But there is another piece that plays an important factor in teen mental health, especially now: sleep and its role in boosting mental health and emotional resiliency.
With children and teens readjusting to the world in the wake of pandemic isolation, sleeping well can be a protective factor, says Lisa Meltzer, a pediatric psychologist at National Jewish Health in Denver.
“When you don’t sleep well, emotional regulation is one of the first things to go,” she says. “Insufficient, poor-quality or poorly timed sleep — each one of these can exacerbate mental health conditions.”
How much sleep — and when
According to many sources, including the National Sleep Foundation and the American Academy of Sleep Medicine, teens should be getting eight to 10 hours of sleep a night. But fewer than one-fourth of high school students are meeting even the minimum, according to the results of the most recent national Youth Risk Behavior survey, conducted every two years by the Centers for Disease Control and Prevention.
From a mental health standpoint, aiming for more than just the minimum eight hours can be most helpful, experts have found. In one study, teens who got 8¾ to nine hours of sleep per night had the lowest levels of mental health issues, including moodiness, feelings of worthlessness, anxiety and depression.
In a recently published study examining college students’ sleep and mood, Tim Bono, a lecturer in psychological and brain sciences at Washington University in St. Louis, found that the students who got the most weeknight sleep on a regular basis also posted the biggest increases in happiness and well-being over the course of the semester. This was true even for students who had lower baseline happiness levels at the start of the study.
Students with the most erratic sleep schedules were unhappy nearly twice as often, the study found. Key best practices for sleep, including consistency, seem to “significantly [affect] the trajectory of students’ psychological health,” Bono says.
When teens aren’t getting enough sleep during the week, they often sleep in late on the weekends to make up for the shortfall, which perpetuates the cycle.
The protective role of sleep
Getting enough sleep can provide an emotional buffer to help teens handle daily stressors, research shows.
Tiffany Yip, chair of the psychology department at Fordham University, has researched how sleep affects teens’ ability to handle stress related to discrimination. A study she co-authored found that getting a good night’s sleep helped teens cope when they experienced discrimination and discrimination-related stress the following day.
Specifically, teens who had slept well the night before were better able to select effective coping strategies, such as reaching out for support and not ruminating or obsessing over what happened, she says. “When adolescents sleep well,” she says, “they’re better able to cope with the stresses that come their way tomorrow.”
And what about the sleep teens get after a stressful day? It provides an emotional reset, helping them rebound so there’s less spillover into the following morning. Researchers have documented this “bounce-back” effect, finding that when teens got more sleep, they had a more positive overall mood the next morning, much like their mood following a low-stress day.
A “dose-dependent” association also exists between the amount of sleep teens get and their mood and self-harm behaviors. An analysis of the results of the Youth Risk Behavior survey revealed that high-schoolers who reported getting less sleep on school nights were correspondingly more likely to report feeling sad or hopeless.
When compared with the teens who had slept for at least eight hours, those who had slept for six hours or less were more than three times as likely to have considered suicide, made a plan or actually attempted it, according to the analysis.
How can we help teens get sleep?
Meltzer characterizes the relationship between sleep and mental health as “intricately interwoven”: Sleep loss can have a negative effect on mood and emotional resiliency, and mental health issues can affect sleep.
“We know that, for different mental health diagnoses, anxiety and depression in particular, sleep can be both a symptom and a negative outcome of the disorder,” she says. “If we can improve the sleep, some of the mental health symptoms will improve. But just treating the sleep issue isn’t going to necessarily cure depression or anxiety.”
Instead, she recommends that both sides of the equation — the sleep issues and the mental health issues — be addressed concurrently. (She also notes that teens regularly sleeping too much — more than 10 hours every night — may be a sign of them being depressed.)
Meltzer stresses the importance of sleep consistency for teens, along with good sleep habits and best practices upon waking. “Being exposed to bright light and getting out of bed in the morning are really critical,” she says. “For circadian rhythm regulation, it’s really important to have darkness in the evening and bright light in the morning.”
She also recommends that teens don’t linger in bed, particularly if they’re spending that time ruminating or using electronic devices.
“When we’re talking about sleep and mental health, those are the three takeaways: one, a consistent schedule; two, bright light in the morning; and three, only being in bed when they’re sleeping,” Meltzer says.
Other suggestions to help promote better sleep among teens include:
Moderate caffeine intake: Caffeine is consumed by about 80 percent of teens and is a quick and effective pick-me-up, but caffeine in the afternoon or evening can make it harder to fall asleep that night. (As neuroscientist Matthew Walker notes in “Why We Sleep,” caffeine has a half-life of about five to seven hours, which means that, even by bedtime, half of the caffeine will still be in your system.)
Be strategic about napping: Teens who nap too late in the day and/or nap too long can end up in a bad cycle.
Exercise: Moderate to vigorous physical activity, such as walking, running or playing basketball, can help set the stage for better sleep that night. Again, timing matters: Late-night exercising may cause teens to feel more alert. (If evening practices and the like cannot be avoided, being intentional about winding down before bed can help counteract this.)
Bono describes sleep as an “investment.” As he tells students: “Yes, it takes away from the number of waking hours that you have, but it ensures that, for the hours you are awake, you’re at your optimal performance for happiness, for connecting with other people and for well-being.”
Although it’s not a panacea, he says, “it’s a simple thing that can go a long way.”
Lisa L. Lewis is a parenting journalist and the author of the forthcoming book “The Sleep-Deprived Teen: Why Our Teenagers Are So Tired, and How Parents and Schools Can Help Them Thrive.” On Twitter and Instagram, she’s @LewisLisaL. She can also be found at lisallewis.com.