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Why Are American Teens So Unhappy? How Do We Solve This Crisis?

Derek spoke with Matthew Biel of MedStar Georgetown University Hospital about rising teenage unhappiness and what we can do to fix it

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This is our second installment of happiness week on the Plain English podcast. On Tuesday, I spoke with the directors of the Harvard Study of Adult Development about what makes a good life, based on their 80-year longitudinal study.

Today’s episode is about the phenomenon of rising teenage unhappiness. What’s actually happening? Why is it happening? What theories make sense, and what theories don’t? How can we fix this problem? Today’s guest is Matthew Biel, the chief of child and adolescent psychiatry at Georgetown University Medical Center and chief medical officer at Fort Health.

If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. You can find us on TikTok at www.tiktok.com/@plainenglish_


In the following excerpt, Matthew Biel discusses the factors playing a role in mental health among adolescents and why they reflect a wider societal shift.

Derek Thompson: So this is a topic that I’ve written a lot about, that I’ve talked about on this show with a few different people. I’ve talked to Jon Haidt, the social psychologist. I’ve talked to writers and economists and sociologists. On Tuesday of this week, we talked to the directors of the Harvard Study of [Adult] Development. You are the first psychiatrist I’ve spoken to on this show, not to mention the first adolescent psychiatrist, not even to mention the first chief of adolescent psychiatry at a major university medical center. So it seems to me that the only reasonable place to start here is to acknowledge our profound expertise gap and give you the floor for a second. I know you’ve read some of my pieces. You generally know where I stand on this issue. What are you seeing on the ground, in your work and practice? What is the state of teenage mental health from your point of view?

Matthew Biel: Thanks, Derek. Really glad to be here. I’m equally humbled by being in the presence of a writer whose synthesis around these issues I’ve really admired. I think the work you’ve been doing has been really important. I’ve learned a lot from it. So I’m glad to be here in dialogue with you today.

I mean, I think there’s a couple of things that I’d outlined. Many of us have been really shocked and dismayed at the data that came out from the CDC last week around adolescent mental health. And I think I’d start by saying, as someone who sees young people and their families in my office every week, that this crisis is very real. There are a huge number of kids that are in terrible distress. Our health-care system is not able to respond as effectively and as quickly as needed. The system doesn’t have the bandwidth or the infrastructure to deliver effective treatments to young people who need them. And as a result, emerging problems become entrenched problems, and manageable clinical issues become very difficult clinical issues because we’re not getting care to kids fast enough.

The rates of depression and suicidal thinking and behavior in teen girls reported by the CDC are extremely alarming, as are the rates of exposure to bullying and community violence and sexual violence. And these data reflect exactly what my colleagues and I are seeing in our clinical practices. I think we’ll have a chance to talk later today about some of the potential causes of this crisis in our conversation about social media, through time with friends, and some of the other things that you’ve written about.

The second thing I want to point out is I see the distress in adolescents as revealing a broader level of distress in our society. And in particular, based on my clinical experience, I interpret this data about teens in the context of a larger state of crisis in families. Parents and families are struggling terribly. Americans of all ages are struggling to feel connected, to feel hopeful, to feel purposeful. Parents are feeling overwhelmed. Overwhelmed by fears about the future for themselves and for their kids, in particular. By economic uncertainty, by the cumulative burdens of work and childcare and eldercare, as well as by less support from the communities around them. And we know that teenagers in any era are vulnerable to mental health challenges due to the developmental obstacles they face. And they’re struggling, particularly in our current era. Teenagers don’t exist in a vacuum. They live in families, and families right now are not flourishing. So I think it’s important to address this crisis from the standpoint of asking how we can support entire families to feel less overwhelmed, better connected, better able to cope effectively.

And then, finally, Derek, you’ve written about how in the last 10 years, we have learned or maybe we’ve been conditioned to take in information and to respond to information on the internet in a very specific way. Social media, and all digital media, really, emphasize anger and despair and hopelessness and disconnection. This is the material that gets the most attention, the most clicks. And I think that this has really cheapened the way that we talk about our emotions. And this cheapening, this kind of coarsening, is affecting the way that all of us, including teenagers, who spend so much time online, experience our lives. It makes it much more likely that we identify intense emotional states, particularly intense negative emotional states, like sadness or anxiety or loneliness, as central to our experience. And so the stories that we tell ourselves about our lives and about our world shape our internal emotional landscape. And when the stories that we hear and that we’re engaged with online are all about rage and misunderstanding and trauma, there’s a considerable and cumulative emotional toll.

This excerpt was edited for clarity. Listen to the rest of the episode here and follow the Plain English feed on Spotify.

Host: Derek Thompson
Guest: Matthew Biel
Producer: Devon Manze

Subscribe: Spotify