Thread by @lfoulkesy

The theme for this year’s #MentalHealthAwarenessWeek is anxiety.

I research how the current conversation about mental health is affecting teenagers, and I think something is going seriously wrong when it comes to anxiety:

The basics: Anxiety is a common emotion that exists on a continuum throughout the population. As you move up the spectrum it becomes more frequent, more intense, more distressing, harder to control and more disruptive to daily life

The two extreme ends are very different, but the trouble is there's clear no transition point between 'normal' and 'clinical' anxiety, and no distinguishing language in the public domain

As a result of this ambiguity, I think that the massive efforts to raise awareness about anxiety have led many people, especially teenagers, to diagnose themselves as 'having anxiety

Some of these people really do have debilitating anxiety - so awareness would be helpful - but others will be experiencing milder, more transient anxiety, and this is where the problem lies

Adolescence is a period of identity development. It may be that the identity of ‘having anxiety’ is now being adopted by some teenagers as a culturally-popular way to understand their distress. See excellent paper below on this idea
tandfonline.com/doi/abs/10.108…

Also, take a look at what teenagers are being fed online. This is just one example – video after video, young people are being told they have an anxiety problem. No wonder so many of them are self-identifying as having anxiety

tiktok.com/@therapywithma…

We might now be in the bizarre situation where having anxiety is actually socially desirable among teenagers, especially girls. I am regularly asked if having anxiety (and depression) might now be considered cool along young people

One parent recently told me that her teenage daughter felt left out because she was the only one in her peer group who didn’t have anxiety or depression.

There’s no empirical work on this idea yet though (as far as I know)

Take a look at what you can buy online (Etsy) . Have we gone so far beyond destigmatising that anxiety is attractive for some groups?
Below are classic examples of so-called ‘identity signallers’ – in this case literal badges to advertise that you’re in the anxiety club

As I always say: many teenagers (and adults) desperately need help for their anxiety and aren’t getting it. Stigma still exists. But that doesn’t negate the above. Some teenagers desperately need help, and *in parallel*, some are receiving and acting on deeply unhelpful ideas

This isn't just semantics. Many teachers email me to say that, increasingly, young people are asking for adjustments (eg deadline extensions, exams in different rooms). In some cases, this is necessary, but

If adjustments are granted indiscriminately and indefinitely, this is akin to avoidance. This can maintain and exacerbates anxiety in the long-run, setting up young people to fail.
See thoughtful commentary on this by a headteacher below
queenwood.nsw.edu.au/Queenwood-News…

I think we need to take very seriously the possibility that, with the best intentions, awareness-raising efforts have unleashed something deeply concerning among some teenagers:

They have received the message that feeling anxious is something that must always be labelled and accommodated – in a way that *in principle* might be useful but *in practice* often isn’t

Where do we go from here? Here are some possibilities:
1) Fund Better treatments and better access to treatments for anxiety. If we can successfully reduce clinical anxiety across the population, all of this might calm down

2) Research how well-known aspects of adolescent development, like peer influence and identity development, interact with mental health awareness efforts to influence outcomes

3) Empirically test the impact of anxiety awareness materials. We should stop assuming that talking about all this is inherently better than not talking about it
(fin)