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Some parents may notice that their teens seem more stressed every school year. And they are correct. According to The American Institute of Stress, 27% of U.S. teens feel extreme stress during the school year, approximately 18% experience an anxiety disorder caused by stress, and almost 30% report feeling depressed.¹

Why Are Teens So Stressed Out?
Parents of teens may remember feeling stressed when they were teens and expect their children to navigate the years successfully, as they did. Teens today still face the same normal developmental stressors, such as finding peer groups, navigating the highs and lows of team sports, and increasing academic pressure, according to experts. In addition, pediatricians and mental health practitioners are also concerned about the growing impact of unrestricted social media access, increasing academic pressures at school, climate change, gun violence and, finally, the still lingering effects of the COVID-19 pandemic on current teen mental health.

Prior to the pandemic, pediatricians and mental health professionals were already noticing increasing rates of stress and mental illness in adolescents. However, the pandemic caused a significant psychological impact on youth and families. A recent American Psychological Association survey on stress in America pointed out that our society continues to experience psychological impacts of stress and traumatic experiences in the aftermath of pandemic lockdowns, school closures and disruptions in family routines.² Additionally, families and experts are still seeing the aftereffects of social isolation and academic underachievement on teen stress levels.

Another new factor increasingly affecting teens is social media. Experts are warning parents that prolonged social media use is associated with low self-esteem, depression, anxiety, poor sleep, eating disorders and suicide risk. Teens who spend more than three hours on social media per day face double the risk of mental health difficulties, according to an advisory from the U.S. Surgeon General in 2023,³ but studies have emerged showing that teens spend on average 4.8 hours per day navigating different social media platforms.⁴

The risk of negative mental health consequences from social media overuse is particularly high for adolescent girls. Girls are prone to comparing themselves to peers and defining their identity via others' opinions, making them more vulnerable to depression after repeated exposure to social media. Girls, ages 13-19, have been found to spend more than five hours per day on social media,⁵ which means they feel the pressure to be "clever, smart and popular" all day, first at school and then on social media. It also means teens are being judged and criticized all day long, exposing them to constant social pressure. A rumor spread on social media can reach thousands of people in a matter of seconds.

Stress Is Part Of Life, Isn't It?
Daily stress is definitely part of life, and it is important to teach children how to navigate it. Long-term stress, however, is a risk for a variety of mental health difficulties. Stress can also cause significant wear on the immune system and lead to poor physical health. While experiencing stress is not necessarily detrimental for teens, how they cope with it is important. From my observations, teens are more likely to report using passive coping strategies, such as taking a nap or listening to music. While these methods work, they often don't allow for learning active coping strategies, which help embrace and navigate stress, rather than just distract from it.

HOW CAN TEENS COPE BETTER WITH STRESS?
The following are some active ways of coping that parents can easily discuss with and teach to their children.

Manage social media use. Ever-increasing social media use is worsening teens' stress levels, mental health, social skills, sleep and academic performance. The U.S. Surgeon General's recent advisory cautioned that social media use in adolescence interferes with learning self-control, emotional regulation, learning and social skills and recommends parents take steps to prevent negative and spiraling effects of social media on teen mental health and stress levels.⁶ The following are some strategies that parents can do:

1. Parents should not allow their teens to access social media until they are 16. If they do decide to let them use it, they should consider an Instagram Teen Account, which includes some safeguards and parental controls.
2. Parents can create boundaries around family social media use. Parents should not allow smartphones to be used during meals or family activities. They should also serve as a good example to their teens by putting their phones away when talking, listening and eating.
3. Parents can teach teens how to handle social comparisons forced on them by social media. They can discuss how influencers and algorithms can affect them and how social media posts don't portray real-life experiences.
4. Parents can teach their children how social media is often used for cyberbullying. They can encourage them to block bullies and stay connected only to peers who are positive, fun and supportive. They should also report all cyberbullying and exploitation of their teen.

Engage in physical activity. Only 15% of teens get enough daily exercise.⁷ Exercise is one of the most effective stress and anxiety relievers. It can also work as well as antidepressants or cognitive-behavioral therapy to reduce symptoms of depression.⁸ Any of these activities are helpful: yoga, hiking, biking, walking, dancing, running, basketball, rock climbing and skateboarding. The best activity is one that involves a social component, but it doesn't need to be a team sport.

Get enough sleep. The recommended amount of sleep for teens is eight to 10 hours, according to recommendations from the American Academy of Pediatrics.⁹ However, surveys find that most teens sleep, on average, less than eight hours per night.¹⁰ Lack of sleep is connected to increased levels of stress, anxiety, depression and decreased academic performance. Teens who don't get enough sleep are four times as likely to develop depression as those who are well-rested.¹¹

Resist academic pressure. Teens are pressured more than ever to make high-stakes choices, know exactly who they are, perform perfectly all the time and achieve more. There is competition, social judgment and pressure from parents, teachers and society. Parents can teach their teens that they don't have to be perfect, don't have to get it right at any age, and can always change their minds when they are older. What they do now academically will not determine their entire lives.

Parents should discuss the importance of sometimes saying no to academic pressure. Their teen does not need to take every AP class their school recommends and participate in every club, sport and leadership activity. I recommend no more than two organized after-school activities for teens to allow for more time socializing with peers and engaging in self-care activities.

Parents can encourage their teens to engage in social and fun activities, not just required school activities. They should also allow them enough time to participate in religious youth groups, craft and talent activities, camps and community events. It's also important that they keep in mind that colleges look for happy and well-rounded students, not just students with good grades and a multitude of standard activities.

Engage in meditation and mindfulness. Mindfulness refers to paying attention to life in the present, being fully aware of our surroundings and what we are doing, and being in the moment and enjoying it fully, rather than constantly being distracted by electronics, social media and text messages. When we don't have the ability to be in the moment, anxiety grows, and we become too overwhelmed to solve problems.

Teens who are always distracted and worried about the future begin to struggle with chronic stress and anxiety. Parents can teach their teens to put away their phones at the dinner table and turn off the TV the next time their family is eating dinner. They can encourage them to focus on eating their food and enjoying its flavors. Or the next time their teen is watching a show, they can suggest they don't chat about it on social media or text friends at the same time, and instead stay fully tuned in to the program. Parents can encourage their children to do activities that require calm concentration, such as crafts, prayer, reading, science experiments or playing a musical instrument.

Talk about stress. Parents can teach their teens to talk to them and other family members daily about their stress. Even if their teen seems unwilling to open up, they can try to ask about stress on a daily basis and discuss ways they can handle their own stress. When adults show teens how they actively cope with stress, they tend to repeat their good skills. Parents can encourage teens to set limits on how much they absorb peers' stress. Teens listening to their friends is OK, but always feeling the pressure to solve their problems is not.

I advise parents that if they think their teen needs more help dealing with stress and anxiety, they should talk to their pediatrician or search for a mental health provider. While family is often the best place to learn coping skills for stress, sometimes teens' mental health requires careful evaluation and psychotherapy. For example, cognitive-behavioral therapy has been demonstrated as an effective and quick intervention to help teens learn stress management.¹²

By teaching teens to be proactive in building the tools needed to live happier and more balanced lives, they can gain confidence to better manage everyday stress.

ELENA MIKALSEN is the chief of pediatric psychology at CHRISTUS Children's in San Antonio and an associate professor of pediatrics at Baylor College of Medicine.

NOTES

1. "The Most Important Statistics About Teen Stress," The American Institute of Stress, https://www.stress.org/more-stress-information/#teen-stats.
2. "Stress in America 2023: A Nation Grappling with Psychological Impacts of Collective Trauma," American Psychological Association, November 1, 2023, https://www.apa.org/news/press/releases/2023/11/psychological-impacts-collective-trauma.
3. "Social Media and Youth Mental Health: The U.S. Surgeon General's Advisory," U.S. Department of Health and Human Services, 2023, https://www.hhs.gov/sites/default/files/sg-youth-mental-health-social-media-advisory.pdf.
4. Jonathan Rothwell, "Teens Spend Average of 4.8 Hours on Social Media Per Day," Gallup, October 13, 2023, https://news.gallup.com/poll/512576/teens-spend-average-hours-social-media-per-day.aspx.
5. Rothwell, "Teens Spend Average of 4.8 Hours on Social Media Per Day."
6. "Social Media and Youth Mental Health: The U.S. Surgeon General's Advisory."
7. "The 2022 United States Report Card on Physical Activity for Children and Youth," Physical Activity Alliance, 2022, https://paamovewithus.org/wp-content/uploads/2022/10/2022-US-Report-Card-on-Physical-Activity-for-Children-and-Youth.pdf.
8. Lynette L. Craft and Frank M. Perna, "The Benefits of Exercise for the Clinically Depressed," Primary Care Companion to The Journal of Clinical Psychiatry 6, no. 3 (2004): https://doi.org/10.4088/pcc.v06n0301.
9. Melissa Jenco, "AAP Endorses New Recommendations on Sleep Times," AAP News, June 13, 2016, https://publications.aap.org/aapnews/news/6630/AAP-endorses-new-recommendations-on-sleep-times.
10. Anne G. Wheaton et al., "Short Sleep Duration Among Middle School and High School Students — United States, 2015," Centers for Disease Control, January 16, 2018, https://www.cdc.gov/mmwr/volumes/67/wr/mm6703a1.htm.
11. Maanvi Singh, "Less Sleep, More Time Online Raise Risk For Teen Depression," Your Health, NPR, February 6, 2014, https://www.npr.org/sections/health-shots/2014/02/06/272441146/less-sleep-more-time-online-amp-up-teen-depression-risk.
12. Stefan G. Hofmann et al., "The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-Analyses," Cognitive Therapy and Research 36, no. 5 (July 2012): 427-440.