Teen Mental Health: Under the Surface Calm of the Holidays
While December often brings images of family gatherings and holiday cheer, it’s not always a joyful time for teenagers. A Toronto psychiatrist warns that many young people feel increased stress leading into the holiday season, a troubling trend even after the initial impacts of the COVID-19 pandemic.
"A lot of depression, a lot of anxiety, or general struggles with school – those are the things we see most commonly," says Dr. Kevin Gabel, a psychiatrist who runs the Day Hospital program for children and youth at North York General Hospital (NYGH).
Gabel’s specialized program offers academic, mental health, and coping skills to high school students struggling to attend school due to anxiety or other mental health issues. He notes a surge in demand for their services each November, a time many think of as less stressful than the start of the school year.
"Just a lot of it [is related] to more pressures with school,” Gabel explains. ‘Sometimes the seasonal effect as well. It gets a little bit colder and darker with the winter months coming. There can be a little bit more stress around that too.”
He adds that while the beginning of the academic year allows for a more relaxed pace after the summer, by October and November, classes are in full swing, intensifying the pressure.
Eating disorders, social difficulties, and problems exacerbated by ADHD also reappear or worsen alongside mood and anxiety disorders. A disturbing study released by the Centre for Addictions and Mental Health (CAMH) in August further supports these concerns.
The CAMH survey discovered a “worrying” overall decline in mental health among Ontario students in grades 7 to 12.
“ 37 per cent experienced elevated stress levels, while 51 per cent reported a moderate-to-serious level of psychological distress. That last figure has doubled over the past decade," the report stated.
Even more alarmingly, 33 per cent of the surveyed students felt they needed professional mental health support within the past year but did not seek it.
"The most common reasons cited for not seeking help are thinking they could manage it themselves, being afraid of what others would think about them, and being ‘too busy,’” the CAMH report revealed.
Gabel stresses the importance of open communication between parents and their teenagers. “We always encourage parents to have open communication with their teenagers, just sort of being there and listening and trying to understand what they’re experiencing,” he says.
Identifying if a teen needs help can be difficult. Be on the lookout for prolonged sadness or anxiety lasting days, weeks, or even longer.
"And then also when it really starts to interfere with their functioning,” he notes. “We look for changes at home, at school, with peers.”
Early warnings include withdrawal from social activities and a drop in academic performance.
“So really looking at the persistence, like something that’s lasting, and also how much it’s interfering with their functioning, or grades really dropping. So any big changes we really look for,” Gabel explains.
Despite the challenges, Gabel remains optimistic. Many of the teens seeking help at NYGH are eager to discuss their struggles and find solutions.
“All of our therapists on our teams who do the assessment really try to come at things sort of being open, non- judgmental – just trying to sort of meet a teen where they’re at, and trying to understand what they’re experiencing.”
The Day Hospital program offers a unique approach, providing a tailored combination of therapy and school in an eight-week program designed to help teens transition smoothly back into their academic lives.
While the causes for these mental health issues are multifaceted, Gabel suggests that the pandemic’s lasting impact continues to affect many teens.
"I think for a period of time, for different reasons, you didn’t have to go to school. There was sort of that option to stay home," Gabel says. “And I think for some of those kids, even though it’s a few years later now, it’s still sometimes a struggle getting back. The more you avoid something, or aren’t engaging in something, it can be a little bit harder to get back to it.”
The holiday season, often fraught with its own pressures, can exacerbate existing problems.
“For teenagers, coming into exams, [the] term is ending, so there’s some stress around that, certainly," Gabel says. “Or if they’re struggling with family conflict that can be exacerbated around the holidays.”
He adds, "Sometimes socially there’s even more opportunity to connect with friends and peers over the holidays, but sometimes if a kid is struggling with that, that can be highlighted a little bit.”
For families in need, NYGH’s assessment and many of its youth mental health services are covered by OHIP. Information about their services is readily available on their website.
Additional resources include Kids Help Phone and Help Ahead, offering centralized access to mental health and well-being resources specifically for children, youth, and families in Toronto. In emergencies, always dial 911 or contact the national suicide crisis helpline by dialing or texting 988.
## Teen Mental Health: Beneath the Holiday Cheer
**An expert Interview with Dr. Kevin gabel**
**World Today News: ** The holiday season is frequently enough portrayed as a time of joy and togetherness. Yet, recent studies and expert observations suggest a darker undercurrent, particularly for teenagers. Dr. Kevin Gabel, a psychiatrist at North York general Hospital and head of their day Hospital program for children and youth, shares his insights into this troubling trend.
**WTN:** Dr. Gabel, your program helps high school students struggling with mental health challenges. You mentioned a surge in demand each November. What are the primary factors contributing to this increase?
**Dr.Gabel:** Absolutely. While manny assume back-to-school season is the most stressful time, we see a spike in cases around November. A confluence of factors is at play. Firstly, the initial excitement and slower pace of theÀacademic year often gives way to intensified academic pressures by October and November.Deadline pressures, extracurricular activities, and social expectations can create a significant burden.
Additionally, the onset of winter with shorter days and colder weather can exacerbate existing conditions like seasonal affective disorder. These factors combined often lead to a heightened sense of stress, anxiety, and even depression among teenagers.
**WTN:** The CAMH study highlighting the decline in mental well-being among Ontario students is quite alarming. What specific issues are you observing in your practice during this time of year?
**dr. Gabel:** CAMH’s findings reflect the concerning reality we’re facing. We see a range of issues, from mood and anxiety disorders intensifying to eating disorders and social difficulties resurfacing.For students with ADHD, the academic demands can become particularly overwhelming, leading to increased struggles.
It’s crucial to remember that these aren’t isolated incidents. They point toward a systemic issue requiring immediate attention.
**WTN:** why do you think there’s a reluctance among teenagers to seek professional help, as highlighted by The CAMH study?
**Dr. Gabel:** There are several reasons. Stigma surrounding mental health still persists. Teenagers may fear judgment from peers,teachers,or even family members. They might also downplay their symptoms, believing they can cope independently or fearing being labelled “weak.”
Additionally,access to mental health services can be a significant barrier. Long wait times and limited resources make it challenging for many families to access the support their children need promptly.
**WTN:** What advice would you give parents and caregivers who suspect their teenager might be struggling during this time?
**Dr.Gabel:** Pay attention. Look for changes in behavior, sleep patterns, appetite, or academic performance. Open interaction is crucial. Create a safe space for your teenager to share their feelings without judgment.
Encourage them to prioritize self-care – getting enough sleep, eating healthily, and engaging in activities they enjoy. If you suspect your teen needs professional help, don’t hesitate to reach out to a mental health professional.Early intervention is key to their well-being.
**WTN:** This holiday season, what message would you like to share with teenagers who might be feeling overwhelmed or alone?
**Dr. Gabel:** Know that you are not alone. Many teenagers struggle with similar feelings during this time. It’s okay to ask for help. Your mental health matters, and there are people who care about you and want to support you. Reach out to a trusted friend,family member,teacher,or counsellor. There is hope, and with support, you can navigate these challenges.
Remember, taking care of your mental health is just as critically important as taking care of your physical health, perhaps even more so during the holidays.
