathe in while you count to 3. Breathe out while you count to 5. Take 3-4 breaths like this. It seems so simple. But it has a powerful benefit. It helps to reset the brain's threat sensor. The benefit adds up, so practice it often.

Do things that you enjoy. Trauma can make it harder to feel the positive emotions that naturally help you recharge. Play, laugh, enjoy nature, make music or art, cook. These activities can reduce stress, build your resilience. They even help you be a better learner when it's time to focus.

Know that you can do this. Believe in yourself. Everyone has the ability to adapt and grow, even with difficult challenges. It takes patience and effort. And there are people who will help you.

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Sometimes after experiencing a traumatic event, a person has a strong and lingering reaction known as posttraumatic stress disorder (PTSD). Getting treatment and support can make all the difference.

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Teenage girls have a lower self-esteem in their teenage years mainly attributed to social media.

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Girls Have Much Lower Self-Esteem During Their Teen Years, According To New Study

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Girl’s and boy’s mental wellness was pretty similar through primary school and it wasn’t until 14 that there started to be marked differences.

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Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma.

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How Common is PTSD in Children and Teens?

Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors.

What Events Cause PTSD in Children?

Children and teens could have PTSD if they have lived through an event that could have caused them or someone else to be killed or badly hurt. Such events include sexual or physical abuse or other violent crimes. Disasters such as floods, school shootings, car crashes, or fires might also cause PTSD. Other events that can cause PTSD are war, a friend's suicide, or seeing violence in the area they live.

Child protection services in the U.S. get around three million reports each year. This involves 5.5 million children. Of the reported cases, there is proof of abuse in about 30%. From these cases, we have an idea how often different types of abuse occur:

65% neglect

18% physical abuse

10% sexual abuse

7% psychological (mental) abuse

Also, three to ten million children witness family violence each year. Around 40% to 60% of those cases involve child physical abuse. (Note: It is thought that two-thirds of child abuse cases are not reported.)

What Are the Risk Factors for PTSD?

Three factors have been shown to raise the chances that children will get PTSD. These factors are:

How severe the trauma is

How the parents react to the trauma

How close or far away the child is from the trauma

Children and teens that go through the most severe traumas tend to have the highest levels of PTSD symptoms. The PTSD symptoms may be less severe if the child has more family support and if the parents are less upset by the trauma. Lastly, children and teens who are farther away from the event report less distress.

Other factors can also affect PTSD. Events that involve people hurting other people, such as rape and assault, are more likely to result in PTSD than other types of traumas. Also, the more traumas a child goes through, the higher the risk of getting PTSD. Girls are more likely than boys to get PTSD. It is not clear whether a child's ethnic group may affect PTSD. Some research shows that minorities have higher levels of PTSD symptoms. Other research suggests this may be because minorities may go through more traumas.

Another question is whether a child's age at the time of the trauma has an effect on PTSD. Researchers think it may not be that the effects of trauma differ according to the child's age. Rather, it may be that PTSD looks different in children of different ages.

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Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors.

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At any given point in time between 0.3-0.4% of young women and 0.1% of young men will suffer from anorexia nervosa

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In the United States, as many as 10 in 100 young women suffer from an eating disorder. Disordered eating related to stress, poor nutritional habits, and food fads are relatively common problems for youth. In addition, two psychiatric eating disorders, anorexia nervosa and bulimia, are on the increase among teenage girls and young women and often run in families. These two eating disorders also occur in boys, but less often.

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Eating Disorders in Teens

In the United States, as many as 10 in 100 young women suffer from an eating disorder. Disordered eating related to stress, poor nutritional habits, and food fads are relatively common problems for youth. In addition, two psychiatric eating disorders, anorexia nervosa and bulimia, are on the increase among teenage girls and young women and often run in families. These two eating disorders also occur in boys, but less often.

Parents frequently wonder how to identify symptoms of anorexia nervosa and bulimia. These disorders are characterized by a preoccupation with food and a distortion of body image. Unfortunately, many teenagers hide these serious and sometimes fatal disorders from their families and friends.

Symptoms and warning signs of anorexia nervosa and bulimia include the following:

A teenager with anorexia nervosa is typically female, and a perfectionist and a high achiever in school. At the same time, she suffers from low self-esteem, irrationally believing she is fat regardless of how thin she becomes. Desperately needing a feeling of mastery over her life, the teenager with anorexia nervosa experiences a sense of control only when she says "no" to the normal food demands of her body. In a relentless pursuit to be thin, the girl starves herself. This often reaches the point of serious damage to the body, and in a small number of cases may lead to death.

The symptoms of bulimia are usually different from those of anorexia nervosa. The patient binges on large quantities of high-caloric food and/or purges her body of dreaded calories by self-induced vomiting, extreme exercise, or laxatives. The binges may alternate with severe diets, resulting in dramatic weight fluctuations. Teenagers may try to hide the signs of throwing up by runing water while spending long periods of time in the bathroom. Frequent vomiting can cause a serious threat to the patient's physical health, including dehydration, hormonal imbalance, the depletion of important minerals, and damage to vital organs.

Binge eating can also occur on its own without the purging of bulimia and can lead to eventual purging. Children with binge eating disorder also require treatment from a mental health professional.

Avoidant/Restrictive Food Intake Disorder (or ARFID) is another eating disorder which can occur in younger children or adolescents. It involves a disturbance in eating or feeding which includes substantial weight loss or a lack of expected weight gain, and nutritional deficiencies. ARFID can lead to dependence on a feeding tube or dietary supplements.

With comprehensive treatment, most children and teenagers can recover from disordered eating. The child and adolescent psychiatrist is trained to evaluate, diagnose, and treat these psychiatric disorders. Treatment for eating disorders usually requires a team approach, including individual therapy, family therapy, working with a primary care physician, working with a nutritionist, and medication. Many children and adolescents also suffer from other problems including depression, anxiety, and substance abuse. It is important to recognize and get appropriate treatment for these problems as well.

Research shows that early identification and treatment leads to more favorable outcomes. Parents who notice symptoms of anorexia or bulimia in their teenagers should ask their family physician or pediatrician for a referral to a child and adolescent psychiatrist.

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medical issues affecting youth mental health

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Eating Disorders in Teens In the United States, as many as 10 in 100 young women suffer from an eating disorder. Disordered eating related to stress, poor nutritional habits, and food fads are relatively common problems for youth.

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Students with low self-esteem were detected at a prevalence of 19.4%

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Dat Tan Nguyen 1*,

E. Pamela Wright ²,

Christine Dedding 3†,

Tam Thi Pham ¹ and

Joske Bunders ³

Faculty of Public Health - Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam

Guelph International Health Consulting, Amsterdam, Netherlands

VU University Athena Institute, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands

Background: There is a correlation between self-esteem in adolescents and risks and protective factors for their health and welfare. The study was conducted to determine the prevalence of low self-esteem and sociodemographic features related to anxiety, depression, educational stress, and suicidal ideation in secondary school students in Vietnam.

Methods: A cross-sectional design was employed for this study with participation of 1,149 students in Cantho City in Vietnam. A structured questionnaire was applied to ask about self-esteem, depression, anxiety, educational stress, and suicidal ideation.

Results: Students with low self-esteem were detected at a prevalence of 19.4%. High educational stress and physical and emotional abuse by parents or other adults in the household were major risk factors correlated to low self-esteem, while a protective factor for low self-esteem was attending supplementary classes. An association among lower self-esteem and increased anxiety, depression, and suicidal ideation was detected.

Conclusions: Self-esteem is associated with anxiety, depression, and academic stress, which significantly affect students' quality of life and links to suicidal ideation. These results therefore suggested the need for a school-based or web-based provision aimed at proactively increasing students' self-esteem and skills for dealing with academic stress.

Introduction

It is well recognised that adolescence is one of the most rapid phases of human development ( 1). It is characterised by a rapid physical, social, and cognitive growth, as well as changes in self-esteem. Self-esteem is reported to have a significant impact on important life outcomes including health and social outcomes during adolescence and adulthood. For example, there is a clear connection between higher self-esteem and positive outcomes, such as occupational success, better social relationships, a sense of well-being, and positive perceptions by peers, academic achievement, and good coping skills ( 2, 3). Low self-esteem is causally related to depression, substance abuse, antisocial behaviour, and suicide ( 4- 6). The literature demonstrates that social functioning, such as acceptance by peers, is lower in children with low self-esteem ( 7).

Extensive research has explored risk and protective factors related to low self-esteem development during adolescence. Reported risk factors include being a girl ( 6, 8, 9), the family's low socioeconomic status ( 10), parents' education level, family eligibility for public assistance, eligibility for free or reduced-cost school meals, the parents' employment status ( 11), and school performance and grades ( 6, 12), as well as obesity ( 13).

Academic achievement is known to be affected by self-esteem, while self-esteem may also influence academic achievement ( 7). High self-esteem is reported as an important predictive factor for students' academic achievement ( 14). Another study found that while high self-esteem resulted in many positive outcomes and benefits, it did not necessarily lead to good school performance ( 15). On the other hand, adolescents with poor academic results did not always have low general self-esteem ( 16).

There is an association between low self-esteem and negative outcomes for young people's behavioural and mental health problems, including health-compromising behaviours such as substance abuse, early sexual activity, and eating problems ( 17). A longitudinal study among a large sample of young New Zealanders found, however, that while low self-esteem significantly predicted adolescent eating and other health-compromising behaviours, it was not related to substance abuse and early sexual activity ( 18). With regard to mental health, a correlation has been detected between low self-esteem and depression ( 19, 20), anxiety ( 10, 21), and adolescents' suicidal ideation and attempts ( 18, 22).

Reports during the past few years indicate that there is a strong relationship between academic pressure and stress, depression, anxiety, low self-esteem, and suicidal ideation among students in secondary or high school and in young adults ( 23- 25). A study describing perceptions about mental illness in Hue in Vietnam noted that "studying or thinking too much" is a cause of mental health problems ( 26). In Vietnamese culture, the pressure from parents and schools might be expected to have an unintended effect, leading to lower self-esteem and associated outcomes seen elsewhere among high school students. There are as yet no reports of systematic studies on this issue in Vietnam, and there are few reports of descriptive or analytical research into adolescent self-esteem.

This is particularly relevant since we found high levels of depression, anxiety, and suicidal ideation among secondary school students in Vietnam [Nguyen, D. T., Dedding, C., Pham, T. T., Wright, P., & Bunders, J. ( 25)]. This article reports on a study that aimed to determine (1) the prevalence of low self-esteem; (2) the characteristics associated with low self-esteem; and (3) the relationships among self-esteem and anxiety, depression, educational stress, and suicidal ideation in secondary school students. We hypothesised that low self-esteem would be associated with a greater risk of poor mental health status.

Materials and Methods

Study Design and Participants

A cross-sectional study design was used to recruit 1,260 students at three secondary schools in urban and suburban areas in Cantho City in Vietnam. All data were collected during the first academic semester, from September to December 2011. A more detailed description of the sampling and its participants can be found elsewhere ( 25).

Measures

All participants were invited to provide information by self-reporting using a questionnaire. This was done after class or at home anonymously to minimise potential reporting bias and to keep information confidential. The detailed components of the questionnaire have been described elsewhere ( 25).

The 10-item Rosenberg Self-esteem Scale ( 21, 27) was used to assess global self-esteem, with higher scores indicating more positive self-regard. Each item asked for response using a 4-point Likert scale ranging from 1 (strongly agree) to 4 (strongly disagree). The scale is generally reliable, with test-retest correlations value between 0.82 and 0.88 ( 21). The Cronbach α of the scale in the present study was 0.77. The scale ranges from 0 to 30: a score greater than 25 suggests high self-esteem; scores between 15 and 25 are considered to be within normal range, whereas scores less than 15 suggest low self-esteem (Morris Rosenberg).

A more detailed method description on employing the Center for Epidemiology Studies Depression (CES-D), the anxiety scale, and the Educational Stress Scale for Adolescents for this study is available ( 25).

To address the issue of suicidal ideation, additional questions on whether the student had ever seriously considered suicide or made a suicide plan used a 3-point scale (never, sometimes, and often). A yes/no question was also used to identify students who had attempted suicide.

To define risks and protective factors, we explore the variables listed in Table 1, including mother's education, physical and emotional abuse by parents or other adults in the household or school, academic performance in the last semester, educational stress, attendance at a supplementary class, and use of personal tutor. The data collected using the questionnaire is available in the Supplementary Data File.

Table 1 Frequencies and percentages (%) of sociodemographic variables of participants by self-esteem status.

Data Analysis

Demographic data were analysed descriptively to determine basic characteristics of the sample population and presented as means ± standard deviations (SD). The χ ² test was used to assess the significance of differences in the distribution of participants by selected sociodemographic characteristics, risk factors, and outcome variables. Associations between low self-esteem and family characteristics, educational stress, and academic achievement were explored by logistic regression analysis. Univariate independent predictors of low self-esteem with p < 0.10 were entered in a multivariate logistic regression model, and the backward Wald method was applied to study their influence on the presence of low self-esteem. Univariate logistical analyses were also applied to determine the relationships among low self-esteem and anxiety, depression, and suicidal ideation, and Pearson correlation coefficients were used to measure the correlations among these. All analyses were carried out using a significance level of 5%, and all tests were 2-sided. The 95% confidence intervals (CIs) of odds ratios (ORs) were also calculated. All analyses were analysed by using SPSS Inc, Chicago, the United States of America version 16.0.

Results

Demographics

Of the 1,260 students invited to participate, 111 (7.3%) were excluded from analysis because they did not adequately complete the questionnaire; for example, they did not provide answers to five or more items in the CES-D. The final sample comprised 1,149 senior high school students with a mean age of 16.1 years. Participating students were fairly evenly distributed in terms of sex: 36.5% males and 63.5% females ( Table 1). This proportion also reflects the proportion of males and females enrolled in the classes studied. Students' participation from each grade (10-12) did not significantly differ, at around 33% each. Ninety-five percent of students were ethnically Kinh; other ethnic groups included Hoa and Khmer. This sample was in line with the school population in this area.

Prevalence of Low Self-Esteem and Characteristics Associated With Self-Esteem

The mean self-esteem score was 17.56 on a scale of 0 to 30. The scores for boys and girls were similar (17.83 vs. 17.40; t = 1.720; p = 0.086). Based on all scores, nearly a fifth (19.4%) of the respondents reported low self-esteem according to Rosenberg's criteria, with scores below 15 ( Table 1). Based on univariate logistic regression analysis, among six investigated variables, two variables "having a personal tutor" and "attendance at supplementary class" were negatively associated with the risk of low self-esteem, while the other variables were positively correlated to low self-esteem ( Table 2). Students were likely to show lower self-esteem, when their mother's education was at primary level or below, when they were often physically or emotionally abused at home or at school, when they had below average/very poor academic performance in the last semester, or when they reported experiencing high educational stress.

Table 2 Factors associated with low self-esteem: multivariate logistic regression analyses.

In the multivariate regression analysis (with the backward Wald method), not accounting for effect modification, four variables remained correlated to low self-esteem, either in a negative or positive direction. Having a personal tutor and academic performance in the last semester were no longer a significant association, but attending supplementary classes still remained a protective factor for low self-esteem (reduced OR of 43% compared with students not attending) ( Table 2).Study results that were considerably positively associated to low self-esteem were medium and high educational stress (ORs = 2.25 and 4.02, respectively).

Relationships Between Self-Esteem and Anxiety, Depression, and Educational Stress, and Suicidal Ideation

As shown in Table 3, four variables-self-esteem, anxiety, depression, and educational stress-were related to each other. Self-esteem was negatively correlated to anxiety, depression, and educational stress, while educational stress was positively correlated to anxiety and depression.

Table 3 Pearson correlations between self-esteem, anxiety, depression, and educational stress.

One of the purposes of the study was to identify the impact of self-esteem on mental health problems. The results of univariate logistics indicate that low self-esteem contributed significantly to anxiety, depression, and suicide among adolescents. Compared to students who reported normal self-esteem, the students who reported low self-esteem had twice the odds of having anxiety symptoms [20.3% (187/921) vs. 34.2% (76/222)] (OR = 2.04; 95% CI OR = 1.48-2.82, p < 0.001), nearly six times the odds of being at risk of depression (CES-D score of ≥16) (74.0% vs. 33.2%), (OR = 5.72; 95% CI OR = 4.11-7.59), four times the odds of having depressive symptoms (CES-D scores of > 21) (50.7% vs. 19.8%) (OR = 4.16; 95% CI OR = 3.06-5.66), and nearly five times the odds of having depression (CES-D score of > 25) (41.7% vs. 13.0%), (OR = 4.79; 95% CI OR = 3.45 - 6.65). Students with low self-esteem also were significantly more likely to have considered or attempted suicide ( Table 4).

Table 4 Associations between self-esteem and suicidal ideation.

Discussion

We investigated the prevalence of low self-esteem among secondary school students, the characteristics associated with low self-esteem, and the relationships among self-esteem and anxiety, depression, and suicide. Nearly 20% of the students had low self-esteem, with no difference between girls and boys. These results are in line with some previous studies ( 12, 28), but inconsistent with others ( 6, 12). Cultural and social differences in the study populations could explain some of the differences.

Reasons for Having a Higher Prevalence of Low Self-Esteem Among Females

The results of this study cannot provide precise reasons for the higher prevalence of lower self-esteem among females; however, a number of possible causes for the gender differences are worth discussing. Although gender equality has improved in recent years in Vietnam and is clearly legislated, gender issues within the family and society remain a challenge for most Vietnamese, who are strongly influenced by traditional culture and custom ( 29). There is an association between female gender and emotionally unstable personality ( 30, 31). As a result, women are more prone to develop emotionally unstable personality (e.g. borderline personality) ( 32). Thus, females' self-esteem may be more likely to fluctuate, depending on how they themselves or others, especially their parents, evaluate their achievements.

A high prevalence of low self-esteem among the secondary school students should be considered as an important mental health problem not only by parents, school teachers, and principals but also by policy makers in the education and health sectors in Vietnam. In fact, health care related to psychological disorders has not received adequate consideration yet in Vietnam ( 33). Therefore, it is important to take mental health care into account when developing a policy framework to improve general school health services, such as directive no. 23/2006/CT-TTg on having well-equipped and professionally qualified health officers in schools ( 34), and Decision No. 401/2009/QD-TTg, which approved the program "Preventing and combatting diseases in educational establishments belonging to the national education system" ( 35).

Our results confirm the findings of previous studies ( 6, 10, 25, 36), namely, that family characteristics, including mother's low educational level and physical and emotional abuse by parents or other adults in the household, were associated with low levels of self-esteem. In addition, educational characteristics such as the school environment, academic performance, and high educational stress were strongly associated with self-esteem. These findings are consistent with results of other studies, for example, by Pullmann & Allik ( 16), which found that parents have a great deal of influence on their children's psychological development, including on the relationships outside the family environment ( 6, 10). Students who attended one or more supplementary classes appeared to be at lower risk of having poor self-esteem. In Vietnam, these students are usually from a family with a higher socioeconomic status. Attending supplementary class may reduce the stress of workload and academic pressure for those students. It would be useful to confirm this with further studies in the Vietnamese context, but this kind of support is unlikely to be available to families who cannot pay for it.

Low self-esteem in the adolescents in Cantho City was associated with poor academic performance. Aryana ( 14) reported that high self-esteem among preuniversity students was an important factor in predicting high academic achievement. Our finding also highlights that self-esteem plays an important role in predicting academic achievement, although a cross-sectional study design is unable to demonstrate causality; a prospective study to identify causality of the low self-esteem would be appropriate in future research.

With regard to mental health, the results of Pearson correlation analysis showed that self-esteem was negatively correlated to anxiety, depression, and educational stress, while the results of univariate logistic regression illustrated that low self-esteem contributed to a high risk of anxiety, depression, and suicidal ideation. These results are comparable to others showing that low self-esteem was associated with depression ( 19, 20, 37) and identifying a relationship between self-esteem and anxiety ( 10, 21), as well as a relationship between low self-esteem and suicidal ideation and suicide attempts among adolescents ( 18, 22). Screening for low self-esteem in adolescents is a possible strategy to help identify secondary school students at risk of anxiety, depression, and suicide. In addition, our previous study ( 25) showed an association between mental health problems and academic pressure, resulting from an overloaded curriculum and pressure from teachers and parents to succeed. There is clearly a need to reduce mental health problems among today's secondary school students in Vietnam. The development of a website to provide psychoeducation designed to meet the needs of young Vietnamese and of school-based counselling services for students, possibly by collaborating with volunteers from the Youth Union, the largest sociopolitical Vietnamese youth organization, at local universities, teachers, and parents, will be explored as one of the solutions ( 36). Around 66.3% of young Vietnamese downloaded the mobile health applications for disease prevention ( 38). Nevertheless, one of the challenges to using a digital health intervention is that young Vietnamese with a higher perceived stress level were significantly less likely to use such interventions ( 39).

Study Limitations

One limitation of this study relates to the sample and its generalizability. Although the distribution of girls and boys reflected the true/current situation in the classes selected, the sample was from only three schools in urban and suburban Cantho. Another limitation concerns the study design, which specified collection of data from adolescents by self-reporting using standardised questionnaires. The respondents' personality and identity development are still incomplete, which could result in fluctuating self-perceptions ( 9) and thus unreliable reporting. Also, the exploration of potential causes of low self-esteem as self-reported by subjects was not included in the survey. Another limitation is that the cross-sectional study design does not permit detection of links between covariates; longitudinal studies on this topic are still needed. Finally, the self-esteem, anxiety, and CES-D scales, like other screening instruments, cannot be viewed as diagnostic tools, but only as screening tests to identify members of groups at risk for these conditions. The results tell us how the students perceive their health but are not in themselves evidence of medical concerns. Moreover, there is no assessment of stress coping and stress levels, obesity ( 40), and chronic medical illness (e.g. asthma) ( 41), which may confound and influence anxiety, depression, and suicidal ideations. Finally, in a cross-sectional study, the cause-effect relationship cannot be measured; that requires a longitudinal cohort or a randomised controlled study.

Conclusions

Our research suggested that self-esteem is correlated to anxiety, depression, and academic stress, which significantly affects students' quality of life and is linked to suicidal ideation. The results therefore suggest the need for a school-based or web-based provision of information or services aimed at proactively increasing students' self-esteem and skills for dealing with academic stress.

Ethics Statement

The study was approved by the Scientific and Training Committees of Cantho University of Medicine and Pharmacy. Written informed consent for participation was obtained from students' parents or legal guardians before data collection.

Author Contributions

A first draft of the manuscript was prepared by DN under the guidance of CD. All authors contributed to the final manuscript version. DN, JB, and CD jointly generated the research idea and the study design. DN, CD, TP, and EW contributed to the survey tools. DN and TP coordinated the surveys and data collection in the field. DN, TP, CD, and EW carried out data analysis.

Funding

The study has been supported by a scholarship from the "Strengthening teaching and research capacity of preventive medicine staffs to meet the challenges of emerging infections and new environmental hazards to health" Project, collaboration between Hanoi University, NUFFIC, and the Dutch Government.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

Special thanks to all the students who participated in the study. We would also like to thank Hanoi University of Medicine and Cantho University of Medicine and Pharmacy as the Coordinating Board of the project in Vietnam and Professor Pham Van Linh, Rector of Cantho University of Medicine and Pharmacy, for their kind support for this work. Our appreciation also goes to Professor Wim Brandsma and Professor Wim van Brakel for their kind advice on the data analysis.

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyt.2019.00698/full#supplementary-material

References

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Low Self-Esteem and Its Association With Anxiety, Depression, and Suicidal Ideation in Vietnamese Secondary School Students: A Cross-Sectional Study

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Background: There is a correlation between self-esteem in adolescents and risks and protective factors for their health and welfare. The study was conducted to determine the prevalence of low self-esteem and sociodemographic features related to anxiety, depression, educational stress, and suicidal ideation in secondary school students in Vietnam.Methods: A cross-sectional design was employed for this study with participation of 1,149 students in Cantho City in Vietnam.

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In 2016, 3.2% of children had diagnosed depression.

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Your teen years are full of significant changes. Physically, mentally, and socially - your brain, body, and environment are going through a major evolution.

You might feel bogged down from the demands of high school and college assignments piling up. Or you may feel sadness about transitioning to a more independent and unfamiliar life. Throw in a worldwide pandemic, and it's no surprise that uneasy feelings are on the rise, as shown by recent teen depression statistics and research.

These changes can easily become overwhelming. Understandably, you might shut down, become irritable, or lose interest in the activities that previously made you light up.

While these responses are valid and usual, depression is a condition that's much more serious than fleeting teen moodiness.

If negative emotions are keeping keep you from functioning like you usually do, or you've experienced a sense of hopelessness for more than 2 weeks, you might want to consider treatment for depression.

1. It's more common than you might think

Everyone goes through a rough patch or feels listless on occasion. But major depression is a leading cause of disability in the United States, and teens are becoming the most likely group to screen for symptoms of this mental health condition.

Data shows that depression affects high numbers of young people:

Data from the 2016 National Survey of Children's Health showed that 3.2% of children ages 3 to 17 had a depression diagnosis. The frequency of depression diagnosis tends to increase as children enter their teen years.

Around teens ages 12 to 17 had one major depressive episode in 2017.

According to a 2021 Mental Health America (MHA) report, severe major depression has increased in youth to 9.7%. This is an increase from 9.2% in 2020.

The 2021 MHA report also states that youth ages 11 to 17 were the most likely age group to score in the moderate-to-severe depression categories when screened for mental health conditions.

The symptoms of depression might be a bit different in teens and adults. You can read about the symptoms of depression in teens here.

2. Depression rates are higher in females and gender minority teens

While depression can affect teens of any sex and gender identity, a study published by the JAMA Network found that by 15 years old, females were twice as likely to have experienced episodic depression than males.

When comparing male and female depression rates, depression continues to present at a higher rate in females than males from the teen years into adulthood.

Also, according to the National Institute of Mental Health, risk factors leading to depression are highest among adolescents and young adults who identify with a gender minority, such as transgender, genderqueer, and nonbinary.

3. Teens with two or more racial or ethnic identities report the highest rates of depression

Your teen years are often called the "coming-of-age" era for a reason. You're discovering, questioning, and deciding many aspects of your identity, including what your cultural, racial, and ethnic identity means in your life.

This, coupled with societal pressures and prejudices, can reasonably leave you feeling stressed and emotionally shaken up.

Teens ages 12 to 17 years old with more than one racial identity are the most at-risk racial or ethnic group to report a major depressive episode, according to data published by Substance Abuse and Mental Health Services in 2017.

American Indian/Alaskan Native teenagers reported the second highest rates of depression at .

4. LGBTQ+ teens are at greater risk for depression

Recent research shows that sexual identity can impact rates of depression among teens. The Centers for Disease Control and Prevention (CDC) reports that lesbian, gay, and bisexual youth are at a higher risk for depression, suicide, and substance use.

But factors like supportive parents and an accepting atmosphere at school can also decrease the risk of depression in LGBTQ+ adolescents.

5. Most teens with depression are not receiving treatment

Depression is not a weakness, and you should never feel ashamed of a depression diagnosis. While major depression is a widespread mental health condition, it still requires attention and professional treatment.

You may be tempted to ignore your negative feelings and symptoms associated with depression, but a consistent treatment plan is vital for depression management.

Left untreated, depression has a higher chance of recurring throughout your lifetime.

According to the MHA, the majority of adolescents with depression - 60% - did not receive treatment for their major depression from 2017 to 2018. Further, more than two-thirds of adolescents diagnosed with depression did not continue with consistent treatment.

6. COVID has increased depression and uncertainty in teens

As if the normal stressors and changes happening during your teen years weren't enough, for many, the pandemic has upended any remaining sense of normalcy and routine as well.

Quarantine, loss of social interactions, illness, fear of illness, the loss of loved ones, and financial distress are only some of the compounding and life-altering stressors that teens have faced since March 2020.

These changes have had a lasting physical and psychological impact on U.S. society. According to teen depression statistics in the Stress in America 2020 survey, Generation Z teens and young adults ages 13 to 23 years old have reported increased uncertainty and depression symptoms.

For all ages, loneliness and isolation trended as the top reason for uncertainty and mental health conditions during the pandemic.

7. There's no single cause of depression

Depression often brings deeply negative or apathetic feelings, but it's important to remember that these emotions do not reflect any character flaws.

In fact, depression often stems from events outside of your control, such as:

early childhood trauma

genetics

a major life crisis

Depression can also accompany or become exacerbated by existing medical conditions. These include:

Of course, depression can also develop without a specific triggering event or preexisting condition, just as it can result from numerous sources. Exploring the causes of your depression with a professional can help you determine the most effective treatment plan.

8. There are many types of depression

If you feel depressed, it does not automatically mean you have a depressive disorder. Depression may be a symptom of another physical or psychological medical condition.

Depression could also be a natural response to a major stressor and does not indicate that you'll need to prepare to live with recurring depression.

Some types of depression include:

No matter what form your depression takes, it's important to work with a medical professional to identify the type of depression you are experiencing and, ultimately, develop a treatment plan tailored to your needs.

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Teenage Depression: Facts and Statistics

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Your teen years are full of significant changes. Physically, mentally, and socially - your brain, body, and environment are going through a major evolution. You might feel bogged down from the demands of high school and college assignments piling up. Or you may feel sadness about transitioning to a more independent and unfamiliar life.

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Eating disorders can take a devastating toll on teens. To help protect your child, understand the possible causes of teen eating disorders and know how to talk to your son or daughter about healthy-eating habits.

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Prevention tips for teen eating disorders

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How to talk to your teen about eating disorders and promote a healthy lifestyle for the entire family.

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yes because over 20% of teens have it had multiple sources also have proof
for it

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biologically. In moving towards adulthood, young people begin to discover who they are. Independent of parents, they begin to establish friendships and go through puberty. There are obvious physical changes associated with adolescence and puberty. But a large amount of internal change also occurs. Adolescent eating disorder statistics show 2.7% of teens in the U.S. between 13 and 18 years old have an eating disorder. For many teenagers, entering into puberty can be a time wrought with intense emotions, confusion, and stress. This period of change is what makes teens susceptible to developing eating disorders.

https://polaristeen.com/articles/10-statistics-of-teenage-eating-disorders/

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Polaris Teen Center: Premier Adolescent Treatment Center in Los Angeles

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The adolescent and teenage years are a time of growth and transformation, physically, mentally and biologically. In moving towards adulthood, young people begin to discover who they are. Independent of parents, they begin to establish friendships and go through puberty. There are obvious physical changes associated with adolescence and puberty. But a large amount of internal change also occurs. Adolescent eating disorder statistics show 2.7% of teens in the U.S. between 13 and 18 years old have an eating disorder. For many teenagers, entering into puberty can be a time wrought with intense emotions, confusion, and stress. This period of change is what makes teens susceptible to developing eating disorders.

Adolescent eating disorders (such as anorexia, bulimia, binge eating disorder, and compulsive overeating) are concerns every parent hopes to avoid. Yet, because so many young people struggle with eating disorders, it is important to know the facts.

4% of adolescents and teens, ages 13 to 18, suffer from an anorexia, bulimia, or binge eating disorder.

Anorexia is a serious, life-threatening eating disorder affecting many teenagers. Those who suffer from anorexia go to extreme lengths to control their food intake. Or, worse, they avoid eating altogether. Additionally, those with anorexia also have a distorted body image. They still feel "fat," regardless of how thin they become.

Teenagers with bulimia typically binge (periods of uncontrollable overeating) and purge (self-induce vomiting). Inducing vomiting is the most common compensatory behavior. But there are others, such as laxatives or excessive exercise.

Binge-eating disorder is characterized by excessive eating. Many teens who suffer from binge-eating disorder describe feeling like they have no control over their behavior. They also experience intense guilt and shame following a binge.

50% of teens with anorexia will develop bulimia or binge-eating disorder

Anorexia is an eating disorder marked by significantly restricting caloric intake due to intense fear of weight gain. Teens with anorexia engage in some level of self-starvation. This extreme dietary restriction often leads to another eating disorder, such as bulimia or binge-eating disorder. Long periods of malnutrition take a toll on the body's systems and organs. This, along with experiencing hunger cues and pains, can eventually lead a teen to "giving in" to the desire for food. And like the extreme nature of the restricting, once a teenager begins to eat again, it can be extreme as well (such as binging).

90% of teens with anorexia are female

Anorexia most commonly emerges in the adolescent and teenage years. This eating disorder develops from a number of factors including, for some, the onset of dieting, converge. While dieting does not cause anorexia, the reduction in calories dieting entails often triggers the disorder. Especially in those who are genetically predisposed to it.

The average amount spent on eating disorder research per affected individual is .93¢

In comparison, $44 per affected individual is spent on autism research. Schizophrenia research spends $81 per affected individual. Lastly, $88 is spent on Alzheimer's disease research per affected individual.

Young women with anorexia are 12 times more likely to die than women the same age who do not have anorexia.

Anorexia nervosa is the third most common chronic illness among adolescent and teenage girls. Anorexia also has the highest mortality rate of any psychiatric disorder.

50% of teenage girls and 30% of teenage boys use unhealthy weight control behaviors.

Some of these behaviors include skipping meals, fasting, smoking cigarettes, purging (throwing up), taking laxatives, over-exercising, taking diet pills, hiding food, and drinking highly caffeinated energy drinks.

50% of teens with an eating disorder also suffer from depression

Depression may lead to eating disorders in teenagers, but in many cases, the eating disorder itself is what triggers depression. Malnourishment causes physiological changes in the brain that can affect emotion regulation and mood.

69% of females (ages 10 to 18) state that photographs of models and celebrities in the media motivated their "ideal" body shape.

The rate at which teens are becoming aware of their body shape and size is getting younger and younger, and media plays a big part in this. Many teenagers site media as being on of the biggest influencers when it comes to body image (how one perceives his or her body when looking in the mirror). In the United States, media and overall popular culture strongly idealize thinness, and adolescents and teens are amongst the population most strongly influenced, especially with the popularity of social media. Unfortunately, the substantial influence the media plays in teenagers lives leads many (even teens with a normal body weight), are still susceptible to viewing themselves as "overweight" or "fat". The importance placed on thinness in the media can create a desire to achieve the impossible in terms of body shape and size, and can obviously become a trigger to dieting and weight loss.

In this day and age, being concerned with weight and body size is incredibly common, especially amongst adolescent and teenaged girls. Adolescence is when bodies begin to change, and there is an increased awareness of media and peer pressures. Couple this with a lack of knowledge around nutrition, and many teenage girls are engaging in some very risky dietary behaviors as a way to cope with body dissatisfaction. Although all teenage girls are susceptible, there are certain risk factors that make some more likely to use dangerous diets including:

Family factors - low family connectedness, absent or neglectful parents, or dieting amongst parents can all contribute to increasing a teenage girl's risk of engaging in dieting behavior.

Environmental factors - poor school involvement, bullying/teasing by peers (especially around weight-related issues), or participation in a sport that is weight-focused will likely make a teen more prone to using diets.

Individual factors - being female alone increasing one's inclination towards dieting. Other individual factors include low self-esteem, early puberty, being overweight or obese, or practicing vegetarianism.

How many teen boys actually have eating disorders? Boys make up approximately 10 to 15% of the adolescent and teenage population with eating disorders, but are much less likely to seek treatment due to the gender stereotypes surrounding the disorders.

Many people believe that an eating disorder is a "female" problem. And while more common in girls and women, eating disorders do affect males as well. Because there is far more discussion about teenage girls and eating disorders, many teen boys are reluctant to discuss their symptoms or admit they have a problem. For some, there may be fear of appearing less masculine, or being judged by friends and peers. This unfortunately prevents many male teenagers from getting the help they need.

Involvement in certain athletic activities - such as bodybuilding, wrestling, swimming, and gymnastics all increase a teenage boy's chances of developing an eating disorder. This is because these are sports where weight control can influence performance, and coaches often encourage maintaining a certain weight range.

Sexual orientation - homosexual males or males questioning their sexual identity are at an increased risk of struggling with an eating disorder.

Being overweight - teenage boys who are currently overweight, or were overweight as children are more prone to eating disorders. This is especially true if a bullying and/or teasing is involved.

Parental dieting - parents model behaviors to their children, whether they intend to or not. Thus, teenage boys who see one or both parents using restrictive diets to lose weight may begin to practice similar behavior.

While it is possible for any boy to develop an eating disorder throughout his adolescent and teenage years, there are certain factors that increase one's likelihood including:

If you think your teen may be struggling with an eating disorder, contact Polaris Teen at (844) 836-0222 to find out more about residential treatment options for your son or daughter.

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10 Statistics of Teenage Eating Disorders

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Many young people struggle with eating disorders. If you think your teen falls into this category, discover how you can help support them. Read here

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75% of girls with low self-esteem reported engaging in negative activities like cutting, bullying, smoking, drinking, or disordered eating.

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The majority of U.S. teens have self-esteem issues that will follow them into adulthood.

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I think that teens struggle with mental health. These four categories, show that mental health can come in many different forms, and can vary between each person.

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18.5% 14-16

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National Institute of Mental Health (NIMH)

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An overview of statistics for major depression. Major depression is one of the most common mental disorders in the United States. For some individuals, major depression can result in severe impairments that interfere with or limit one’s ability to carry out major life activities.

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1. 9% of the U.S. population, or 28.8 million Americans, will have an eating disorder in their lifetime.

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Eating Disorder Statistics | General & Diversity Stats | ANAD

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ANAD's eating disorder statistics provide specific insights into various types of disorders and the diverse populations affected.

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Substance Abuse and Mental Health Services Administration

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Frequently Asked Questions - What is SAMHSA’s National Helpline?

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In 2017, 13% of U.S. teens ages 12 to 17 (or 3.2 million) said they had experienced at least one major depressive episode in the past year, up from 8% (or 2 million) in 2007. One-in-five teenage girls – or nearly 2.4 million – had experienced at least one major depressive episode (the proxy measure of depression used in this analysis) over the past year in 2017. By comparison, 7% of teenage boys (or 845,000) had at least one major depressive episode in the past 12 months. The total number of teenagers who recently experienced depression increased 59% between 2007 and 2017. The rate of growth was faster for teen girls (66%) than for boys (44%).

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National Institute of Mental Health (NIMH)

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Being a teenager can be tough, but it shouldn't feel hopeless. If you have been feeling sad most of the time for a few weeks or longer and you're not able to concentrate or do the things you used to enjoy, talk to a trusted adult about depression.

Do I have depression?

Do you often feel sad, anxious, worthless, or even "empty"?

Have you lost interest in activities you used to enjoy?

Do you get easily frustrated, irritable, or angry?

Do you find yourself withdrawing from friends and family?

Are your grades dropping?

Have your eating or sleeping habits changed?

Have you experienced any fatigue or memory loss?

Have you thought about suicide or harming yourself?

Depression looks different for everyone. You might have many of the symptoms listed above or just a few.
How do I get help for depression?

Talk to a trusted adult (such as your parent or guardian, teacher, or school counselor) about how you've been feeling.

Ask your doctor about options for professional help. Depression can be treated with psychotherapy (also called "talk therapy"), medication, or a combination of medication and talk therapy.

Try to spend time with friends or family, even if you don't feel like you want to.

Stay active and exercise, even if it's just going for a walk. Physical activity releases chemicals, such as endorphins, in your brain that can help you feel better.

Try to keep a regular sleep schedule.

Eat healthy foods.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
NIMH Identification No. OM 22-4321

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The information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy the images in the publication. If you do use our materials, we request that you cite the National Institute of Mental Health. To learn more about using NIMH publications, refer to NIMH's reprint guidelines.

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Teen Depression: More Than Just Moodiness

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This fact sheet is intended for teens and young adults and presents information about how to recognize the symptoms of depression and how to get help.

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The American Foundation for Suicide Prevention (2010) estimates that approximately 3 in 4 suicidal individuals show warning sgns to a family member or friend.
https://go.gale.com/ps/i.do?id=GALE%7CA319811844&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=10864385&p=HRCA&sw=w&userGroupName=anon%7Ed71b73c9

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Teen depression and suicide: effective prevention and intervention strategies

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Despite numerous efforts and interventions, depression and suicide continue to afflict a sizeable percentage of youth each year. In the past year, 28.5% of teens were depressed and 15.8% had seriously considered attempting suicide (Centers for Disease Control and Prevention [CDC], 2012).

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Students with low self-esteem were detected at a prevalence of 19.4%. High educational stress and physical and emotional abuse by parents or other adults in the household were major risk factors correlated to low self-esteem, while a protective factor for low self-esteem was attending supplementary classes.

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doi: 10.3389/fpsyt.2019.00698.

Affiliations

¹ Faculty of Public Health - Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam.

² Guelph International Health Consulting, Amsterdam, Netherlands.

³ VU University Athena Institute, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.

Free PMC article

Free PMC article

doi: 10.3389/fpsyt.2019.00698.

Affiliations

¹ Faculty of Public Health - Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam.

² Guelph International Health Consulting, Amsterdam, Netherlands.

³ VU University Athena Institute, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.

Abstract

Background: There is a correlation between self-esteem in adolescents and risks and protective factors for their health and welfare. The study was conducted to determine the prevalence of low self-esteem and sociodemographic features related to anxiety, depression, educational stress, and suicidal ideation in secondary school students in Vietnam. Methods: A cross-sectional design was employed for this study with participation of 1,149 students in Cantho City in Vietnam. A structured questionnaire was applied to ask about self-esteem, depression, anxiety, educational stress, and suicidal ideation. Results: Students with low self-esteem were detected at a prevalence of 19.4%. High educational stress and physical and emotional abuse by parents or other adults in the household were major risk factors correlated to low self-esteem, while a protective factor for low self-esteem was attending supplementary classes. An association among lower self-esteem and increased anxiety, depression, and suicidal ideation was detected. Conclusions: Self-esteem is associated with anxiety, depression, and academic stress, which significantly affect students' quality of life and links to suicidal ideation. These results therefore suggested the need for a school-based or web-based provision aimed at proactively increasing students' self-esteem and skills for dealing with academic stress.

Keywords: Vietnam; adolescents; anxiety; depression; self-esteem; suicide.

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References

World Health Organization Maternal, newborn, child and adolescent health: adolescent development. Retrieved 29/07, 2019, from https://www.who.int/maternal_child_adolescent/topics/adolescence/develop....

Boden JM, Fergusson DM, Horwood LJ. Does adolescent self-esteem predict later life outcomes? A test of the causal role of self-esteem. Dev Psychopathol (2008) 20(1):319-39. 10.1017/S0954579408000151 - DOI - PubMed

Trzesniewski KH, Donnellan MB, Robins RW. Stability of self-esteem across the life span. J Pers Soc Psychol (2003) 84(1):205-20. 10.1037//0022-3514.84.1.205 - DOI - PubMed

Choo CC, Harris KM, Chew PKH, Ho RC. What predicts medical lethality of suicide attempts in Asian youths? Asian J Psychiatr (2017) 29: 136-41. 10.1016/j.ajp.2017.05.008 - DOI - PubMed

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national center for biotechnology information

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Low Self-Esteem and Its Association With Anxiety, Depression, and Suicidal Ideation in Vietnamese Secondary School Students: A Cross-Sectional Study - PubMed

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Background: There is a correlation between self-esteem in adolescents and risks and protective factors for their health and welfare. The study was conducted to determine the prevalence of low self-esteem and sociodemographic features related to anxiety, depression, educational stress, and sui ...

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Low self-esteem can be particularly hard for young people especially when they’re doing things  like starting high school or work, and forming new friendships and relationships

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While it can be normal for a teenager to lack confidence at times, people with self-esteem issues normally view themselves differently to how others view them.

Low self-esteem can be particularly hard for young people especially when they're doing things like starting high school or work, and forming new friendships and relationships. Keep reading to understand self-esteem issues that may come up for your teenager and ways to help your child feel better about themselves and their capabilities.

This can help if you:

suspect your child is suffering from low self-esteem

want to learn how to build your child's self-esteem

would like to identify the causes of your child's low self-esteem.

Why your child's self-esteem is important

Positive self-esteem for teens is important as it allows them to try new things, take healthy risks and solve problems. In turn, their learning and development will be productive and will set them up for a healthy and positive future. A young person with healthy self-esteem is more likely to display positive behavioural characteristics, such as:

acting independent and mature

taking pride in their accomplishments/acheivements

accepting frustration and dealing with it responsibly

trying new things and challenges

helping others when possible

How can low self-esteem affect my child?

When someone has low self-esteem they tend to avoid situations where they think there's risk of failure, embarrassment or making mistakes. These can involve school work, making friends, and trying new activities, which are all important parts of a healthy teenage life.

If the low self-esteem is not identified and treated, then it can lead to problems such as:

relationship troubles or difficulty making friends

- negative moods such as feeling sad, anxious, ashamed or angry

low motivation

poor body image

earlier sexual activity

drinking alcohol and/or taking drugs to feel better

What can cause low self-esteem?

How a person feels about themselves is a result of their experiences and how they deal with situations. The most common causes of low self-esteem in teenagers are:

unsupportive parents, carers or others that play an influential role in their life

friends who are bad influences

stressful life events such as divorce or moving houses

trauma or abuse

poor performance at school or unrealistic goals

mood disorders such as depression

bullying or loneliness

ongoing medical issues

Signs of low self-esteem

A child with low self-esteem will more than likely be having negative thoughts about their worth and value as a person. Some general signs that your child has low self-esteem include:

avoiding new things and not taking up opportunities

feeling unloved and unwanted

blaming others for their own mistakes

- not being able to deal with normal levels of frustration

- negative self-talk and comparisons to others

fear of failure or embarrassment

difficulty making friends

low levels of motivation and interest

can't take compliments and shows mixed feelings of anxiety or stress.

There are things you can do to support your child to have positive self-esteem, but it's also important to remember that teenage self-esteem develops and changes quite frequently overtime. If your child doesn't show signs of positive self-esteem immediately, it doesn't necessarily mean you're doing something wrong!

You can help your child develop positive self-esteem with tips here.

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Self-esteem and teenagers - ReachOut Parents

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While it can be normal for a teenager to lack confidence at times, people with self-esteem issues normally view themselves differently to how others view them. Low self-esteem can be particularly hard for young people especially when they're doing things like starting high school or work, and forming new friendships and relationships.

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Kids who seemed confident throughout childhood may struggle to maintain self-assurance during the teen years. For many, adolescence is a time filled with self-doubt, a questionable body image, and insecurity. Teens who struggle to master a skill may conclude they're complete failures. For instance, a teen who has difficulty with math may decide they're not smart. Or a teen who fails to make the soccer team may decide they'll never be good at sports.

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Kids who seemed confident throughout childhood may struggle to maintain self-assurance during the teen years. For many, adolescence is filled with self-doubt, a questionable body image, and insecurity.

The good news is, you can take steps to help your teen build self-esteem. Here are eight strategies that will instill life-long confidence in your teen.

Promote Self-Improvement

Teens who struggle to master a skill may conclude they're complete failures. A teen who has difficulty with math may decide they're not smart. Or a teen who fails to make the soccer team may decide they'll never be good at sports.

Show your teen that it's possible to accept flaws while also striving to become better. There is a healthy balance between self-acceptance and self-improvement. Rather than label themselves as "stupid," help your teen see that while they're struggling academically, they can still strive to become better.﻿﻿

Praise Effort Instead of Outcome

Rather than praise your teen for getting a good grade on an exam, praise them for all the studying they did. Instead of saying, "Great job scoring those five points in the game," say, "All that practicing you've been doing has been paying off." Show them that it's important to try hard and it's OK if they don't succeed all the time.﻿﻿

Teach Assertiveness Skills

Teens need to know how to speak up for themselves in an appropriate manner.﻿﻿ An assertive teen will be able to ask for help when they don't understand school work, rather than allow themselves to fall behind.

A teen who can speak up is also less likely to be treated poorly by peers. They'll speak up for themselves when they don't like how they're being treated, and they'll be able to ask for what they need in a direct manner.

Encourage Your Teen to Explore New Opportunities

Trying new activities, discovering hidden talents, and challenging themselves can help grow teens' confidence. But many teens are afraid of failure and don't want to embarrass themselves.

Encourage your teen to join a new club, play a musical instrument, engage in volunteer work, or find a part-time job. Mastering new skills will help them feel better about themselves.

Model Confidence

Your teen will learn the most about confidence based on what you do-not what you say. If you're guilty of making critical statements about your body or your abilities, you'll teach your child to do the same.

Role model how to face new situations with courage and confidence and demonstrate the importance of loving yourself.﻿﻿ Talk to your teen about times when you've been brave or things you've done in your life to help build your confidence.

Build Self-Worth on a Healthy Foundation

If your teen only feels good when they get a certain amount of likes on social media or when fit into a certain size pair of pants, they'll struggle to maintain confidence when situations don't suit their needs. Basing self-worth on superficial things, external circumstances, or other people leads to a lack of confidence in the long run.

Help your teen build a healthy and stable foundation for self-worth. Emphasize your values and teach that true self-worth is about living according to those values. For example, help them see that it's more important to be kind and caring rather than thin or attractive.﻿﻿

Balance Freedom with Guidance

Micromanaging your teen's choices will only reinforce that they can't be trusted to make good decisions independently. It's important to balance just the right amount of freedom with plenty of guidance.

Provide your teen with plenty of opportunities to practice the skills you've taught. Let them experience natural consequences and they'll learn from their own mistakes. Over time, they'll develop increased confidence in their ability to make healthy choices.

Help Develop Positive Self-Talk

Your teen's inner monologue will play a major role in how they feels about themselves. If they are always thinking things like, "I'm so ugly," or "No one likes me," they're bound to feel bad about themselves.

Teach your teen to develop healthy self-talk. Point out how many thoughts aren't true and help them see how being overly harsh can be detrimental. Teach her to reframe irrational thoughts like, "I'm going to fail because I'm stupid," with something more realistic like, "I can pass math class if I work hard."

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How Parents Can Help Their Teen Build Self-Confidence

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Kids who seemed confident throughout childhood may struggle to maintain self-assurance during the teen years. For many, adolescence is filled with self-doubt, a questionable body image, and insecurity. The good news is, you can take steps to help your teen build self-esteem. Here are eight strategies that will instill life-long confidence in your teen.

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65 precent of people neglect it

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More than 40% of boys in middle school and high school regularly exercise with the goal of increasing muscle mass.

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The majority of U.S. teens have self-esteem issues that will follow them into adulthood.

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Teen girls are three times as likely as teen boys to have experiences with depression.

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Depression has become increasingly common among American teenagers - especially teen girls, who are now almost three times as likely as teen boys to have had recent experiences with depression.

In 2017, 13% of U.S. teens ages 12 to 17 (or 3.2 million) said they had experienced at least one major depressive episode in the past year, up from 8% (or 2 million) in 2007, according to a Pew Research Center analysis of data from the 2017 National Survey on Drug Use and Health.

One-in-five teenage girls - or nearly 2.4 million - had experienced at least one major depressive episode (the proxy measure of depression used in this analysis) over the past year in 2017. By comparison, 7% of teenage boys (or 845,000) had at least one major depressive episode in the past 12 months.

The total number of teenagers who recently experienced depression increased 59% between 2007 and 2017. The rate of growth was faster for teen girls (66%) than for boys (44%).

While teenage girls are more likely to have faced depression than their male peers, they are also more likely to have received treatment by seeing a professional or taking medication. Among teen girls who had recent depressive episodes, 45% received treatment for depression over the past year. By comparison, 33% of teen boys with recent depressive episodes received treatment.

The number of adults who had experienced depression also increased from 14.8 million in 2007 to 17.3 million in 2017, though the share remained the same (7%). Adults also differed by gender in their experiences with depression (9% of women vs. 5% of men).

Adults who have experienced depression are treated at higher rates than teens. Among adults who had recent depressive episodes, about two-thirds (67%) received treatment. Again, women who had a recent experience with depression (72%) were more likely than men (58%) to receive treatment.

Teens express concern about anxiety and depression among peers, feel day-to-day pressures

Seven-in-ten U.S. teens said anxiety and depression is a major problem among people their age in the community where they live, according to a Pew Research Center survey of teenagers ages 13 to 17 conducted in fall 2018. An additional 26% cited anxiety and depression as a minor problem.

About three-in-ten teens (29%) said they felt tense or nervous about their day every or almost every day, and 45% said they felt tense or nervous sometimes. About a third of teen girls (36%) reported feeling this way every day or almost every day, compared with 23% of teen boys.

Academic and social pressures are among the reasons cited by experts who have studied teen depression. The Center's survey asked about some of those pressures teens face in their daily lives. About six-in-ten teens (61%) said they personally felt a lot of pressure to get good grades, while roughly three-in-ten reported a lot of pressure to look good and fit in socially (29% and 28%, respectively).

About this analysis

This analysis uses data from the 2017 National Survey on Drug Use and Health (NSDUH), which is directed by the U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration and overseen by the Center for Behavioral Health Statistics and Quality.

"Major depressive episode" is used throughout this analysis as a proxy measure of depression; as such, that term and "depression" are used interchangeably. A " major depressive episode " is defined as a period of at least two weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specific depression symptoms in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). "Treatment" of depression is defined in the NSDUH survey as seeing or talking to a health or alternative service professional or using prescription medication for depression in the past year.

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A growing number of American teenagers - particularly girls - are facing depression

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Depression is rising among American teenagers, and teen girls are particularly likely to have had recent depressive episodes.

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every 100 minutes 1 teen takes their own life

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Depression Symptoms in Teens: Why Today’s Teens Are More Depressed Than Ever

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Depression symptoms in teens? Teen and adolescent suicides have continued to rise dramatically in recent years. Find out why today’s teens are more depressed than ever.

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About 20 percent of all teens experience depression before they reach adulthood

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Depression Symptoms in Teens: Why Today’s Teens Are More Depressed Than Ever

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Depression symptoms in teens? Teen and adolescent suicides have continued to rise dramatically in recent years. Find out why today’s teens are more depressed than ever.

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75 precent of people have low self esteem

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Teen depression is a serious mental health problem that causes a persistent feeling of sadness and loss of interest in activities. It affects how your teenager thinks, feels and behaves, and it can cause emotional, functional and physical problems. Although depression can occur at any time in life, symptoms may be different between teens and adults.

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Overview

Teen depression is a serious mental health problem that causes a persistent feeling of sadness and loss of interest in activities. It affects how your teenager thinks, feels and behaves, and it can cause emotional, functional and physical problems. Although depression can occur at any time in life, symptoms may be different between teens and adults.

Issues such as peer pressure, academic expectations and changing bodies can bring a lot of ups and downs for teens. But for some teens, the lows are more than just temporary feelings - they're a symptom of depression.

Teen depression isn't a weakness or something that can be overcome with willpower - it can have serious consequences and requires long-term treatment. For most teens, depression symptoms ease with treatment such as medication and psychological counseling.

Symptoms

Teen depression signs and symptoms include a change from the teenager's previous attitude and behavior that can cause significant distress and problems at school or home, in social activities, or in other areas of life.

Depression symptoms can vary in severity, but changes in your teen's emotions and behavior may include the examples below.

Emotional changes

Be alert for emotional changes, such as:

Feelings of sadness, which can include crying spells for no apparent reason

Frustration or feelings of anger, even over small matters

Feeling hopeless or empty

Irritable or annoyed mood

Loss of interest or pleasure in usual activities

Loss of interest in, or conflict with, family and friends

Low self-esteem

Feelings of worthlessness or guilt

Fixation on past failures or exaggerated self-blame or self-criticism

Extreme sensitivity to rejection or failure, and the need for excessive reassurance

Trouble thinking, concentrating, making decisions and remembering things

Ongoing sense that life and the future are grim and bleak

Frequent thoughts of death, dying or suicide

Behavioral changes

Watch for changes in behavior, such as:

Tiredness and loss of energy

Insomnia or sleeping too much

Changes in appetite - decreased appetite and weight loss, or increased cravings for food and weight gain

Use of alcohol or drugs

Agitation or restlessness - for example, pacing, hand-wringing or an inability to sit still

Slowed thinking, speaking or body movements

Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse

Social isolation

Poor school performance or frequent absences from school

Less attention to personal hygiene or appearance

Angry outbursts, disruptive or risky behavior, or other acting-out behaviors

Self-harm - for example, cutting or burning

Making a suicide plan or a suicide attempt

What's normal and what's not

It can be difficult to tell the difference between ups and downs that are just part of being a teenager and teen depression. Talk with your teen. Try to determine whether he or she seems capable of managing challenging feelings, or if life seems overwhelming.

When to see a doctor

If depression signs and symptoms continue, begin to interfere in your teen's life, or cause you to have concerns about suicide or your teen's safety, talk to a doctor or a mental health professional trained to work with adolescents. Your teen's family doctor or pediatrician is a good place to start. Or your teen's school may recommend someone.

Depression symptoms likely won't get better on their own - and they may get worse or lead to other problems if untreated. Depressed teenagers may be at risk of suicide, even if signs and symptoms don't appear to be severe.

If you're a teen and you think you may be depressed - or you have a friend who may be depressed - don't wait to get help. Talk to a health care provider such as your doctor or school nurse. Share your concerns with a parent, a close friend, a spiritual leader, a teacher or someone else you trust.

Symptoms

Suicide is often associated with depression. If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

Also consider these options if you're having suicidal thoughts:

Call your mental health professional.

Contact a suicide hotline.

In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. The Spanish language phone line is 1-888-628-9454 (toll-free). Services are free and confidential.

Or contact a crisis service for teenagers in the U.S. called TXT 4 HELP: Text the word "safe" and your current location to 4HELP (44357) for immediate help, with the option for interactive texting.

Seek help from your primary care doctor or other health care provider.

Reach out to a close friend or loved one.

Contact a minister, spiritual leader or someone else in your faith community.

If a loved one or friend is in danger of attempting suicide or has made an attempt:

Make sure someone stays with that person.

Call 911 or your local emergency number immediately.

Or, if you can do so safely, take the person to the nearest hospital emergency room.

Never ignore comments or concerns about suicide. Always take action to get help.

Causes

It's not known exactly what causes depression, but a variety of issues may be involved. These include:

Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of your brain and body. When these chemicals are abnormal or impaired, the function of nerve receptors and nerve systems changes, leading to depression.

Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression.

Inherited traits. Depression is more common in people whose blood relatives - such as a parent or grandparent - also have the condition.

Early childhood trauma. Traumatic events during childhood, such as physical or emotional abuse, or loss of a parent, may cause changes in the brain that increase the risk of depression.

Learned patterns of negative thinking. Teen depression may be linked to learning to feel helpless - rather than learning to feel capable of finding solutions for life's challenges.

Risk factors

Many factors increase the risk of developing or triggering teen depression, including:

Having issues that negatively impact self-esteem, such as obesity, peer problems, long-term bullying or academic problems

Having been the victim or witness of violence, such as physical or sexual abuse

Having other mental health conditions, such as bipolar disorder, an anxiety disorder, a personality disorder, anorexia or bulimia

Having a learning disability or attention-deficit/hyperactivity disorder (ADHD)

Having ongoing pain or a chronic physical illness such as cancer, diabetes or asthma

Having certain personality traits, such as low self-esteem or being overly dependent, self-critical or pessimistic

Abusing alcohol, nicotine or other drugs

Being gay, lesbian, bisexual or transgender in an unsupportive environment

Family history and issues with family or others may also increase your teenager's risk of depression, such as:

Having a parent, grandparent or other blood relative with depression, bipolar disorder or alcohol use problems

Having a family member who died by suicide

Having a family with major communication and relationship problems

Having experienced recent stressful life events, such as parental divorce, parental military service or the death of a loved one

Complications

Untreated depression can result in emotional, behavioral and health problems that affect every area of your teenager's life. Complications related to teen depression may include, for example:

Alcohol and drug misuse

Academic problems

Family conflicts and relationship difficulties

Suicide attempts or suicide

Prevention

There's no sure way to prevent depression. However, these strategies may help. Encourage your teenager to:

Take steps to control stress, increase resilience and boost self-esteem to help handle issues when they arise

Practice self-care, for example by creating a healthy sleep routine and using electronics responsibly and in moderation

Reach out for friendship and social support, especially in times of crisis

Get treatment at the earliest sign of a problem to help prevent depression from worsening

Maintain ongoing treatment, if recommended, even after symptoms let up, to help prevent a relapse of depression symptoms

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This serious mental health problem affects how your teenager thinks, feels and behaves, and can cause emotional, functional and physical problems.

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20% of all teens experience depression before the are a adult

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Depression Symptoms in Teens: Why Today’s Teens Are More Depressed Than Ever

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Depression symptoms in teens? Teen and adolescent suicides have continued to rise dramatically in recent years. Find out why today’s teens are more depressed than ever.

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Participants were 150 adolescent survivors of childhood cancer, 146 mothers, and 103 fathers who completed the Impact of Events Scale–Revised, the Posttraumatic Stress Disorder Reaction Index, and the PTSD module of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Results PTSS are common in families of childhood cancer survivors. Parents reported more symptomatology than former patients. Mothers and fathers had relatively equal rates of current PTSD and levels of PTSS. Nearly 30% of mothers met diagnostic criteria since their child's diagnosis, with 13.7% currently experiencing PTSD. Nearly 20% of families had at least one parent with current PTSD. Ninety-nine percent of the sample had at least one family member reexperiencing symptoms.

https://academic.oup.com/jpepsy/article/29/3/211/924603

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Abstract

Most survivors of childhood cancer and their families adjust well after cancer diagnosis and treatment, although a subset experience continuing distress that may interfere with functioning ( Kazak, 1994). The posttraumatic stress model is helpful for understanding the long-term psychological sequelae for survivors of childhood cancer and their family members ( Stuber, Kazak, Meeske, & Barakat, 1998). Posttraumatic stress acknowledges the life threat inherent in the diagnosis and treatment of childhood cancer while also providing a framework in which ongoing distress such as intrusive thoughts, arousal, and avoidance may be conceptualized and treated. Most research in this field has looked at posttraumatic stress in individuals, rather than examining the impact on the family system.

Nir (1985) and Pot-Mees (1989) first described posttraumatic stress disorder (PTSD) in childhood cancer survivors, and Stuber and colleagues published the first quantitative pilot report ( Stuber, Nader, Yasuda, Pynoos, & Cohen, 1991) laying the groundwork for subsequent field trials for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) ( American Psychiatric Association, 1994). These field trials documented PTSD in childhood cancer survivors and their parents ( Alter et al., 1996; Pelcovitz et al., 1996), and the DSM-IV reflects these findings: "[E]xperiencing, witnessing or confronting events that involve actual or threatened death or serious injury, or a threat to the physical integrity of self or others" was added as a potentially traumatic event. Subsequent empirical research consistently demonstrates low rates of PTSD in the cancer-survivor population but substantial rates of subclinical posttraumatic stress symptoms (PTSS), particularly for parents and for young adults who had cancer during childhood.

In a study of 320 families of childhood cancer survivors 8-16 years old and their parents, the survivors did not differ from controls on level of PTSS ( Kazak et al., 1997). Additionally, the incidence of PTSD was not remarkable; structured psychiatric interviews completed with a subset of participants revealed that 5% of survivors met criteria for a diagnosis of PTSD. These data were substantiated by Butler, Rizzi, and Handwerger (1996), who found that 7% of adolescent cancer survivors qualified for a diagnosis of PTSD, and Erickson and Steiner (2001), who reported that 10% of their sample of survivors 12-35 years old qualified for the diagnosis of PTSD. The most impressive data arose from examining the number of respondents fulfilling PTSD symptom clusters. Kazak et al. (2001) found that 50% of survivors fulfilled criteria for the B symptom (reexperiencing) cluster and 29% fulfilled criteria for the D (arousal) cluster. Additionally, Erickson and Steiner (2001) reported that 78% of their sample met at least one symptom of reexperiencing, arousal, or avoidance at a functionally significant level.

Higher rates of PTSD and PTSS have been found in young adult survivors of childhood cancer than in younger cohorts, suggesting that the traumatic impact of serious childhood illness may be more evident at a later developmental stage. Hobbie et al. (2000) reported that 21.0% of survivors at a long-term follow-up clinic had experienced PTSD since their diagnosis. In a larger and higher-functioning sample of young adult survivors recruited from the community, 15.9% had PTSD since the end of their cancer treatment. Most (75.3%) met criteria of cluster B (reexperiencing), with nearly half (47.3%) meeting criteria of cluster D (arousal) ( Rourke, Hobbie, & Kazak, 2002).

Rates of PTSD and PTSS tend to be somewhat higher in parents of adolescent cancer survivors than in the survivors themselves. Kazak et al. (2001) found that 11% of their sample of mothers met criteria for a diagnosis of PTSD based upon clinical interviews. Manne, DuHamel, Gallelli, Sorgen, and Redd (1998) report similar rates. In one study, 6% of mothers of pediatric cancer survivors had current PTSD. In a subsequent multisite study, 8% of mothers qualified for the diagnosis ( Manne et al., 2002). Again, despite these low rates of diagnosis, subclinical PTSS rates were elevated. Manne et al. (1998) found that 20% of their sample of mothers reported partial PTSD, defined as meeting criteria on two of the three symptom clusters. Kazak et al. (2001) found that 95% of mothers fulfilled criteria for reexperiencing and 53% of mothers fulfilled criteria for hyperarousal. Furthermore, data from self-report inventories indicate that mothers and fathers of childhood cancer survivors have levels of PTSS that are elevated relative to control subjects ( Kazak et al., 1997).

Given that PTSD is conceptualized at the individual level yet affects multiple members of the family (particularly parents), understanding PTSS from a family systems perspective is important. If individuals with PTSS cluster within families, that is, if symptoms are concordant within families, a relatively smaller overall number of survivor families would be affected. Alternatively, if only one person within a family tends to have PTSS, then more families would be affected. Examining concordance of PTSS among family members is one approach to begin to understand the impact of childhood cancer on families.

The current study examines how PTSD and PTSS cluster within families of survivors of childhood cancer. Prior discrepancies in rates of PTSD and PTSS indicate the importance of assessing both. We used two approaches-well-validated and frequently used questionnaire measures of posttraumatic stress and a structured psychiatric interview. Data from adolescent survivors, mothers, and fathers provide the opportunity to identify and compare symptoms reported by family members with different roles and to describe concordance within families.

Method

Sample Recruitment and Procedure

Names and contact information of childhood cancer survivors between 11 and 19 years of age and 1-10 years posttreatment were gathered from our hospital's tumor registry. Exclusion criteria were: relapse, severe cognitive impairment, lack of fluency in English, and current residence greater than 150 miles from the hospital. After medical record review, eligible families were sent letters inviting participation. Follow-up phone calls were made to ensure eligibility, describe the research program, answer questions, and secure enrollment. Of 530 families, 437 (82.5%) were reached by phone. Of these, 107 (24.5%) were found to be ineligible (i.e., out of the limits for age, time since treatment, or geographic range). Of the 330 contacted families whose eligibility was confirmed, 150 (45.5%) enrolled in the study. Those declining participation were asked their reasons for refusal: 45.8% indicated that they did not want to revisit the cancer experience; 61.4% cited time and scheduling difficulties.

Across the 150 families, data were collected from 150 teen survivors, 146 mothers, and 106 fathers. The teen survivors ranged in age from 11.1 to 19.3 years ( M = 14.7, SD = 2.4) and had completed treatment, on average, for 5.3 years ( SD = 2.9) prior to participation. Roughly half of the teens were female (52.0%). Diagnoses included: leukemias (30.5%), solid tumors (35.1%), lymphomas (21.2%), and other (13.2%). The mean age at diagnosis was 7.9 years ( SD = 4.3; range = 3 months to 16.4 years). Most of the survivors were white (84.7%) with 9.3% black, 4.7% Hispanic, and 1.3% Asian. This distribution is characteristic of our survivorship clinic population and of national samples of cancer survivors (Robison et al., 2002). Mean parental age was in the early to mid-forties (mothers, M = 43.2, SD = 5.6; fathers, M = 45.7, SD = 6.0). Median household income was in the $50,000 to $75,000 range, consistent with census tract data for the hospital's catchment area ( U.S. Census Bureau, 2002). Educational attainment of the parents completing the study was as follows: 22.6% of mothers and 17.0% of fathers completed grades 9-12; 24.0% of mothers and 17.9% of fathers completed some college and/or vocational school; 48.0% of mothers and 52% of fathers received at least a degree from a 4-year college.

Procedure

The data presented within this paper are culled from preintervention home visits, collected as part of a randomized clinical trial of an integrated cognitive-behavioral and family therapy intervention, the Surviving Cancer Competently Intervention Program (SCCIP) ( Kazak et al., 1999). Research assistants secured written informed consent or assent from all participants and guided the family members through the structured clinical interviews and questionnaires. To promote disclosure, the interviews were conducted privately with individual family members. They were also audiotaped and reviewed to ensure accuracy.

Measures

Impact of Events Scale-Revised (IES-R)

All participants completed the 22-item IES-R ( Weiss & Marmar, 1997). The items reflect the DSM-IV cluster criteria for PTSD: intrusive thoughts (e.g., "I thought about it when I didn't mean to"), avoidance ("I stayed away from reminders about it"), and hyperarousal ("I was jumpy and easily startled"). Respondents were asked to focus on the child's cancer experience as the stressful event. Each item was rated for frequency of occurrence in the past 7 days on a weighted 4-point scale (0 = not at all, 1 = rarely, 3 = sometimes, 5 = often). A total score and the three subscale scores were calculated. In our samples, internal consistency for the IES-R total score ranged from.91 to.95.

Posttraumatic Stress Disorder Reaction Index (PTSD-RI)

All participants completed the PTSD-RI ( Pynoos, Frederick, Nader, & Arroyo, 1987), a 20-item self-report measure with items paralleling the diagnostic criteria for PTSD. Each item was worded with the child's cancer as the potentially traumatic event and was rated by participants for frequency of occurrence on a 5-point scale. Total scores were calculated and categorized into severity of posttraumatic stress reaction based upon the following scores: 12 to 24 = mild reaction; 25 to 39 = moderate reaction; above 40 = severe reaction. Two reversed coded items were estimated from the adolescent's other responses to create a total score, as our past research has indicated that these items are difficult for younger participants to comprehend. Across mothers, fathers, and survivors, internal consistency was.89.

Structured Clinical Interview for DSM-IV (SCID)

Mothers, fathers, and teen survivors were administered the PTSD section of the nonpatient edition of the SCID ( First, Spitzer, Gibbon, & Williams, 1995). This interview includes items assessing each of the DSM-IV diagnostic criteria for PTSD, plus current and lifetime (here defined as since cancer diagnosis) PTSD. Interviews were conducted by graduate students and postdoctoral fellows trained in the administration of the SCID. Each interview was audiotaped and rated by a second interviewer to ascertain and ensure accuracy and consistency across raters and time. Kappas for the full-scale PTSD items ranged from.58 for mothers to.71 for fathers and adolescent survivors.

Results

Three sets of analyses were conducted. First, using descriptive statistics, the rates and prevalence of PTSD and PTSS for individuals in this sample are reported. Second, planned comparisons on rates of PTSD and PTSS between mothers and fathers and parents and survivors are presented. For the PTSD-RI and IES-R total scores, paired t-tests were used, nesting participants within their families. Given that the average intercorrelation of family members' PTSS scores in this sample was approximately equal to.2, and using an α of.05, our smallest paired sample ( n = 94) afforded a power greater than.95 to find a medium size difference ( Cohen, 1988). To examine similarities and differences between family members on rates of PTSD on the SCID, we conducted a series of McNemar analyses with continuity correction ( Siegel & Castellan, 1988). Finally, the concordance of posttraumatic stress symptomatology of family members within families and the total number of families with PTSD and PTSS in at least one family member have been calculated. Chi-square analyses were used to determine whether family members shared PTSS at a rate greater than chance. In these analyses, at α =.05, our sample sizes afforded us power greater than.85 to find a medium size effect ( Cohen, 1988).

Rates and Prevalence of PTSD and PTSS

Scores on the IES-R and the PTSD-RI indicate substantial endorsement of PTSS for all members of the family (see Table I). Moderate to severe levels of PTSS were seen on the PTSD-RI for mothers (43.7%), fathers (35.3%), and teen survivors (17.6%).

Current PTSD diagnosis was noteworthy, with 13.7% of mothers and 9.6% of fathers qualifying for the diagnosis based on the SCID. Previously reported rates of current PTSD for adults exposed to violent crimes or tragic deaths fall in the 7% to 11% range ( Breslau, 2001). More strikingly, 29.5% of mothers had met criteria for a PTSD diagnosis at some point since their child's diagnosis with cancer; 11.5% of fathers fulfilled the same criteria. Data from the National Comorbidity Survey ( Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995) suggest that the lifetime prevalence rates of PTSD, given a history of at least one traumatic event, are 20.4% for females and 8.1% for males. Rates for survivors were 4.7% for current PTSD and 8.0% for PTSD since cancer diagnosis. Although well-developed norms are currently unavailable for PTSD in children, these rates are similar to the 5.4% of children who qualified for a diagnosis of PTSD 3 months after Hurricane Hugo ( Shannon, Lonigan, Finch, & Taylor, 1994).

Responses to the SCID revealed that the majority of survivors of childhood cancer and their mothers and fathers met criteria for PTSD diagnostic criteria cluster B (reexperiencing). A total of 63.7% of mothers, 44.2% of fathers, and 41.3% of survivors endorsed enough symptoms of arousal to meet criteria for PTSD cluster D. It was less common for family members to fulfill criteria for cluster C (avoidance), yet more than one third of mothers did meet the criteria, reporting three or more avoidance symptoms.

Comparing Family Members on Rates of PTSD and PTSS

Mothers and fathers had relatively equal rates of current PTSD and levels of PTSS (see Table II), though mothers were more likely than fathers to endorse a history of PTSD at some time since their child's cancer diagnosis, χ ²(1, N = 100) = 8.26, p <.005. Parents' PTSS scores tended to be higher than those of their children: mothers vs. survivors, PTSD-RI, t(135) = 5.59, p <.001; IES-R, t(136) = 2.26, p <.03; fathers vs. survivors, PTSD-RI, t(95) = 4.03, p <.001; IES-R, t(94) = 1.27, p =.21. SCID data revealed that mothers' rates of PTSD were significantly higher than those in their children: current PTSD, χ ²(1, N = 146) = 7.35, p =.01; PTSD since diagnosis, χ ²(1, N = 146) = 20.00, p <.005. Fathers' rates tended in the same direction: current PTSD, χ ²(1, N = 103) = 3.77, p =.09; PTSD since diagnosis, χ ²(1, N = 103) = 3.77, p =.09.

Concordance of PTSD Among Family Members

In general, concordance among survivors, mothers, and fathers for PTSD current and since diagnosis was infrequent, ranging from 0% to 5 % ( Table III). However, one third of two-parent families had both parents fulfill criteria for the arousal symptom cluster and 84% of families had both parents endorse symptoms of reexperiencing. Only arousal symptoms were shared at a rate greater than that expected by chance, χ ²(1, N =101) = 7.7, p <.006; odds ratio = 3.47 (confidence interval = 1.4 to 8.5). It was uncommon for both parents to fulfill criteria for avoidance. It was also uncharacteristic for teenage survivors to share symptomatology with their parents. Only 2 families had both a parent and the teen survivor currently experiencing PTSD and only 6 families had both a parent and the teen survivor report PTSD at some time since the cancer diagnosis. Although only 15 (10%) parents and survivors shared symptoms of avoidance, this had a level of concordance that exceeded chance, χ ²(1, N = 149) = 5.36, p <.02. This effect was driven by concordance between mothers and survivors, χ ²(1, N = 146) = 5.88, p <.02; odds ratio = 2.9 (confidence interval = 1.17 to 7.22).

With elevated rates of occurrence and low rates of concordance of PTSD across family members, the overall number of families in which PTSD was seen in at least one member since diagnosis was noteworthy, ranging from 34% to 38% ( Table IV). Nearly 20% of the families had at least one parent qualify for a current diagnosis of PTSD and over one third had at least one parent qualify at some time since the cancer diagnosis. At least one parent met cluster criteria for reexperiencing in 98.7% of families, for arousal in 69.1% of families, and for avoidance in 40.9% of families.

When including survivors, 37.6% of the families had at least one member with PTSD at some time since the cancer diagnosis, and 22.1% currently had a family member who qualified for a diagnosis of PTSD. The sample found 99.3% of families with at least one member who met cluster B (reexperiencing). Over 80% had at least one member who had two or more symptoms of arousal, and nearly half had at least one member with three or more symptoms of avoidance.

Discussion

The diagnosis of childhood cancer and the demands of treatment are unquestionably among the most distressing of experiences for families. The conceptualization of PTSD and PTSS provide a framework for understanding the ongoing psychological sequelae of survival and offer opportunities for intervention and prevention. The data in this study provide additional support for the relevance of the posttraumatic stress framework in serious childhood illness and highlight how trauma responses affect families more broadly. Posttraumatic distress is common across families but tends to affect particularly one member, rather than multiple people, within a single family.

The substantial rates of endorsement of PTSS in this sample of adolescent survivors and their parents are not surprising. Reexperiencing, avoidance, and arousal are all understandable reactions to particular events during treatment (e.g., knowing that your child could die, invasive medical procedures, pain, emergency department and intensive care admissions, knowing other children who died). Even when cancer treatment has concluded, ongoing medical surveillance is essential, given known and emerging late effects of treatment and the risk for second malignancies ( Friedman & Meadows, 2002). Exposure to potentially traumatic events therefore continues.

These data suggest that both PTSD and PTSS are important in understanding the psychological sequelae of childhood cancer survivors and their families. Particularly for mothers of survivors, the likelihood of PTSD at some point since the child's illness was 30% in this sample. Perhaps reflecting gender patterns, differences in exposure, or family patterns, fathers did not report such elevated levels of PTSD. However, a focus on diagnosing PTSD would limit understanding of the full traumatic impact of cancer on families given the prevalence of subsyndromal symptoms of reexperiencing, avoidance, and arousal.

This study provides data on fathers and draws particular attention to the relevance of posttraumatic stress for multiple family members. Both mothers and fathers remember many cancer-related events, recall their psychological reactions vividly, and are likely to have a clear and somber understanding of the circumstances (including the potential for the child to die), perhaps more so than their children. Fathers, who are sometimes seen as more peripherally involved in the care of their child, were similar to mothers in current PTSS, showing that the experience has long-lasting effects for them. Although fathers tend to participate in research studies like ours at lower rates than mothers, they were active participants and their data are important. Home-based data collection procedures (such as those in this study) may facilitate the involvement of fathers and other family members. We view the study results as strongly supportive of the recommendations of Seagull (2000) regarding the importance of fathers in pediatric psychology research and practice. Additionally, the potentially traumatic effect of childhood cancer is seen in adolescent siblings, reported in another paper originating from this project ( Alderfer, Labay, & Kazak, 2003).

The finding that PTSS tend to be reported by only one member of a given family is new. This suggests the importance of evaluating all family members for PTSS. Indeed, if only mothers had been researched, 40% (8 of 20) of the two-parent families with a parent with PTSD would have been overlooked. In working with families of children with cancer, it is important to assess PTSD and PTSS across members of the family, as the patient or parent present may not be the symptomatic person in the family. It seems from our data that one person tends to hold the symptoms for the family and that PTSD and PTSS are not "contagious." Speculatively, it might be that differences between family members in PTSS may reflect differences in exposure, preexisting psychological resilience or vulnerability, and/or cancer-related beliefs. Neither the impact on other family members of the PTSD/PTSS of one member nor the differential effect of parental or child symptoms on individual and family functioning is known. However, PTSS in one family member may affect parenting style, parent-child interactions, and ongoing attention to medical concerns for the survivor in ways that have yet to be explored.

These data provide additional documentation of the relevance of PTSS in pediatric health care more broadly. PTSS have been documented in pediatric liver transplantation ( Walker, Harris, Baker, Kelly, & Houghton, 1999). Avoidance related to PTSS has also been associated with nonadherence to pediatric liver transplantation regimens ( Shemesh et al., 2000). A series of studies on child PTSS supports the importance of the concept in pediatric injury ( Aaron, Zaglul, & Emery, 1999; Fein et al., 2002; Stallard, Velleman, & Baldwin, 1998) and subsequent to traumatic brain injury ( Levi, Drotar, Yeates, & Taylor, 1999; Max et al., 1998). Expanding the appreciation of PTSD and PTSS responses at the family level for these groups may faciliate a broader understanding of the morbidity of pediatric illness and help to identify interventions to reduce long-term distress.

The participants in this study were part of an intervention study and therefore could reflect a biased sample. However, rates of PTSS on the PTSD-RI for survivors, mothers, and fathers in this sample are similar to those in a previous (nonintervention) study of cancer survivors ( Kazak et al., 1997), indicating that this sample was not more distressed than a nonintervention sample. If more symptomatic families agreed to participate in studies, compared with those who are less affected by psychological sequelae, this would result in an overestimation of PTSD and PTSS. However, refusal to participate in studies is linked closely to explicit concerns about not wanting to revisit the cancer experience ( Streisand, Rourke, Katz, Stein, & Kazak, 1999). It is therefore also possible that this study underestimates the prevalence of PTSD and PTSS because the most avoidant families do not participate.

Methodologically, reliance on retrospective report of symptoms since diagnosis is a limitation. With respect to appreciating the impact at the family level, the data would be enriched by consideration of how symptoms are expressed, recognized, and addressed within the family, and over time. It is not known, for example, the extent to which exposure to traumatic events during treatment (e.g., a parent in a direct caregiver role) is predictive of PTSS, or what components of family structure and process might contribute to PTSS. Although there are data that illustrate commonalities and differences between mothers of survivors and young adult survivors in terms of what contributes to PTSS ( Kazak et al., 2001), the interpersonal impact of PTSD or PTSS on close family members is not known. In the cancer survivor literature, symptoms that do not meet diagnostic criteria for PTSD are generally accepted as important and clinically meaningful. However, further exploration of the implications of subdiagnostic PTSS for intervention structure and delivery are necessary and important.

These data have several implications with respect to intervention. First, parents of children who have survived cancer may experience PTSD and, if so, should be considered for treatment. Second, it is likely that any member of a family with a childhood cancer survivor may be experiencing treatable bothersome intrusive memories, arousal, or avoidance specific to the cancer treatment for themselves or another family member. We have reported on a pilot study that indicates that a brief, integrated cognitive-behavioral/family therapy intervention may be effective in reducing PTSS and enhancing family functioning ( Kazak et al., 1999). Within this treatment model, ongoing cancer-related adversities (e.g., symptoms of intrusion, avoidance) are identified, with the goal of reframing beliefs about the experience to achieve a more adaptive outcome. Importantly, this process is conducted within the context of the family, with an emphasis on using family communication about PTSS to help family members recognize and respond in ways that reduce distress and promote adaptive development for individuals and the family. Given the presence of the diagnosis of PTSS in the majority of families in this sample and its distribution across family member roles, family intervention models seem well suited for this population (regardless of which family member[s] may be affected). By intervening contextually, the strengths of the family can be identified to promote both understanding of the legacy of cancer and the growth of the family system.

Even one or two symptoms of posttraumatic stress may have repercussions for this medically vulnerable population. If a long-term survivor (or parent who oversees medical care) has reexperiencing or arousal symptoms when reminded of cancer treatment, that distress may impede the ability to understand medical guidelines or to relay important information to the health care team. Individuals with PTSS may refuse medical care to avoid the distress that is triggered by exposure to medical treatments, leading to potentially suboptimal medical care for survivors who are at risk for long-term medical complications. Alternatively, hypervigilance may be another response to PTSS and could contribute to higher health care utilization and cost.

Although some of the exposure to traumatic events that occurs during treatment is inevitable and actually likely to increase with more intensive cancer treatment protocols, there are implications for prevention. Interventions that decrease the traumatic impact of treatment may help to reduce the development of PTSD in childhood cancer survivors and other groups. These include effective strategies for child pain and distress, attention to the impact of treatment- related events on all members of the family (e.g., admissions to the intensive care unit, death of a patient known to the family), and helping families to anticipate the likelihood of PTSS after treatment ends.

This study was supported by a grant from the National Cancer Institute (CA63930). The authors would like to thank all of the families who participated and the SCCIP research team for their contributions to this study.

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Posttraumatic Stress Disorder (PTSD) and Posttraumatic Stress Symptoms (PTSS) in Families of Adolescent Childhood Cancer Survivors

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Most survivors of childhood cancer and their families adjust well after cancer diagnosis and treatment, although a subset experience continuing distress that may interfere with functioning ( Kazak, 1994). The posttraumatic stress model is helpful for understanding the long-term psychological sequelae for survivors of childhood cancer and their family members ( Stuber, Kazak, Meeske, & Barakat, 1998).

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75 precent of teen have some form of depression

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Globally, one in seven 10-19-year-olds experiences a mental disorder, accounting for 13% of the global burden of disease in this age group.

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Adolescence (10-19 years) is a unique and formative time. Multiple physical, emotional and social changes, including exposure to poverty, abuse, or violence, can make adolescents vulnerable to mental health problems. Promoting psychological well-being and protecting adolescents from adverse experiences and risk factors that may impact their potential to thrive are critical for their well-being during adolescence and for their physical and mental health in adulthood.

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At least 20% of all teens suffer from depression before they become adults.

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Depression Symptoms in Teens: Why Today’s Teens Are More Depressed Than Ever

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Depression symptoms in teens? Teen and adolescent suicides have continued to rise dramatically in recent years. Find out why today’s teens are more depressed than ever.

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2.1 million teens in america have depression

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Centers for Disease Control and Prevention

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Mental health is an important part of children's overall health and well-being. Mental health includes children's mental, emotional, and behavioral well-being. It affects how children think, feel, and act. It also plays a role in how children handle stress, relate to others, and make healthy choices.

Mental disorders among children are described as serious changes in the way children typically learn, behave, or handle their emotions, causing distress and problems getting through the day. Among the more common mental disorders that can be diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), anxiety, and behavior disorders.

There are different ways to assess mental health and mental disorders in children. CDC uses surveys, like the National Survey of Children's Health, to describe the presence of positive indicators of children's mental health and to understand the number of children with diagnosed mental disorders and whether they received treatment. In this type of survey, parents report on indicators of positive mental health for their child and report any diagnoses their child has received from a healthcare provider. The information on this page provides data about indicators of positive mental health in children and mental health disorders that are most common in children.

Facts about mental health in U.S. children

National data on positive mental health indicators that describe mental, emotional, and behavioral well-being for children are limited. Based on the data we do have:

Facts about mental disorders in U.S. children

ADHD, anxiety problems, behavior problems, and depression are the most commonly diagnosed mental disorders in children. Estimates for ever having a diagnosis among children aged 3-17 years, in 2016-19, are given below.

ADHD 9.8% (approximately 6.0 million)

Anxiety 9.4% (approximately 5.8 million)

Behavior problems 8.9% (approximately 5.5 million)

Depression 4.4% (approximately 2.7 million)

Some of these conditions commonly occur together. For example, among children aged 3-17 years in 2016:

Having another mental disorder was most common in children with depression: about 3 in 4 children with depression also had anxiety (73.8%) and almost 1 in 2 had behavior problems (47.2%).

For children with anxiety, more than 1 in 3 also had behavior problems (37.9%) and about 1 in 3 also had depression (32.3%).

For children with behavior problems, more than 1 in 3 also had anxiety (36.6%) and about 1 in 5 also had depression (20.3%).

For adolescents, depression, substance use and suicide are important concerns. Among adolescents aged 12-17 years in 2018-2019 reporting on the past year:

Learn more about high-risk substance use among youth. Learn more about suicide.

Mental, behavioral, and developmental disorders begin in early childhood
1 in 6 U.S. children aged 2-8 years (17.4%) had a diagnosed mental, behavioral, or developmental disorder.

Prevalence of mental disorders change with age

Diagnoses of ADHD, anxiety, and depression become are more common with increased age.

Behavior problems are more common among children aged 6-11 years than younger or older children.

Adverse childhood events (ACEs) are associated with children's physical and mental health. In 2016-2019, among children aged 6-17 years:

Children who were discriminated against based on race or ethnicity had higher percentages of one or more physical health conditions (37.8% versus 27.1%), and one or more mental health conditions (28.9% versus 17.8%).

Racial/ethnic discrimination was almost seven times as common among children with three other ACEs compared to those with no other ACEs.

Note: The estimates reported on this page are based on parent report, using nationally representative surveys. This method has several limitations. It is not known to what extent children receive these diagnoses accurately. Estimates based on parent-reported diagnoses may match those based on medical records, but some children may also have mental disorders that have not been diagnosed, or receive diagnoses that may not be the best fit for their symptoms. Limited information on measuring children's mental health nationally is available.

Read more about children's mental health from a community study.

Access to mental health treatment

Early diagnosis and appropriate services for children and their families can make a difference in the lives of children with mental disorders. Access to providers who can offer services, including screening, referrals, and treatment, varies by location. CDC is working to learn more about access to behavioral health services and supports for children and their families.
View information by state describing the rates of different types of providers who can offer behavioral health services providers by county. Read a recent report describing shortages of services, barriers to treatment, and how integration of behavioral health care with pediatric primary care could address the issues. Read a policy brief on potential ways to increase access to mental health services for children in rural areas
Data sources for mental health and related conditions

There are many different datasets which include information on children's mental health and related conditions for children living in the United States.

Healthy People 2030
Healthy People 2030 sets data-driven national objectives to improve health and well-being over the next decade, including children's mental health and well-being.

National Survey of Family Growth (NSFG)
NSFG gathers information on family life, marriage and divorce, pregnancy, infertility, use of contraception, and general and reproductive health.

National Health and Nutrition Examination Survey (NHANES)
NHANES assesses health and nutritional status through interviews and physical examinations, and includes conditions, symptoms, and concerns associated with mental health and substance abuse, as well as the use and need for mental health services.

National Health Interview Survey (NHIS)
NHIS collects data on children's mental health, mental disorders, such as ADHD, autism spectrum disorder, depression and anxiety problems, and use and need for mental health services.

National Survey of Children's Health (NSCH)
NSCH examines the health of children, with emphasis on well-being, including medical homes, family interactions, the health of parents, school and after-school experiences, and safe neighborhoods. This survey was redesigned in 2016.

For previous versions of this survey, see also:
National Survey of Children's Health (NSCH 2003, 2007, 2011-12)
National Survey of Children with Special Healthcare Needs (NS-CSHCN 2001, 2005-6, 2009-10)

National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (NS-DATA)
NS-DATA collects information about children, 2-15 years old in 2011-2012, who had ever been diagnosed with ADHD and/or Tourette syndrome (TS), with the goal of better understanding diagnostic practices, level of impairment, and treatments for this group of children.

National Survey on Drug Use and Health (NSDUH)
NSDUH, administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), provides national- and state-level data on the use of tobacco, alcohol, and illicit drugs (including non-medical use of prescription drugs), as well as data on mental health in the United States.

National Vital Statistics System (NVSS)
NVSS contains vital statistics from the official records of live births, deaths, causes of death, marriages, divorces, and annulment recorded by states and independent registration areas

National Youth Tobacco Survey (NYTS)
NYTS is a nationally representative school-based survey on tobacco use by public school students enrolled in grades 6-12.

School Associated Violent Death Study (SAVD)
SAVD plays an important role in monitoring trends related to school-associated violent deaths (including suicide), identifying the factors that increase the risk, and assessing the effects of prevention efforts.

School Health Policies and Programs Study (SHPPS)
SHPPS is a national survey assessing school health policies and practices at the state, district, school, and classroom levels. Collected data includes mental health and social service policies.

Web-based Injury Statistics Query and Reporting System (WISQARS)
WISQARS is an interactive database system that provides customized reports of injury-related data.

Youth Risk Behavior Surveillance System (YRBSS)
The YRBSS monitors health-risk behaviors, including tobacco use, substance abuse, unintentional injuries and violence, sexual behaviors that contribute to unintended pregnancy, and sexually transmitted diseases.

References

1. Perou R, Bitsko RH, Blumberg SJ, Pastor P, Ghandour RM, Gfroerer JC, Hedden SL, Crosby AE, Visser SN, Schieve LA, Parks SE, Hall JE, Brody D, Simile CM, Thompson WW, Baio J, Avenevoli S, Kogan MD, Huang LN. Mental health surveillance among children - United States, 2005-2011. MMWR 2013;62(Suppl; May 16, 2013):1-35. [Read summary]

2. Bitsko RH, Claussen AH, Lichtstein J, Black LJ, Everett Jones S, Danielson MD, Hoenig JM, Davis Jack SP, Brody DJ, Gyawali S, Maenner MM, Warner M, Holland KM, Perou R, Crosby AE, Blumberg SJ, Avenevoli S, Kaminski JW, Ghandour RM. Surveillance of Children's Mental Health - United States, 2013 - 2019 MMWR, , 2022 / 71(Suppl-2);1-42. [Read article]

3. Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, Blumberg SJ. Prevalence and treatment of depression, anxiety, and conduct problems in U.S. children. The Journal of Pediatrics, 2018. Published online before print October 12, 2018 [Read summary]

4. Bitsko RH, Holbrook JR, Ghandour RM, Blumberg SJ, Visser SN, Perou R, Walkup J. Epidemiology and impact of healthcare provider diagnosed anxiety and depression among US children. Journal of Developmental and Behavioral Pediatrics. Published online before print April 24, 2018 [Read summary]

5. Cree RA, Bitsko RH, Robinson LR, Holbrook JR, Danielson ML, Smith DS, Kaminski JW, Kenney MK, Peacock G. Health care, family, and community factors associated with mental, behavioral, and developmental disorders and poverty among children aged 2-8 years - United States, 2016. MMWR, 2018;67(5):1377-1383. [Read article]

6. Hutchins HJ, Barry CM, Valentine V, Bacon S, Njai R, Claussen AH, Ghandour RM, Lebrun-Harris LA, Perkins K, Robinson LR (submitted). Perceived racial/ethnic discrimination, physical and mental health conditions in childhood, and the relative role of other adverse experiences. Adversity and Resilience Science published online May 23, 2022. [Read summary]

7. US Department of Health and Human Services Health Resources and Services Administration & Maternal and Child Health Bureau. Mental health: A report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, and National Institutes of Health, National Institute of Mental Health; 1999. [Read report]

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Data and Statistics on Children's Mental Health | CDC

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Read data highlights about children's mental health.

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In 2017, 13% of U.S. teens ages 12 to 17 (or 3.2 million) said they had experienced at least one major depressive episode in the past year, up from 8% (or 2 million) in 2007, according to a Pew Research Center analysis of data from the 2017 National Survey on Drug Use and Health.

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Depression has become increasingly common among American teenagers - especially teen girls, who are now almost three times as likely as teen boys to have had recent experiences with depression.

In 2017, 13% of U.S. teens ages 12 to 17 (or 3.2 million) said they had experienced at least one major depressive episode in the past year, up from 8% (or 2 million) in 2007, according to a Pew Research Center analysis of data from the 2017 National Survey on Drug Use and Health.

One-in-five teenage girls - or nearly 2.4 million - had experienced at least one major depressive episode (the proxy measure of depression used in this analysis) over the past year in 2017. By comparison, 7% of teenage boys (or 845,000) had at least one major depressive episode in the past 12 months.

The total number of teenagers who recently experienced depression increased 59% between 2007 and 2017. The rate of growth was faster for teen girls (66%) than for boys (44%).

While teenage girls are more likely to have faced depression than their male peers, they are also more likely to have received treatment by seeing a professional or taking medication. Among teen girls who had recent depressive episodes, 45% received treatment for depression over the past year. By comparison, 33% of teen boys with recent depressive episodes received treatment.

The number of adults who had experienced depression also increased from 14.8 million in 2007 to 17.3 million in 2017, though the share remained the same (7%). Adults also differed by gender in their experiences with depression (9% of women vs. 5% of men).

Adults who have experienced depression are treated at higher rates than teens. Among adults who had recent depressive episodes, about two-thirds (67%) received treatment. Again, women who had a recent experience with depression (72%) were more likely than men (58%) to receive treatment.

Teens express concern about anxiety and depression among peers, feel day-to-day pressures

Seven-in-ten U.S. teens said anxiety and depression is a major problem among people their age in the community where they live, according to a Pew Research Center survey of teenagers ages 13 to 17 conducted in fall 2018. An additional 26% cited anxiety and depression as a minor problem.

About three-in-ten teens (29%) said they felt tense or nervous about their day every or almost every day, and 45% said they felt tense or nervous sometimes. About a third of teen girls (36%) reported feeling this way every day or almost every day, compared with 23% of teen boys.

Academic and social pressures are among the reasons cited by experts who have studied teen depression. The Center's survey asked about some of those pressures teens face in their daily lives. About six-in-ten teens (61%) said they personally felt a lot of pressure to get good grades, while roughly three-in-ten reported a lot of pressure to look good and fit in socially (29% and 28%, respectively).

About this analysis

This analysis uses data from the 2017 National Survey on Drug Use and Health (NSDUH), which is directed by the U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration and overseen by the Center for Behavioral Health Statistics and Quality.

"Major depressive episode" is used throughout this analysis as a proxy measure of depression; as such, that term and "depression" are used interchangeably. A " major depressive episode " is defined as a period of at least two weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specific depression symptoms in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). "Treatment" of depression is defined in the NSDUH survey as seeing or talking to a health or alternative service professional or using prescription medication for depression in the past year.

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A growing number of American teenagers - particularly girls - are facing depression

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Depression is rising among American teenagers, and teen girls are particularly likely to have had recent depressive episodes.

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In the United States, as many as 10 in 100 young women suffer from an eating disorder. Disordered eating related to stress, poor nutritional habits, and food fads are relatively common problems for youth. In addition, two psychiatric eating disorders, anorexia nervosa and bulimia, are on the increase among teenage girls and young women and often run in families. These two eating disorders also occur in boys, but less often.

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Eating Disorders in Teens

In the United States, as many as 10 in 100 young women suffer from an eating disorder. Disordered eating related to stress, poor nutritional habits, and food fads are relatively common problems for youth. In addition, two psychiatric eating disorders, anorexia nervosa and bulimia, are on the increase among teenage girls and young women and often run in families. These two eating disorders also occur in boys, but less often.

Parents frequently wonder how to identify symptoms of anorexia nervosa and bulimia. These disorders are characterized by a preoccupation with food and a distortion of body image. Unfortunately, many teenagers hide these serious and sometimes fatal disorders from their families and friends.

Symptoms and warning signs of anorexia nervosa and bulimia include the following:

A teenager with anorexia nervosa is typically female, and a perfectionist and a high achiever in school. At the same time, she suffers from low self-esteem, irrationally believing she is fat regardless of how thin she becomes. Desperately needing a feeling of mastery over her life, the teenager with anorexia nervosa experiences a sense of control only when she says "no" to the normal food demands of her body. In a relentless pursuit to be thin, the girl starves herself. This often reaches the point of serious damage to the body, and in a small number of cases may lead to death.

The symptoms of bulimia are usually different from those of anorexia nervosa. The patient binges on large quantities of high-caloric food and/or purges her body of dreaded calories by self-induced vomiting, extreme exercise, or laxatives. The binges may alternate with severe diets, resulting in dramatic weight fluctuations. Teenagers may try to hide the signs of throwing up by runing water while spending long periods of time in the bathroom. Frequent vomiting can cause a serious threat to the patient's physical health, including dehydration, hormonal imbalance, the depletion of important minerals, and damage to vital organs.

Binge eating can also occur on its own without the purging of bulimia and can lead to eventual purging. Children with binge eating disorder also require treatment from a mental health professional.

Avoidant/Restrictive Food Intake Disorder (or ARFID) is another eating disorder which can occur in younger children or adolescents. It involves a disturbance in eating or feeding which includes substantial weight loss or a lack of expected weight gain, and nutritional deficiencies. ARFID can lead to dependence on a feeding tube or dietary supplements.

With comprehensive treatment, most children and teenagers can recover from disordered eating. The child and adolescent psychiatrist is trained to evaluate, diagnose, and treat these psychiatric disorders. Treatment for eating disorders usually requires a team approach, including individual therapy, family therapy, working with a primary care physician, working with a nutritionist, and medication. Many children and adolescents also suffer from other problems including depression, anxiety, and substance abuse. It is important to recognize and get appropriate treatment for these problems as well.

Research shows that early identification and treatment leads to more favorable outcomes. Parents who notice symptoms of anorexia or bulimia in their teenagers should ask their family physician or pediatrician for a referral to a child and adolescent psychiatrist.

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medical issues affecting youth mental health

# data[].attributes.attachment_link.description
Eating Disorders in Teens In the United States, as many as 10 in 100 young women suffer from an eating disorder. Disordered eating related to stress, poor nutritional habits, and food fads are relatively common problems for youth.

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bad memories, called flashbacks, that make it seem like the trauma is still happening. bad dreams or trouble sleeping. avoiding things that remind them of the trauma. changes in mood, such as feeling sad, moody, angry, or detached.

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bad memories, called flashbacks, that make it seem like the trauma is still happening. bad dreams or trouble sleeping. avoiding things that remind them of the trauma. changes in mood, such as feeling sad, moody, angry, or detached.

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Teen depression is a serious mental health problem that causes a persistent feeling of sadness and loss of interest in activities

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Overview

Teen depression is a serious mental health problem that causes a persistent feeling of sadness and loss of interest in activities. It affects how your teenager thinks, feels and behaves, and it can cause emotional, functional and physical problems. Although depression can occur at any time in life, symptoms may be different between teens and adults.

Issues such as peer pressure, academic expectations and changing bodies can bring a lot of ups and downs for teens. But for some teens, the lows are more than just temporary feelings - they're a symptom of depression.

Teen depression isn't a weakness or something that can be overcome with willpower - it can have serious consequences and requires long-term treatment. For most teens, depression symptoms ease with treatment such as medication and psychological counseling.

Symptoms

Teen depression signs and symptoms include a change from the teenager's previous attitude and behavior that can cause significant distress and problems at school or home, in social activities, or in other areas of life.

Depression symptoms can vary in severity, but changes in your teen's emotions and behavior may include the examples below.

Emotional changes

Be alert for emotional changes, such as:

Feelings of sadness, which can include crying spells for no apparent reason

Frustration or feelings of anger, even over small matters

Feeling hopeless or empty

Irritable or annoyed mood

Loss of interest or pleasure in usual activities

Loss of interest in, or conflict with, family and friends

Low self-esteem

Feelings of worthlessness or guilt

Fixation on past failures or exaggerated self-blame or self-criticism

Extreme sensitivity to rejection or failure, and the need for excessive reassurance

Trouble thinking, concentrating, making decisions and remembering things

Ongoing sense that life and the future are grim and bleak

Frequent thoughts of death, dying or suicide

Behavioral changes

Watch for changes in behavior, such as:

Tiredness and loss of energy

Insomnia or sleeping too much

Changes in appetite - decreased appetite and weight loss, or increased cravings for food and weight gain

Use of alcohol or drugs

Agitation or restlessness - for example, pacing, hand-wringing or an inability to sit still

Slowed thinking, speaking or body movements

Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse

Social isolation

Poor school performance or frequent absences from school

Less attention to personal hygiene or appearance

Angry outbursts, disruptive or risky behavior, or other acting-out behaviors

Self-harm - for example, cutting or burning

Making a suicide plan or a suicide attempt

What's normal and what's not

It can be difficult to tell the difference between ups and downs that are just part of being a teenager and teen depression. Talk with your teen. Try to determine whether he or she seems capable of managing challenging feelings, or if life seems overwhelming.

When to see a doctor

If depression signs and symptoms continue, begin to interfere in your teen's life, or cause you to have concerns about suicide or your teen's safety, talk to a doctor or a mental health professional trained to work with adolescents. Your teen's family doctor or pediatrician is a good place to start. Or your teen's school may recommend someone.

Depression symptoms likely won't get better on their own - and they may get worse or lead to other problems if untreated. Depressed teenagers may be at risk of suicide, even if signs and symptoms don't appear to be severe.

If you're a teen and you think you may be depressed - or you have a friend who may be depressed - don't wait to get help. Talk to a health care provider such as your doctor or school nurse. Share your concerns with a parent, a close friend, a spiritual leader, a teacher or someone else you trust.

Symptoms

Suicide is often associated with depression. If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

Also consider these options if you're having suicidal thoughts:

Call your mental health professional.

Contact a suicide hotline.

In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. The Spanish language phone line is 1-888-628-9454 (toll-free). Services are free and confidential.

Or contact a crisis service for teenagers in the U.S. called TXT 4 HELP: Text the word "safe" and your current location to 4HELP (44357) for immediate help, with the option for interactive texting.

Seek help from your primary care doctor or other health care provider.

Reach out to a close friend or loved one.

Contact a minister, spiritual leader or someone else in your faith community.

If a loved one or friend is in danger of attempting suicide or has made an attempt:

Make sure someone stays with that person.

Call 911 or your local emergency number immediately.

Or, if you can do so safely, take the person to the nearest hospital emergency room.

Never ignore comments or concerns about suicide. Always take action to get help.

Causes

It's not known exactly what causes depression, but a variety of issues may be involved. These include:

Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of your brain and body. When these chemicals are abnormal or impaired, the function of nerve receptors and nerve systems changes, leading to depression.

Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression.

Inherited traits. Depression is more common in people whose blood relatives - such as a parent or grandparent - also have the condition.

Early childhood trauma. Traumatic events during childhood, such as physical or emotional abuse, or loss of a parent, may cause changes in the brain that increase the risk of depression.

Learned patterns of negative thinking. Teen depression may be linked to learning to feel helpless - rather than learning to feel capable of finding solutions for life's challenges.

Risk factors

Many factors increase the risk of developing or triggering teen depression, including:

Having issues that negatively impact self-esteem, such as obesity, peer problems, long-term bullying or academic problems

Having been the victim or witness of violence, such as physical or sexual abuse

Having other mental health conditions, such as bipolar disorder, an anxiety disorder, a personality disorder, anorexia or bulimia

Having a learning disability or attention-deficit/hyperactivity disorder (ADHD)

Having ongoing pain or a chronic physical illness such as cancer, diabetes or asthma

Having certain personality traits, such as low self-esteem or being overly dependent, self-critical or pessimistic

Abusing alcohol, nicotine or other drugs

Being gay, lesbian, bisexual or transgender in an unsupportive environment

Family history and issues with family or others may also increase your teenager's risk of depression, such as:

Having a parent, grandparent or other blood relative with depression, bipolar disorder or alcohol use problems

Having a family member who died by suicide

Having a family with major communication and relationship problems

Having experienced recent stressful life events, such as parental divorce, parental military service or the death of a loved one

Complications

Untreated depression can result in emotional, behavioral and health problems that affect every area of your teenager's life. Complications related to teen depression may include, for example:

Alcohol and drug misuse

Academic problems

Family conflicts and relationship difficulties

Suicide attempts or suicide

Prevention

There's no sure way to prevent depression. However, these strategies may help. Encourage your teenager to:

Take steps to control stress, increase resilience and boost self-esteem to help handle issues when they arise

Practice self-care, for example by creating a healthy sleep routine and using electronics responsibly and in moderation

Reach out for friendship and social support, especially in times of crisis

Get treatment at the earliest sign of a problem to help prevent depression from worsening

Maintain ongoing treatment, if recommended, even after symptoms let up, to help prevent a relapse of depression symptoms

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This serious mental health problem affects how your teenager thinks, feels and behaves, and can cause emotional, functional and physical problems.

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yes because some kids have problems with their life and they struggle with family

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1000 out of 10000 women have eating disorder

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75% of girls with low self-esteem reported engaging in negative activities like cutting, bullying, smoking, drinking, or disordered eating. This compares to 25% of girls with high self-esteem

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75% of girls with low self-esteem reported engaging in negative activities like cutting, bullying, smoking, drinking, or disordered eating. This compares to 25% of girls with high self-esteem

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In the United States, as many as 10 in 100 young women suffer from an eating disorder.

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Eating Disorders in Teens

In the United States, as many as 10 in 100 young women suffer from an eating disorder. Disordered eating related to stress, poor nutritional habits, and food fads are relatively common problems for youth. In addition, two psychiatric eating disorders, anorexia nervosa and bulimia, are on the increase among teenage girls and young women and often run in families. These two eating disorders also occur in boys, but less often.

Parents frequently wonder how to identify symptoms of anorexia nervosa and bulimia. These disorders are characterized by a preoccupation with food and a distortion of body image. Unfortunately, many teenagers hide these serious and sometimes fatal disorders from their families and friends.

Symptoms and warning signs of anorexia nervosa and bulimia include the following:

A teenager with anorexia nervosa is typically female, and a perfectionist and a high achiever in school. At the same time, she suffers from low self-esteem, irrationally believing she is fat regardless of how thin she becomes. Desperately needing a feeling of mastery over her life, the teenager with anorexia nervosa experiences a sense of control only when she says "no" to the normal food demands of her body. In a relentless pursuit to be thin, the girl starves herself. This often reaches the point of serious damage to the body, and in a small number of cases may lead to death.

The symptoms of bulimia are usually different from those of anorexia nervosa. The patient binges on large quantities of high-caloric food and/or purges her body of dreaded calories by self-induced vomiting, extreme exercise, or laxatives. The binges may alternate with severe diets, resulting in dramatic weight fluctuations. Teenagers may try to hide the signs of throwing up by runing water while spending long periods of time in the bathroom. Frequent vomiting can cause a serious threat to the patient's physical health, including dehydration, hormonal imbalance, the depletion of important minerals, and damage to vital organs.

Binge eating can also occur on its own without the purging of bulimia and can lead to eventual purging. Children with binge eating disorder also require treatment from a mental health professional.

Avoidant/Restrictive Food Intake Disorder (or ARFID) is another eating disorder which can occur in younger children or adolescents. It involves a disturbance in eating or feeding which includes substantial weight loss or a lack of expected weight gain, and nutritional deficiencies. ARFID can lead to dependence on a feeding tube or dietary supplements.

With comprehensive treatment, most children and teenagers can recover from disordered eating. The child and adolescent psychiatrist is trained to evaluate, diagnose, and treat these psychiatric disorders. Treatment for eating disorders usually requires a team approach, including individual therapy, family therapy, working with a primary care physician, working with a nutritionist, and medication. Many children and adolescents also suffer from other problems including depression, anxiety, and substance abuse. It is important to recognize and get appropriate treatment for these problems as well.

Research shows that early identification and treatment leads to more favorable outcomes. Parents who notice symptoms of anorexia or bulimia in their teenagers should ask their family physician or pediatrician for a referral to a child and adolescent psychiatrist.

# data[].attributes.attachment_link.keywords[]
medical issues affecting youth mental health

# data[].attributes.attachment_link.description
Eating Disorders in Teens In the United States, as many as 10 in 100 young women suffer from an eating disorder. Disordered eating related to stress, poor nutritional habits, and food fads are relatively common problems for youth.

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Say positive things to yourself .

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Self-esteem: Take steps to feel better about yourself

Harness the power of your thoughts and beliefs to raise your self-esteem. Start with these steps.
By Mayo Clinic Staff
Low self-esteem can affect nearly every aspect of life. It can impact your relationships, job and health. But you can boost your self-esteem by taking cues from mental health counseling.

Consider these steps, based on cognitive behavioral therapy.

1. Recognize situations that affect self-esteem

Think about the situations that seem to deflate your self-esteem. Common triggers might include:

A work or school presentation

A crisis at work or home

A challenge with a spouse, loved one, co-worker or other close contact

A change in roles or life events, such as a job loss or a child leaving home

2. Become aware of thoughts and beliefs

Once you've learned which situations affect your self-esteem, notice your thoughts about them. This includes what you tell yourself (self-talk) and how you view the situations.

Your thoughts and beliefs might be positive, negative or neutral. They might be rational, based on reason or facts. Or they may be irrational, based on false ideas.

Ask yourself if these beliefs are true. Would you say them to a friend? If you wouldn't say them to someone else, don't say them to yourself.

3. Challenge negative thinking

Your initial thoughts might not be the only way to view a situation. Ask yourself whether your view is in line with facts and logic. Or is there another explanation?

Be aware that it can be hard to see flaws in your logic. Long-held thoughts and beliefs can feel factual even if they're opinions.

Also notice if you're having these thought patterns that erode self-esteem:

All-or-nothing thinking. This involves seeing things as either all good or all bad. For example, you may think, "If I don't succeed in this task, I'm a total failure."

Mental filtering. This means you focus and dwell on the negatives. It can distort your view of a person or situation. For example, "I made a mistake on that report and now everyone will realize I'm not up to the job."

Converting positives into negatives. This may involve rejecting your achievements and other positive experiences by insisting that they don't count. For example, "I only did well on that test because it was so easy."

Jumping to negative conclusions. You may tend to reach a negative conclusion with little or no evidence. For example, "My friend hasn't replied to my text, so I must have done something to make her angry."

Mistaking feelings for facts. You may confuse feelings or beliefs with facts. For example, "I feel like a failure, so I must be a failure."

Negative self-talk. You undervalue yourself. You may put yourself down or joke about your faults. For example, you may say, "I don't deserve anything better."

4. Adjust your thoughts and beliefs

Now replace negative or untrue thoughts with positive, accurate thoughts. Try these strategies:

Use hopeful statements. Be kind and encouraging to yourself. Instead of thinking a situation won't go well, focus on the positive. Tell yourself, "Even though it's tough, I can handle this."

Forgive yourself. Everyone makes mistakes. But mistakes aren't permanent reflections on you as a person. They're moments in time. Tell yourself, "I made a mistake, but that doesn't make me a bad person."

Avoid 'should' and 'must' statements. If you find that your thoughts are full of these words, you might be putting too many demands on yourself. Try to remove these words from your thoughts. It may lead to a healthier view of what to expect from yourself.

Focus on the positive. Think about the parts of your life that work well. Remember the skills you've used to cope with challenges.

Consider what you've learned. If it was a negative experience, what changes can you make next time to create a more positive outcome?

Relabel upsetting thoughts. Think of negative thoughts as signals to try new, healthy patterns. Ask yourself, "What can I think and do to make this less stressful?"

Encourage yourself. Give yourself credit for making positive changes. For example, "My presentation might not have been perfect, but my colleagues asked questions and remained engaged. That means I met my goal."

You might also try these steps, based on acceptance and commitment therapy.

1. Spot troubling conditions or situations

Again, think about the conditions or situations that seem to deflate your self-esteem. Then pay attention to your thoughts about them.

2. Step back from your thoughts

Repeat your negative thoughts many times. The goal is to take a step back from automatic thoughts and beliefs and observe them. Instead of trying to change your thoughts, distance yourself from them. Realize that they are nothing more than words.

3. Accept your thoughts

Instead of resisting or being overwhelmed by negative thoughts or feelings, accept them. You don't have to like them. Just allow yourself to feel them.

Negative thoughts don't need to be controlled, changed or acted upon. Aim to lessen their power on your behavior.

These steps might seem awkward at first. But they'll get easier with practice. Recognizing the thoughts and beliefs that affect low self-esteem allows you to change the way you think about them. This will help you accept your value as a person. As your self-esteem increases, your confidence and sense of well-being are likely to soar.

In addition to these suggestions, remember that you're worth special care. Be sure to:

Take care of yourself. Follow good health guidelines. Try to exercise at least 30 minutes a day most days of the week. Eat lots of fruits and vegetables. Limit sweets, junk food and saturated fats.

Do things you enjoy. Start by making a list of things you like to do. Try to do something from that list every day.

Spend time with people who make you happy. Don't waste time on people who don't treat you well.

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Show references

1. Orth U, et al. Is high self-esteem beneficial? Revisiting a classic question. American Psychologist. 2022; doi:10.1037/amp0000922.

2. Levenson JL, ed. Psychotherapy. In: The American Psychiatric Association Publishing Textbook of Psychosomatic Medicine and Consultation-Liaison Psychiatry. 3rd ed. American Psychiatric Association Publishing; 2019. https://psychiatryonline.org. Accessed April 27, 2022.

3. Kliegman RM, et al. Psychotherapy and psychiatric hospitalization. In: Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed April 27, 2022.

4. Fusar-Poli P, et al. What is good mental health? A scoping review. European Neuropsychopharmacology. 202; doi:10.1016/j.euroneuro.2019.12.105.

5. Van de Graaf DL, et al. Online acceptance and commitment therapy (ACT) interventions for chronic pain: A systematic literature review. Internet Interventions. 2021; doi:10.1016/j.invent.2021.100465.

6. Bourne EJ. The Anxiety and Phobia Workbook. 7th ed. New Harbinger Publications; 2020.

7. Ebert MH, et al., eds. Behavioral and cognitive-behavioral interventions. In: Current Diagnosis & Treatment: Psychiatry. 3rd ed. McGraw Hill; 2019. https://www.accessmedicine.mhmedical.com. Accessed May 4, 2022.

8. Self-esteem self-help guide. NHS inform. https://www.nhsinform.scot/illnesses-and-conditions/mental-health/mental-health-self-help-guides/self-esteem-self-help-guide. Accessed May 4, 2022.

See more In-depth

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Overcome negative self-talk and low self-esteem by using techniques from mental health counseling.

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Yes because they are surrounded by kids that have all their feeling bawled up in their mind so they take it out on other people. its like a disease that spreads and speads and doesn't stop

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20% of females and 6.8% of males aged 12-17 suffered a depressive episode in 2017
16.9% of adolescents “reporting two or more races” suffered a depressive episode in 2017; this represents the highest subgroup of adolescents affected by depression, according to the NIMH
60.1% of depressed adolescents received no treatment; 19.6% received treatment from a health professional; 2.4% were treated with medication alone; 17.6% received treatment from both a health professional and medication (NIMH)
Based on the 2017 Youth Risk Behaviors Survey, 7.4 percent of youth in grades 9-12 reported that they had made at least one suicide attempt in the past 12 months

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Teenage depression might be more common than you think. Learn about the symptoms, causes, and how you can help as a parent.

It's normal for teenagers to have bouts of irritability, sleepiness, and sadness. But when symptoms last for two weeks or more, it could signal depression. "It's generally stated that one in five young people will develop depression before they reach age 25," says Susan Weinstein, co-executive director of programs and operations at Families for Depression Awareness. Learn more about teen depression statistics, then understand the causes, risk factors, and how you can help as a parent.

Teen Depression Statistics

According to the National Institute of Mental Health (NIMH), 13.3% of adolescents aged 12 to 17 had "at least one major depressive episode" in 2017. That equates to 3.2 million American teens. What's more, 70.77% of depression sufferers experienced at least one instance of "severe impairment" that interfered with life.

Here are some other relevant statistics:

20% of females and 6.8% of males aged 12-17 suffered a depressive episode in 2017

16.9% of adolescents "reporting two or more races" suffered a depressive episode in 2017; this represents the highest subgroup of adolescents affected by depression, according to the NIMH

60.1% of depressed adolescents received no treatment; 19.6% received treatment from a health professional; 2.4% were treated with medication alone; 17.6% received treatment from both a health professional and medication (NIMH)

Based on the 2017 Youth Risk Behaviors Survey, 7.4 percent of youth in grades 9-12 reported that they had made at least one suicide attempt in the past 12 months

Unfortunately, rates of teenage depression have risen over the years, says Jennifer Rothman, senior manager of youth and young adult initiatives at the National Alliance on Mental Illness (NAMI). While more research needs to be done, Rothman hypothesizes a couple reasons behind the trend: the increasing pressure of school work and bullying. Cyberbullying that "doesn't end with the school day" is especially problematic. "We're seeing mental health issues more and more," says Rothman. "People are becoming more aware of the warning signs and seeking help. The earlier depression is recognized, the better the outcomes for the future."

What Causes Depression in Teens?

Depression may be caused by several different factors, according to Rachel Busman, PsyD, a board-certified child and adolescent psychologist and senior director of the Anxiety Disorders Center at the Child Mind Institute. For starters, she says "kids can have a biological predisposition toward anxiety or depression, which sets the stage for the condition." In other words, having a parent with depression makes children and teens more likely to develop depression themselves. That's partly because kids learn from their parent's behavior and tend to imitate their actions.

Depression may also be triggered by your biology/brain chemistry, as well as negative childhood experiences like neglect, trauma, abuse, or parental divorce. Another risk factor is being forced into stressful life events - like dealing with a family death or starting college - without sufficient coping strategies or a support network. What's more, Rothman says kids who have a hard time in school, such as those with learning disabilities, could develop depression if they're falling behind in their classes and grades.

Finally, there may be a link between childhood depression and anxiety. "An untreated anxiety disorder in a child is one of the top predictors of developing depression by the time you hit adolescence,"says Lynn Lyons, licensed clinical social worker, psychotherapist, speaker, and author of Anxious Kids, Anxious Parents. "If you have an anxiety issue and don't learn the skills to help, your odds of becoming depressed are pretty high."

Symptoms of Teen Depression

If your teen displays at least five of the following symptoms for two weeks or more, he/she may have depression:

Sadness or a depressed mood

Feelings of hopelessness or worthlessness

Large amounts of irritability or anger

Loss of interest in activities he/she previously enjoyed

Changes in sleep patterns

Changes in eating habits

Restlessness

Excessive guilt

Difficulty concentrating

Headaches, stomach problems, or body aches

Suicidal tendencies; "these can range from thinking about death to planning to kill yourself," says Dr. Busman

Depression Treatment: How to Help a Teen with Depression

If you think your teen has depression, don't panic. "Remember that depression is a treatable disorder. It's not permanent," says Lyons. However, it's important to seek treatment sooner rather than later, since depression can come with a host of negative consequences. These include academic failure, substance misuse, impaired interpersonal relationships with family and peers, eating disorders, increased severity of health conditions, crime, and suicidal behaviors, says Weinstein. What's more, Rothman adds that kids with depression simply won't live life to the fullest.

The first step a parent should take is "seeking out accurate information from people who specialize in the treatment of depression," says Lyons. Then you should approach your teen with openness and acceptance. Don't be afraid to call out symptoms you've been noticing (like spending excess time alone, dwindling grades, etc.) and ask their opinion about treatment options. "Parents always want to give opinions and advice, but they don't always take the time to listen to children's needs and feelings," says Rothman. "Parents need to make their children feel heard and make them a part of the solution."

"Look for a mental health provider who has specialization in children and adolescents and who practices evidence-based care," Dr. Busman suggests. It's important to note, however, that you should seek help immediately if your child has suicidal thoughts or behaviors.

Experts often treat teen depression with medication or talk therapy (psychotherapy). For moderate to severe depression, teens usually improve best with a combination of medication and therapy - particularly cognitive behavioral therapy (CBT), says Weinstein. She also recommends three lifestyle factors that can manage symptoms of depression: adequate sleep, balanced eating, and exercise.

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Teen Depression: Statistics, Causes, and Treatment

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Teenage depression might be more common than you think. Learn about the symptoms, causes, and how you can help as a parent. It's normal for teenagers to have bouts of irritability, sleepiness, and sadness. But when symptoms last for two weeks or more, it could signal depression.

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Yes because when something traumatic happens in their life they won't want to be happy unless they get over that sadness

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yes very much so.

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Depression has become increasingly common among American teenagers - especially teen girls, who are now almost three times as likely as teen boys to have had recent experiences with depression.

In 2017, 13% of U.S. teens ages 12 to 17 (or 3.2 million) said they had experienced at least one major depressive episode in the past year, up from 8% (or 2 million) in 2007, according to a Pew Research Center analysis of data from the 2017 National Survey on Drug Use and Health.

One-in-five teenage girls - or nearly 2.4 million - had experienced at least one major depressive episode (the proxy measure of depression used in this analysis) over the past year in 2017. By comparison, 7% of teenage boys (or 845,000) had at least one major depressive episode in the past 12 months.

The total number of teenagers who recently experienced depression increased 59% between 2007 and 2017. The rate of growth was faster for teen girls (66%) than for boys (44%).

While teenage girls are more likely to have faced depression than their male peers, they are also more likely to have received treatment by seeing a professional or taking medication. Among teen girls who had recent depressive episodes, 45% received treatment for depression over the past year. By comparison, 33% of teen boys with recent depressive episodes received treatment.

The number of adults who had experienced depression also increased from 14.8 million in 2007 to 17.3 million in 2017, though the share remained the same (7%). Adults also differed by gender in their experiences with depression (9% of women vs. 5% of men).

Adults who have experienced depression are treated at higher rates than teens. Among adults who had recent depressive episodes, about two-thirds (67%) received treatment. Again, women who had a recent experience with depression (72%) were more likely than men (58%) to receive treatment.

Teens express concern about anxiety and depression among peers, feel day-to-day pressures

Seven-in-ten U.S. teens said anxiety and depression is a major problem among people their age in the community where they live, according to a Pew Research Center survey of teenagers ages 13 to 17 conducted in fall 2018. An additional 26% cited anxiety and depression as a minor problem.

About three-in-ten teens (29%) said they felt tense or nervous about their day every or almost every day, and 45% said they felt tense or nervous sometimes. About a third of teen girls (36%) reported feeling this way every day or almost every day, compared with 23% of teen boys.

Academic and social pressures are among the reasons cited by experts who have studied teen depression. The Center's survey asked about some of those pressures teens face in their daily lives. About six-in-ten teens (61%) said they personally felt a lot of pressure to get good grades, while roughly three-in-ten reported a lot of pressure to look good and fit in socially (29% and 28%, respectively).

This analysis uses data from the 2017 National Survey on Drug Use and Health (NSDUH), which is directed by the U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration and overseen by the Center for Behavioral Health Statistics and Quality.

"Major depressive episode" is used throughout this analysis as a proxy measure of depression; as such, that term and "depression" are used interchangeably. A " major depressive episode " is defined as a period of at least two weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specific depression symptoms in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). "Treatment" of depression is defined in the NSDUH survey as seeing or talking to a health or alternative service professional or using prescription medication for depression in the past year.

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A growing number of American teenagers - particularly girls - are facing depression

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Depression has become increasingly common among American teenagers - especially teen girls, who are now almost three times as likely as teen boys to have had recent experiences with depression. In 2017, 13% of U.S.

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Yes, because many of the statistics show how most teens struggle with many mental health issues. 15% - 43% of girls and 14% - 43% of boys go through at least one trauma, which can lead towards mental health issues. So yes, teens can struggle from mental health issues.

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2.7% of teens in the U.S. between 13 and 18 years old have an eating disorder.

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Prevention tips for teen eating disorders

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How to talk to your teen about eating disorders and promote a healthy lifestyle for the entire family.

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Yes I think they do with everything going on and trying to figure out where they need should be and where they fit in and their family life.