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‘A really difficult year’: High school seniors are struggling with their mental health

When history threw many young people’s carefully laid plans off course, diagnoses of common mental health concerns like anxiety and depression soared — as did the rates of substance use, said Cindy Doth, Hazelden Betty Ford Foundation youth and school outreach manager.

Sarah Jagerson’s life changed drastically in March 2020, when her school and her community went into lockdown.
Sarah Jagerson’s life changed drastically in March 2020, when her school and her community went into lockdown.
Courtesy of Sarah Jagerson

Sometimes, Sarah Jagerson, 18, likes to separate her young life into two distinct parts: In the first part, before COVID-19 changed everything, Jagerson was a hard-working, high-achieving junior at Anoka High School. She was involved in a bunch of clubs and after-school activities. She had a job, she studied hard and got good grades. She looked forward to one day going to college — but she was also eagerly anticipating her senior year. Life felt sweet.

Then, Jagerson’s life changed drastically in March 2020, when her school and her community went into lockdown. Her happy, busy life shut down almost overnight, and those drastic changes sent her into a tailspin of sorts, sparking a series of debilitating panic attacks.

“Normally I felt like my life was surrounded by school and work and the activities I’d done,” Jagerson recalled. “Then that was all taken away. I didn’t have school. I didn’t have work. In a way, my identity was gone.” She’d always thought of herself as an overachiever, a great student. “When I couldn’t go to school, when my clubs weren’t meeting in person, I was stripped of that identification. That was the hardest part. I didn’t know who I was anymore.”

The panic attacks led Jagerson’s parents to schedule an appointment for her with a therapist, who eventually prescribed an antianxiety medication. Though Jagerson resisted taking the medication at first, her isolated, stressful days soon began to take a toll.

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“I’d get these panic attacks, one after the other,” she said. “I felt really, really anxious. I finally tried the medication. I felt like I didn’t have another option.”

The medication, combined with talk therapy and her district’s gradual return to in-person school, slowly helped Jagerson regain her footing. But she’d be the first to admit that the last year and a half has taken a serious toll on her mental health. For the next few years at least, she said, she will approach the world from a more cautious perspective — without the same solid trust that her future will always be predictable and smooth.

“For the most part,” Jagerson said, “it was a really difficult year. In school, there were constant transitions to different learning types. The world outside of school was always shifting, too. It made things really difficult and confusing. In so many ways my senior year wasn’t even close to the way thought it would be.”

Cindy Doth
Cindy Doth
Jagerson isn’t the only member of the class of 2021 who’s struggled with their mental health over the last year, said Cindy Doth, Hazelden Betty Ford Foundation youth and school outreach manager. The chaos and uncertainty sparked by the global pandemic has thrown many young people off course, causing them and their parents to rethink or readjust their plans for the future.

“Before the pandemic, before everything exploded, many families were urging and even pushing their kids to go right off to college after high school graduation,” Doth said. “Students had this sense of invincibility, of, ‘I can go out and I can do this. I can conquer the world. School’s going to be fine.’ For most families, their teen’s mental health wasn’t much of a focus or concern.”

But when history threw many young people’s carefully laid plans off course, diagnoses of common mental health concerns like anxiety and depression soared — as did the rates of substance use, Doth said. In her work counseling young people in several Twin Cities schools, she has seen a rising number of high school seniors who are struggling with some very adult problems.

“Students are sicker now than what I’ve seen in previous years,” she said. Doth sees this rise in mental health and addiction issues as a result of young people living through a chaotic year that didn’t match their long-held expectations of what the culmination of their high school career would be like: “Kids have been struggling to adjust to all this change, this uncertainty. Even today I got a referral from one of the schools I work with where a student had overdosed at school. And that’s not the first [overdose] case I’ve seen.”

Kristina Kothrade
Kristina Kothrade
Kristina Kothrade, a social worker at Andover High School, said that many students in her school of some 1,750 are showing symptoms of serious stress.

“The anxiety that people feel in school is much higher than it was in the past,” Kothrade said. Part of that anxiety, she believes, has its roots in the months students were forced into distance learning: “I noticed that when we were in distance mode, the level of engagement was just not there. The distance learning aspect of it is much harder for some kids — and it can take a toll on their mental health.”

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Being back in school, if even on a reduced schedule, has helped many students see a light at the end of the tunnel, Kothrade said.

But some students are having a much harder time climbing out of the pandemic pit than others, she added. “Most kids are really resilient. They are making it through. But the kids that were already struggling prior to the pandemic, those that were dealing with mental health or chemical health issues before, are now in an even tougher spot.”

Amy Gardner
Amy Gardner
Amy Gardner, counselor at Anoka High School, said that returning to in-person school felt hard, even traumatic, for some young people: “They’ve lived through this time where everything held still. Then, when we finally came back in person, everything is pretty fast and furious.”

To make this adjustment, Gardner said, students have had to dig deep and rely on their resilience skills to make a healthy transition: “For some, that’s taken some real adjusting.”

Interconnected struggles

There are moments when she’s working with a troubled high schooler that Gardner has a hard time determining if their central struggle is with their mental health or their chemical health. Then she reminds herself that the distinction really doesn’t matter.

“Mental health and chemical health are so interconnected,” she said. “They’re really not two separate issues.” Because of this reality, Gardner said she makes a point of advising parents that when their teens appear to be struggling with their mental health, it helps to be also be aware of the very real potential for substance use.

“Parents should have open eyes and ears,” she said. “When you think your child might be struggling, initiate that conversation. Tell them you are there for them, that you support their struggles. Make it clear that you are aware of their issues and you are there to help them.”

Doth believes that the rise in addictive behaviors that she’s been observing among high school seniors may be an unconscious reaction to stress created by pandemic-induced upheaval.

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“There has been this ongoing lack of structure, this lack of accountability combined with an increase in intense emotion, and a lack of coping skills,” she said. “Those elements combined create a situation that is just ripe for substance use and mental health difficulties.”

Too many times, Doth said, she’s spoken to parents who cling to the hope that a college-driven change in scenery will help their struggling teen reset and start a new, healthier young-adult life.

“They believe that a transition to a more mature life event like college was the tweak that their kid needed to get over this little hurdle they were experiencing,” she said. In her experience, the shift to college won’t solve an already-existing problem: “This attitude demonstrates a general lack of understanding about the significance of substance use and mental health, a refusal to acknowledge that these are ongoing, chronic, treatable diseases that need more than a change of geography to address them. Going away to college is not the solution to an internal struggle.”

A healthier approach is to address the issue when it first arises, Doth said. Early help, she believes, can change behavior that, if left untreated, can bloom into a lifetime of struggle.

“The reality is if a student is struggling with substance use or mental illness in high school and that is left unaddressed, wherever you go there you are,” Doth said. “Those issues will follow you. A kid brings along their untreated substance use and mental health issues when they go to college.”

The reality that a location change isn’t enough to address mental health and substance use issues underlines the importance that parents help their high school students build a strong foundation for resiliency during challenging times, Gardner said.

“The parents won’t be there when their kid is at college. When these kids are on their own, they will come across situations where they will have to make important choices on the spot. Having family conversations early on about values and the impact of choices is important. It helps build a foundation.”

Though most teens push back against parent-initiated interventions of any sort, Gardner said that even as their children get close to leaving the nest, parents should still establish some ground rules and expectations.

“Kids, even older teens, need to know that parents care where they are, what they are doing and who they are with,” she said. “Students need to understand that there are boundaries and ground rules and that they exist keep them safe.”

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Toughest on seniors

Gardner has been around long enough to know that this particular senior year feels very different from how senior years felt in the not-so-distant past.

“In a normal year, the anxiety would be combined with excitement, maybe with a little bit of grief,” she said. “This year, these kids didn’t get that much time together. They didn’t get those natural events that you usually get as a senior class.” Because of that, she continued, “The anxiety moving forward feels different. A lot of it stems from getting used to re-engaging.”

While Gardner said that current seniors at her school are “really excited; many are ready to look at that next chapter,” she’s also witnessed more internal struggle than ever before.

“We’re seeing an increase in mental illness,” she said. “It is probably mostly anxiety. We’re also seeing issues with kids finding the motivation needed to keep moving forward. This year, more than other years, we saw students just shut down. It was hard for them to see the light at the end of the tunnel and keep going when they weren’t sure what was going to happen at the end of this year.”

For many kids, acknowledging that this time in their life isn’t unfolding in a traditional way can feel like a letdown, Gardner said.

“That’s where that grief process comes in. Their senior year didn’t turn out how they hoped it would. It’s no one’s fault. It happened. So how do we deal with that? How do you handle that frustration and anger and turn it around so that you’re still thankful and grateful for what we have?”

One way to turn this letdown year into a potentially positive experience, Gardner said, is to frame the experience as an achievement of sorts, as playing an important role in history.

“Years later they will say,” she chuckled, “‘I was in the class of 2021 and we did our senior year through COVID.’”

Doth said that she’s spoken with many high school seniors who are feeling unsure about their future college choices. “A lot of young people are feeling anxiety around some of the big decisions they are making right now.”

She advises parents to be patient with their teen’s hesitancy. Helping a young person make the transition to college, Doth said, “starts with having a conversation about it, with making it OK to not be OK.” Young people have had their lives turned upside down over the last year, she said: Give them time and permission to struggle and question. “When you ask your kid, ‘How are you doing?’ their response may be a flat, ‘I am fine,’ but everything about how they are presenting themselves may lead you to think differently. Know that it is OK to follow up, to ask more questions.”

Kothrade said that most of the high school seniors she works with are doing surprisingly well, though she can identify a few who are really struggling. “I have one senior in particular,” she said. “He’s hardly coming to school. I don’t know if he is going to graduate. The last year has just really been hard on him and he’s feeling stuck.”

Jagerson, for her part, has her freshman year in college mapped out. She’ll be attending Bethel University in Arden Hills, living on campus with a rommmate, but close enough to home to feel comfortable with the transition.

“I’m only going to be about 30ish minutes from my house,” she said “I’m at the point where I’m ready for that change, but I’m also happy that I won’t be going too far. I’m not feeling too anxious about that, and I think that’s part of why.”

She said she has noticed that some of her peers who selected schools farther away from home seem to be feeling a little nervous.

“Some of them are anxious,” Jagerson said, adding that since beginning of the pandemic, many of her peers have started taking antidepressants or antianxiety medications. “For those people who are moving out of state or across the country, it feels like everything is changing for them. I think some of them are second-guessing their decisions. So many things seem so unsure these days. It’s hard to be confident about your choices.”

These days, Jagerson, who’s fully vaccinated against COVID, feels confident that her future is looking more predictable — and hopeful — than it did last spring. She’s ready to move on to the next part of her life.

“As of right now I feel like everything is in a way back to normal,” she said. “I can go to school. I can have a graduation. For the most part, things feel pretty normal. I have a lot better mindset now, and this last year has helped me become more adaptable to change.”