The most vivid memory of my childhood is of me, a six or seven-year-old boy, crying in the playground corner every day for months. It is so intense that I wonder if that is a product of imagination. However, the same scene, with the blue bench, in the dark right corner of the playground, keeps on playing in my head when I think about those early days of my childhood.

It is, undoubtedly, the way my brain interpreted the situation. Me, a small weak boy, threatened by a group of “cooler,” stronger, and bigger boys. This would probably sound like a boring minor incident that affected one individual somewhere. But the more I progress through residency and learn about it, the more I realize how big of a problem bullying is.

Bullying is defined as repetitive behaviors by an individual or a group towards another. The bullied person is usually perceived as vulnerable. Examples of bullying include physical harm, social exclusion, verbal threats or humiliation, spreading rumors or lies, and cyberbullying, among others. The problem is estimated to affect 20 to 30 percent of schoolchildren in the United States between 2005 and 2013. Seventy-seven percent of the children in the third through sixth grades either bully or encourage bullying of schoolmates who were seen as weaker for different reasons. Unfortunately, bullying is not an isolated act, as it is directly related to other psychological diseases. Compared with people who were not bullied, the incidence of negative outcomes such as depression, anxiety, suicide, and loneliness was higher among those who were bullied. This effect is still valid years after bullying ends.

More than 20 years after my bullying events, I am in the adolescent clinic talking with 11-year-old John (name changed) about an incident that made my memories. John now stopped going to school because it exacerbates his anxiety.

When talking to him, John sounds very astute and mature. He describes the intricate social hierarchy in their class; unfortunately, he was at the bottom. His close friends were afraid of talking to him. They ignored him to protect themselves from being bullied. The bullies, a group of muscular young men, often push him around, take his food, make fun of the way he walks or talks or moves, and ridicule anyone who empathizes with him.

John describes his daily struggle to survive one day of school, a day full of humiliation, mockery, and abuse. Talking to the teachers about it won’t help, he says, as it made things worse. Not only are teachers often blind to what is going on, their “punishments” are often ineffective. Also, John’s bullying worsens after “snitching” on his colleagues. John is later diagnosed with anxiety and depression. He was started on Sertraline and has regular psychotherapy sessions. He is now homeschooled.

This encounter was one of the times when I was frowned at for spending an hour and a half talking to the patient. In the current clinic setting, one has 10-20 minutes maximum to finalize a patient encounter as a general pediatrician, and a little bit more in an adolescent medicine clinic. However, throughout our talk, I directly connected to John’s story as it reminded me of my own. I could feel his frustration. I could feel our powerlessness against this problem.

This is not something I could not solve within the limits of my clinic’s walls. It is not something I could repair with medications or therapy.

Reflecting on my experience, I was lucky to have my art teacher. She noticed me hiding in the corner every recess. She used to spend much of her time with me and helped me express my emotions through some of my assignments. She also was a needed barrier against those eyeing me, waiting for an opportunity to mock me in an attempt to climb the ladder of social status. Unfortunately, the “art teacher-savior” concept is not always a reality. I wished I could be John’s savior.

Bullying, however, is not an individual problem. It is a societal problem that requires collective efforts. Preventative strategies should be applied, such as teaching empathy and diversity in schools, promoting friendlier and more inclusive environments, and encouraging teacher intervention whenever bullying is detected in schools. We also know that the bully and bullied both are at higher risk of mental health problems, such as depression. Applying these interventions will not only help the bullied but also affect the bully and society as a whole positively.

Samer Bou Karroum is a pediatric resident.