WCW's Women Change Worlds Blog

This post was written by Becky Chen, a member of the Wellesley College Class of 2023 who took a Calderwood Seminar on public writing taught by WCW Senior Research Scientist Linda Charmaraman, Ph.D.

It was 1 a.m. I was performing a nightly ritual: lying in bed scrolling through TikTok. I came across a video with the title “5 Signs You Have ADHD” that listed things like forgetfulness, inability to tell a story in a linear manner, and distraction as symptoms of attention deficit hyperactivity disorder (ADHD). To my surprise, I found myself feeling incredibly aligned with the video. In the comments, people expressed feelings of validation—of “feeling seen.” As a college student, I was surprised and taken aback but intrigued by the possibility that I had a disorder that could explain some of the experiences I’ve had.

The hashtag #ADHD has garnered 14.5 billion views on TikTok, the social media platform that 67% of teens are on. When you search this hashtag, you can find videos that contain resources, skits, advocacy, and community-building related to ADHD. These videos have been credited with destigmatizing and deconstructing the shame that can often be attached to people with ADHD, while also raising concerns among professionals about how easily misinformation can spread.

One of the main reasons for concern is the increase in teens turning to social media to self-diagnose themselves with mental illness. In the comments section of many of these videos, you can see comments that echo the sentiment I had of thinking I have ADHD.

The conversation about ADHD is especially salient with women and other populations that have been underrepresented when it comes to the diagnosis. For the first time, they feel seen, as studies show girls are half as likely to be diagnosed with ADHD as boys—often due to the phenomenon of “masking,” of being quiet and obedient, in line with society’s expectations of how girls should behave.

One of the benefits of these TikToks is that they make information about ADHD and neurodivergence accessible. Anyone who has a mobile device can tune into the app to learn more. This is especially imperative in cultures where mental health and disability are not often talked about. We see historically marginalized communities often co-construct their identities within the social media sphere, and this can also be true for neurodivergent creators who are able to find community on TikTok.

However, experts worry about these videos hitting the mainstream. There has been an increase in misinformation and oversimplification of ADHD. One study showed that almost 52% of videos on ADHD contain some sort of misleading information. Only 11% of the creators of this kind of content are certified professionals. There has also been conversation about TikTok glorifying neurodivergence, fueling embarrassment among members of the neurodivergent community.

It is clear that there is a huge need to implement mental health education in U.S. classrooms. Youth should not be turning to social media to self-diagnose. We can see this as a reflection of the way our current systems have failed to offer safe, trusted paths when they’re feeling othered. Destigmatizing mental health and neurodivergence is crucial to help youth sort through what is accurate versus misleading information. Another way schools can support youth is in providing more transparent and accessible resources for mental health support and opportunities to get tested for learning disabilities like ADHD, including therapists and counselors.

Since that 1 a.m. night, I have been diagnosed with depression and anxiety, coming to learn that many of the symptoms often manifest in similar ways to ADHD. From my own personal journey of exploring ADHD and neurodivergence, I’ve learned that social media can be a powerful space to find community, share your thoughts, and illuminate steps to better your mental health—but it cannot be your only resource on your mental health journey. Leave it to professionals to provide an accurate diagnosis along with research-based steps to improve your mental health.

Becky Chen is a member of the Wellesley College Class of 2023 studying cognitive and linguistic science and education studies.

Over the past few years, you may have read about the crisis in youth mental health. In October 2021, the American Academy of Pediatrics declared a national emergency in child and adolescent mental health, and in December 2021, the U.S. surgeon general highlighted the urgent need to address the nation’s youth mental health crisis. Just this month, the U.S. Preventive Services Task Force recommended screening for depression in adolescents aged 12 to 18.

October is National Depression and Mental Health Screening Month, so we’d like to highlight one of the tools WCW has been using to approach the youth mental health crisis that is in line with that recommendation: school-based mental health screenings.

Mood Check, our program, partners with schools to screen all students in designated grades and offers additional support to adolescents at high risk for depression and/or suicidal behaviors. We have a multi-pronged approach: We offer resources that increase the school community’s mental health awareness and literacy, which serves as a prevention tool. Then we provide two-level screening for students, including universal, self-reported screening for all students followed by in-depth interviews with students who are identified as high risk. We communicate with parents and guardians about youth depression and resources, and provide more significant follow-up (both immediate and long-term) for parents and guardians of high-risk teens. Finally, we offer referral access for all school families who need to find a mental health professional to help their teen moving forward.

This past school year, we screened a total of 2,078 middle and high school students in the greater Boston area for both depression and anxiety. We met one-on-one with 646 students (about 31%); 237 students (about 11%) revealed to us that they had current or past thoughts of suicide, and 57 students reported that they revealed suicidal thinking or behavior to an adult for the first time when meeting with a clinician on our team. For those who reported suicidal thinking/behavior, we introduced safety plans: a way to identify warning signs, internal coping strategies, supportive people and places, how to make the environment safe, and a motivator for living, along with providing the Suicide Prevention Lifeline phone number. Students retained a copy of the plan that they could reference themselves and/or share with parents, providers, or trusted adults.

A review of our data over time suggests that Mood Check is associated with decreased depressive symptoms in at-risk adolescents and may encourage families to seek treatment for students we identify. This kind of success in a school setting is in line with other research, which shows that teens prefer to receive mental health services in schools, rather than in mental health specialty settings. Anecdotally, we’ve found that teens are more willing to speak with us, because they know they won’t see us again; it can be easier to tell the truth to a stranger than to a parent, teacher, or guidance counselor. We’re glad to provide that listening ear for them.

School screenings alone cannot solve the crisis in youth mental health. But they are an important tool to be used in combination with depression prevention efforts and expanded access to treatment. Our goal is for more teens to be able to get the help they need in order to live healthier and happier lives.

Tracy R. G. Gladstone, Ph.D., is research director, an associate director and a senior research scientist at the Wellesley Centers for Women, where she leads the Depression Prevention Research Initiative.

This piece was written by Carolyn Bacaj and Mikhaela Andersonn, students at Wellesley College who recently took a Calderwood Seminar on public writing taught by WCW Senior Research Scientist Linda Charmaraman, Ph.D. As young adult members of the LGBTQ+ community, Carolyn and Mikhaela are passionate about identifying support networks for sexual minority groups and creating safe spaces for younger members of the community.

When Mikhaela was younger, she and her friends found themselves spending tons of time online. Through their usage of social media—typically websites that their peers weren’t on, like Tumblr—they discovered parts of their identity after being exposed to communities that gave them room to explore. Mikhaela ended up coming out as queer in the 7th grade, and she believes that without the assistance of social media as an outlet for expression and exploration, the process of discovering her identity would have been harder.

Mikhaela’s personal experiences with social media mirror the experiences of LGBTQ+ youth in a recent study of over 1000 students ages 10-16 by Dr. Charmaraman and her colleagues in the Youth, Media & Wellbeing Research Lab. The study found that LGBTQ+ youth use social media differently than their peers for reasons unique to their sexual minority identities. While privacy and bullying are concerns, social media is an integral part of their lives.

How do LGBTQ+ youth use social media differently?

There are key differences in how LGBTQ+ youth use social media versus how their peers may use it, including:

• Spending more time online exploring their identity
• Being less likely to have their accounts private
• Being less likely to have friends and family on their social media pages
• Being more likely to use social media websites that their parents disapprove of

These differences highlight the idea that social media plays a different role for LGBTQ+ youth by being a more integral part of their identity development.

With a little guidance from their families and teachers, LGBTQ+ youth can maintain close-knit online communities that help them develop their identities and improve their mental health.

Why is examining these differences important?

Social technologies are essential tools for guiding LGBTQ+ youth toward identity development and supportive communities of peers. According to Dr. Charmaraman’s study, adolescents who identify as sexual minorities are more likely to experience depression, loneliness, and isolation. With nearly half of LGBTQ youth having no one to talk to about their sexuality, this isolation is only compounded by confusion and fear about their identity. As someone from West Virginia, where there is little LGBTQ+ presence and rampant homophobia, it was difficult for Carolyn to navigate her identity without external support from the community she had grown up in.

Still, we understand the internet can be a scary place for children and teens. Since sexual minorities are more likely to view self-harm content, it’s unsurprising that they are twice as likely to have attempted self harm. This might make parents or educators nervous to encourage LGBTQ+ adolescents to use social technologies. But regardless of what teens see online, they’re not going to stop using tech—and they shouldn't.

How can the internet be a safe haven for LGBTQ+ youth?

By finding LGBTQ+ groups online, adolescents can find peers who relate to them. According to Dr. Charmaraman’s study, sexual minority adolescents more often join online communities to combat loneliness. They can find friends to talk to about things that their heterosexual peers don’t understand, such as family acceptance, lack of representation, paranoia over being outed, and internalized homophobia. It makes sense that sexual minority youth are more likely to have friends they only know through the internet. Finding this social support is essential, as it’s the most protective factor against negative mental health outcomes like depression and loneliness.

The online atmosphere is changing and becoming more accepting of the LGBTQ+ community. Platforms like Tumblr and TikTok have fostered LGBTQ+ youth voices, becoming safe havens. The Trevor Project, the largest suicide prevention and crisis intervention organization for LGBTQ+ youth, has over two million followers on Instagram, Twitter, and Facebook. The internet is a resource that has built-in anonymity and widespread access for teens living in areas that aren’t as accepting. These online communities are particularly essential in supporting youth when in-person communities aren’t available, as access to identity-affirming spaces lowers rates of suicide. According to Dr. Charmaraman’s study, LGBTQ+ adolescents are more likely to find online friends significantly more supportive than in-person ones. Finding LGBTQ+ friends online means opportunities to find positive role models and support in coming out.

How can I support an LGBTQ+ adolescent in my life?

With a little guidance from their families and teachers, LGBTQ+ youth can maintain close-knit online communities that help them develop their identities and improve their mental health. Here are some tips:

• Talk to LGBTQ+ adolescents in your life about how to recognize depression.
• Discuss the risks of being online.
• Talk about their online communities and support.
• If online support isn’t enough, check out school-based or community-based resources (i.e., gay-straight alliances, organizations like Out MetroWest).
• If applicable, connect them to an LGBTQ+ family member or community member who may be able to advocate for them or provide mentorship.
• Check out these organizations that support LGBTQ+ youth.

Carolyn Bacaj is a member of the Wellesley College Class of 2023 majoring in education and biology. Mikhaela Andersonn is also a member of the Class of 2023 and is majoring in psychology and Spanish.

May is Mental Health Awareness Month. This year, it comes at a time when we have an increased focus on mental health due to the COVID-19 pandemic. Media reports have focused on the increase of symptoms and the difficulties related to accessing care.

As a chronic stressor, the COVID pandemic is a difficult one. It has limited our social contact, caused financial distress, taken away jobs, schools, and childcare, and created a collective and personal grief in the lives that we have lost. While these factors have and will contribute to the development of mental health disorders for some people, it also must be acknowledged that, for many people, the distress felt in response to these factors represents a normative reaction in a difficult time. In other words, it is normal to feel sad, lonely, unmotivated, and worried during a global pandemic, and those feelings do not necessarily indicate clinical depression or anxiety.

While it seems that more U.S. adults are reporting current symptoms of depression or anxiety, there is also evidence that the level of these symptoms fluctuates based on situational factors connected with the pandemic. For example, one study found that U.S. adults reported an increase in the average psychological distress that they experienced from March 2020 to April 2020, at which point the average psychological distress reported started decreasing. By the end of June 2020, after lockdown regulations were starting to ease, people were reporting the same level of overall psychological distress as they had in early March.

This suggests that more people are reporting experiences (sadness, loss of interest, feeling nervous, and uncontrollable worry) that can indicate the presence of mental health symptoms, but that these experiences are fluctuating over time—perhaps as situational factors change for individuals. This could indicate that much of the increase in distress is caused by the events around us, and not necessarily the development of mental health disorders which would be marked by a set of specific symptoms that are present for the majority of the time (for over two weeks for depression and over six months for anxiety). While it is important to acknowledge psychological distress due to stressors, it can also be helpful to remember that it is a common reaction.

Research on resilience provides a framework to understand our experiences with mental health over the course of the pandemic.

Research on resilience provides a framework to understand our experiences with mental health over the course of the pandemic. While some mental health professionals view resilience as a personal quality, others focus on symptom trajectories over time. Studies on symptom trajectories find that the most common outcome to hardship is resilience and recovery. What I have always found to be most comforting about these studies is that people who were later found to follow a resilience trajectory were not necessarily symptom-free following the stressor. Resilience was not necessarily a measure of making it through unscathed, but rather, a measure of bouncing back over time. People on the recovery trajectory experience more initial symptoms, but again, they return to baseline functioning over the course of time.

This is not to discount the distress experienced or the difficulties that individuals have endured over the course of the past year. There will be people who develop or continue experiencing chronic mental health symptoms. Access to clinicians and well-researched interventions that have proven to be effective as well as a general shift in our understanding and treatment of mental health is crucial to promoting recovery and supporting each other. And it may help to remember that, with time, many people will bounce back from the hardships of the past year.

A glimmer of hope was provided by the preliminary look at the mortality data for 2020. (It should be noted that these data represent a national snapshot and do not examine trends within specific racial or demographic groups.) These data suggest that as many more of us began to experience psychological distress, the deaths by suicide decreased from the year before. When I shared this with my partner, his immediate response was, “Do you think it’s because people have a greater awareness that so many of us are having a difficult time? It feels more normal to struggle?” I have no idea if this is the case. And yet, I hope that this is one thing that we can take away from the pandemic—we are not alone in our struggles. Hopefully, this knowledge can guide us to reach out to others with empathy and support one another through the challenging times as we look toward recovery.

Katherine R. Buchholz, Ph.D., is a postdoctoral research scientist working on the Depression Prevention Research Initiative at the Wellesley Centers for Women.

If you or someone you know needs immediate help, please call the National Suicide Prevention Lifeline at 1-800-273-8255 or check out these resources.

Happy New Year from all of us at the Wellesley Centers for Women! This is a moment of profound reflection about all we’ve been through and where we are headed.

2020 was a year like no other. From out of nowhere came a global pandemic that left no one untouched. Many of us, myself included, were visited by the strange new sickness known as COVID-19. Many of us endured the loss of loved ones whose lives were cut short by a virus we barely understood, but thanks to scientists working around the clock and around the world, the genome was quickly mapped, its elusive symptoms were painstakingly documented, and life-saving therapies and vaccines were developed and tested in record time. In many respects, this was a year when we learned what we were capable of as one human race writ large.

Yet, it was also a year when we had to face some of our ugliest demons. The specters of racial inequality and racial violence jointly rose up amid the pandemic, sparking a racial justice movement larger and more inclusive than any we have seen in decades, perhaps ever. We were moved to tears and rage by the CDC’s data showing that people of color were roughly 3 times more likely to die from COVID-19 as white people, as well as by the ongoing killings of Black people — such as George Floyd, Ahmaud Arbery, Breonna Taylor, and Rayshard Brooks — even with the pandemic raging on. The movement for racial justice generated important dialogues, as well as many changes in policy and practice around the country. Yet, it also highlighted all the work we have yet to do to ensure a world of equality, justice, and wellbeing for all.

The devastating pandemic deepened financial fissures, ripping away what little economic security many people had managed to accumulate. We saw unemployment spike, surpassing all past records, we saw food pantry lines triple and quadruple, we saw more people become unhoused or buckle under the looming threat of eviction. Yet, against this backdrop, we witnessed in 2020 the emergence of the world’s first centibillionaires — that is, individuals whose wealth exceeds $100 billion.

On the bright side, our society came to recognize the tremendous worth of many low-wage essential workers — from nursing assistants and emergency medical technicians, to grocery and restaurant workers, to truck drivers, delivery people, and everyone in logistics, to gig workers of all kinds — expressing long-overdue gratitude for all they do to keep society functioning. Yet, most are still economically vulnerable and will remain so without a major rethinking of what makes a society thrive economically.

As we begin a new year, we must concern ourselves with the fact that economists have predicted a K-shaped pattern of economic recovery — one in which those who are financially well-off are expected to do better and better and those who are financially vulnerable are expected to do worse and worse.

The mental health consequences of 2020 were not insignificant. The stresses of the pandemic, the stresses of racial inequality and violence, the stresses of economic precarity, the stresses of new patterns of life, and the stresses of looming unknowns affected virtually everyone in some way. For those of us who had to suddenly pivot last March from “life as usual” to “work from home” and, often, “remote schooling” for our children, there were many new stressors, from having no clear boundaries between work, family, and self, to the pressure of having to take on new roles such as homeschool teacher or family nurse and public health officer.

These pressures were especially acute for women, a not insignificant number of whom made the difficult decision to retreat from the workforce, whether to care for family or pursue other life goals. We must also remember what the year was like for those women and girls — in fact, for anyone — for whom home was not a safe place to be, whether for reasons of intimate partner violence, sexual abuse or exploitation, or child abuse — all at a time when protective services and resources were sharply curtailed due to the pandemic.

For people who had to isolate at home alone, loneliness and disconnection became real risks, as did fears of what would happen if they got sick with no one around. The year was perhaps most stressful of all for those who could not be together with loved ones who were in the hospital or, even more tragically, those who could not be together with loved ones who were dying.

And we cannot forget the doctors, nurses, and other medical personnel who were the heroic heart of the year, who were caring for us and our loved ones, despite the uncertainties related to their own health and survival, and despite the risk to their own families.

2020 was a year of great sacrifice for every single person on this planet, in fact, a year of profound trauma for some, and we owe each other the grace of that. Against this backdrop, we must look ahead in 2021.

The fact that 2020 was an election year almost fades into the background, yet, it becomes a source of hope when we imagine the possibilities of a new administration and all that we can do together, inside and outside politics, to restore faith in ourselves and the world.

We must, in particular, acknowledge the historic first of Kamala Harris, a Black woman, a South Asian woman, and first-generation woman born of immigrant parents, being elected Vice President of the United States, and the courage of Joe Biden, a white male presidential candidate, to buck the trend of history by choosing her as a running mate.

These things bode well as we continue our work of building a more inclusive and equitable society in which all can prosper and thrive. We at the Wellesley Centers for Women are energized by a tempered optimism, geared up for another year of doing what we do best — shaping a better world through research and action — and we look forward to partnering with all who share our vision in 2021!

Layli Maparyan, Ph.D., is the Katherine Stone Kaufmann ’67 Executive Director of the Wellesley Centers for Women at Wellesley College.

The challenges of isolation and loneliness have become apparent over the past several months of social distancing. Not only are we physically separated from our friends and extended families, but we’re concerned about their health and wellbeing as well as our own. We may be juggling childcare, homeschooling, and our own work. Or we may be wondering how we’ll support ourselves through this. We may know those who are sick, or who are high-risk, or who are essential workers putting themselves at risk for our sake. We may have lost people close to us. And we may feel powerless to do anything.

The situations that we find ourselves in can be overwhelming, and can contribute to low mood, irritability, and other potential depressive symptoms. If these symptoms persist and severely impact your day-to-day functioning, it can be a good time to check in with your doctor or a therapist. Many providers have moved to telehealth during this time, so it’s possible to connect to extra support. But if you just notice your mood dropping a bit or you feel a bit unmotivated, you may want to try out new strategies to prevent further depressive symptoms or bounce back from these moments of low mood.

First of all, it’s important to acknowledge that this is a time of adjustment and loss. Many of us will experience normal mood fluctuations such as low mood and sadness related to the loss of life the way it used to be. As with any loss, reactions will come and go, and feel different from day to day. Being gentle with yourself and others is important for maintaining mental health. For example, focus on “good enough” instead of “perfect” or “how I would usually do this.” Think of tasks that help you to feel productive, need to be done, and give you joy, and engage in a mix of those things. Let go of getting everything done. When you do achieve something, celebrate it.

It’s also important to remember that every person is different and will have certain strategies that work better for them in maintaining mental health. Different circumstances and situations will call for different approaches. Consider this a time of experimentation: try new strategies, but don’t be afraid to give them up and use others if they don’t work for you.

Social support from family and friends can help to prevent symptoms of depression. The lack of close personal contact during this time of social distancing is a challenge and can lead to feelings of isolation and loneliness. While we may not be able to interact with one another in the ways we’re used to, there are plenty of ways to stay connected.

If you’re lucky enough to be social distancing with your family, take some time out to connect with your kids or spouse. Even small moments of connection can improve your mood. When it comes to technology, find what works best for you, whether it’s virtual parties or one-on-one chats with a friend. While social media is one way to connect, it may be less helpful than picking up the phone and calling or FaceTiming. And just as in life before, know your limits. Having time to yourself to recharge is still important, and if you’re feeling Zoom overload, it’s perfectly okay to say no to a virtual happy hour.

When you’re interacting with others or when you’re alone, don’t forget to notice the good or joyful moments — that can do a lot to improve your mood. Did you have a good laugh about something silly with your family? Did you get a sense of satisfaction from completing that puzzle that’s been sitting in your living room for years? Notice when those moments come up and what you’re doing, and look for opportunities to engage in more of them. Along those lines, you can start tracking three good things or three things that went well each day. In addition to writing these three things down, write what made them go well or what caused them. Research has demonstrated that doing this daily for a month can help to improve your mood and increase happiness.

Repetitive negative thinking can contribute to depressive symptoms, so it can be helpful to take time to notice thoughts that are connected to feelings of sadness, anger, fear, and other emotions that bring your mood down. Once you notice these thoughts you can make efforts to reframe them or focus your attention on more helpful ones. If you notice that a bothersome thought keeps coming up, see if you can switch it up. For example, “I’ll be stuck at home forever” could be turned into, “I feel stuck right now, and this is a temporary situation. I’m looking forward to seeing my dad after this is over.”

Taking care of your physical health can have a strong effect as well. You may see a lot of runners and bikers out in your neighborhood these days, and they’ve got the right idea. Exercise has been found to be effective in preventing depression. Just engaging in something active can help — check out streaming yoga or old-school Richard Simmons videos. Take a walk around your house or challenge yourself to a stair climb. It doesn’t matter what you do as long as you get moving, and your mood will likely improve as a result.

Though it can be hard to put down your phone or turn off the news, getting enough sleep (but not too much) can help keep your mood stable and make it easier to roll with the punches. If you’re having difficulty sleeping, work on improving your sleep hygiene. Start preparing an hour before bedtime by turning off screens, doing some relaxation, and clearing your head.

Finally, remember that it’s not about never feeling low — it’s about bouncing back from the low mood. Honor the fact that this is a difficult, sad, and anxiety-provoking time. Remind yourself that social distancing and staying at home are temporary. Think of other difficult times in your life and what strategies you used to get through those times. If we are mindful of our thoughts and intentional about the strategies we use throughout the day, we may be able to maintain good mental health — despite all of the challenges we’re facing.

Further resources:

• American Psychological Association’s Psychology Help Center
• Anxiety and Depression Association of America Helpful Expert Tips and Resources

Katherine R. Buchholz, Ph.D., is a postdoctoral research scientist working on depression prevention research at the Wellesley Centers for Women.

This article was originally posted by Amy Banks, M.D., on April 12, 2020, on her Wired for Love blog on Psychology Today.

To protect ourselves, our families, and our communities from the devastation of the coronavirus health experts are strongly encouraging everyone to “socially distance” — to stay 6-10 feet away from other people.

I am concerned — not by the strategy but by the way people are enacting it. The few times I have ventured out to a grocery store or for a walk around my neighborhood, I've seen people not only keeping distant from one another but also seeming afraid. They pass each other on the street or in a store without looking at each other or exchanging greetings.

It’s as if we were each locked in a personal bubble that no one can enter. The threat of COVID-19 and the stress it induces can understandably cause individuals to become terrified and myopic — to turn inward in an attempt to stay safe. While a week of that may be more stressful to some than others, months of this type of social isolation is dangerous. Research clearly shows us that our physical and emotional health and well-being are dependent on loving relationships and physical touch. To weather this pandemic, we need one another.

Weeks ago, my colleague and friend, Roseann Adams, LCSW, recognized that the national strategy of social distancing was a double-edged sword. She identified that social distancing can be a threat to all of us as it leads some people to socially isolate potentially causing further stress and, over the long haul, impairing our bodies’ immune system. In fact, strict social distancing may set us up for other illnesses.

Within the first few days, she was encouraging people to physically distance with social connection. Differentiating physical distance from social distance acknowledges the virus’s malignant ability to be transmitted from person to person but also acknowledges that the virus has no power over our ability to support and nurture one another in this time of extraordinary threat.

Think about the power of social isolation in society. Solitary confinement is considered the worst punishment a human can receive. In fact, most civilized communities consider it a form of torture. The physical and emotional toll it takes over time includes a worsening of mental health issues, an increase in self-injurious behavior and even suicide.

Isolating individuals is perhaps the most common first step domestic abusers use to gain power and control over their victims. He or she begins to control who you can see, where you can go, what you can wear. When a person violates the rules set by the perpetrator the punishment is harsh and swift.

Social distancing, as it has been presented, can feel like that. In fact, in my work with trauma survivors during this time, I have heard people describe feeling trapped and threatened again. That is not sustainable. Becoming socially isolated may keep the majority of us alive, but not well.

By naming the national strategy as physical distancing rather than social distancing and emphasizing the need for human connection we can stay safe from the virus but also hold onto the heightened need we all have for one another right now. Each of us needs an extra dose of being seen and held within our connections during this extraordinary time. Perhaps now more than ever we must be intentional about giving our neural pathways for connection a workout.

In fact, we need to go out of our way to make eye contact, wave, move, or loudly say "hello" from behind the mask. This gives our smart vagus nerve and our mirror neurons a workout. Literally, the sound of a friendly voice and seeing the eyebrows of another person raise in greeting stimulates your social engagement system, which in turn sends a signal to your stress response system to stand down. Those moments of interaction may make the difference in the long run as to how we, as a society, survive the pandemic.

The human nervous system is amazingly adaptive. Our brains will adapt to social isolation over time, but the burden of stress the isolation causes will lead to long-term health problems. As a society we will not be well at the end of all of this — not because of COVID-19 but because of the message we take in that being with others can be dangerous.

That is why each of us must do our part to not only stay physically six feet apart and to wear masks but also to go out of our way on the street, in the grocery store, through FaceTime, Zoom, or whatever platform you can use to reach out to one another. We all must know that nurturing the relationships we have and reaching out to others who may be isolated is as essential to surviving the pandemic as physical distancing.

Let’s add another important directive to our national policy of containing the coronavirus — to reach out each day to three other people — to check in on them, simply hear their voice, or share the pain or joy of the day. This is a wider strategy to not only survive the pandemic but to keep our humanity alive.

Amy Banks, M.D., is a senior scholar at WCW and founding scholar of the International Center for Growth in Connection, which began as the Jean Baker Miller Training Institute at WCW. Dr. Banks has spoken throughout the U.S. on the neurobiology of relationships and is the co-author, with Leigh Ann Hirschman, of Four Ways to Click: Rewire Your Brain for Stronger, More Rewarding Relationships.

This policy brief originally appeared in the Spring/Summer 2016 Research & Action Report from the Wellesley Centers for Women as part of the multi-media series Advancing the Status of Women & Girls, Families & Communities: Policy Recommendations for the Next U.S. President.

Depression is Prevalent but Prevention Programs Are Limited

According to the World Health Organization, depression is the leading cause of disability worldwide—it is the most common psychiatric disorder in the U.S., and is particularly common among lower income populations, and among women beginning in adolescence. The average age of onset for depression is 15, and about 20 percent of all people will have experienced an episode of depression by the end of adolescence. Youth depression is associated with a host of negative and long-term consequences, including poorer school performance, difficult peer and family relationships, increased risk of substance abuse, and poorer functional outcomes in adulthood. Of particular note is the connection between youth depression and suicide. Although not all people who commit suicide were depressed at the time, depression and suicidal behavior are indeed linked. Suicide is a tremendous problem in the U.S. and is the second leading cause of death among American adolescents.

Although depression is among the most treatable of all mental illnesses, and although we have evidence-based treatment approaches for depressed youth, the reality is that only about half of all depressed children and adolescents ever receive treatment, and only about half of those who do receive treatment actually improve as a result. Nearly all of those who recover from depression will experience a subsequent depressive episode within a few years. Specifically, 40 percent of youth who have experienced a past episode of depression will relapse within two years, and 75 percent will relapse within five years. This means that a typical 15 year-old who develops an episode of depression, if she is fortunate enough to receive treatment and benefit from it, will experience another depressive episode while she is graduating from high school and transitioning to adulthood.

Although nearly one in five young people experience an episode of depression by the end of adolescence, treatment protocols for youth depression only help about half of those they target, and relapse is common and debilitating. Funding for depression prevention efforts is limited, and preventive programs are difficult to access.

Promising Prevention Efforts

Youth depression is a problem of major proportions, affecting millions of children and families and interfering with children’s social, emotional, and academic functioning. Although evidence-based treatments for youth depression have been found to work well, treatment resources often are difficult to access. Most adolescents who recover experience relapse, and the long-term consequences of youth depression are significant.

Recently, promising research has suggested that depression is among the most preventable of major mental illnesses. We now know of strategies that work to prevent youth depression, including providing cognitive behavioral interventions to adolescents at high risk and helping youth to strengthen social relationships. Based on this research, many European colleagues now encourage a focus on preventive efforts for youth at risk for depression. Although funders and policymakers in the U.S. support preventive efforts for medical concerns, such as healthy eating and exercise to address heart disease, prevention, unfortunately, is often overlooked in mental health. Researchers, policymakers, and practitioners should focus attention on identifying youth at risk for depression, providing evidence-based preventive interventions to at-risk youth and families, and assisting at-risk youth in accessing preventive and/or treatment resources, as needed.

Approaches & Recommendations

Recommendations for enhancing a focus on the prevention of youth depression include:

• Increase use of depression prevention interventions by increasing funding for research. Although several depression prevention interventions have been found to decrease the onset of depressive symptoms or disorders among at-risk youth, such programs are still not readily available in community-based mental health settings, and many practitioners do not know how to implement evidence-based protocols. More funding is needed for large-scale effectiveness trials that examine ways of disseminating evidence-based interventions in real-world settings and for large-scale trials that compare the efficacy of different evidence-based programs for different populations.

• Attend to family processes that influence depression risk and that promote depression prevention. Research suggests that parental depression is a significant risk factor for depression onset in youth, and that family processes both maintain and may help alleviate depression. Policymakers, funders, and practitioners must attend to the important role of families in identifying and supporting youth at risk for depression who are appropriate for preventive efforts. In addition, interventions to prevent youth depression may benefit from a focus on enhancing family understanding of youth depression, improving parenting skills, and also on addressing parental depressive symptoms that may affect the efficacy of interventions targeting at-risk youth.

• Integrate youth depression prevention efforts into places where youth are most readily accessed. Efforts to prevent youth medical concerns are an established focus of public health strategies, resulting in, for example, vaccinations from physicians and auditory screenings Integrate youth depression prevention efforts into places where youth are most readily accessed. Efforts to prevent youth medical concerns are an established focus of public health strategies, resulting in, for example, vaccinations from physicians and auditory screenings at school. Unfortunately, routine screening for depression and suicide risk is generally overlooked both in primary care and in schools, although these are the places that youth are most readily accessed and serviced. Policymakers, funders, and practitioners must support additional training for school and medical personnel in identifying at-risk youth, evaluating youth for mental health concerns, and connecting youth to appropriate mental health services. Additionally, research is needed to evaluate primary care and school-based depression prevention interventions, so that, when at-risk adolescents are identified, evidence-based depression prevention services are readily available in locations that are comfortable and accessible to those in need.

Tracy Gladstone, Ph.D. is an associate director and senior research scientist at the Wellesley Centers for Women as well as the director of the Robert S. and Grace W. Stone Primary Prevention Initiatives, which focus on research and evaluation designed to prevent the onset of mental health concerns in children and adolescents.