“Stop being so difficult” — Why we need to rethink puberty
Many mental health issues, like depression, bipolar disorder, or schizophrenia become apparent at an early age. Three out of four people diagnosed with a mental illness experience their first symptoms before they turn 18, with about half of them being younger than 15. Frequently, children in puberty are viewed as hard to deal with. In my teenage years, mental health wasn’t part of my family’s table talk. When my sister and I were expressing anger and were not in the mood to talk, we were “being difficult”. During seventh grade, my sister developed school anxiety. She refused to go to school, didn’t talk with anyone and escaped into the online world. Despite being close with my sister, we weren’t comfortable discussing this and I still don’t really know how she felt during that time. I remember the helplessness I felt. I was fed up with my daily struggles. At home, I often felt alone and misunderstood.
Today, I’m a PhD student researching adolescent mental health and brain development within the eBRAIN study. I believe that it’s vital to talk about child and adolescent mental health, especially considering the extraordinary mental health challenges the pandemic imposes on young people. In the past two years, children and adolescents have been dealing with isolation, ongoing uncertainty, anxiety, and grief. This adds up to the usual struggles that young people face, and research has found that puberty is a particularly sensitive period for emerging psychopathologies.
How does puberty work?
Puberty is when our body matures from childhood to adulthood. Children in puberty commonly experience pronounced and fast physical changes. These are driven by hormones that essentially tell our bodies what to do. For example, to start developing breasts or pubic hair.
Sometime between the age of 8 and 14, our body starts to produce steroid hormones like oestrogen, progesterone, and testosterone. This initiates pubertal development. Fast-changing hormone levels not only trigger visible bodily changes but also kick-start a highly exciting time for our brain!
How your brain changes
Brains are plastic. They are made up of billions of cells, called neurons, communicating through trillions of connections. As we learn something new, neurons that communicate to accomplish the task, form stronger connections.
Let’s assume I’m learning to play Beethoven’s “Fur Elise” on the piano. As I attempt to play the song, neurons responsible for moving my fingers are activated in a certain pattern. With practice, their connections become stronger, making it easier for me to move my fingers in the right sequence to play “Fur Elise”. At the same time, connections we do not use weaken. Thus, our brain organises itself according to the functions that we use. Researchers refer to this amazing process as neuroplasticity. The pubertal brain In puberty, the developing brain is particularly plastic, which means it is highly adaptive to the demands of the environment. On the one hand, increased neuroplasticity enables learning and adapting to environmental demands easily. On the other hand, aversive experiences, like family conflict, or being rejected by your crush, are more likely to change the way your brain is organised. Thereby, painful experiences and failures can shape how we think, feel, and behave continuously. Thus, puberty is a sensitive period for maladaptive brain development and emerging psychopathologies. But why do some people get away fine with the struggles of puberty and others develop mental health difficulties? As usual in life, the answer is not that easy. Here, I consider a few factors that have been researched quite extensively. It’s all about timing According to multiple studies, children starting puberty earlier are more likely to develop depression, anxiety, eating disorders, or to use drugs. Why’s that? First, puberty that starts at a young age likely hits children unprepared. Children that go through puberty relatively early may feel like they are not ready yet and may have trouble coping with the physical changes they didn’t ask for. This likely elicits feelings of confusion, stress, or shame, which may become serious mental health challenges. Second, we commonly compare ourselves to others. When children that find themselves a bit off-time in their pubertal development compare themselves to same-aged peers, they may feel substantially different from the others. Not fitting the status quo within their age group, they may feel strange, excluded, and pressured to change.
Lastly, physical changes during puberty affect not only how young people perceive themselves, but also how they are perceived by others. It’s always easy to pick up on something that stands out, or that looks somewhat strange or different from most others. Thus, children with early puberty may suffer from being bullied. Bullying has severe consequences for one’s mental and physical health. Being bullied likely triggers adverse feelings towards one’s body image, anxiety, and shame.
Who’s particularly affected?
Girls who start puberty at a young age are particularly at risk for psychopathologies. Maturing girls are likely to be exposed to sexualised comments and unwanted attention. Apart from being troublesome enough that women must learn to cope with this, young girls may be particularly unprepared to do so, making them feel ashamed and anxious in public.
Puberty can be an equally stressful experience for boys. Research has shown that speedier progression through puberty puts boys at risk of developing mental health difficulties. When physical changes progress very fast, there is less time for getting used to one’s new bodily appearance and for adjusting one’s self-concept.
Lastly, adultification may represent additional harm for Black children with relatively early puberty. This is when teachers and other authorities perceive Black children as being more mature and less innocent for their age as compared to their white peers. For example, a white child’s silly remark in school would be attributed to its young age, whereas a same-aged Black peer would more likely be held fully responsible for it.
Let’s rethink puberty!
To bring it all together, pubertal timing that deviates from the average makes it harder for children to deal with the challenges they are experiencing, and intensifies social risks, like bullying and social pressure. This is particularly true for early maturing girls and boys, and Black children. The increased distress during puberty can affect brain development, making it more likely to develop lasting mental health difficulties.
To lessen this risk, one way forward would be to refrain from calling young people “difficult”, and instead, acknowledge that their bodies, including their brains, go through a rough time. We can start doing that by being aware of the mental health challenges children and adolescents are facing, and by attempting to talk with, and not about, them.
Header image by Taylor Harding on Unsplash