While Teen Girls Are Clearly Struggling, Depression in Boys Going Undetected

It is becoming common knowledge that collectively, girls in America are struggling with their mental health. A February 2023 CDC report showed that U.S. high school girls are experiencing an “overwhelming wave of violence and trauma” along with unprecedented levels of hopelessness and suicidal thoughts. In 2021, nearly three in five teenage girls reported feeling persistently sad or hopeless, double the rate of boys, the report showed, and nearly one in three girls seriously considered attempting suicide.

As alarming as these statistics are, experts believe these data do not tell the whole story, NBC News reports. Boys are struggling with mental health too, but their struggles are going unnoticed for two reasons: they have become less engaged with the medical system, and the signs of depression can look different in boys.

Both boys and girls are struggling

According to the World Health Organization (WHO), the COVID-19 pandemic triggered a 25% increase in the prevalence of anxiety and depression worldwide. Many young men are struggling with mental health as well, but their needs are going undetected, experts note.

“We are right to be concerned about girls,” said Kathleen Ethier, director of the Division of Adolescent and School Health at the Centers for Disease Control and Prevention. “But I don’t ever want us to lose sight of the fact that boys aren’t doing well, either.”

Depression in boys may go undiagnosed, said Ethier and other experts, because their symptoms present differently. Boys usually don’t manifest the same signs of melancholy typically found in girls.

“We have this very classic understanding of depression as being sad, being tearful, crying more, not eating as much and losing weight,” said Dr. Lauren Teverbaugh, pediatrician and child psychiatrist at Tulane University. “That’s just not how it looks for a lot of young boys.”

‘Boys are disappearing’ from the data

A newly published study in the journal Pediatrics found that while antidepressant prescriptions have risen dramatically for teenage girls and young adult women since the pandemic began, the corresponding rate of such prescriptions for young men “declined abruptly during March 2020 and did not recover.” The gender differences in antidepressant dispensing during the same time period were striking.

Dr. Kao-Ping Chua, the study’s lead author and pediatrician at the Susan B. Meister Child Health Evaluation and Research Center at the University of Michigan, found this discovery – that boys weren’t accessing antidepressant medications once the pandemic hit – to be “perplexing.”

“In males, it’s theoretically possible that this reflects improved mental health, but I’m struggling with that explanation,” said Chua. “Given that everybody’s mental health got worse, I would have expected that boys’ antidepressant dispensing would have at least remained stable, not decrease.”

Drawing on his experience as a pediatrician, Chua says it is more likely that during the pandemic, boys stopped engaging with the health care system on the whole during the pandemic.

“There was something happening to make male adolescents not come in for mental health,” Chua said. “They didn’t go to their doctors. They skipped physicals.”

As a result, depression remained undetected and untreated in teen boys. “Boys are disappearing,” he said.

What does depression look like in boys?

While no two people experiencing depression manifest it in exactly the same way, boys struggling with mental health issues tend to have a shorter fuse, becoming quickly irritated, frustrated, or aggressive.

“A lot of times, parents who have boys with depression say that they’re walking on eggshells around them because they don’t know what would set them off,” said Dr. Mai Uchida, a pediatric psychiatrist and director of the Child Depression Program at Massachusetts General Hospital.

Mental health issues in boys may go undetected – by parents, pediatiricans, and even psychiatrists – because “they don’t fit the stereotypical image of depression,” Uchida added.

For years, women have been much more likely to be diagnosed with depression than men. But when you consider “irritability” to be a symptom of depression, a 2013 study found, the rate of depression is nearly the same between the sexes: 30.6% of men and 33.3% of women.

Other depression symptoms in boys include impusivity, risk-taking behavior, and becoming increasingly argumentative. These symptoms are frequently mistaken for typical teenage angst, said Dr. Willough Jenkins, a psychiatrist and the medical director of emergency and consultation liaison psychiatry at Rady Children’s Hospital in San Diego.

“There’s a myth that teenagers are supposed to be irritable, that they’re supposed to be cranky,” she said. “I think too many parents have heard that and think it’s normal behavior, when it’s really indicating that there could be a struggle.”

While the data on teen girls and mental health are unmistakable, “Both boys and girls are struggling,” Jenkins said. “None of our young people are doing well in terms of their mental health.”

Pandemic stay-at-home orders led to fewer referrals

Schools are on the front lines of monitoring youth mental health, said Teverbaugh.

“Not only do they see that child, but they see other children their same age also experiencing some of the same environmental factors,” she said. “They’re a really good measure for being able to pick up on something that is beyond the norm.” Teverbaugh along with other experts stressed that many mental health referrals for boys arise from behavioral difficulties in school.

So when school went online, and many in-person activities were canceled, fewer kids – especially boys – were referred for help.

“We’re often not seeing [boys] in the office, because it’s just not being picked up as much in the community,” she explained.

Read the full article here.

 

Edwards, Erika. “’Boys are disappearing’ from mental health care as signs of depression go undetected.” NBCNews.com, 17 Mar 2024, https://www.nbcnews.com/health/health-news/depression-anxiety-teen-boys-diagnosis-undetected-rcna141649.