Teen Girls Report Record Levels of Sadness, C.D.C. Finds


The Youth Risk Behavior Survey was given to 17,000 adolescents at high schools across the United States in the fall of 2021.Credit…Annie Flanagan for The New York Times

By Azeen Ghorayshi and Roni Caryn Rabin, Reprinted from The New York Times

Nearly three in five teenage girls felt persistent sadness in 2021, double the rate of boys, and one in three girls seriously considered attempting suicide, according to data released on Monday by the Centers for Disease Control and Prevention.

The findings, based on surveys given to teenagers across the country, also showed high levels of violence, depression and suicidal thoughts among lesbian, gay and bisexual youth. More than one in five of these students reported attempting suicide in the year before the survey, the agency found.

The rates of sadness are the highest reported in a decade, reflecting a long-brewing national tragedy only made worse by the isolation and stress of the pandemic.

I think there’s really no question what this data is telling us,” said Dr. Kathleen Ethier, head of the C.D.C.’s adolescent and school health program. “Young people are telling us that they are in crisis.”

The Youth Risk Behavior Survey was given to 17,000 adolescents at high schools across the United States in the fall of 2021. The survey is conducted every two years, and the rates of mental health problems have gone up with every report since 2011, Dr. Ethier said.

“There was a mental health crisis before the pandemic — it just didn’t catch everyone’s attention the way it does now,” said Dr. Cori Green, the director of behavioral health education and integration in pediatrics at Weill Cornell Medicine in New York City.

Still, Dr. Green said that she is seeing more of her young patients test positive on screenings for depression. “The pandemic led to more social isolation — a risk factor for depression,” she said.

She also pointed out that depression symptoms sometimes manifest differently in boys and girls, which might not be fully reflected in the survey. Although girls with depression often have persistent feelings of sadness or hopelessness, which the survey asked about, boys with depression often exhibit irritability or aggression, she said.

On a handful of topics, the survey results suggested teenagers were doing better than in previous years. They reported lower rates of illicit drug use and bullying at school, for example. And teenagers are having less sex, with fewer sexual partners, than in previous years.

But about 57 percent of girls and 69 percent of gay, lesbian or bisexual teenagers reported feeling sadness every day for at least two weeks during the previous year. And 14 percent of girls, up from 12 percent in 2011, said they had been forced to have sex at some point in their lives, as did 20 percent of gay, lesbian or bisexual adolescents.

“When we’re looking at experiences of violence, girls are experiencing almost every type of violence more than boys,” said Dr. Ethier of the C.D.C. Researchers should be studying not only the increase in reports of violence, she said, but its causes: “We need to talk about what’s happening with teenage boys that might be leading them to perpetrate sexual violence.”

The researchers also analyzed the data by race and ethnicity, finding that Black and Hispanic students were more likely to report skipping school because of concerns about violence. White students, however, were more likely to report experiencing sexual violence.

The increase in sadness and hopelessness was reported across all racial groups over the last decade. Though Black students were less likely to report these negative feelings than other groups, they were more likely to report suicide attempts than white, Asian or Hispanic adolescents.

The 2021 survey asked about students’ sexual orientation but did not ask about their gender identity, so data on risk factors for transgender students is not available.

Dr. Victor Fornari, the vice chair of child and adolescent psychiatry for Northwell Health, New York’s largest health system, noted that the drop in teen well-being coincided with the rise of smartphones. Although the technology’s full impact on adolescents’ mental health is still unknown, he said, there is “no question” of an association between the use of social media and the dramatic increase in suicidal behavior and depressive mood.

“Kids are now vulnerable to cyberbullying and critical comments, like ‘I hate you’, ‘Nobody likes you,’” he said. “It’s like harpoons to their heart every time.”

More girls than boys reported being cyber-bullied, according to the C.D.C. report, which found one in five girls said they had been the target of electronic bullying, almost double the 11 percent of boys.

Dr. Fornari added that the number of adolescents coming to the emergency room at Long Island Jewish Medical Center in New Hyde Park, where he practices, for suicidal thoughts or attempts has increased dramatically in recent decades. In 1982, there were 250 emergency room visits by suicidal adolescents. By 2010, the number had increased to 3,000. By 2022, it was 8,000.

“We don’t have enough therapists to care for all these kids,” Dr. Fornari said.

The C.D.C.’s report also noted, however, that the number of adolescents who reported needing medical attention for a serious suicide attempt had been fairly low and stable, hovering around 2 or 3 percent, since 2011.

“Lots of people think about taking their life. Most of them will not act on it,” said Dr. Jill Harkavy-Friedman, senior vice president of research of the American Foundation for Suicide Prevention. “We don’t want to panic people with this. We want people to start having these conversations, checking in, and then making a plan to help each other.”

The C.D.C. survey follows another bleak report released by the agency last week showing that suicide rates were up among younger Americans and people of color after a two-year decline.

The C.D.C. report stressed that healthy relationships at school can improve adolescents’ mental health.

“Young people who feel connected in middle school and high school 20 years later have better mental health, are less likely to be perpetrators or victims of violence, are less likely to use substances and are less likely to attempt suicide,” Dr. Ethier said. “So school connectedness is a very powerful protective factor.”

If you or someone you know is having thoughts of suicide, call or text 988 to reach the National Suicide Prevention Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.

A correction was made on 

Feb. 13, 2023

An earlier version of this article misstated the year the first smartphone was released. It was 2007, not 2012.

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