By Stephanie Filio
The preteen and teen brain operates largely on emotion and feelings, which can get confusing during these years of rapid-fire hormones. Eventually, the brain gets so tired it surrenders and gives the green light to things like riding on the hood of a car or sneaking out of the house after curfew (sorry, Mom!). With so much natural turmoil occurring during adolescence, it is hard to distinguish between age-appropriate difficulties and a larger problem.
In the six years that I have worked in public schools, I have seen a quick rise in students who struggle with attention, focus, inhibitory control, and depression. I now expect at least one parent a month to ask for help with a student who reports not wanting to go to school due to looming sadness. Often, the student appears to be part of a social group, has established relationships with teachers, and seems happy and engaged at school. Where is this despondency coming from? Have the angst and rebellion of previous generations been replaced by a passive disinterest in school, activities, and the growing world?
Pieces of the Puzzle
Over the winter break I came across a podcast series aptly titled What Were You Thinking? by Dina Temple-Raston, which presents stories of extreme teen thinking—such as teens joining ISIS or the phenomenon of suicide clusters—and explains the role of adolescent cognition in the teens’ decision-making. The series was so spot-on with descriptions of behaviors I see in my hallways that I immediately started jotting down notes. As I listened to the stories, I was able to take a step back and really view my students through the lens of their generational influences and barriers. I also came up with new questions to ask students when troubleshooting problematic behaviors. My many students diagnosed with depression or presenting with depressive symptoms need assistance to find contentment and more emotional control, and I felt lucky to have found more tools for my counseling toolbox.
I noticed three major threads that the stories on the podcast have in common with my students: increasing use of technology, addicted behaviors associated with technology, and less controlled sleep. These three components seem to have created a perfect storm unique to contemporary teens. They are almost always hiding in the background of conversations I have with exhausted parents who are crying out for help with their low-performing students or with caseloads of students who tell me that they feel very little joy throughout the day.
The symptoms of technology addiction and sleep deprivation are remarkably similar to those of depression—inattention, sadness, and disorientation, among others. As school counselors, it might not be our job to diagnose students, but it is essential that we have an understanding of mental health barriers that affect students’ education and development. Let’s take a look at some of these barriers.
The Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM-5) describes symptomatic criteria that have to be met in order for a psychological or medical professional to make a diagnosis. A patient needs to exhibit several symptoms nearly daily for a period of time, creating social or environmental impairment (for example, social isolation and avoidance of responsibilities or recreational activities), in order to be diagnosed with major depressive disorder. Major depressive disorder is a diagnosis that school counselors are seeing more and more often in student files.
Truth be told, many symptoms of major depressive disorder, such as irritability, sleep disruptions, agitation, and lack of concentration, are similar to typical hormone-induced adolescent behavior. Descriptions in the DSM-5 of moderate impairments from depressive episodes sound like a typical weekend with my own preteen and teen: negativity, lack of motivation, avoidance using electronics, minimization of personal responsibility. The difference, however, comes when symptoms become severe, even entering dangerous territory with thoughts of suicide and self-harm.
The US Department of Health and Human Services lists sleep deprivation as detrimental to the overall health and well-being of a person. Not getting enough sleep can cause physiological problems, such as heart disease and obesity, and psychological effects, such as irritability, lack of focus, poor memory retention, and low reactivity. Good sleep can be obstructed by stress, pain, mental illness, and/or distractions in the sleep environment.
Often, students tell me that they play video games late into the night and report feeling groggy, hoping to go home early. As schools push back start times for high school students in hopes of making healthier teens, they may be missing the mark. Though later start times may help teens feel less stressed, they don’t do anything about what really keeps kids up past bedtime and the positive sleep habits that are interrupted by cell phones, video games, and streaming videos.
The DSM-5 distinguishes between substance abuse and addictive disorder. Gambling addiction, currently the only diagnosis for a nonsubstance addiction, presents with compulsion, sacrifice of life opportunities, obsessive feelings of preoccupation, irritability, avoidance of other responsibilities, and withdrawal when not gambling. In other words, my 12-year-old when his video games are taken away (I’m battling right there with you, parents!).
Internet gaming disorder has recently been added to the DSM-5 as a condition, but is not diagnosable because research is still being collected. Even the language used in these documents shows the infancy of information collected so far by citing “computer use.” Ask any young person about their “computer use” and they will laugh. If you do not see what is the big deal, you were probably born around the same time as me! Our kids are using video game consoles for social connections, scanning multiple social media sites on tablets, watching hours of YouTube on their phones, and holding full-length conversations in their school-sponsored Chromebook Google Docs.
The Big Picture
Psychological disorders should only be diagnosed by trained and certified mental health providers. It cannot be stressed enough how an ignored, misdiagnosed, or undiagnosed disorder can be grossly dangerous. However, we are entering uncharted territory in terms of internet and technology addictions. Is it possible that some students are being misdiagnosed with depression—or anxiety or ADHD—when the real issue is technology addiction presenting with depressive symptoms? How often are students addicted to gaming and internet use and, subsequently, are sleep deprived?
Considering their exposure to technology, younger generations seem to be particularly vulnerable to its ill effects, with technology causing long-lasting repercussions on their education, relationships, and overall motivation to succeed.
Where to Go from Here
In an episode of What Were You Thinking? Dina Temple-Raston refers to an assessment that students in Korea have to take that measures their dependency on smartphones and determines if they are eligible to receive counseling. Hearing that was such a lightbulb moment for me! It felt good to know there are communities that are already finding ways to serve their populations in order to try to reframe how younger generations look at and use technology. While just beginning to brainstorm, here are a couple of interventions I am thinking about implementing:
- Make it a habit to ask parents and students about internet use and sleep habits.
- Poll students on their use of technology (what are they using most, how many hours each day, how much stress do they feel when they cannot participate in these activities).
- Provide pop-up classes to teach students different not-technology-centered hobbies (like art, crochet, shuffleboard, board games, card games).
- Hang posters in the hallway of easy yoga poses and include breathing directions for relaxation tips.
- Create competitions for lower screen time. Even if students are not honestly reporting their time, the competition puts attention on the subject and can plant a seed for mindfulness.
- Share results of student technology use polls with parents and offer suggestions on how to monitor use.
- Collaborate with P.E. teachers to offer a health lesson on the repercussions of too much technology use and ways to slowly reduce screen time.
Adolescence is tough. And students experiencing depressive symptoms have an additional layer of difficulty during this tough time. As we learn more about the effects of technology on the growing brain, we will learn more about differential diagnosis (distinguishing between conditions with similar symptoms) and methods of relief. Our standards of how much time should be spent on technology are outdated, and our approach to ensuring that students are not becoming addicted to technology may need a huge update to best serve our young people. As is often the case, the front line will likely be education, where we can provide students with real solutions that will allow them to reframe their relationship with technology and find that they can once again put themselves first.
Stephanie Filio is a middle school counselor in Virginia Beach. She received her undergraduate degree in interdisciplinary studies from the University of Virginia and her M.Ed. in counseling from Old Dominion University. In a discussion with one of her UVA professors about her desire to stay in school forever, her mentor wisely responded, “If you want to be a lifelong learner, go into education,” and so she found her place. Prior to her six years as a school counselor, Stephanie worked in private education, specializing in standardized tests, test preparation, and future planning. She writes about her career and hobbies at her blog, Weekend Therapy, and can be found on Twitter @steffschoolcoun. Stephanie also enjoys spending time with her books, crafts, and family.
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