The crisis in teen mental health and how Lifestyle Psychiatry can help

Those of us in the mental health care professions have known about the crisis in adolescent mental health for many years. However, the U.S. Center for Disease Control (CDC) just released a report, the Youth Risk Behavior Survey, that highlights the problem with statistics that everyone can understand: In 2021, 42% of high school students experienced persistent feelings of sadness or hopelessness, 22% seriously considered attempting suicide, 18% made a suicide plan, and 10% attempted suicide. For teen girls, the figures are even higher: 57% felt persistently sad or hopeless, 30% seriously considered suicide, 24% made a suicide plan, and 13% attempted suicide.

With nearly half of our teens experiencing depression and about a quarter considering suicide, the situation meets the definition of a crisis. And yet, our mental health system is already overrun. There simply aren’t enough adolescent inpatient psychiatric hospital beds, and there aren’t enough adolescent mental health providers to accommodate this tidal wave of young patients. 

What can be done? CDC proposes that school based mental health be expanded. But would more help at school alone be enough? Is there anything that parents and other caregivers can do within the home?

Fortunately, the answer is yes. Lifestyle Medicine arrived as a board-certified branch of medicine in 2017. Lifestyle Medicine provides evidence-based recommendations for how to improve health, including mental health, in six domains: nutrition, exercise, sleep, stress reduction, social and emotional connectedness, and detoxification from chemical substances. Lifestyle Psychiatry, emphasizing the recommendations specific to mental health, has also arrived; its first textbook was published by the American Psychiatric Association in 2019. The recommendations of Lifestyle Psychiatry are readily implemented in the home. 

What are the recommendations of Lifestyle Psychiatry?

1. For optimal nutrition to prevent, reverse, and treat deficiencies associated with depression, implement the Whole Food Plant Based diet, supplemented with vitamin B12. “Whole” means natural and unprocessed. “Plant based” means 90 to 95% plants, rather than animal based products.
2. For optimal fitness and to guard against a sedentary lifestyle, which can contribute to depression, teens should exercise 300 minutes each week. This could be 30 minutes 5 days each week, or 150 minutes each weekend day, or any combination of these that still adds up to 300 minutes per week.
3. For adequate sleep, adolescents require anywhere between 7 and 9 hours each night. “Sleep hygiene” is the set of evidence-backed guidelines that promote restful, refreshing sleep. Research shows that, of all sleep hygiene recommendations, the most important is getting adequate sunlight, which can mean anywhere between 20 and 30 minutes, depending upon the time of day.
4. Stress reduction, which consists of four things: decreasing the stressful events and requirements in teens’ lives down to manageable levels, increasing their resilience to stress with coping strategies, decreasing their perceptions of stress with therapies such as Cognitive Behavioral Therapy (CBT), and increasing their awareness of support from family and friends.
5. Social and Emotional Connectedness, which speaks for itself. And
6. Avoidance of or detoxification from chemical substances such as alcohol, nicotine, cannabis, and others that have been shown to be harmful to the adolescent brain.

The crisis in adolescent mental health is deep, and sufficient professional resources are lacking. But Lifestyle Psychiatry provides clear and definitive guidelines with which parents and other caregivers themselves can contribute to the mental and emotional well-being of their teens.

Cheryl L. Green, M.D., is a lifestyle psychiatrist based in Southern California and the author of Heal Your Daughter: How Lifestyle Psychiatry Can Save Her from Depression, Cutting, and Suicidal Thoughts.