January 2019
Girls’ Depression Levels are Skyrocketing: Concerning Trends and How To Help
1/15/2019
According to the Center for Disease Control, more teens than ever are reporting mental health problems; depression rates are skyrocketing, especially among girls. As a professor in the LSU Counselor Education program in the School of Education, I have closely followed the alarming increase in girls’ depression. It is troublesome to read that girls’ level of depression increased by 50% just between the years of 2012-2015. According to the most recent national Youth Risk Behavior Survey, a full 41% of girls between the ages of 12-17 reported they experienced persistent feelings of sadness and hopelessness during the past year (compared to 21% of boys). Further, in 2017 almost 20% of all teen girls experienced an episode of Major Depressive Disorder, and 22% said they had seriously considered attempting suicide (compared to 11% for boys)[i].
Girls’ risk for depression is more than double than it is for boys, and it is noteworthy that this gender difference first appears in early adolescence. Until the age of 12 or 13, girls and boys experience roughly equal rates of depression. This changes dramatically by age 13, as at that point girls are twice as likely as boys to become depressed. This 2:1 ratio is present throughout adolescence and adulthood, so that one of the highest risk factors for depression is being female!
So what is going on for girls starting around age 13? I discuss multiple risk factors and prevention strategies more fully in my book, Swimming Upstream: Parenting Girls For Resilience in a Toxic Culture[ii], my Psychology Today blogs (Girls, Women, and Wellness)[iii] and in a recent article in Journal of Child and Adolescent Counseling[iv]. Here I will discuss some of the risk factors that increase girls’ risk for depression.
Girls are at higher risk for depression when they…
There is a significant line of research that links social media use with depression and other negative mental health outcomes, and this link is strongest for middle school girls. Girls are more absorbed in frequent, daily social media use on sites like Snapchat and Instagram than are boys, and the more time they spend with their screens, the more likely it is to have a negative effect on their self-esteem, body image, and relationships. The risk is highest for teens who use social media more than two hours per day, and teens who use social media five or more hours daily are the most likely to report unhappiness, depression, and suicidal ideation[v].
During puberty girls bodies are changing dramatically, their hormones are surging, and they often feel bewildered by what is happening to them. Imagine this stress paired with all of the other changes of early adolescence --- facing unrealistic cultural pressures regarding appearance, transitioning to a new school and new academic expectations, bullying, romantic relationships —while also going through puberty at the same time! Boys are somewhat protected from this because they tend to reach puberty at a later age than girls. Girls are more likely to be hit with everything at once, and to become depressed as a result.
Girls are socialized to base their self-esteem and worth on the success of their relationships and on gaining others’ approval, making them more sensitive to rejection by family, friends, or romantic partners, as compared to boys, who do not base their sense of self so heavily upon their relationships. Feeling like everyone needs to like her and approve of her at all times, that she is not okay if any of her relationships are not okay, can leave a girl prone to depression.[vi]
When girls place an over-emphasis on their appearance, weight, and shape in determining self-worth, and when they frequently compare themselves to others and believe they do not measure up, they are at risk of developing negative body image and engaging in disordered eating practices, all of which are also risk factors for depression[vii].
The brain undergoes major remodeling and rewiring during the adolescent period, and brain studies show that compared to children or adults, adolescents experience their emotions more intensely, are easily excited, and are more responsive to stress and anger. Girls’ strong emotional reactions, especially in response to relationship conflict, can become risk factors for depression[viii].
With the brain changes that occur in adolescence, girls are now better able to think abstractly and to use critical thinking skills. While this can be a strength, these same skills also open the door to negative thinking patterns that can contribute to depression. One such pattern is rumination: the habit of worrying excessively about problems, blaming yourself for every bad thing that happens and mulling your shortcomings and mistakes over and over in your head instead of taking action to make the problem better. Girls are more likely to use this style of thinking than are boys, and rumination is highly linked to depression. Girls, more so than boys, also talk about their feelings and problems with their friends. This is called co-rumination -- ruminating with others, sharing your weaknesses and problems in a way that just fuels negative thinking rather than moving anything towards positive change. The more that girls co-ruminate with their friends-either in person or on-line, the more likely they are to become depressed over time.[ix]
What Can We Do to Help Prevent Depression in Teen Girls?
The reason that one girl develops depression while another does not is not easily understood.
However, research suggests that girls who spend less time on social media, who have supportive relationships, and who develop effective coping skills are better protected from the risks described above.
Based on these findings, here are some major ways parents, teachers, and concerned adults can promote girls’ resilience and protect them from depression risk during early adolescence:
Preventing Depression
- Recognize signs and symptoms of depression in teen girls. While all teens experience sad moods, symptoms of depression can include prolonged sadness, being overly anxious, having trouble concentrating, eating and sleeping problems, decreased energy, or excessive feelings of guilt or worthlessness. See the American Counseling Association’s resources on depression at https://www.counseling.org/knowledge-center/mental-health-resources/depression for more information. When several of these symptoms are present for more than a few days, it's time for a parent or concerned adult to take action by initiating a conversation with her about their concerns. It is also important to consider seeking out counseling services for her with a licensed mental health professional.
- Encourage limits on social media to no more than two hours per day. According to research cited earlier, any teen who spends two or more hours a day on social media is more at risk for poor mental health, including depression, anxiety, and negative body image. Therefore, place limits on social media use and instead encourage non-screen activities such as face-to-face (versus on-line) interactions with supportive friends, spending time outdoors, and physical activities (all of which are known to enhance positive mood). Further, because lack of sleep is associated with both social media use and with depression, keep teens’ devices out of their bedrooms at night in order to promote better sleep.
- Listen to her with intent. Teen girls often seem to distance themselves from caring adults in their lives even while they actually want their support and guidance. When a teen girl does make an effort to talk, treat this request with respect. Turn off your devices, make eye contact and give her your undivided attention. Try to listen to the full story without interrupting. Remember you are listening for understanding, not for criticizing. You can do this by reflecting her feelings, asking open questions, and encouraging problem solving rather than giving pat answers or quick advice. These face-to-face, active listening skills will help her open up and become more likely to approach you again in the future.
- Help her develop relational resilience. Because girls become vulnerable when problems in relationships affect their overall self-esteem, they benefit when they learn how to evaluate their relationships: Is her friend someone who values her thoughts and opinions? Who respects her and remains loyal to her, even when they disagree? Can she tell this person “no” without threat to the relationship? Help her practice assertiveness in her relationships so that she can remain confident in her own identity regardless of how others might respond to her in a given moment.
- Teach her to think differently. When a girl encounters issues that are causing stress, she can learn to identify the problem and how she wants to manage it. Instead of worrying about the future or staying stuck by ruminating about the past, she can decide: (a) I can do something about this, so I will use effective problem-solving skills, or (b) I can’t change the situation, at least in the present moment, so I will do what I can to cope with it more effectively. All girls can develop a solid coping skills repertoire and have strategies they can implement depending on a given situation. What does she need in the moment that will help her feel better? For example, does she need to do something to release energy? To do something soothing and relaxing? To talk to someone about her feelings? Or does she need to change the way she is thinking about the situation so that it is less harsh and extreme?[x] These types of strategies empower her to stay resilient in the face of the multiple stressors she will face during adolescence.
The problem of depression in girls is an important issue for all educators and adults who are concerned about promoting mental health and wellness in our state and nation. At LSU, Counselor Education program faculty work to prepare future counselors to prevent and provide effective treatment for depression and other mental health concerns. Through our research and teaching, our goal is to promote the positive mental health of today’s adolescents so that they can become resilient future learners and leaders in our community.
Written by:
Dr. Laura Choate, Professor
Jo Ellen Levy Yates Professor, Counselor Education
Dr. Laura Hensley Choate, Jo Ellen Levy Yates Endowed Professor, is the coordinator of the Clinical Mental Health Counseling program. Her research interests include girls’ and women’s mental health, including body image concerns and eating disorders in women. She is the author of four books, Swimming Upstream: Parenting Girls for Resilience in a Toxic Culture (Oxford University Press, 2015), Girls’ and Women’s Wellness: Contemporary Counseling Issues and Interventions (2008), Eating Disorders and Obesity: A Counselor’s Guide to Prevention and Treatment (edited), both published by the American Counseling Association, and Adolescent Girls in Distress: A Guide to Mental Health Treatment and Prevention (Springer Publications, 2013). She regularly conducts workshops for local schools and agencies regarding parenting girls. Dr. Choate teaches Introduction to Counseling Services, Analysis of the Individual, Girls and Women’s Issues in Counseling, and Clinical Mental Health Counseling Practicum. Dr. Choate may be contacted at (225) 578-1248 or by email (lchoate@lsu.edu).
The LSU Counselor Education program is a 60-hour masters degree program in the School of Education, with two concentrations: Clinical Mental Health Counseling and School Counseling. The program is nationally accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP), meets the academic requirements for licensure as a Louisiana Licensed Professional Counselor (for students in the Clinical Mental Health Counseling concentration), and meets all standards of the Louisiana Department of Education for certification as a school counselor (for students in the School Counseling concentration). For more information, visit the counselor education page.
[i] Center for Disease Control (2018). Youth Risk behavior Survey Trends Report.
Available: https://www.cdc.gov/healthyyouth/data/yrbs/pdf/trendsreport.pdf; Twenge,
J. (2018). IGen: Why today’s super-connected kids are growing up less rebellious,
more tolerant, and less happy—and completely unprepared for adulthood—and what that
means for the rest of us. New York: Atria Books.
[ii] Choate, L. H. (2015). Swimming Upstream: Parenting girls for resilience in a
toxic culture. New York: Oxford University Press.
[iii] Choate, L. (2018). Psychology Today blog: Girls, Women, and Wellness. https://www.psychologytoday.com/us/blog/girls-women-and-wellness
[iv] Choate, L. (2017). Depression in girls during the transition to adolescence.
Journal of Child and Adolescent Counseling, 4(1), 50-56. Available: https://www.tandfonline.com/doi/abs/10.1080/23727810.2017.1351808
[v] Twenge, J., Joiner, T., & Rogers, M. (2017). Increases in depressive symptoms,
suicide related outcomes, and suicide rates among US adolescents after 2010 and links
to increased new screen media time. Clinical Psychological Science, 6, 3-17; Royal
Society of Public Health (2018). #Status of Mind: Social media and young people’s
mental health and wellbeing. Available: https://www.rsph.org.uk/uploads/assets/uploaded/62be270a-a55f-4719-ad668c2ec7a74c2a.pdf
[vi] Essau, C.A., & Chang, W. C. (2009). Epidemiology, comorbidity, and course of
adolescent depression. In C. A. Essau (Ed.), Treatments for adolescent depression:
Theory and practice. (pp. 3-26). Oxford, NY. Oxford University Press.; Hankin, B.
L., Wetter, E., & Cheely, C. (2008). Sex difference in child and adolescent depression:
A developmental psychopathological approach. In J. R. Z. Abella & B. L. Hankin (Eds.),
Handbook of depression in children and adolescents (pp. 377-415). New York, NY: Guilford
Press.
[vii] Choate, L. (2014). Adolescent girls in distress: A guide for mental health treatment
and prevention. New York: Springer Publications.
[viii] Steinberg, L. (2015). Age of Opportunity: Lessons from the new science of adolescence.
New York: Mariner Books.
[ix] O’Keefe, G. S., Clarke-Pearson, K., & Council on Communications and Media. (2011).
Clinical report – the impact of social media on children, adolescents, and families.
Pediatrics: Official Journal of the American Academy of Pediatrics, 127, 800-804.
doi:10.1542/peds.2011-0054
[x] Stark, K. D., Streusand, W., Krumholz, L. S., & Partel, P. (2010). Cognitive behavioral
therapy for depression: The ACTION treatment program for girls. In J. K. Weisz & A.
E. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (pp.
93-109). New York: Guilford Press.