Michael Phelps appeared in the film "Angst" and discussed his own mental health.
Michael Phelps appeared in the film "Angst" and discussed his own mental health.
The frightening decline in teens’ mental health was well underway before the COVID-19 pandemic.

Emergency rooms had seen a significant increase in the number of children and adolescents coming with issues of self-harm, anxiety and other mental health struggles. Suicide in people younger than 24 jumped nearly 60% in the decade between 2007 and 2018.

By 2019, 13% of adolescents in the United States reported having at least one major depressive episode per year.

Depression is the leading cause of illness and disability in teens worldwide.

No one knows why.

The good news is that mental health and mental illness have been slowly coming out of the shadows for decades, so there’s less stigma attached and teens are more willing to reach out for help.

“It’s more the older generation that struggles,” said Melissa Stupfel, director of school counseling at Central Catholic High School in Southeast Portland. “It’s more about educating some of the adults.”

Stupfel said she doesn’t see students feeling shame or guilt over their mental health.

The students, however, don’t necessarily know how to deal with anxiety or depression when it hits them.

For that reason, Central Catholic is proactive with education on mental health. At the beginning of last year, the school hosted a showing of “Angst,” a video meant to raise awareness about anxiety so that young people can recognize its symptoms and reach out for help.

Central’s invitation to the showing included middle school students at its main feeder schools.

“It was a great movie, and we received lots of positive feedback,” said Stupfel.

Nancy Casey, a primary care provider who has worked in adolescent health for nearly 20 years, was on a panel discussing the film following the showing. She said it made important points in an accessible way, beginning with the assurance that anxiety is treatable.

“There’s no quick fix,” she said. “There’s always a lot of work that goes into it. But it’s not complex work.”

Casey said anxiety management has a lot to do with how we live our day-to-day lives rather than some dramatic fresh start. “It’s more like a constant monitoring,” she said.

The first part of addressing anxiety, she said, is recognizing and acknowledging our symptoms. When are a headache or insomnia, for instance, not just low blood sugar or too much caffeine but rather anxiety?

Next comes addressing the anxiety, retraining our brains, so that we’re not feeling an everyday stress — studying for a test, perhaps, or a date — like it’s a tiger about to attack.

“Don’t avoid the things that make you anxious,” Cassey said. “The world is a less dangerous place than we think.”

Still, she added, anxiety is normal. “It helps us do better on tests and helps keep us safe. It’s when it becomes out of proportion that it’s a problem.”

Central Catholic bought two other films for one-time showings from the producers of “Angst.” One is about bullying and the other is about social media.

Stupfel has a nuanced view of social media. She does sometimes suggest to a student who comes to her with problems that they might take a break from it, or perhaps check out body-positive apps.

She and other counselors have many suggestions for students dealing with anxiety or other mental health challenges. Stupfel may ask a student about their coping skills. She and the student may brainstorm to come up with more tools for resilience.

She also reminds them of the basics. Are they getting enough sleep?

Eating a healthy diet? How about their connections with their loved ones and peers? Are they getting outside often enough, into the sunshine and fresh air?

Are they remembering breathing techniques? Deep, slow breaths? And how are their connections with their faith community?

That is another source of good news regarding adolescent mental health: There’s a strong correlation between religiosity and mental health.

This spring an Australian study looked at school influences on adolescent depression and found that “adolescents in Catholic schools reported significantly fewer symptoms of depression compared to those in Government and Independent schools.”

In 2019, Jane Cooley Fruehwirth wrote in America magazine that the positive effects of religiosity were strongest for adolescents presenting with the most severe symptoms of depression, teens who are often the hardest to treat.

Fruehwirth is associate professor in the Economics Department at Chapel Hill in North Carolina and co-author of “Religion and Depression in Adolescence,” published in the Journal of Political Economy in June 2019.

She found that teens who are exposed to religious peers become more religious themselves. Increased individual religiosity makes the difference, buffering teens against life’s inevitable blows and revealing a sense of meaning and purpose.

That doesn’t mean that Catholic students are immune from the epidemic of mental health crises.

“All the high schools are facing a mental health crisis at a staggering rate,” said Stupfel.

Neither does it mean that faith is a substitute for treatment.

Cameron Bellm, a Catholic author who has struggled with mental health and is based in Seattle, wrote in Sanctuary Mental Health about attending a Mass when the second reading was Romans 12:12: “Rejoice in hope, endure in affliction, persevere in prayer.”

The words were like a balm to her, but then the pastor’s homily poisoned their meaning. He joked, “Of course, we don’t persevere anymore — we have therapy and medication now instead.”

She emailed him to tell him how many years she had suffered until get-ting mental health treatment, and how therapy and medication “was my moment of reaching out to touch the hem of Jesus’ robe.”

That priest’s joke minimized the value of therapy and put it in opposition to the old virtue of perseverance. Bellm, a faith-filled mother who leads a contemplative life, felt mocked for reaching out for help.

Casey emphasized that anxiety and other mental health struggles don’t just go away. “The longer you wait to address it, the harder it is to tackle it,” she said.

That brings with it a piece of bad news. There is a shortage of therapists and it can be difficult to access mental health care.

This may be where that old-fashioned virtue of perseverance comes in for parents. Don’t give up on getting your teen connected with mental health care.

On a brighter note, schools are open and students no longer isolated.

“I feel a difference, especially with freshmen,” said Stupfel. “They’re com-ing in with a sense of joy.”