Rates of depression and anxiety among young people in America have been increasing steadily for the past 50 to 70 years. Today, by at least some estimates, five to eight times as many high school and college students meet the criteria for diagnosis of major depression and/or anxiety disorder as was true half a century or more ago. This increased psychopathology is not the result of changed diagnostic criteria; it holds even when the measures and criteria are constant.
The most recent evidence for the sharp generational rise in young people's depression, anxiety, and other mental disorders comes from a just-released study headed by Jean Twenge at San Diego State University.[1] Twenge and her colleagues took advantage of the fact that the Minnesota Multiphasic Personality Inventory (MMPI), a questionnaire used to assess a variety of mental disorders, has been given to large samples of college students throughout the United States going as far back as 1938, and the MMPI-A (the version used with younger adolescents) has been given to samples of high school students going as far back as 1951. The results are consistent with other studies, using a variety of indices, which also point to dramatic increases in anxiety and depression—in children as well as adolescents and young adults—over the last five or more decades.
We would like to think of history as progress, but if progress is measured in the mental health and happiness of young people, then we have been going backward at least since the early 1950s.
The question I want to address here is why.
The increased psychopathology seems to have nothing to do with realistic dangers and uncertainties in the larger world. The changes do not correlate with economic cycles, wars, or any of the other kinds of world events that people often talk about as affecting children's mental states. Rates of anxiety and depression among children and adolescents were far lower during the Great Depression, World War II, the Cold War, and the turbulent 1960s and early ‘70s than they are today. The changes seem to have much more to do with the way young people view the world than with the way the world actually is.
Decline in Young People's Sense of Personal Control Over Their Fate
One thing we know about anxiety and depression is that they correlate significantly with people's sense of control or lack of control over their own lives. People who believe that they are in charge of their own fate are less likely to become anxious or depressed than those who believe that they are victims of circumstances beyond their control. You might think that the sense of personal control would have increased over the last several decades. Real progress has occurred in our ability to prevent and treat diseases; the old prejudices that limited people's options because of race, gender, or sexual orientation have diminished; and the average person is wealthier than in decades past. Yet the data indicate that young people's belief that they have control over their own destinies has declined sharply over the decades.
The standard measure of sense of control is a questionnaire developed by Julien Rotter in the late 1950s called the Internal-External Locus of Control Scale. The questionnaire consists of 23 pairs of statements. One statement in each pair represents belief in an Internal locus of control (control by the person) and the other represents belief in an External locus of control (control by circumstances outside of the person). The person taking the test must decide which statement in each pair is more true. One pair, for example, is the following:
(a) I have found that what is going to happen will happen.
(b) Trusting to fate has never turned out as well for me as making a decision to take a definite course of action.
In this case, choice (a) represents an External locus of control and (b) represents an Internal locus of control.
Many studies over the years have shown that people who score toward the Internal end of Rotter's scale fare better in life than do those who score toward the External end.[2] They are more likely to get good jobs that they enjoy, take care of their health, and play active roles in their communities—and they are less likely to become anxious or depressed.
In a research study published a few years ago, Twenge and her colleagues analyzed the results of many previous studies that used Rotter's Scale with young people from 1960 through 2002.[3] They found that over this period average scores shifted dramatically—for children aged 9 to 14 as well as for college students—away from the Internal toward the External end of the scale. In fact, the shift was so great that the average young person in 2002 was more External than were 80% of young people in the 1960s. The rise in Externality on Rotter's scale over the 42-year period showed the same linear trend as did the rise in depression and anxiety.
It is reasonable to suggest that the rise of Externality (and decline of Internality) is causally related to the rise in anxiety and depression. When people believe that they have little or no control over their fate they become anxious: "Something terrible can happen to me at any time and I will be unable to do anything about it." When the anxiety and sense of helplessness become too great people become depressed: "There is no use trying; I'm doomed."
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