Young Adult Mental Health
Overview of Youth Mental Health
“Youth mental health” is a specialist area of mental health which is focused on young people, in other words adolescents and young adults through from mid-teens to early twenties. Young people can get a lot out of a specialised mental health service, because there are some things that make young people special and different. These years are a time of rapid change and development, and this comes with some specific challenges.
The teenage years are a time of rapid growth. Teenagers also develop a male or a female body shape. Not everybody feels ready for these dramatic changes when they happen, and young people often go through a time of feeling uncomfortable or self-conscious with their bodies, even feeling there is something seriously wrong with their body or they do not belong in their body. This can lead to eating disorders, gender dysphoria or severe social anxiety.
The teenage years are also associated with dramatic hormonal changes, particularly increases in testosterone (in boys) which is associated with assertiveness, impulsiveness, anger, irritability and increased sexual desire, and oestrogen and progesterone (in girls) with is associated with sexual desire and mood changes. Not everybody is ready for these dramatic new emotions and it can take time to learn how to manage them.
The brain is growing rapidly through the teenage years and into the early twenties. Certain nerve pathways in the brain are being upgraded through a process of “myelination”, which can be compared to upgrading an internet connection from copper wire to broadband fiber-optic cables, or upgrading roads from dirt tracks to four lane motorways. These parts of the brain become super-connected and super-efficient. The limbic system (the emotional part of the brain) develops in the early teens, and the pre-frontal cortex (also called the “frontal lobe”) develops in the late teens up to the mid-twenties. The pre-frontal cortex is responsible for “executive functions”, and a bit like the chief executive officer of a large corporation, it is the “boss” of the brain. These “management” functions include managing your emotions, resisting temptations and impulses, planning ahead, multi-tasking, focusing on the task at hand and ignoring distractions, and managing social situations and social responsibilities.
Because of this lag in frontal lobe development, many young people have difficulties with managing intense emotions, impulsive behaviour and social relationships, and also managing high level academic expectations at school or at university.
This time of brain development is also important because the attitudes and behaviours that get established in the young adult years can get “hard wired” and locked in as myelinated brain pathways which are hard to change in later life. This makes this time of life an ideal opportunity for early intervention to prevent life-long mental health problems.
This time of life is also a time of massive social changes and challenges. It is a time of separation from your family and connection into social groups and organisations outside of the family. It is also a time when your main emotional connections shift from parents to friends or romantic or sexual partners.
High school can be a time of intense academic demands and social pressure. Young people have to find a way of fitting in and being accepted, and some have to cope with the added stress of bullying or social rejection. Then there is the challenge of leaving home and living independently, or adapting to living in a shared house or with romantic partner. This might be a time of going to University, with higher levels of academic demands and the need to manage your own time.
In your teens many things become “legal”, including sexual consent, consenting to medical treatment, driving a car, borrowing money, and taking out a lease. But just because it is legal doesn’t mean any young person has the skills to do it. There are a huge number of skills to learn including budgeting, understanding finances, banking and taxes, time management, advanced study skills, understanding how to function in the workplace, and understanding your legal rights. All of this poses a strain on the developing brain.
Young people are also developing their identity including gender identity (how you feel about being male or female) and sexual orientation (what kind of people you are attracted to). You are also developing your cultural and ethnic identity (what kind of social group you want to identify with), your political beliefs, your sense of how you fit into the world and the kind of future you are entitled to. At a more personal level your identity is also how you feel about yourself in the world. As a young person you are forming ideas and beliefs about yourself, for example whether you are a good and worthwhile person, where you belong, and where you fit in.
To move out into the world, young people need the secure base of a family which loves and supports you, has given you the confidence to believe in yourself, and will continue to support you as you separate from them and support you when you need to come back to them from time to time. Without this support, young people are more vulnerable to mental health problems.
Some young people have the added stress of coming from a home where there is a lot of conflict, or where a parent has a serious physical or mental health problem. It is even harder to deal with the usual issues of growing up if you are also dealing with this stress. Some young people have been rejected or abandoned by a parent, and this can be a reason for sadness make you doubt whether you are a worthwhile person.
There are life experiences in childhood, teenage years and young adult life which can have severe lasting effects on how you feel about yourself. This can include severe bullying at school, or being abused or mistreated at home. Many girls experience some kind of sexual assault in their teenage years. All of these experiences can lead to mental health problems.