The Millennial Mental-Health Crisis

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The Millennial Mental-Health Crisis
By: Olga Khazan - The Atlantic News - 06-11-20
Re: https://www.theatlantic.com/health/a...rising/612943/

Suicides and overdoses among young adults were already skyrocketing before the pandemic started. Now experts fear that the situation is going to get even worse.
If you are having thoughts of suicide, please know that you are not alone. If you are in danger of acting on suicidal thoughts, call 911. For support and resources, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text 741-741 for the Crisis Text Line.

Throughout the summer of 2012, Tylor Morgan would call his sister Lacey at night and beg her to come over and sit with him.

It wasn’t obvious why Tylor felt so depressed. Growing up in Pocatello, Idaho, Lacey and Tylor had a fairly happy childhood. Tylor was shy, with lily-white hair and blue eyes. He retreated to the background while their charismatic older brother, Mark, drew the limelight. Their parents had divorced and remarried, but the siblings stayed close. Recitals were attended and mountains explored. Tylor was “pretty much a normal kid,” Lacey, who is now 26, told me.

Tylor graduated high school in 2007, right before the Great Recession. But even that initially seemed okay; he liked to work. As a young man, he managed stores and fast-food restaurants around Pocatello. In his free time, he would tinker with his pickup truck or ride motorcycles.

The only troubling thing Lacey noticed was that Tylor had been drinking a lot. Occasionally, he would get drunk and tell Lacey that he was in pain, and he wanted it to stop. The air felt heavier around him. He would get upset about girls, or not having a good enough job, or not making enough money. The exact problem wasn’t always clear. A few times, Lacey sat with him in the hospital, where he was staying the night because his blood-alcohol level was teetering on deadly.

Then, that May, Mark died at 25 in what was ruled a suicide. His brother’s death left Tylor awash in guilt and horror. The brothers had argued the night of Mark’s death, and Tylor blamed himself.

One night three months later, Tylor called Lacey again and asked her to come over. Lacey couldn’t go that night—she can’t remember precisely why—but she promised to see him in the morning. “I need you to just wait until tomorrow,” she told him.

Minutes after they hung up, Tylor called the police and reported a suicide at his house. Then he picked up his gun and pulled the trigger. He was 23.

Tylor’s and Mark’s deaths became two of a growing number of suicides among Millennials. Though they might seem in the prime of their life, recent research shows that Millennials—people born from roughly 1981 to 1996—are more likely to die prematurely from suicide and drug overdoses than previous generations were.

Perhaps that’s to be expected, given the turmoil Millennials have faced in recent years. After scrambling up a slippery career ladder during the Great Recession, Millennials were slammed with the opioid epidemic. Billions of narcotic pills were shipped to parts of the U.S. where people had few opportunities, but plenty of pain.

Now even more challenges loom over young people. Many Millennials who had their careers crippled by the 2008 recession are being flung into yet another economic downturn, just as they’re supposed to be hitting their career peak. Because of social-distancing restrictions meant to reduce the spread of the coronavirus, young people who hoped to find a partner haven’t been able to date in person for months. And still more outbreaks of COVID-19, the disease caused by the coronavirus, might occur this year. As David Grusky, the director of the Stanford Center on Poverty and Inequality, put it to me, Millennials are “the bad-luck cohort.”

Interviews with more than a dozen experts on suicide and mental health reveal that Millennials are financially and generally stressed, and it’s driving some of them to extremes. Older Millennials snapped into adulthood after 9/11, fought in two wars, entered the job market during a recession, and are now weathering a global pandemic in overpriced one-bedroom apartments. They’ve experienced slower economic growth than any other generation in U.S. history, according to a Washington Post analysis. And having been clobbered by the last recession, they’re about to get clobbered again.

In a report published last year by the Stanford Center on Poverty and Inequality, economists Mark Duggan and Jackie Li found that mortality rates for people from ages 25 to 34 had risen by more than 20 percent since 2008. “That is, mortality rates among millennials ages 20 to 34 were substantially higher in 2016 than among their counterparts from Generation X when they were [their age] exactly 16 years earlier,” they write. The main contributors to the increase have been suicides and drug overdoses, and the increase was highest among white people.

Another report from the Trust for America’s Health last year found that drug-related deaths among people ages 18 to 34 more than doubled from 2007 to 2017, while alcohol-related deaths rose by 69 percent and suicides by 35 percent.

This tendency toward premature death has been especially pronounced among Millennials who, like Tylor, never earned a college degree. In 2017, white people without a bachelor’s degree born in 1980 were four times more likely to die by suicide than those with a college degree, as Princeton economists Anne Case and Angus Deaton write in their new book, Deaths of Despair and the Future of Capitalism. Among those without college degrees, the later you were born, the more likely you are at any given age to live in pain, binge-drink, have poor health, and die from suicide or a drug overdose. White people in their 20s and 30s are dying from alcoholic liver disease, a condition that normally takes decades of hard drinking to develop.

To be sure, the rise in Millennial suicides is set against a broader backdrop of despair: Rates of suicide are going up for all Americans, including Gen Z, the generation after Millennials. People ages 45 to 64 still have the highest overall risk of suicide.

For Millennials, the reason behind this uptick appears to be that young people with less education face more financial strain than previous generations did. The good jobs that used to be available to people without college degrees have slowly evaporated. “Jobs are a source of meaning in our lives,” says Cheryl Fulton, a professor in the counseling program at Texas State University. “So if you don't have a job or are underemployed, you’re not deriving that satisfaction that comes from the meaning and purpose a job provides.”

Rising health-care costs have encouraged employers to reduce headcounts and have eaten into employees’ salaries, Case and Deaton write. In addition, the decline in manufacturing jobs and the rise of the gig economy have driven non-college-educated young people’s wages into the ground. Millennials without a college degree are earning far less in early adulthood than previous generations did, according to another report in the Stanford series. The median salary for a 25-year-old man with a high-school degree or less is $29,000 a year, which is about $2,600 less than what Gen Xers earned at that age and nearly $10,000 less than Baby Boomers. In 1970, more than 90 percent of 30-year-olds were earning more than their parents were at the same age; in 2010, only half of 30-year-olds were. Millennials have, on average, no housing wealth.

Therapists who treat Millennials told me that many of their clients feel frustrated and embarrassed that they aren’t able to afford “adult things” such as houses and vacations, either because they don’t earn enough or because they are handcuffed to enormous student loans. Marriage can alleviate loneliness and ease financial strain, but Millennials are getting married later than previous generations. “They feel that they shouldn’t be in this situation,” says Gail Saltz, a psychiatrist who works at Weill-Cornell Medical College. That can cause shame, and shame is “one of the bigger drivers of suicide.”

he difference between what we have and what others have can prompt the bone-deep shame that leads to suicidal ideation, says Jonathan Singer, an associate professor of social work at Loyola University Chicago and the president of the American Association of Suicidology. People might start to feel like a burden or, if they’re unable to land a job, like they have no way of building a social network. More so than in other cultures, Americans tend to intertwine their jobs with their identity. “In the United States, if somebody is unemployed, we see that as an indication of bad character,” Singer told me.

Yet Millennials are the first generation to have come of age with Facebook and Twitter—compelled to compare themselves with others but not jaded enough to know how empty these comparisons can be. Gen Z actually has a more healthily skeptical view toward social media, says Kate Comtois, a professor who focuses on suicide prevention at the University of Washington. These platforms had already ripened by the time Gen Z became teens, and perhaps as a result, they see social media’s downsides more clearly. Millennials, by contrast, were the first to reveal their life to an online audience, and some felt stung by the reception. As Lacey, Tylor’s sister, put it to me, “We have our blooper reel in our head, and everyone else’s highlight reel in the palm of our hands.”

Lacking the money they need and the idyllic life they crave, Millennials experience extremely high levels of anxiety and perfectionism, several therapists told me. “They have almost double the rate of anxiety disorders compared to Baby Boomers,” says Nadine Kaslow, a psychiatrist and suicide-prevention expert at Emory University School of Medicine, who estimates that at least a third of her clients are Millennials. “The anxiety, depression, perfectionism, and substance use all increase their risk for suicidal thoughts.”

The nature of these substances, for that matter, blurs the line between overdoses and suicides. Some people use depressants such as alcohol to take the edge off their anxiety, then wind up depressed. And some suicides are simply drug overdoses in disguise—someone who doesn’t care much about living might get less and less careful about not overdosing.

The competing crises of 2020 are likely to make all of this worse. One study found that graduating into a recession has long-term, negative effects on life expectancy into middle age. People who entered the labor market in the recession of the early ’80s suffered higher rates of lung cancer, liver disease, and drug overdoses later in life. For Millennials who entered the labor market from 2008 to 2010, “all kinds of expectations they had about how they’re going to move right into the next job blew up,” Comtois told me.

As the economy folds in on itself, the gains that older Millennials have made in the past 10 years may be erased entirely. A recent survey found that 31 percent of people ages 18 to 34 lost their jobs or were put on a temporary leave because of the pandemic, compared with 22 percent of those ages 35 to 49 and 15 percent of those ages 50 to 64.

The recent protests against systemic racism and police abuses are yet another example of the frustrations faced by young people, especially black Millennials. In recent weeks, there’s been an outpouring of examples of unequal treatment of people of color in prestige industries such as journalism and publishing. Though racism itself can harm public health and life expectancy, the protests and police tactics used during them are also likely to spread the coronavirus. That could mean more deaths from COVID-19 in coming months, or another economy-crushing shutdown.

Every person I spoke with was concerned that suicides among Millennials and other groups might rise further in the coming years. Diana Anzaldua, a therapist in Austin, Texas, says she’s heard more of her Millennial clients talking about suicidal ideation recently. The social connections that buoyed us have been stripped away because of pandemic-related social-distancing measures. One study projected that the pandemic could lead to 75,000 additional deaths from drugs, alcohol, and suicide. Most gun deaths are suicides, and there’s been an uptick in gun purchases during the pandemic.

What does suicidal ideation look like? Some researchers theorize that it’s a feeling of defeat and humiliation followed by a sense of entrapment—of no exit. Some people say they’re thinking about hurting themselves, or that they feel utterly alone. Others are more explicit: “I just want this to be over.” When someone says, “I’m thinking this is how I would do it,” the alarms clang in therapists’ heads.

These alarming trends don’t mean we should give up on Millennials—or on anyone else who is contemplating hurting themselves. Suicide prevention can be, in fact, extremely effective. Admitting that you struggle with depression can still summon more stigma than help, but Millennials, at least, are more open to talking about mental health than previous generations were.

In fact, in part because the quarantine struggle has been a shared experience, some early reports have suggested that suicides have not increased so far during the pandemic. People see that others are depressed and lonely, making defeat feel more like a temporary problem than a permanent condition. The pandemic is a shared burden, not an individual one.

One of the best ways to prevent suicide is to make people feel less alone by assuring them that someone cares about them. It doesn’t even have to be a special someone. Some studies found that suicidal people were less likely to act on their thoughts if the hospital where they had sought treatment mailed them a simple form letter, as Jason Cherkis reported for HuffPost. Just because someone is suicidal doesn’t mean they’re hopeless.

Lacey felt guilty for a long time after Tylor’s death, but was also unsure exactly how much guilt she should feel. If Tylor had said, “Hey, if you don't come over, I'm going to kill myself,” she would have rushed to his side. Ultimately, she has come to the conclusion that, given how many times he had alluded to suicide, he would have likely harmed himself at another time.

Lacey credits Tylor’s death with changing her perspective on life. She no longer goes weeks without speaking to her family members after an argument, “because we know what it’s like to one second have them, and one second not,” she says. Even though she’s in only her mid-20s, she’s been a foster mom to 10 kids and adopted a baby girl. When I asked how to describe her in this article, Lacey said, “A mom, foster mom, and adoptive mom.”

She knows the quote about making lemonade out of lemons is a stretch. But, she said, even after the worst tragedies, you can make something resembling lemonade, approaching lemonade. Even if you don’t have lemonade, you’ll have something.

About this writer: OLGA KHAZAN is a staff writer at The Atlantic and the author of Weird: The Power of Being an Outsider in an Insider World.

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Personal note: Even at my age I felt uneasy and sad about the circumstances of this post.

This little story posted happens just about everywhere - not just the poor. Even the wealthy see struggles in moods and changes in each other. Whether help is available or offered depends on the person in question and if they are willing to seek help or if someone is there to help them through it.

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