The Perfect Storm

Around the world, more than 300 million people are suffering from depression , an increase of more than 18 percent between 2005 and 2016.

In 2017, the United Nations declared depression a global emergency. Today, this epidemic is accelerating. The need to uncover its roots is growing more urgent by the day. Some of the possible causes are obvious, and some, as we suggest below, are more deeply hidden.

In the U.S., while depression rates for adults as a whole seem stable, sharp increases for teenagers and young adults have occurred over the last decade. About 20 percent of children now experience a major depressive episode before leaving school.

Forum on Child and Family Statistics

America's Children: Key National Indicators of Well-being

Source: Forum on Child and Family Statistics

The above graph tracks major depression rates for U.S. teenagers from 2004 to 2015. A sharp upward trend is noticeable from around 2012, especially with females, and among older teens.

The next graph tracks mobile phone and smartphone ownership in the U.S. Note that the emergence and rapid increase in smartphone ownership closely mirror the sharp increase in depression rates among U.S. teens. We need to urgently explore why this correlation exists.

Pick your battles. Kids can't absorb too many rules without turning off completely. Forget arguing about little stuff like fashion choices and occasional potty language. Focus on the things that really matter - that means no hitting, rude talk, or lying.

Pew Research Center

Mobile Fact Sheet

Source: Pew Research Center

The ramifications of the depression epidemic are widespread. Depressed children have a higher risk of drug addiction , yet government agencies and non-profits involved in related prevention initiatives hardly mention this link. In the U.S., the number of young people dying from drug addiction now exceeds the number of deaths from gunshot wounds or car accidents.

The perfect storm
Around the world, the steep rise of depression is the result of a “perfect storm,” a convergence of multiple causes. Different regions of the world may be impacted most strongly by differing variables. For example, children in East Asia, who are experiencing some of the highest depression rates in the world, seem to be especially affected by the stress and loneliness resulting from crushing academic pressure and competition .

Given the number of potential causes, it is difficult to quantify their relative ranking. On top of that, due to the splintering of the sciences into narrow areas of specialization, we have lost sight of the big picture, which is getting even bigger, as new areas of inquiry uncover new causes. For example, following the discovery of a “gut-brain axis,” we now have evidence that changing nutritional habits may play a significant role.

Bearing this in mind, a rapidly expanding number of studies and reviews in the social and natural sciences point to the following suspects:

Take charge. Children crave limits, which help them understand and manage an often confusing world. Show your love by setting boundaries so your kids can explore and discover their passions safely.

1. The erosion of traditional social structures and communities. A gradual disintegration of the social fabric, which has closely paralleled industrial and technological growth, has resulted in greater isolation and loneliness. In his ground-breaking book Bowling Alone, based on volumes of statistical data, Robert Putman showed how, in the U.S., we have become increasingly disconnected from family, friends, and neighbors. Urbanization and the breakup of the extended family and rural community are leading causes of this social atomization.

Nonetheless, less visible but equally powerful forces are leading to greater isolation.

2. Changes in modes of communication. Following the physical upheaval of urbanization, the world has been swept by a tidal wave of electronic innovation . Many children have become heavily dependent on electronic means of communication, with teenagers worldwide spending an average of around 200 minutes per day on social media . This has had a profound impact on the frequency and depth of face-to-face interaction. Children, in particular, are less aware that the exchange of pixels on a screen cannot replace the multi-dimensional nature of unmediated face-to-face communication involving body language , tone of voice and physical contact. We now know that the so-called “love” hormone , oxytocin , is generated during various forms of social bonding , including in-group relationships, especially through close physical contact. Could extended social media usage, especially if it replaces face-to-face contact, lead to a deficiency of oxytocin?

Though we are still exploring the relationship, a strong correlation exists between depth of depression and time spent on social media, watching TV, and especially gaming.

Remarkably, the alarming rise in depression among U.S. youth during the period 2004–2015, depicted in the above graph, coincides with the birth and rapid growth of smartphone usage during the same period. While this does not prove a cause-effect relationship, it would seem to reinforce an urgent need to closely examine the impact of smartphone usage on the communication skills and psychological wellbeing of young people.

Put on your own oxygen mask first. In other words, take care of yourself or you can't be a fully engaged parent. Parents who deprive themselves of rest, food, and fun for the sake of their kids do no one a favor. "People feel guilty when they work a lot, so they want to give all their free time to their kids," says Fred Stocker, a child psychiatrist at the University of Louisville School of Medicine, in Kentucky. "But you risk getting squeezed dry and emotionally exhausted." A spa weekend may not be realistic, but it's OK to take 15 minutes for a bath after you walk in the door. (A tall request for a kid, yes, but a happier Uno player goes a long way.) Running ragged between activities? Ask your child to prioritize, says Taylor. She may be dying for you to chaperone a field trip but ambivalent about your missing a swim meet—the ideal amount of time for a pedicure.

3. Changes in Diet. We have recently discovered that more than 50 percent of the cells in the human body are bacterial and not human. In normal conditions, most of these are “probiotic” bacteria that make their home in the digestive tract and, in return for the favor, provide a vast range of services essential to human well-being. Certain strains of these bacteria, recently coined "psychobiotics," found in fermented foods, human milk, and not coincidentally, in the human gut, produce and modulate neurotransmitters and neuropeptides essential to our mental wellbeing, including GABA, serotonin, dopamine , and BDNF.

Consumption of processed foods, which mostly contain a serious imbalance of omega fats, large quantities of sugar, and a lack of fermented ingredients, are radically affecting the delicate balance of our gut flora. A landmark comparison between North Africans and North Americans revealed sharp declines in bacterial diversity among the North American group, including genera containing the psychobiotic strains. Is fast food and processed food throwing our microbiome, that is, our internal environment, into chaos in the same way that pollution is destroying the macrobiome?

4. The intense competition surrounding education among industrialized nations. Korea, Japan, China, and to a growing degree, Western nations, are experiencing an exponential rise in youth depression. In East Asia, fierce competition in the academic arena, in which academic success is equated with social and economic “success” by parents , is leading to a loss of personal autonomy and acute stress.

Secondary schools are now largely focused on exam-centered curricula. These curricula are specifically designed for success in the race for university entrance, and marked by a lack of content related to life skills, social-emotional learning, and wellbeing in general. On top of sleep deprivation and psychological stress, students complain that they have lost control of their own lives and career trajectories. The shift from internal locus of control to external locus is closely related to a decline in psychological wellbeing.

Avoid food fights. A healthy child instinctively knows how much to eat. If he refuses to finish whatever food is on his plate, just let it go. He won't starve.

5. The familiar socio-economic suspects, including war and poverty. Nations strongly affected by conflict and extreme poverty, with an emphasis on extreme, rank relatively high on the depression scale and low in happiness and satisfaction. Nonetheless, the relationship between GDP and depression/happiness rates is by no means linear. The Gallup Global Emotions Report, which tracks positive and negative emotions (as opposed to quality of life, tracked by the World Happiness Report) ranks many South American nations with average GDPs on the top of the list. Personal freedom and the presence of social networks, two factors inversely correlated to depression mentioned above, are highly related to scores on the Positive Experience Index of the Global Emotions Report.

While the above presents a grim picture, by trying to identify the causes of the global depression epidemic, we may discover threads that could lead to its unraveling. It is arguably within our power to impact many of the problems described. For example, we should make room for social-emotional learning in secondary schools, encourage social media giants to promote cyber hygiene, educate people on the psychological impact of eating patterns, and appeal for government funding aimed at depression prevention initiatives.

The biggest obstacle facing such initiatives may be invisible: Apathy among those who have not experienced depression and thus fail to recognize that quiet, psychological suffering is in no way less disabling than physical injury.