Hello beloved readers,

🙏🏼 Welcome to How to Live. Every Wednesday, the author of Little Panic: Dispatches From An Anxious Life (me!) takes readers on a guided tour through one complex idea from psychology and mental health, breaking down practical tools, techniques, and insights that you can use to feel better.

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Last week’s piece was on the tyranny of the shoulds. You can read that here.

xx, Amanda

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FREE comprehensive mental health resources are in short supply. Today’s piece is about kids, a group actively seeking help for mental health online and they are not finding it.

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THIS WEEK’S REC IS…LITTLE BLACK HOLE by Molly Webster and Alex Willmore.

Rec Qualifications: If something enhances my life, or I think it might enhance yours.

THERE ARE MENTAL HEALTH RESOURCES AT THE VERY BOTTOM OF THIS NEWSLETTER

The Emergency

On December 7, 2021, two months after the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association joined forces to declare a national state of emergency for children’s mental health, the U.S. Surgeon General Dr. Vivek Murthy made headlines when he confirmed this, announcing to the nation that kids were really struggling, especially in the wake of the pandemic.

The headlines are alarming, not simply because young people are suffering, and our society is at risk of failing them, but as Dr. Murthy’s public advisory made clear, this crisis, while urgent, is not new. The difference, however, is that young people are suffering in new ways, and at earlier ages; during the pandemic, the already limited resources were crumbling under the weight of need from adults and young people alike.

Society fails us over and over, and it’s become clear that it’s up to us, as members of society, to recognize what’s missing and attempt to fill it. We are at an inflection point. The window is closing on the moment in which we can work hard to push policymakers to take our mental health seriously so that they can put in place what was missing when we most needed it. So that we can help ourselves and our children when the next crisis comes.

Overlooking Emotions

We have dismissed children’s emotional pain as long as children have existed because we dismiss emotions. We have been socialized to believe the narrative that crying and feeling signals weakness for so many generations that it is nearly impossible to deprogram it from our brains or transmit the message that it is fundamentally untrue. What’s the point of having emotions if you don’t feel them?

Children feel out loud, and we often shut them down. Adults feel more inwardly, and we are often shut down by others or, worse, by our internal voices. It’s not possible to tend to other people’s emotions with any tenderness and care when we neglect, or belittle, our own.

The society we live in tends to prioritize and value the wrong things. We take physical pain more seriously than emotional pain and therefore have more resources for physical ailments than mental ones. This leaves people to problem-solve alone, which can lead to disastrous outcomes. Many people self-medicated throughout the pandemic. Some even chose to end their lives.

The pandemic exacerbated issues that people were struggling with before the shutdown, and created the emergency that forced us to confront what our government has long ignored—we all need help that isn’t readily available. Therapists were so overburdened that they weren’t able to take on new clients. Or, if they could, people in need had to wait months for an available appointment.

Therapy is cost-prohibitive for many people, but there were few resources to make it accessible to those in need. We were failed because the government was not prepared because mental anguish has been disregarded for far too long.

We have to change that.

Now.

We deserve the resources to get the help we need for our own mental health and for the mental health of our children. While the resources for adults are lacking, it’s even worse for children.

Take for instance the fact that there are more than 100,000 clinical psychologists in the U.S., and only 4,000 are child and adolescent clinicians. The recommended ratio of school psychologists to students is 1:500. Now there is an egregious shortage that finds the current national estimate to be 1:1,211; some states have an appallingly low 1:5,000 ratio. Imagine how burnt out these therapists are.

The only way to ensure that our children become healthy and thrive demands a collective effort from every member of our society, and it includes forcing institutional, educational, and policy changes.

How Did We Get Here?

Well before COVID, the leading cause of poor life outcomes in young people was untreated mental health disorders. A cursory glance at the references in Dr. Murthy’s report reveals citations from articles published as early as 1982. Not only does this indicate we don’t have enough current research, but it exposes how long-standing an issue this is.

Take for instance, the CDC advisory that reported: “Those who are socio-economically disadvantaged are two or three times more likely to develop mental health conditions than peers with higher socio-economic status.” Those figures are taken from a paper published in 2013. 

In the years between 2009 to 2019, the increase of high school students who felt persistently sad and hopeless increased by 40%. Suicidal ideation rose by 36% and those who created a suicide plan rose by 44%. Before the pandemic, the suicide rate increased by 57%.

The kids are not alright, and they haven’t been for an extremely long time.

And let’s be honest, neither have we.

We are all in need.

We all need help.

And that is OKAY.

While conversations around mental health are slowly normalizing, the stigma still exists, and getting accurate figures is a challenge. For instance, when I was in high school, I had an undiagnosed panic disorder and a substance use issue—you could not have given me enough cocaine to admit to my mental anguish, the shame was far too profound. AND I LOVED COCAINE. My point is, for every young person who talks about their struggles, there are ten that don’t (this is an entirely unscientific Sternian “fact”).

Where Did It All Go Wrong?

As we well know, kids receive their information from social media, the news, their friends, and their parents. They absorb our morals and values, and those of their heroes. They cope the way the adults in their lives, and in the world do.

The world is more polarized than ever. Many of our politicians do not behave like sophisticated adults—they threaten, belittle, and create policies that actively hurt women, children, and those with any sort of visible or invisible perceived differences.

Our society has its values and morals on backward. We’ve created a paradigm of success predicated on money, power, and consumption. It’s hard for adults not to get sucked in, for kids, it’s even harder.

Kids can value the wrong things because we can value the wrong things. Our definition of success often excludes character, spirituality, service-oriented goals, and community engagement. We, as a society, do not chase what brings happiness or nurtures a deep and rewarding life. We have become more siloed and fill our sense of self-worth with external validation, which reaps fewer internal rewards.

We are disengaged and lonely, and we turn to social media too often, and this may be another reason that children aren’t participating as often in outdoor and community-oriented activities. They mistake being online for being actively engaged.

But guess what? We are disengaged and lonely, because we, the adults, often don’t get the help we need. How can we take care of ourselves AND our kids when we are both suffering from the same issues?

How We Were Raised …

Many of us were raised to believe we shouldn’t have to tolerate feelings of uncertainty and discomfort. While they meant well, many of our parents, and their parents, didn’t know how to help us feel better by teaching us how to manage our emotions because they didn’t know how—it wasn’t something you learned in school (and that’s one of the many things that school should teach, btw).

Being taught that uncertainty and discomfort should not be tolerated led many of us (like me!) to avoid the things that might have given rise to these intolerable feelings—that certainly made my life harder. When I learned that Bad policy has created problems for us and for our children that those in power have not truly tried to solve. When we look forward, we’re afraid. When kids look at their future, they’re terrified.

It’s true that COVID-19 gave rise to and intensified this crisis. And it’s also true that children have lost more now than children have in recent history. They’ve lost family members and friends. They’ve lost out on important developmental markers, rites of passage, socialization, and more. The headlines are alarming, not simply because young people are suffering, but because we are all suffering, and no one is allocating the funds to tend to the mental health services we so desperately need. If anything, those funds and resources are being cut.

And we don’t just lack resources, we lack a national, administrative spokesperson who can advocate for us.

The most significant question we need to ask and demand an answer to is: why isn't mental health considered part of our overall health?

To Help Our Kids, We Have to Help Ourselves.

First, know this: You did your best. You DO your best. Even when you don’t feel at your best, you show up. The pandemic was not your fault. The choices you made during the pandemic were not wrong and they did not screw up your kid/s. You have to give yourself a break, these were unprecedented times.

This has been a brutally difficult period of life, for everyone.

And every instance of trouble is an opportunity to learn and remedy.

In the winter of 2020, I was despondent and deeply, frighteningly, depressed. This period of time lasted for three or four months. It was agony. My friends were amazing. My family was incredible. I was lucky. I have resources. I want to BE a resource. But many, many others do not have such things. They are just figuring it out as they go and they’re afraid.

People want to connect. They miss hugging. They miss contact. You are not alone in your need and in your fear. And this is why knowing how you feel and identifying the markers of uncertainty are so powerful because they offer information about yourself, and what you need.

There is one answer to disconnection, and that’s a real-time, offline connection.

True connection is an integral part of our mental health. It can take as little as ten minutes. Be completely present with someone, anyone, for ten minutes. Don’t check your phone, and don’t turn on the TV. Just have a conversation. Listen. Share. Don’t interrupt, or finish someone else’s sentence. Try to match the amount of talking you do with theirs.

Make this time a daily priority. You need this. Your child needs this. (Meaning, do this first, for yourself with another adult, and then do this with your kid). True presence is a curative for the soul. When we make the time for open-hearted, authentic connection, we are conferring value on someone.

To get himself through a difficult period during the pandemic, the artist John Donohue discovered that drawing everyday objects, including his dishrack, calmed his nervous system, lowered his cortisol, and made him feel more centered. (He wrote about it here.)

This is the antidote to loneliness. We think we don’t have the power to change our or someone else’s life, but we are profoundly mistaken.

Be of service. Offer to carry your neighbors’ heavy bags up the stairs. Walk your neighbor’s dog when they’re sick. Drive someone to the doctor. Or, simpler, smile at someone. Compliment a stranger. Pay for someone’s coffee.

These small moments create a sense that we belong. And there is nothing more grounding for a person to feel they have a place in the world.

Service reaps enriching and profoundly long-lasting rewards. Last August, I was in a Toronto drugstore when an elderly man began fighting with the pharmacist because the price of his medication went up, and he couldn’t afford the $15. The pharmacist wouldn’t budge and the man began panicking. So, I handed him $20. This is a service. I could afford it; he couldn’t. He needed something I had, and so I gave it to him. This small act connected us both and gave us what we needed.

The choices we make every day add up. The choices other people make every day add up. If someone chooses to be passive-aggressive with us every day, that harms our emotional spirit. If someone chooses to compliment us every day, that shores us up. The same is true for the choices we make.

Another powerful way to connect is to share your own struggles. Tell your stories. This is what normalizing mental health means. It means going first. When we share with our kids how we overcame or are actively facing and overcoming our struggles in real time, we show them what growth looks like. This is what we want them to model.

We need to care for our children by looking beyond just their symptoms.

There was a disproportionate impact on children of color during the pandemic because there was a disproportionate impact on people of color. Structural racism has forced people of color to live in conditions that increase and often create mental, physical, and medical illnesses.

They don’t have equal access to basic and foundational resources. Those in underserved communities lack the tools, and security needs, that others take for granted.

The pandemic was a macro trauma, but in underserved communities, the microtraumas of everyday life lead to long-term exposure, and the consequences can be deadly and were deadly when the larger emergency descended.

These are mental health risks we need to identify, learn about, and teach. When we learn how our small, daily actions for good can lead to someone else’s long-term outcome, it makes us feel worthwhile; it gives us a purpose.

This is our moment. This is when we need to advocate for the change we need in our society, in the workplace, and in our schools, but we cannot make any institutional change without first knowing what we need.

So ask yourself, and ask your child:

What do you need?

And then listen.

You are a warrior. You made it through a goddamn pandemic. It’s okay if you’re suffering. It’s okay to need help, and it’s really okay to ask for it. There’s nothing shameful about your suffering, or your child’s suffering. You are human, and you have lived through an actual plague.

You are a fucking superstar.

Do you have resources others should know about? Let us know in the comments.

Amanda

📬️ Email me if you have questions, comments, or topic ideas! [email protected]

💋 Don't keep How to Live a secret: This newsletter is written for everyone interested in psychology and the art of living.

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RESOURCES:

RESOURCES FOR PARENTS & YOUNG PEOPLE

NAMI: Kids, Teens, and Young Adults

Take a Mental Health Test 

Bring Change to Mind (Mental health organization. I’m on the advisory board)

The JED Foundation (Suicide Prevention)

Born this way (Lady Gaga’s Foundation dedicated to building a kinder, braver world).

Channel Kindness (A digital space founded by Lady Gaga for kids to tell stories about kindness and resilience)

OPEN STUDIES for teens 11-16 to HELP BROADEN & STRENGTHEN THE FIELD

Add resources for families and parents

Signs to Look for In Your Kids

The Most Common Mental Health Issues To Look Out For.

Where to find help:

Youth-friendly mental health resources

Child and Adolescent Mental Health Services in NYC 

Resources for Adolescents and parents

Even more mental health resources for parents and kids

PEOPLE to KNOW:

DeLeon Gray created Black and Belonging, a platform that works with young thinkers to design cultural experiences that create a more welcoming society.

Books: Belonging, by Geoffrey Cohen, and Together by Vivek Murthy