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Adolescent Depressive Episodes Declined From 2021- 2024, With Andrew Yockey, PhD
Survey data show a nearly 40% drop in adolescent depressive episodes post-pandemic, though clinicians should remain vigilant for disparities and unmet care needs, Yockey says.
New national survey data reveal a nearly 40% decline in adolescent depressive episodes following the pandemic, but experts caution that improvements should not overshadow persistent disparities, diagnostic challenges, and gaps in care.
In an interview with HCPLive, investigator Andrew Yockey, PhD, assistant professor at the University of Mississippi, discussed findings from a recent analysis of the 2021–2024 National Survey on Drug Use and Health (NSDUH), which found a notable decline in past-year major depressive episodes (MDE) among 43,828 US adolescents aged 12 to 17 years. Prevalence decreased from 20.5% in 2021 to 14.8% in 2024, representing a 38.5% relative reduction.
“I think there is a partial recovery,” Yockey said. “During COVID, I think things just got hammered, and things just got very bad in terms of mental health, and we don’t know enough about the recovery time. Seeing that decline really helps.”
Yockey said other factors could contribute to the decline in depressive episodes, including better screening, an uptick in telehealth services, and reduced stigma of mental health care through national campaigns.
“Things are getting better, but let's not mitigate the issue here that 1 in 5 adolescents have mental health conditions,” he said.
The study confirmed several well-established risk patterns. Girls had > 3-fold greater odds of a major depressive episode compared with boys, and older adolescents were at increased risk. Racial and ethnic differences were also observed, with multiracial adolescents experiencing greater odds of depression. Alcohol and marijuana use were associated with increased odds of major depressive episodes, reinforcing the importance of integrated behavioral health approaches that address both mood symptoms and substance use.
Although girls continue to have greater rates of depression, boys have higher suicide completion rates, illustrating the importance of nuanced assessment. Yockey encouraged clinicians to recognize that adolescent depression may present beyond sadness, including irritability, substance use, emotional withdrawal, and loss of direction.
Yockey emphasized the need for broader and more nuanced research to determine whether improvements are sustained. Priorities include examining neurobiological and cognitive factors, as well as emotional processes such as rumination and emotional suppression. Intersectionality was also identified as an underexplored area, as adolescents with overlapping marginalized identities may experience unique stressors affecting mental health that are not captured in current screening approaches.
Yockey also highlighted the need to modernize screening tools, noting that traditional instruments may not fully capture irritability, cultural distress, or evolving symptom presentations among adolescents. He stressed the importance of connecting adolescents to treatment pathways, including therapy, medication when appropriate, and community-based resources.
“One of the things that I've always envisioned is having youth support groups in schools,” Yockey said. “We know from our research that if youth are involved with their parents or they're involved in a social activity, they’re less likely to report depression and substance use, so getting better ways to engage youth is critical.”
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