Teen anxiety is on the decline in northwest Washington, but still high

Originally published in the Salish Current

Childhood best friends Rowan and Vivian are growing up in an era of increased teen anxiety. Luckily, the two teens have each other.

Following a few stressful years during the COVID-19 pandemic, teens in Northwest Washington are experiencing less anxiety. According to data collected as part of the Washington State Healthy Youth Survey, 62% of 10th graders in Whatcom County reported feeling nervous, anxious, or on edge within a given two-week period in 2023, down from 72% in 2021. 

Lindsay Anderson is the Mental Health Coordinator for Nooksack Valley School District, northeast of Bellingham. She says that the pandemic was a major cause of stress for families in her rural district. 

“Initially when we first shut down in 2020, some of our families who had already been dealing with hardship and adversity prior to the pandemic were like, ‘We know how to deal with hard things. We can roll with this,’“ Anderson said. 

“But the longer we continued to not be physically present at school, the harder it was for families for whom school was a really important source of not just education and friendship, but also two meals a day. School was where they had extra trusted adults, a hub of family supports, especially in our rural community.”

For these lower-income students, Anderson said, a major cause of anxiety during the pandemic stemmed from uncertainty about whether their family would have enough money to pay for their basic needs. Although such stressors continue following the return of in-person schooling, some of this worry has been alleviated. 

The stress of the pandemic was experienced somewhat differently within Native communities, said Thrisa Phillips Jimmy, a mental health provider at the Lummi Tribal Health Center. Many important cultural ceremonies such as Canoe Journey and summer pow wows were canceled for several years during the pandemic. 

“These ceremonies are a big, important part of our lives,” said Phillips Jimmy. “Canoe Journey in particular gives us a time to gather and work as a team. It also has a cultural component called ‘protocol’ involving specific dances and songs.” 

Phillips Jimmy said that the cancellation of important ceremonies during the pandemic triggered some intergenerational trauma in Native communities, who were reminded of the time not that long ago when the practice of many of their cultural traditions was forbidden. From 1883 to 1978, participating in Native religious ceremonies was a crime in the United States. “These ceremonies are healing. When we don’t have a way to heal, that creates another kind of trauma,” she said.

Hailey Henderson-Paul, the school counselor at Friday Harbor High School, said that teens in the San Juan Islands face a unique set of stressors. Lack of affordable housing has long been a cause of stress for lower and middle income families on the islands. Henderson-Paul said many families had even less stable employment and housing during the pandemic, which caused more of her students to miss school. 

There are only about 270 students at Friday Harbor High School, and being a ferry ride away from other communities means that teens on the islands are more isolated. “This is a place where everyone knows everyone,” said Henderson-Paul, “That has its pros and cons.” 

Larger trends

“Yes, the pandemic was bad. But these trends were developing before that,” said James Harle M.D., a child and adolescent psychiatrist and the director of the Sendan Center in Bellingham. 

Even though trends in the short term are improving, Harle said mental health among youth has been declining for decades. According to the National Alliance on Mental Illness (NAMI), the United States is in the midst of a youth mental health crisis. And according to the World Health Organization (WHO), youth mental health has been declining throughout the globe.  

“Some anxiety is healthy,” said Harle, “but the dividing line is the degree of distress. Is it interfering with their day-to-day functioning? Their schoolwork? Their peer relationships?” Harle said that persistent anxiety often leads to depression.

Nooksack Valley School District conducts a Student Universal Wellness Screener every year, and Anderson said that this survey has been helpful in revealing some of the sources of teen anxiety. 

Some teens, said Anderson, are anxious because they are worried that they can’t keep up with their coursework. Many of them report difficulty asking for help because they are afraid of the stigma associated with falling behind. Instead of asking for the support they need, they “fly under the radar,” said Anderson, which can then cause them to fall further behind. 

If left unchecked, academic anxiety can lead to school avoidance. “But the longer they're out,” Anderson said, “the harder it is to come back. Avoiding the thing that makes you anxious tends to perpetuate the anxiety cycle.”  

Anderson also notices elevated levels of anxiety amongst her district’s Spanish-speaking students, some of whom are concerned about their family’s immigration status. The severity of this anxiety tends to fluctuate with the political context. “I remember that vividly, especially in 2016” she said, “And I know it's popping up again.” 

Anderson has high school seniors who are afraid to apply for financial aid to attend college. “​​Some of them worry that if they fill out the FAFSA for this coming season, and their parents are undocumented workers, it could put them in harm’s way. They are afraid it will put their parents at risk of deportation.” 

She also says that many LGBTQ+ students have higher rates of anxiety due to harmful rhetoric and bullying. 

Phillips Jimmy said that it is impossible to separate teen anxiety from the larger social challenges of our time, including political instability, climate change, and an increasing sense of hopelessness about the future. 

In addition to all of these stressors, Harle said there are also cultural trends at play. He pointed to the work of John Haidt, author of The Anxious Generation, in attributing the rise of youth anxiety to two main trends. 

The first, he said, is algorithmic social media. Many teens are being exposed to anxiety-provoking content that they may not have the tools to handle on their own. “Until fairly recently, we haven't been aware of all the dangers of life online,” said Harle. Many teens, he cautioned, are being underprotected in the virtual world. 

This is coupled by a second trend: overprotective parenting in the real world. Many children are not given enough opportunities to take risks, make mistakes, or encounter difficult situations on their own, so they lack experience in effectively working through challenges when they arise. Well-meaning parents, said Harle, are doing a disservice to their children by not giving them an appropriate amount of space to develop their independence. 

Finding support

Access to mental health providers in Washington State varies across counties. Harle said there aren’t enough licensed mental health providers who work with children and teens to meet the need in Whatcom County. For rural families in the Nooksack Valley, transportation might be a barrier. For recent immigrants, language might be an issue. In small communities like the San Juan Islands, it can be difficult for families to find a provider when they need one, especially one who accepts insurance or Medicaid.

There’s a lot that families, schools and communities can do to support teens before their anxiety becomes problematic. Some social media may have protective benefits, helping teens connect with one another and form communities online. But social media can also be harmful. The American Psychological Association recommends monitoring and limiting your child’s use of certain kinds of platforms, especially platforms with a “like” function, which have been shown to be particularly problematic (especially for girls), and platforms that use artificial intelligence to promote excessive scrolling.

If you know a teenager who does experience anxiety, the best evidence-based intervention, said Harle, is called Exposure and Response Prevention (ERP). This is a method of shutting down the anxiety cycle through voluntary, gradual exposure to the thing that’s making a person anxious. 

“There is a lot of nuance to this work,” said Harle, “I call it ‘small steps of brave practice.’” Harle also works directly with parents to help them discern when it’s appropriate to do things for their children, and when it might be more beneficial to let children do things for themselves. He gave the example of a child who doesn’t want to order for themselves in a restaurant. 

“If you step in and order for your child, the problem is that you’re indirectly validating that fear. It might not be intentional, but the message is that ordering at a restaurant is potentially dangerous.” He recommends the resources at Let Grow, a national movement which advocates for “real-world ways to get our kids back to having some adventures, solving some problems, and blossoming.”  

Anderson brings as many mental health resources to the Nooksack Valley School District as she can, including parenting workshops on positive discipline. She also sees a need for social programs to help reduce financial stress for low-income families, such as food, housing and transportation assistance, and legislation that would make people’s work schedules more conducive to raising children, such as more flexibility and paid time off. 

Phillips Jimmy said that adults can help teens who have a sense of despair about the future by validating their experience and letting them know they are not alone. She likes to remind young people that they have made it through difficult experiences in the past, and they will have the tools to make it through difficult experiences in the future. 

The National Alliance on Mental Illness (NAMI) is also a helpful resource, with local chapters in Skagit, Whatcom and San Juan Counties. Their Ending The Silence Program in schools teaches students about the warning signs of mental health conditions and what steps to take if you or a loved one are experiencing such symptoms.

“Teens are in a season of life where they're getting ready to launch from their adults, and there's a lot of push and pull,” said Anderson. “It can be really hard to parent teens, but they need trusted adults way more than they might show in their actions or say with their words.”

“A trusted adult doesn’t have to be a parent or family member,” said Anderson, “It could be a teacher, coach, or mentor. I know a lot of kids whose parents can't help them in the way that they want to. And having that extra layer of support is really important.”