My personal mental health problems, namely anxiety and depression, started in my teens, and I’m not alone in that.
According to the National Alliance on Mental Illness, 20 percent of youth ages 13-18 live with a mental health condition, and 50 percent of all lifetime cases of mental illness begin by age 14. Suicide is the third leading cause of death in youth ages 10-24, and 70 percent of youth in state and local juvenile justice systems have a mental illness.
The mental health of teenagers recently caught attention in light of the Netflix show 13 Reasons Why, which graphically portrayed the suicide of a high school girl character who turned to self-harm as a result of a poor life at school. A recent study said there were more than 195 more suicides by kids 10-17 than would have been expected in the nine months following the show’s March 2017 release.
Researchers said they can’t prove the show is why the jump occurred, but they argued that the graphic portrayal of the act can be a spur for kids considering suicide.
This is not a piece where I’m determined to level 13 Reasons Why, to say that it’s bad for teen mental health. In fact, another study (note: it was commissioned by Netflix) showed that 58 percent of teen viewers reported talking to their parents about the show and the issues it raised, while 51 percent stated they apologized to someone for how they treated them after watching it. So I’m far from qualified in evaluating the show’s effect on teen mental health — mostly because I haven’t watched it myself.
But 13 Reasons Why has at least done one thing, whether you think it is worth watching or harm’s teen mental health. It’s started the conversation over what’s helpful and what’s harmful. And that is always a good thing, because America’s teens, and teens around the world, need more than what they’re getting, particularly from Christians.
The Precarious State Teenagers Live In
The world has changed a lot from when I was a teenager. The year I turned 18, 2010, was very different. Kanye West’s My Beautiful Dark Twisted Fantasy was the top new album, Toy Story 3 the highest grossing movie, and Barack Obama was president. Man, it seems so long ago.
But as a former teenager myself — quite recently, in fact — and through my conversations with teens over the last few years, I’ve lived and heard what it’s been like to be a teenager in the 21st century and to deal with all the pressures that come with that age group.
Teenagers nowadays — and maybe always, to be fair — feel that they are not respected as much as adults and not loved as much as little kids. They feel that they are asked to be adults in many ways, but are not given the same level of respect and the same voice as adults. They go to school, have part-time jobs, take care of siblings and try to have social lives simultaneously. Adults may spend their time on specific things quite differently, but the amount of commitments is similar.
Many teens fall in one of two categories: living under some level of pressure from their parents’ expectations, or living without one or both birth parents. Both situations cause stress and anxiety from a young age, with other mental illnesses affecting them depending on their circumstances. The 69 percent of children under age 18 living with both parents — a decrease from the 88 percent in 1960, by the way — will often find themselves struggling to meet standards set for them, whether in the classroom or on the sports field. The 23 percent of children living with a single mother — an increase from 8 percent in 1960 — and 4 percent living with just their father are missing a parental figure and thus a significant part of their development (statistics here).
Of course, it’s near impossible to accurately measure how teens many feel high expectations from home and how that affects their lives and academic performance, but there’s enough anecdotal evidence to prove it’s a significant problem, particularly among communities where an ethnic or socioeconomic culture adds pressure.
Therein lies another problem facing teenagers and their mental health. Remember how that 13 Reasons Why study said the show helped some talk about the issues presented? The same study stated that 80 percent of adolescent and young-adult viewers said others their age dealt with similar issues to those in the series, and younger teens and teens with higher levels of social anxiety said they felt more comfortable talking about the topics present in 13 Reasons Why with parents, peers and other supportive adults after watching the show.
There’s a stigma wrapped around mental health, particularly depression and anxiety. Unlike some diseases, even mental illnesses, things like depression and anxiety are not bodily visible, but take a lot of work to keep hidden. A lot of teens seem to have not learned how to control their emotions, and that’s not necessarily their fault. They’re learning who they are, and they’ll often learn through experience how to control their emotions. But in a world where looking good, talking good and living good are prized above all else, anything that gets in the way of that is scary for a teenager. They want to be prized by their peers, and anything that makes them stand out or be different for any negative reason — like being sad all the time or coming to school with cuts on their wrists or arms — is something to be hidden.
Adults are no different, really. We all put on faces when we go out in public, desiring for our colleagues and friends to see us as the put-together person we desire to show. Most of the time, we even want to see ourselves that way. In my 26-and-a-half years of life, I’ve rarely met an adult who I could tell was totally and completely themselves the vast majority of the time. I’ve met one, a good friend of mine from college and even he, deep down, struggled with self-confidence from time-to-time.
Teenage-dom is a precarious state. Whether it’s the still-developing brain or the lack of life experiences, life is on a tightrope, a pendulum stuck in the middle, shifted up or down, back or forth, at a moment’s notice.
A Personal Matter
It’s in this environment that mental illness thrives.
Struggles like anxiety disorders and clinical depression live for this scenario. Anxiety gets activated by the slightest uncertainty, with the mind beginning to race and rumble over the smallest worry. Early experiences with rejection or being left out can add substance to the feeling of depression — “Look what’s happened to me! Can you blame me for being depressed?”
I write this because I’ve been there. This has happened to me. The slightest uncertainty has sent me into a tailspin, wondering about the 50 different outcomes to a particular situation, which one is best, which one is worst, which one is most likely.
Allow me to be nerdy for a second: It’s like Doctor Strange using the Time Stone to see the potential outcomes of the Avengers’ fight against Thanos, but he gets stuck in the time loop, preventing him from telling Iron Man and the Guardians of the Galaxy that there’s one way to win out of 14 million-plus. A remembrance of a specific time of rejection — either by an eighth-grade girl who didn’t want to dance with me or a place of employment going “another direction” with the opening — can kickstart a half-hour of unbreakable sadness.
Most people can shrug off those perfectly normal scenarios. But those of us with severe anxiety and depression try to avoid them like the plague because we know what they do to us. They cripple us. They lead us down a path we don’t want to go down, and most of the time we can’t help it or get out of it.
Last night — just under 12 hours before writing the first draft of this essay — I thought of rejection from multiple job interviews and another scenario where rejection was hurtful and got depressed, unable to have a good conversation with my wife and ultimately descending into an anxious state. I didn’t know how to get out of it because, no matter how hard you try, sometimes it’s impossible. And don’t tell me to “stop trying so hard.” I’ve done that too.
This is both a biological and sociological issue. We live in a society where mental health has either been put on the back burner, to be “talked about later,” or not discussed at all. And nowhere has this become more obvious than in schools, where America’s teens spend anywhere between 35-50 hours a week, depending on extracurricular activities.
According to the National Association of School Psychologists, the ratio of students per school psychologist was estimated to be 1,381:1 in the 2014-2015. That’s higher than the recommended ratio of 1,000:1 in general and 500-700:1 “when more comprehensive and preventive services are being provided.” Hiring personnel for public schools has become an increasingly significant political discussion, with legislation for funding such positions often reliant on the increasingly divisive political process. While I’m not going to take a political position on this — I recognize that state governments do not have a bottomless treasure chest full of money to spend on every needed thing — this shortage opens students to a significant portion of their week when they are either underserved or not served at all in the mental health arena.
This is not necessarily the fault of the schools or the states that fund them. I simply believe this is a sign that we haven’t taken students’ mental health seriously enough. I think that’s changing, as more and more groups advocate for increasing mental health services for students and increased funding for related positions in schools.
To take it seriously, we’ve got to start by listening to personal stories and see how mental health services can actually help people and create safe spaces for conversation and healing.
And the church is one of the best places to do that.
The Body of Christ as a Safe Space
You might think that a church youth group would be better than your average high school classroom. The kids are mostly, if not all, Christians, kind to one another, finding a home in the Lord’s house on Sunday and/or Wednesday nights.
While my youth group was fantastic, I brought my depression and anxiety into the room with me every time. That made common youth group experiences, like lock-ins and summer camp, a haven for anxiety-inducing moments and triggers for depression. Unfortunately, at the time, I didn’t know that’s what I was dealing with.
Writing on why young people with anxiety and depression often don’t go to church, child and adolescent psychiatrist Dr. Steve Grcevich states, “To appreciate the struggles that teens might experience in attending worship services, participating in youth group, serving in outreach activities or going on mission trips, we need to recognize how attributes of mental conditions common to this population cause difficulty functioning in the environments where ministry takes place. We also need to see how the interaction of those attributes with common elements of church culture — our expectations for how people should act when we gather together — creates real barriers to church involvement for teens with mental illness.”
Dr. Grcevich lists seven reasons why it’s tougher for teens with mental health conditions to connect: stigma around mental health, social anxiety in certain situations, struggle with self-control, sensory processing issues, weak social communication skills, social isolation and even past experiences with church.
I relate to those, but more in my college days with the student ministry I was involved in. I felt like social isolation was sometimes my only recourse for my straggling mind. For the crazy thoughts I had that didn’t make sense to me, so of course they wouldn’t make sense to others. For not feeling comfortable around girls because I still worried about how I’d be perceived by them. For not wanting to let others know I was doubting my faith because I felt I’d likely lose my position of leadership within the group and, even scarier, my place in the group as a whole. For not wanting to go out and share the gospel with people because making new friends, or at least acquainting myself with new people voluntarily, made me shiver in my boots.
It was in this environment that I did not find the body of Christ to be a safe space. I’m not totally blaming them. Christianity has historically lagged behind the “secular culture” in wrestling properly with problems, so why would mental health be any different? I’ve seen it on the bookshelves in stores recently, where new books claim to examine the Bible afresh with its diversity in thought and seeming contradictions, something “secular culture” has been doing for years.
It is vital, especially for the sake of our teenagers, both in and outside the church, that we become a safe space for those struggling with mental health issues. In the same way we seek to accommodate the elderly with wheelchairs and 12-year-old who broke his leg climbing a tree, we need to accommodate those struggling with mental injuries of any kind.
In today’s culture, some in the political sphere, or people leaning one way on the spectrum, mock the idea of “safe spaces” on college campuses or other places. These students need to deal with reality, they say, and accommodations for their little fears and worries is babying and coddling.
Jesus babies us. Jesus coddles us. He meets us where we are, and while He does ask a lot of us, He’s willing to be the one who loves us as we are. We should be the same with those who are struggling with mental illness, inside the church and out.
Creating a Haven
How do we get there? Always the biggest question to ask when you’re suggesting a major shift in thinking, or working to consider something different.
We have to be like Jesus. That seems to be the end goal, the operative framework. But what does that look like in helping teens with mental health issues in the church?
Welcome them in, warts and all. One of the most popular paintings of Jesus — or what white Christian America deemed as Jesus — is the Savior sitting with a group of children, one on His lap, another sitting nearby. Jesus is either teaching with an arm outstretched or has his hand on a child’s head in a gentle, fatherly manner. The paintings are probably inspired by the Savior’s words in Matthew 19:14 — “Let the little children come to me, and do not stop them; for it is to such as these that the kingdom of heaven belongs.”
Having that attitude with teens with a mental illness — and all teens for that matter, but that’s for another time — is vital. It’s an attitude of not stopping someone because of any nerve they might get on or annoyance they bring or difficulty they have. It’s about welcoming them in and loving them the way Jesus did. They have enough difficulties on their own. Far be it from us in the church to give them another one by rejecting them.
Learn about mental health from professional sources. Paul’s method of ministry was remarkable: “I have made myself a slave to all, so that I might win more of them” (1 Corinthians 9:19). The original Greek word’s root, doloó, means to “bring into bondage, become a servant.” Paul said, “Hey, I’m going to turn myself into a slave to everyone, so I can preach the gospel to them.” He dedicated himself to being like others so he could relate to them.
The best example of this, to me at least, is when Paul preaches to the Areopagus in Athens, the center of Greek thought and academic discourse in the city. As Matthew Henry states in his commentary, “One discourse of this kind we had before to the rude idolaters of Lystra that deified the apostles (Acts 14:15); this recored here is to the more polite and refined idolaters at Athens, and an admirable discourse it is, and every way suited to his auditory and the design he had upon them.”
Paul even went so far as to quote the Greek philosopher Epimenides and poet Aratus in v. 28 — “For ‘in him we live and move and have our being’; as even some of your own poets have said, ‘For we too are his offspring.’” Both of those lines were attributed to Zeus in Greek literature, but Paul, being an educated man and dedicated to reaching people for Jesus, used that writing to make a point that God really is not that far away, and that the gods the Greeks worshipped were false.
We don’t need to have master’s degrees in psychology, social work or counseling to be able to love and counsel teens who have mental illnesses. We simply need to look to Paul’s example. It is good for those working with high schoolers and other youth to learn more about any relevant mental health disorders — anxiety and depression are a good start — so that we can better understand them. Find reliable sources, both Christian and “secular.”
Open the conversation, publicly. I don’t know the split, but the teachings of Jesus recorded in the Bible seem to be half in private conversations and half in public messages. There’s the notable Sermon on the Mount in Matthew 5-7. There’s the Upper Room Discourse in John 13-17.
I’m going to make a plug here that, when we speak about mental health to teens, we don’t limit the conversation or the scope to one-on-one interactions. The teens may feel more comfortable sharing their own stories and their own struggles in that smaller environment, but speaking about it in an open forum like youth group will help put them at ease that it’s OK for them to struggle and be a part of the group.
This extends to talking about it on Sundays in front of everybody as well. It is my firm belief that we won’t make significant progress on mental health in the church unless pastors begin making mental health a topic of Sunday sermons, or addressing it in the context of other messages. The church thing to do — at least it was for me growing up, and I’m sure it still happens — is to talk about the sermon during Sunday lunch. In today’s small group culture, the message is often the point of conversation during those weekly meetings. By having an open message on the topic on Sundays, we further the church’s awareness of the topic and stifle the stigma so often associated with mental health.
I’ve worked with and around youth for years now, and having been a teenager myself pretty recently, I think I’ve got a decent idea about how they work.
There’s something they value a lot: commitment and consistency. I know because I failed at it myself.
I worked with a youth group at my old church for a couple years, helping out the youth pastor who was one of my best friends. He was a groomsman in my wedding and I was in his.
He and his wife were about to move to South Carolina for him to attend seminary, so he announced he would be leaving the church at the end of the upcoming summer. It was a devastating conversation. The high schools seniors who had him as their youth pastor all four years were destroyed. One of them, who usually didn’t show a lot of extreme emotion, began to cry.
Soon after that, my wife and I, who had just gotten married, left to go to another church. We didn’t really say much about it.
When we’ve returned to that church on occasion, the bond that we had with them has felt strained, if not cut off entirely. High school kids are a lot more intuitive and smart than we often give them credit for. They know when things are going on, and they have feelings about those things. But like most people, they have to know you’re there for the long haul before they let you in.
The relationship my friend had with them was so strong because he was committed. He went to their sporting events and music recitals. He went to their high school graduations. He would have them over to his apartment to hang out. He’d play video games online with them regularly. He was committed.
If you’re going to interact with youth at all and try to make a Christ-like impact — especially kids dealing with mental health disorders — you’ve got to be committed. You’ve got to show them, prove to them, that you’re going to be there for the long haul. You’ve got to, in a sense, chip away at the hard exterior to get to what’s underneath.
It takes time and effort. But that’s what Jesus did for you, right? It may have been one swing and He was in, or maybe He took little pokes until the shell cracked and He was in your life for good. He was able to do that because He lasted three years on earth, underwent every temptation known to man, and made it through all that without sin. Then He died the most horrendous death, in my mind, humanity has come up with.
The message of this piece is pretty simple: Be like Jesus when it comes to dealing with teens and their mental health, particularly in a church setting. Start chipping.