They received a call that their 19-year-old son had been transported to the local hospital, extremely agitated and intoxicated, with a blood alcohol level of .245. What they learned over the next few days was that this wasn’t the first time their son had been drinking heavily on a weeknight. He confessed that the pressure of keeping up with his classes, sports commitments, and making new friends often left him feeling overwhelmed, anxious, and depressed. When he drank, his problems went away for a while, but they always roared back when he was sober.

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This scenario has become exceptionally common as more teens and young adults in the U.S. attempt to deal with stress and psychological challenges by self-medicating with alcohol and drugs. For the children of affluent families, a study conducted by researchers at Columbia University found that these negative coping mechanisms occurred more frequently.

Children and young adults from upper-class families had a higher incidence of alcohol use, binge drinking, and substance use, as well as other maladjustment behaviors including lying, cheating, theft from parents and peers, destruction of property and violence toward others. The authors of the Columbia study concluded, “The evidence suggests that the privileged young are much more vulnerable today than in previous generations.”

Dr. Cheryl Rampage, a licensed clinical psychologist and executive vice president at The Family Institute at Northwestern University, found that anxiety among affluent children is 25% to 30 % higher compared to teens of other socioeconomic backgrounds, and 20% are diagnosed with clinically significant depression, an incidence three times the national average.

Other researchers have found that in high school students from middle- and upper-class families, depression, anxiety, suicidal thoughts, loneliness, and physical manifestations of mental health issues, such as headaches, stomachaches, and pain, occur at twice the rate of national averages.

The signs parents need to know

Early signs of mental health issues such as anxiety, depression and alcohol and substance use can be subtle and easy to miss, especially when children and young adults have learned that they should push through problems and roadblocks in their lives.  Signs that a teen or young adult may be experiencing these problems can include a range of symptoms, such as unprovoked feelings of sadness and crying; frustration or anger over small issues; irritability; loss of interest in usual activities and interactions; conflict with family and friends;  fixating on past failures; excessive sleeping;  bloodshot eyes; frequent nosebleeds; poor hygiene and more.

What parents need to know

While the majority of parents encourage their children to do their best academically and achieve financial success when they reach adulthood, children of successful families appear to feel an even higher level of expectation and stress surrounding these issues, believing, even if their parents do not say it, that they must consistently achieve “star status” in all their academic, extracurricular and social endeavors.

To reach those higher levels of achievement, these children and young adults lead heavily scheduled lives, which in turn leaves little downtime during which they can de-stress and recuperate psychologically. In addition, young people who are overscheduled and whose parents are exceptionally involved in the details of all aspects of their lives do not have the chance to learn how to effectively manage their time and resources and are frequently protected from the consequences of failure, which means they miss the opportunity to develop the resilience one gains from being allowed to fail and experience those consequences.

Strategies to lower the risk

Parents should not assume that their children know they are loved and supported. It is important for parents to regularly express to their children that they are unconditionally loved and valued and that this love and value are not based on achievement. They are a given no matter what the circumstance.

No child or young adult can consistently achieve perfection without paying a high psychological, and in many cases, physical, price. Parents should encourage children to set realistic goals that result from a child’s own desire to achieve rather than parents’ expectations of what achievement should look like.

Another strategy recommended by Dr. Rampage is for parents to combine high-structure and high-warmth parenting practices that allow children to build their own sense of self, coping skills, and develop the habits of mind needed to create a life filled with meaning and purpose. These practices can include performing regular household chores, limiting material purchases as a means of gratification or mood-boosting, regular family dinners, limits on privacy, taking part in social service activities and listening to what children have to say without expressing judgment. In addition, it is important that they express confidence in them managing their own anxieties so that children are less likely to be negatively affected by them.

Getting access to needed support and treatment

Knowing the signs of depression, anxiety, and substance use is an important first step in helping teens and young adults who are struggling with these issues. However, knowing a problem exists and finding and accessing the needed care and resources are not the same thing. It can be exceptionally difficult for parents to find skilled, experienced mental health providers who have immediate appointments available. At most, many parents simply receive a listing of healthcare providers who specialize in the treatment of teens and young adults. What’s often missing is discrete, compassionate guidance on how to gain access to the care their children need in a timely manner. And that’s critical, because in the end, getting access to the best treatment as quickly as possible can be the lifesaving difference.

Miles J. Varn is chief medical officer, PinnacleCare, and can be reached on LinkedIn.

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