According to the National Center for Health Statistics, suicide rates among youth ages 10-24 in the U.S. increased by 57 percent between 2007 and 2018. It just so happens it was around 2009 that technology like the iPhone and Facebook became more popular, as well as the rise of social media and thus, less in-person social interaction.

Then more recently, with the instability due to the COVID-19 pandemic, including school closures, social isolation, family loss and illness, among other disruptions, a report released last month revealed how high school students’ mental health worsened with 37.1 percent reporting poor mental health. Estimates show more than 6,600 suicide deaths among ages 10-24 in 2020.

At the end of last year, many of the nation’s leading health experts called the rising levels of mental illness among youth “a national emergency.”

We spoke to Xiomara A. Sosa, a clinical mental health counselor based in Summerville, SC, about what signs everyone with, or around, kids should be aware of.

“In the past two to six years, the rate has become even more alarming,” says Sosa. “The pandemic is of course one reason, the political environment, and many, many other factors can be, and often are factors that contribute to depression and anxiety.”

She says there is not just one cause for depression and anxiety, and we need to be careful how we express that because there is “clinical depression” and “clinical anxiety,” which are medical illnesses with psychological and physical symptoms. However, there are also “situational depression” and “situational anxiety.”

“Both are very prevalent now, and it’s our job as clinicians to unravel it all to help provide effective treatment,” says Sosa. “There is no such thing as ‘one’ cause. Some causes are based on neuroscience, biology, our environment, health-related issues, and even possibly genetics. These conditions can sometimes be brought on by an illness or even drug use/abuse or even be related to some medications. Trauma can also be involved. That’s why it’s important that each individual be assessed and evaluated by a trained and skilled clinician.”

Just as there are many causes, there are many signs of depression and anxiety.

“Some signs of depression in school-aged children include behavioral issues at home or at school, sleeping and eating changes, and seeming profoundly sad most of the time while expressing a sense of hopelessness,” says Sosa. “Other signs include losing interest in activities that they were normally excited about, obvious changes in mood such as, noticeable irritability with most things and most people, and a general lack of energy and fatigue/tiredness.”

Anxiety in school-aged children can sometimes resemble the signs of depression, so that is why it is very important that a skilled clinician evaluate and assess them.

“Some signs can include difficulty in concentration, problems with sleep, nightmares, or walking in their sleep,” says Sosa. “Not eating like they normally would, no appetite, consistent worrying, and a lot of negative thoughts. Feeling a lot of tension, being fidgety, and bathroom concerns, are also signs to look out for.”

Sometimes it is hard to approach kids and teens because they can be moody or seem like they don’t want to talk. Mental health experts recommend focusing on their strengths when approaching them, and not on the negative, can help with that.

“Really listen to them when they say something, and actually respond to what they are saying in a way that helps them feel heard and understood and not lectured or judged,” says Sosa. “Adult modeling is very important. So, if adults around them have or are experiencing depression or anxiety, be open about it and let them see they are not alone. They need to feel like this is nothing to feel ashamed, or scared about, and that they have someone’s full support and understanding.”

A “no-judgment-zone” is key.

“Show love and encouragement when reaching out to them,” says Sosa. “Encourage them to talk about their thoughts and feelings when it comes to suicidal ideation, and reassure them that it’s very common when experiencing depression. Let them know there is help and support and that you will not judge them about what they are experiencing.”

Don’t force them to talk about it if they don’t want to. However, check-in with them regularly, and let them feel you are there for them unconditionally.

“Ask them how they are doing, and how they are feeling,” advises Sosa. “Let them know you are there and aren’t going anywhere. If, and when, they are ready to talk to you, you will be there. Sometimes just sitting with them, or letting them know you care, can help them feel a little better. Ask them what, if anything, you can do for them to provide them support.”

Clinical depression and anxiety can feel very scary, because it causes feelings of isolation.

“Finding ways to let them know they are not alone and that they are cared about is always a good first step,” says Sosa. “Remember that these disorders can cause cognitive impairments at times, meaning they cause us to believe things that really are not true – like we are worthless and unloved. So being present, showing small acts of kindness, and being very patient and mindful with them can be a good start.”

Also, just as the adult has to put on their own oxygen mask first when an airplane is in an emergency, as adults, we also have to take responsibility for taking care of our own mental health first.

“This will allow us to help raise healthier children and to be much better prepared to recognize and respond appropriately to them if, and when, they show symptoms and signs of depression and anxiety,” says Sosa. “We have to model better behaviors, and better self-care, educate ourselves, and each other, about these conditions and fight the negative stigma still associated with mental health.”