School is out and, for many teens, the pressure of academic performance is gone. Just last week, one of my colleagues noted that there were fewer referrals and many youth were planning monthly instead of weekly sessions. It seems as if summer means a break from mental illness as well as from school.
As well as my colleagues, the youth I see were also discussing this last week:
“Dr. Beck, I’m a lot better now that school is done. Can I have a medical certificate not to go to school at all next year because it causes me stress?”
I answered,” So you’ve been out of school 3 days and you’re ready to say that your anxiety and depression are gone? You may feel better for the moment with the worry of exams and final papers over, but what do you think might happen in a few weeks with no routine that lets you see your friends every day?”
“Well, we’ll probably get together to hang out or party.”
I said nothing. Neither did anyone else in the group for a moment. Then a soft voice penetrated everyone’s reveries:
“I partied last summer and my depression got worse. I have to use less weed this summer and I can’t drink. I felt worse last year after doing that”
Another observation was also quietly expressed: “I have a hard time getting to school sometimes because of my anxiety, but my anxiety can be even worse when I wake up with nothing to do and I’m not sure how I’ll spend the day.”
These youth are reporting what the evidence tells us about those circumstances in which mental illnesses may become worse in summer and my own clinical experience bears this out.
The regular routine of a school day can be a comfort for youth with depression and anxiety. Apart from the routine itself, the isolation from their support network may be difficult for a youth who has a difficult time making new friends. As well as not being surrounded by a supportive network, many youth will travel to new places with their families and go sightseeing. Going to new places can be very difficult for a youth with anxiety. Also, for a young person with Attention Deficit Hyperactivity Disorder, the structured school day likely helped them to manage their symptoms.
We all see summer as “the holidays” and it’s not unusual during the summer for youth to drink or use marijuana as part of their “holiday” routine. The problem with this is that alcohol and marijuana can affect depression and anxiety adversely and can even cause a youth – or an adult – to develop suicidal thoughts as their depression worsens. Added to these dangerous thoughts, the increased impulsivity that you sometimes observe when someone has had a drink or marijuana can be deadly.
Another group for whom summer can be difficult are those with Bipolar Disorder since episodes of mania arise more often in the summer months. For youth who struggle to sleep unless it’s dark, those long summer days in the Northern Hemisphere can make insomnia worse.
Finally, there is a form of Seasonal Affective Disorder that is specific to the summer months. The symptoms of this condition include decreased appetite and weight loss, irritability, anxiety and insomnia.
What can be done to offset these possibilities? While many youth say they can’t wait to spend their summer lying around, a summer job, volunteer work or summer school can actually be a better idea. Any of these activities provide the structure to offset both anxiety and depression or support a youth with Attention Deficit Hyperactivity Disorder. Summer work or school can also give people a feeling of accomplishment and improve self-esteem.
This is not to discourage teens from enjoying the summer. The lovely weather is an excellent time to take advantage of that great natural antidepressant and anxiolytic: exercise in the fresh air. Another activity that can foster connection in a season when youth are separated from their friends is family visits. An afternoon spent with cousins or grandparents can be a balm for loneliness. Also, nothing is more inspiring or uplifting during difficult times than remembering wonderful summers spent with your family. Even as I write this, I remember bouncing in the back of a pickup truck with my cousins as we rode off with my uncle to find the perfect blueberry patch. It was hot and we felt sick to our stomachs, but we couldn’t stop laughing. That was one of the best days ever!
While those of us caring for youth with mental health problems cannot let down our guard in summer, we can act as guardians of the season. We can take people for walks, play complete games of Monopoly, and read wonderful stories to each other. We can sing around campfires and roll our eyes while our mothers tell our children absolutely exaggerated stories of our own summer adventures. Nothing is more helpful for children’s self esteem than hearing about their parents’ hairbrained exploits. We can do all these things to keep depression and anxiety at bay and we fill our children’s minds with memories that will remind them all year of how loved they are.
