Before the pandemic, Aya Raji’s days were jam-packed. She woke up at 6:30 a.m. and took the subway to school. At night, she practiced kick-flips with her skateboarding club and hosted “Twilight” movie nights for friends.
Once her school in Brooklyn turned to remote learning, starting last spring and continuing this fall, the days grew long and lonely. Nothing could distract her from the bleak news as she stared at her laptop for hours during virtual class. She couldn’t sleep, up until 4 a.m., her mind racing with anxiety.
“I felt like I was trapped in my own little house, and everyone was far away,” Aya, 14, said. “When you’re with friends, you’re completely distracted, and you don’t think about the bad stuff going on. During the beginning of quarantine, I was so alone. All the sad things I used to brush off, I realized I couldn’t brush them off anymore.”
Students like Aya felt some relief earlier this fall, when their schools opened with a blend of remote and in-person learning, although the rigid rules and social distancing required during the pandemic still made it rough to connect. And now, with coronavirus caseloads at record levels across the country, many schools are returning to remote classes, at least temporarily through part of the winter.
The social isolation of the pandemic has taken a toll on the mental health of many Americans. But the impact has been especially severe on teenagers, who rely on their friends to navigate the maze and pressures of high school life.
Research shows that adolescents depend on their friendships to maintain a sense of self-worth and to manage anxiety and depression. A recent study of 3,300 high school students found that nearly one-third reported feeling unhappy or depressed in recent months. And while it might seem counterintuitive for a generation used to bonding with friends via texts, TikTok, Snapchat and Instagram, more than one-quarter of those students said they did not feel connected to teachers, classmates or their school community.
“A lot of adults assume teens have it easy,” Aya said. “But it’s hitting us the hardest.”
Since the start of the pandemic, the National Alliance on Mental Illness has heard from many young adults experiencing anxiety and depression, which the organization attributes partly to social isolation. The group has cautioned parents and teachers to look for warning signs, including severe risk-taking behavior, significant weight loss, excessive use of drugs or alcohol, and drastic changes in mood.
The proportion of children’s emergency room visits related to mental health has increased significantly during the pandemic, highlighting concerns about the psychological effects that lockdowns and social distancing have had on youth, according to a new analysis released Thursday by the Centers for Disease Control and Prevention.
Last week researchers at the University of Amsterdam and Emma Children’s Hospital released a study on the mental health of adolescents in the Netherlands, which found that young people reported a significant increase in severe anxiety and sleeping problems during the country’s lockdown period. Children were more likely to report mental health problems if they had a parent who lost work or personally knew someone infected with the coronavirus.
Granted, for some students, the beginning of quarantine brought a measure of relief. They no longer had cliques to impress or bullies to ward off. But that “honeymoon phase” passed quickly, according to Dr. Cora Breuner, a pediatrician. As stressful as adolescent relationships can be, they are also essential for the formation of personal identity.
“Individuation and development of independence is thwarted or slowed way down when they’re sitting at home all day with parents in the next room,” said Breuner, a spokesperson for the American Academy of Pediatrics.
An important part of teenage development is the realization that peers, not just parents, can be a source of emotional support. The twin crises of the pandemic and the economic downturn have imposed new personal hardships on students. Some are taking care of family members who have fallen sick with COVID-19; others have been thrust into dealing with their parents’ unemployment or financial strain. Being holed up at home makes it tough to lean on friends.
When school turned remote last spring, Catherine Khella, a health teacher in Brooklyn, asked her students to keep journals, which she read for signs of mental distress. Many were struggling but hesitant to reach out. One student wrote about feeling unmotivated to do schoolwork, getting frustrated with family members and experiencing emotions “like no other I have ever felt.” Another student, Adolfo Jeronimo, wrote about living in a home with 15 people and becoming nocturnal to find some peace and quiet.
“I’d sleep all day because my sister was up crying and there was barely any food,” said Adolfo, 15, a classmate of Aya’s whose father was hospitalized with COVID-19 and was unable to work for four months. “Usually my friends would’ve helped me, but I didn’t have them, so it was harder to deal with. I felt like I was suffocating.”
Adolfo’s school building closed for a few weeks recently because of reported cases of COVID.
The activities that young people previously relied on for stability and joy have been disrupted. Extracurricular clubs and birthday parties are mostly canceled. So are rites of passage like prom and homecoming. Students spend vast portions of their weeks staring at Zoom screens. Without school events and traditions to anticipate, many say they are struggling to get out of bed in the morning.
“Everything is stagnant now,” said Ayden Hufford, 15, a high school sophomore in Rye, a suburban area north of New York City, whose school now has blended in-person and remote learning. “There’s nothing to look forward to. On virtual days I sit on the computer for three hours, eat lunch, walk around a bit, sit for three hours, then end my day. It’s all just a cycle.”
Ayden identifies as an avid “theater kid” and was looking forward to his school play and science Olympiad. With those out of the question now, he turned to a recent online meeting for student leadership council for inspiration. But that proved demoralizing because he had trouble staying engaged with the Zoom conversation.
“I laid down with my camera off and waited for it to be over,” he said. “It’s sad and somewhat lonely.” And he added that forming new connections with classmates is nearly impossible in a virtual setting: “Unless you try extremely hard, there’s no chance to make new friends this year.”
The isolation has been particularly challenging for young adults who struggle with chronic anxiety or depression and who would typically rely on their social circles for comfort. Nicole DiMaio, who recently turned 19, developed techniques to manage her anxiety over the years. She talks to friends, hugs her mom, exercises and reads books — so many that her family calls her Princess Belle, like the “Beauty and the Beast” protagonist. But nothing seemed to work during the early months of the pandemic.
Nicole’s mother fell sick with COVID in late March after caring for a patient with the coronavirus at Coney Island Hospital, where she works as a nurse. Nicole became her mother’s caretaker and her family’s. She woke up daily at 5 a.m. to clean the house, watch over her younger sister and cook protein-rich foods, which she deposited outside her mother’s bedroom door, while squeezing in schoolwork. Her mother did not want to be ventilated if her lungs failed, so each time she went to the emergency room seeking treatment, Nicole feared she might never come back.
Normally, Nicole would turn to her friends. But she couldn’t see them in person, so instead she had to vent to them on Instagram and Snapchat. “Being 18 and taking it all in is a lot,” she said.
“My chest would get really heavy, and everything inside my body would be jumping,” she said. “The tears would start coming. I would hyperventilate and pace the house until my sister brought me back to reality and said, ‘Hey, you’re here, relax.’ She’s stronger than I am.”
Researchers have begun investigating how today’s high school students will bear the long-term consequences of the pandemic in terms of their education and economic futures. Some psychologists speculate that socially, too, this young adult cohort could be stunted by the amount of time they have been forced to spend alone. Children typically learn the basics of making friends at a young age, but high school is a crucial period for developing nuanced communication skills.
“Learning how to navigate the inner webs of relationships happens in high school,” said Dr. Jessi Gold, a psychiatrist at Washington University in St. Louis. “When you retreat behind a computer, you lose some of those social skills.”
High school counselors and teenagers are exploring a few creative coping strategies. Nandini Ahuja, a social worker at Leadership and Public Service High School in New York, asked her students to write letters to someone or something they are grieving, whether a family member or a concept like senior prom. Ayden said his mental health improved when he got a pet hamster, which he named Astrid.
Teenagers said the opportunity to confide in their teachers and school counselors has been essential, particularly because their parents might be more likely to dismiss mental health symptoms as standard adolescent mood swings. Dr. Gabrielle Shapiro, chair of the American Psychiatric Association’s Council on Children, Adolescents and Their Families, recommended that schools put in place lessons to teach students how to share their emotions.
And whenever possible, teenagers need to see their friends. “Kids need time to be kids again without thinking about all the worries going on in the world,” said Jennifer Rothman, senior manager of youth and young adult initiatives at the National Alliance on Mental Illness.
As the months wear on, Aya is rebuilding healthy habits — spending time with friends outside, getting to sleep at a reasonable hour so she can feel energized for school. She has started meditating and listening to indie rock songs to calm her nerves. But she still wrestles with the amount of time she spends alone in her thoughts.
“Being in another person’s presence makes you feel OK,” she said. “When I can’t see my friends, I feel like the world is caving in.”