Aug. 9, 2021

COVID-19: Depression and anxiety symptoms have doubled in youth, help needed, warn UCalgary clinical psychologists

Meta-analysis of studies involving more than 80,000 youth globally finds an alarming percentage of children and adolescents face a mental health crisis
Sheri Madigan and Nicole Racine
Sheri Madigan, left, and Nicole Racine found that older adolescents and girls are experiencing the highest levels of depression and anxiety. Riley Brandt, University of Calgary

An alarming percentage of children and adolescents living through the COVID-19 pandemic are experiencing a global-wide mental health crisis, according to a new University of Calgary study published in the medical journal JAMA Pediatrics.

The UCalgary study is a meta-analysis, pooling together data from 29 separate studies from around the world, including 80,879 youth globally. The new findings show that depression and anxiety symptoms have doubled in children and adolescents when compared to pre-pandemic times.

“Estimates show that one in four youth globally are experiencing clinically elevated depression symptoms while one in five have clinically elevated anxiety symptoms,” says Dr. Nicole Racine, PhD, a postdoctoral associate, clinical psychologist and lead author of the paper. Further alarming, these symptoms are compounding over time.

Older adolescents, girls most affected

The UCalgary study — which incorporates 16 studies from East Asia, four from Europe, six from North America, two from Central and South America and one from the Middle East — also shows that older adolescents and girls are experiencing the highest levels of depression and anxiety.

“We know from other studies that rates of depression and anxiety in youth tend to ebb and flow with restrictions,” says Dr. Sheri Madigan, PhD, co-author of the paper, a UCalgary clinical psychologist and Canada Research Chair in Determinants of Child Development.

When more restrictions are imposed, rates go up. Being socially isolated, kept away from their friends, their school routines, and social interactions is proving to be really hard on kids.

Madigan adds: “When COVID-19 started, most people thought it would be difficult at the outset but that kids would be better over time, as they adjusted and got back to school. But when the pandemic persisted, youth missed a lot of milestones in their lives. It went on for well over a year and for young people that’s a really substantial period of their lives.

Connection to peers reduced

For many adolescents, that loss can be especially impactful. “Once you enter adolescence you begin differentiating from your family members and your peers can actually become your most important source of social support,” says Racine. “That support has been greatly reduced, and in some cases absent altogether, during the pandemic.”

Older teens in particular have missed out on significant life events such as graduations, sporting events and various coming-of-age activities.

These kids didn’t imagine that when they graduated, they’d never get to say goodbye to their school, their teachers or their friends, and now they’re moving on to something new, with zero closure. There’s a grieving process associated with that.

As more of the population becomes vaccinated and an end to the pandemic seems near, the question arises: how will our children and adolescents fare? Will they bounce back from this traumatic time, or will the mental health impacts linger?

Pandemic as catalyst

“At this point we don’t know the answer to that,” says Racine. “I think for most children who have experienced elevated mental health symptoms, some of that will resolve. But there will be a group of children for whom that isn’t the case. For them, this pandemic may have been a catalyst, setting them off on a trajectory that could be challenging. And there’s another group of children who had mental health difficulties pre-pandemic. They might really struggle long-term.”

For now, though, the elevated mental health symptoms in youth are rising and that’s a problem that must not be underestimated, Madigan warns. “We’re continuing to see compounding effects of the pandemic,” she says. “It’s disjointing for kids because they can’t predict what their environment is going to look like, and we know when their world lacks predictability and controllability, their mental suffers.”

More supports needed

The UCalgary study recommends that more mental health supports should be put in place to help children and adolescents in this time of need.

“Long before the pandemic we had a youth mental health system that was stretched and lacking resources,” says Racine.

A potential doubling of mental health difficulties will overwhelm that system without a significant increase in resources.

Madigan agrees, adding: “If we want to mitigate the sustained mental health effects of COVID-19, because of the chronic stressors our youth experienced, we have to prioritize recovery planning now. Not when the pandemic is over, but immediately. Because kids are in crisis right now.”

Child Health and Wellness

The University of Calgary is driving science and innovation to transform the health and well-being of children and families. Led by the Alberta Children’s Hospital Research Institute (ACHRI), top scientists across the campus are partnering with Alberta Health Services, the Alberta Children’s Hospital Foundation, and our community to create a better future for children through research.

Nicole Racine is a postdoctoral fellow in the Department of Psychology, Faculty of Arts.

Sheri Madigan is an associate professor in the Department of Psychology, Faculty of Arts, and a member of ACHRI, the Owerko Centre at ACHR, the Hotchkiss Brain Institute and the Mathison Centre of Mental Health Research and Education at the Cumming School of Medicine. She is a Tier II Canada Research Chair in Determinants of Child Development.