Adolescence and Mental Health

Adolescence can be a tricky time for many young people and has been highlighted as crucial time in the development of mental health difficulties. The Future in Mind report (2015) found that around half of all mental health difficulties are established by age 14. Here's what the current research is around adolescence and its impact on mental health.

Defining Adolescence

In order to understand why this developmental stage is linked to the onset of mental health difficulties, adolescence needs to be defined for today’s society. In the past, adolescence had a clear starting point - the onset of puberty and biological changes to the body - and ended as certain societal roles were being fulfilled, such as ending education, getting married and starting employment.
The starting point has not changed much, however, the end of adolescence is less clearly defined as expectations and norms in society has changed. Although legally adulthood starts at 18 years old, many young adults are still in education through their mid-twenties with more opportunities to apply for PhDs. The average age for marriage and having children has increased as advances in family planning allow for greater choice in when and how to have children if a career is sought after first, and many may choose not to get married until much later in life.
Adolescence could now be defined as starting with puberty but ending when an individual is able to establish an independent and stable role in society (Blakemore and Robbins, 2012, and Sawyer et al 2012). When discussing adolescence through the next sections, the broadest age range that has been used in research will be adopted which is ages 10-24.

Current Research

Looking into how the brain develops during adolescence is a relatively new field in psychology. Some of the initial findings have come through research with animal and post mortem samples, which have their limitations. These found that there most likely were more changes happening than previously thought, including the development and pruning on synapses (a region where nerve impulses are transmitted and received). With the development of Magnetic Resonance Imaging scanners (MRIs), studies are now being conducted with a wider range of participants and with greater detail (Blakemore and Choudhury, 2006).

One of the main findings from both animal- and MRI-based studies is that the brain appears to undergo significant changes through adolescence. Scans of the prefrontal and parietal cortexes show changes in white and grey matter which is thought to be a process of improving skills such as planning, decision-making and multitasking when exposed to new social, emotional or behavioural stimulus. Hormones released and changing during adolescence may have a crucial part in the rate of brain development and how it structures itself (Blakemore and Choudhury, 2006 and Sawyer et al, 2012).

It is also being understood that different parts of the brain develop at different rates, which is why increased risk-taking might be most common during the teenage years. Although it seems the ability to make decisions improves with age, it is more likely that poorer decisions will be made in adolescence because of changes in development (Blakemore and Choudhury, 2006 and Blakemore and Robbins, 2012). Some studies have developed further on this, looking into risky decision-making in different contexts. Findings show that adolescents engaged in more risky behaviours when with their peers compared to other groups such as with family or with adults (Blakemore and Robbins, 2012).
Behaviours that are learnt during adolescence could contribute towards health conditions such as high blood pressure, so continued engagement in risky behaviours could have a profound negative effect on health and well-being in adulthood (Sawyer et al, 2012).

So, far more might be happening in the brains of our young people than previously thought. Not only are their bodies changing, but how they think and process situations is changing too. It is important that during adolescence, they are being taught and encouraged to participate in healthy behaviours, such as:
- Emotional regulation (talking about and appropriately expressing emotions)
- Healthy Lifestyles (food & exercise)
- Seeking help
so that these behaviours will carry on into adulthood.

Protective and Risk Factors

As well as changes happening within an individual, there are also societal changes which may either help in protecting against or increase the risk of developing mental health difficulties. A defining factor is transition, most obviously seen in education. Adolescence may start while a young person is still in primary school, so they could face at least 3 school transitions:

Primary School -> Secondary School -> College/Sixth Form -> University etc.

Just this one element of a young persons’ life can cause distress. Changing educational setting can mean a change in physical setting, being part of a different or larger cohort, learning new rules and names of teachers, and making choices about subjects to study. On the protective side, it increases a person’s social mobility and increases availability of extra-curricular activities and different types of behaviours. On the risk side, it may decrease the bonding and interaction between peers and teachers, and increase exposure to risky behaviours (Kim, Osterle, Catalano and Hawkins, 2015).

Other factors that can be protective or increase risk are family, peers and community. Interactions between these and the individual can affect health and developing healthy behaviours (Sawyer et al, 2012). As social mobility increases, interactions with the family may decrease, particularly if there is lots of conflict. Feedback they may get from teachers and peers may vary and be different between genders, which is more evident in social media and marketing (Kim et al, 2015 and Sawyer et al, 2012). Drivers of behaviours around health are thought to be parents, peers, marketing and social media. Social learning theory suggests that adolescents may learn behaviours by imitating them, which is more commonly being associated with peers and social media (Sawyer et al, 2012). Therefore, if unhealthy or risky behaviours are learnt during adolescence, it could increase the risk of development of mental health difficulties.

So, what can we do?

1) Talk to them
We were all young people once and know what it is like to juggle all the different school subjects, keep up to date with the latest trends and try and hide the breakouts. I remember appreciating having someone to talk to, who would listen and answer questions honestly. If we are more open to talking to them, they can see it's ok to talk to others, rather than keeping things bottled up.

2) Role model positive behaviours
Alongside the happy moments in life, there are also the times where we feel angry, upset or worried. Sometimes it is OK to show our young people that we have those emotions and can express them appropriately & in a healthy way. If all they see is how celebrities or their friends cope with stresses, they may be more likely to develop unhealthy coping strategies.

3) Accept the good with the bad
Adolescence will be different for each young person. Some days everything will be peachy and other days it's like the world is falling apart. Sometimes they can be really mature and hold their own, other times they can revert back to being like a little child. It is important that we show them love and grace alongside the boundaries, recognising that they may not even know why they are behaving differently. Being a teenager and parenting a teenager are both hard, so rejoice in the happy times and give yourselves a little more grace when the challenges come.

To summarise...

Adolescence, by definition, has changed as society has changed, and it may continue to do so. It has gone from a clearly defined start and end, but now covers a much broader age range and has a less distinct ending. Much more happens both in the individual and in society to increase potential development of mental health difficulties. The brain appears to undergo significant structural change which could affect an adolescents’ ability to make positive decisions in emotional situations and engage in more risky behaviours. This is also a life stage where more transition occurs, potentially creating higher levels of distress. Peers and social media have a much larger influence on learning healthy behaviours and engaging in risky behaviours, as well as a shift in protective and risk factors. However, if we can be more open in talking to them about our mental health and well-being and model positive behaviours, they are more likely to have better well-being and mental health.

If you want to find out more about this topic, have a listen to 'Teenage Brain' by The Infinite Monkey Cage (presented by Prof Brian Cox & Robin Ince).

This piece is adapted from an essay written during my Master's course.