"Recently, I feel like crying for no reason, and sometimes I even want to die."
"My child is refusing school more and more often."

Such concerns are common in child and adolescent psychiatry clinics, where many young people seek help for various challenges. Adolescence is a critical developmental stage, yet many teenagers face difficulties that affect their mental health. What are the challenges they encounter?

Challenges in Adolescent Mental Health

Adolescence is a significant phase of life marked by rapid physical growth, as well as the gradual maturation of mental status. However, many teenagers experience mental health issues during this period.

According to Taiwan's 2015-2017 "Epidemiological Survey on Mental Disorders in Children and Adolescents," the lifetime prevalence of any mental disorder among children and adolescents reached 32.3%. Among these, the lifetime prevalence of Attention Deficit Hyperactivity Disorder (ADHD), Anxiety Disorders, and Autism Spectrum Disorder (ASD) was 10.5%, 10.4%, and 1%, respectively.

In recent years, there has been increasing awareness of adolescent mental health globally, including in Taiwan.

Neurodevelopmental Disorders

When discussing mental disorders, many people think of schizophrenia, a condition characterized by hallucinations and delusions that may develop during adolescence. However, neurodevelopmental disorders are also common during this stage.

Neurodevelopmental disorders, such as ASD, ADHD, and Intellectual Disabilities, often manifest during early childhood. As these children grow into adolescence, they may face new adaptative challenges.

• Autism Spectrum Disorder (ASD):
  Adolescents with ASD often exhibit deficits in social interaction and communication, along with repetitive behaviors and restricted interests. These traits can make it challenging for them to maintain relationships, which may lead to anxiety, depression, or other emotional disorders.
• Attention Deficit Hyperactivity Disorder (ADHD):
  ADHD is the most common childhood psychiatric disorder, with a prevalence of about 5%-10% in school-aged children and 5% in adolescents in Taiwan. Symptoms include inattention, hyperactivity, and impulsivity, which can lead to academic struggles, social difficulties, and higher risks of accidents, high-risk behaviors, and substance abuse during adolescence.

Emotional Disorders

Another category of adolescent mental health issues involves emotional disorders, which are often linked to environmental interactions.

• Anxiety Disorders:
  Anxiety disorders are the most common emotional disorders among adolescents, affecting over 10% of teenagers in Taiwan. These include specific phobia, social anxiety, and panic disorder, which can trigger physical and psychological discomfort in specific or general situation.
• Depressive Disorders:
  Adolescents with depression may experience persistent low mood or irritability, loss of interest or pleasure, sleep disturbances, appetite changes, impaired concentration, feelings of worthlessness, and hopelessness. Severe cases may involve self-harm or suicidal thoughts and behaviors.
• Bipolar Disorder:
  Bipolar disorder involves alternating episodes of mania (elevated or irritable mood, decreased need for sleep, rapid speech) and depression.

According to a Taiwanese survey, the lifetime prevalence of depression in children and adolescents is 1.4%, while bipolar disorder is 0.02%. A 2023 survey by the Child Welfare League Foundation revealed that 17% of Taiwanese high school students rated their depressive symptoms as severe or worse. Although this does not equate to a clinical diagnosis, it highlights the significant emotional distress many adolescents face.

Hidden Crises and Unspoken Struggles

The development of psychiatric disorders in adolescents is influenced by genetic, familial, environmental, personality, and sociocultural factors. Beyond psychiatric conditions, adolescents in this generation face numerous pressures, such as academic stress, social media influence, bullying, and exposure to new types of drugs.

When troubled, many teenagers prefer to talk to peers rather than parents or teachers. A study revealed that only 5.6% of adolescents seek help from counseling teacher, and 17% do not talk to anyone. Although over 30% of Taiwanese children and adolescents experience psychiatric disorders, only 4.6% of those under 18 have sought psychiatric care, highlighting a gap in treatment.

Integrating Resources for Adolescent Well-Being

Promoting adolescent mental health requires joint efforts from families, schools, professionals, and society. Parents and educators should be attentive to signs such as changes in behavior, declining daily functioning, social withdrawal, and negative thoughts. Seeking professional mental health resources is crucial when necessary.

At Far Eastern Memorial Hospital, the Department of Psychiatry and Psychosomatic Medicine provides comprehensive resources, including child and adolescent psychiatrists, clinical and counseling psychologists, social workers, and occupational therapists. Since 2022, we have offered an "Adolescent Mental and Psychological Health Program," featuring diverse assessment and treatment modalities such as individual counseling, group therapy, and parenting sessions.