Episode Transcript
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SPEAKER_01 (00:00):
This episode
includes discussions about
mental health and sexual abuse,which some viewers may find
distressing.
If you or someone you know isstruggling, please reach out to
a trusted friend, family member,or a mental health professional.
Resources and support areavailable.
If you're in crisis, pleasecall, text, or chat with the
Suicide and Crisis Lifeline at988 or contact the Crisis Text
(00:21):
Line by texting TALK to 741741.
SPEAKER_02 (00:30):
Welcome to the
Visibility Gap.
I'm Dr.
Jen Ashton.
Today we're addressing an urgentand deeply concerning issue in
mental health, the sharp rise indepression among teenage girls.
A 2023 report from the New YorkTimes revealed that 53% of
teenage girls reportedexperiencing severe depressive
(00:53):
symptoms, a staggering andalarming figure.
The human toll of thesestatistics is truly
heartbreaking.
According to the Centers forDisease Control and Prevention,
nearly 30% of teenage girls haveseriously considered suicide,
and 13% have made a suicideattempt.
(01:13):
In this episode, we'll examinethe factors fueling this
troubling trend and explore howfamilies, friends, and
organizations can come togetherto support teenage girls in
crisis.
Through greater awareness andunified action, we can protect
the mental health and well-beingof the next generation.
(01:34):
We'll be joined by a panel ofexperts who will share
actionable strategies andinsights for addressing this
critical issue.
But first, we'll hear from aninspiring and brave young woman
who turned her own challengesinto a powerful mission to help
others heal.
Please welcome Haley Hardcastle.
(01:54):
First of all, thank you for yourbravery and your courage to come
and share your story.
I know that it will help so manypeople.
Where do you want to start?
SPEAKER_00 (02:07):
Well, thank you for
having me.
I really appreciate the chanceto share my story with others.
I believe that storytelling isone of the most powerful tools
we have in combating the youthmental health crises.
And I think I would like tostart with some of the root
causes of my mental healthexperiences.
(02:28):
Start wherever you want.
I became aware of my mentalhealth at a very early age.
I experienced what's calledadverse childhood experiences or
ACEs.
I had a single mother who wasvery young.
We didn't have a lot.
We got by, but low income.
And when I was in kindergarten,I experienced childhood sexual
(02:53):
abuse.
And these heavy experiences madegrowing up very hard.
And I became aware of my ownmental health as early as
kindergarten.
And I developed some copingstrategies to deal with the
things that happened.
I later found out that thesecoping strategies could be
described as severe anxiety anddepression.
(03:14):
But at the time, I was justdoing my best.
So when I was a child, I becamevery obsessed with different
numbers and colors and doingthings in patterns.
And these are things that peoplewith anxiety will often do,
especially children withanxiety.
And I had a really hard timegetting to school.
(03:34):
I would have panic attacks onthe way there.
But once I was there, I was astraight-A student and I loved
being there because school wasmy safe place.
And It was the early 2000s, andso mental health was not talked
about as much as it is today.
And I did not have insurance.
You know, we were a low-incomefamily just getting by.
And so it was my schoolcounselors who identified these
(03:58):
challenges that I was goingthrough, and I was able to get
help.
Now, I am a grown woman, and Iam so thankful for all of these
moments of hope where peopleintervened and got me the help
that I needed.
And it was really the adults inmy life who took note that
something was just a little bitoff and got me connected.
SPEAKER_02 (04:16):
Because you were so
young, it's not like you could
have been expected to ask forhelp yourself.
Absolutely.
First of all, I'm so sorry forwhat you went through.
And again, know how difficult itcan be to relive parts of it and
talking about it, but it alsocan be therapeutic.
(04:38):
And it took you quite a while toto seek therapy or start
therapy.
What was the period of time andwhat factors contributed to that
delay?
SPEAKER_00 (04:52):
So I began
experiencing mental health
challenges at such a young age,but I didn't see my first
therapist until I was 21 out onmy own in college.
And I was motivated to get thathelp because, frankly, I had the
means to do it.
Growing up, I didn't have healthinsurance.
I didn't have access to theseresources.
(05:14):
So I relied on my community.
I relied on school counselorsand teachers and friends.
I relied on social media to getme a lot of this information and
that's why I believe it's reallyimportant to have clinically
vetted mental health informationon social media and online.
These were the places that I wasaccessing mental health care.
(05:36):
I called hotlines in high schooljust trying to find, you know, a
beacon of hope, someone to talkto anywhere that I could.
And then when I was 21 incollege, it was during the
COVID-19 pandemic, and therapywas offered via telehealth, and
that made it a of the peoplethat benefited from that new
(06:00):
telehealth landscape.
And I was able to pay for itmyself out of pocket.
And I actually spoke to a gradstudent who was becoming a
therapist, was my therapist forabout a year and a half in
college, and helped me workthrough the trauma that I had
been carrying for the past 21years.
Something I tell the studentsthat I now work with is, you
(06:22):
know, if you need help, itdoesn't mean that something is
wrong with you.
It means you're going throughsomething and you need someone
to talk to.
SPEAKER_02 (06:28):
I want to go back to
your adolescence and your
teenage years.
So much of the psychologicallydevelopmental tasks of being a
teenager are things that welearn in formal education, like
testing boundaries, feeling likeyou're blending into your social
(06:52):
environment, a.k.a.
just peer pressure.
It can be very hard when you'rea teenager recognizing that
something doesn't feel right orsomething bad has happened to
you that makes you differentthan your peer group.
Did you struggle with that?
Were you aware of that?
(07:12):
Were you not aware of it?
And what was that
SPEAKER_00 (07:16):
like for you?
Coming into adolescence and myteen years, I was hit with this
wave of emotion as I wasbecoming a young woman,
understanding the things thathad happened when I was younger
were not okay and that they werenow affecting me.
And you spoke to feeling likeyou maybe don't fit in with your
(07:41):
peers or something happenedthat's out of the ordinary but
something I found healing in isthat it's actually not out of
the ordinary many peoplestruggle with these challenges
and I found a lot of power inconnecting with my peers my best
friend was also struggling withdepression in high school and
once she opened up about herstory I had the means to talk
(08:04):
about mine in a lighter way andwe were able to connect on
That's
SPEAKER_02 (08:09):
incredible.
And your work personally is withteenage girls who obviously are
in a school environment.
That's their community.
But what advice would you havefor companies and employers for
a workplace environment?
Because I can see you having animpact and a ripple effect that
(08:30):
far exceeds that of school andhigh school.
SPEAKER_00 (08:35):
A piece of advice
that I would give to any
organization that wants tosupport their employees' mental
health is to build in supportsthat go beyond traditional
mental health resources.
So, you know, having a hotlineor an HR person, you can go
(08:58):
beyond that.
And I know that in my workplace,getting to share my story has
allowed me to just like flourishin a way that I couldn't see
myself doing otherwise.
I'm sure
SPEAKER_02 (09:10):
now that you've been
having such an incredible
impact, so many lives reachedalready, and I know you have
more work to do.
But is there one story inparticular that stands out in
your recent recollection ofsomeone that you worked with or
that you met or you spoke tothat you could see a direct
(09:33):
impact?
Mm-hmm.
SPEAKER_00 (09:34):
Yeah.
So in my work, since moving intothe advocacy space and sharing
my story on a larger level, Ioften will travel and speak to
students at conferences.
And that is my favorite type ofspeaking to do, sharing with the
youth.
And recently I was at aconference in Georgia where and
(09:57):
I was speaking to my story andas they do, you know, youth come
up and chat with me after andask to take pictures and stuff.
But this one little girl came upto me and she said that she was
having a similar experience athome.
She was in probably third gradeand was sharing what was going
on in her home life.
And I was able to connect herwith her teacher and let her
(10:20):
know something was going on.
And going back to the vocabularypiece, having the words to talk
about what you're feeling is so,so important.
And that might have been thefirst time that little girl
heard the words to explain howshe was feeling.
And so she was able to sharewith me that she was going
(10:40):
through some not great stuff athome.
And I was able to connect herwith someone who could get her
further help.
And so I think, again, havingconversations like these and
sharing that story is just so,so important.
SPEAKER_02 (10:53):
You know, the United
States Surgeon General has
called for there to be awarning, almost like a black box
warning on social media forteens due to potential adverse
consequences on their mentalhealth.
What's your opinion on that?
SPEAKER_00 (11:10):
I would say it
wasn't wholly beneficial for me
to have access to social mediawhile going through a mental
health crisis.
Although there are places toaccess resources on social
media, like I said, I used it tofind information, but it can
also be used as a copingmechanism.
I think that oftentimes adultswill think that The big problem
(11:35):
with social media is comparison,but really it's the
disconnecting from real life.
You know, when I'm in my deepestdepression, I would spend hours
scrolling on TikTok, notreaching out to my friends
because I felt like I was in acommunity.
I was on TikTok, but that's nota community.
That is such
SPEAKER_02 (11:54):
an important
perspective on social media that
I think bears repeating.
You know, you're saying it seemslike you're connecting, but
you're actually disconnecting inmany ways in a real interaction,
human interaction manner.
That's very profound.
SPEAKER_00 (12:16):
Yeah, absolutely.
I think the other part of socialmedia is it is a place to find
resources, but we need to makesure they are accessible.
Yeah.
The credibility
SPEAKER_02 (12:36):
absolutely matters
when you're talking about your
health, mental health, physicalhealth, and how you find it
online or how it finds you.
SPEAKER_03 (12:46):
Mm-hmm.
SPEAKER_02 (12:47):
Do you think there's
any area or recent advance in
terms of adolescent mentalhealth that you find
particularly exciting orinteresting?
SPEAKER_00 (12:58):
I would say that a
recent area of development in
the youth mental health space isthe robust inclusion of youth in
this conversation that hasimproved in the past few years.
When I first started beganmental health advocacy, it was
profound for a youth to be inthe room.
(13:20):
And oftentimes it was only onestudent or the same student over
and over again.
But the truth is we needdiversity of thought in these
conversations.
And in the past year or so, I'veseen so many youth like myself
become advocates and beempowered in their story.
And so many celebrities andgovernment agencies are inviting
(13:44):
youth to be a part of theconversation.
And I think that's the wayforward.
SPEAKER_02 (13:50):
Well, I hope they're
listening because I think you're
right.
And you're how old now, Haley?
I am now 24.
24.
Well, you have certainly...
experience and wisdom way beyondyour chronological years.
And I'm just so impressed andinspired by the work you've done
(14:12):
in just the almost quarter of acentury that you've been alive.
I can't wait to see what youcontinue to accomplish.
And I know you are reaching somany teenagers and the adults
that are in their lives.
So I really want to thank youfor your mission and for coming
(14:33):
to share your story with us.
SPEAKER_00 (14:34):
Thank you so much
for
SPEAKER_02 (14:35):
having me.
And to help us unpack everythingwe just heard and to help us
explore what companies andcommunities can do to help
teenage girls in crisis, I'mjoined by two accomplished and
impressive experts.
Dr.
Wendy Klein is a distinguishedprofessor at Purdue University.
Her career focuses on theintersections of women's health,
(14:58):
reproduction, and the history ofmedicine.
Her latest book, Exposed, TheHidden History of the Pelvic
Exam, marks her fourth majorpublication.
And Dr.
Margaret Rutherford is aclinical psychologist with over
30 years of experiencespecializing in treating
individuals as well as couplesfor depression, anxiety, and
(15:19):
relationship issues.
She is the author of PerfectlyHidden Depression, How to Break
Free from the Perfectionism thatMasks Your Depression.
Dr.
Klein, Dr.
Rutherford, thank you so much.
This could not be a moreimportant topic.
You're right.
the mental health crisis facingteenagers and adolescents,
(15:40):
specifically teenage girls.
It's huge,
SPEAKER_04 (15:43):
and it's getting
worse instead of getting better.
Even with very well-intentionedattention to it, it really is
getting worse.
And I think one of the problemsthat some teenagers have is that
they do try to tell adultswhat's going on with them, but
if they look like Haley...
(16:04):
They have the hurdle of, well,you don't look depressed.
I mean, you're fine.
And then if they do havestruggles with, you know,
they're getting more isolative.
I loved her comment aboutdisconnection, but they're
getting more disconnected,getting more isolated.
Their parents may be worriedabout them, but they're often
family dynamics that are goingto keep that child from saying,
(16:27):
no, no, no, you don'tunderstand.
I really, I need some help.
And you mentioned how
SPEAKER_02 (16:32):
they look.
Yeah.
What's seen, what's not seen.
We know appearances can bedeceiving, but is this a
situation in recent history,Wendy, that you think we're just
more on the lookout for it, sowe're detecting cases more, or
is the incidence really goingup, or a combination of both?
(16:55):
That's
SPEAKER_05 (16:56):
a fascinating
question.
When you talk about mentalhealth, it's sort of hard to
know because the languagechanges.
So what behavior looks differentnow?
in one context or problematic inone context could be perfectly
normal in a different one.
So it's hard as historians toalways know, are the numbers
(17:16):
going up or down?
Is this about awareness?
So I'm going to take the...
Combination.
And say there's definitely acombination.
But what's new and different,which I think helps us see it
more clearly is...
About language and storytelling.
And I think Haley perfectlycaptured that, right?
(18:00):
those connections through socialmedia, I think is partly why we
see more of it today.
I'm going to again suggest thatsome of that comes from power
dynamics changing about 50 yearsago, when whose story gets to be
told is expanding dramaticallythrough different rights-based
(18:22):
organizations.
But certainly we can see We havea new mode of expression through
social media that enables that.
SPEAKER_02 (18:32):
I want to ask you
both about something that has
been recently referred to as thegreatest social experiment in
modern history, the COVIDpandemic.
Right.
The impact on teens and thatparticular age group, that
population...
But how do you think that storywill play out in the history
(18:54):
books of the future?
SPEAKER_05 (19:20):
And so there was a
greater awareness that diseases
have a history as a result ofCOVID.
For me, I happened to beteaching the history of medicine
and public health as COVID brokeout.
And so it was almost too much,right?
I mean, students were like, oh,my God, I'm living it.
You don't need to tell me.
But speaking of storytelling,what I ended up doing was I'm
(19:45):
not a therapist, but I had everystudent write about what they
were going through.
And then I would open eachlecture with one of their
stories.
I wouldn't share the name.
And they commented how powerfulthat was because it made them
feel connected because they wereso isolated, right?
They didn't realize that whatthey were experiencing, other
(20:09):
people around them were too.
And so that was my kind ofteaching moment to try to get
them really to Incredible.
Incredible.
SPEAKER_02 (20:36):
What is specific
about that age group that makes
them particularly vulnerable tomental health issues and
stressors, like the pandemic, orit could just be life?
By the way, I believe the
SPEAKER_04 (20:50):
research says that
teenage girls were much more
affected.
They, because of the socialinteraction that they count on
so much, that they're...
College professors or collegecounselors are noting that these
girls are coming out far lessmature than the teenagers that
came into college prior to thepandemic.
(21:11):
So it definitely has had a hugeeffect.
You know, I want to Houts on theword seems because certainly the
kids I have seen, what they seemlike to others, do they seem to
fit in?
Do they seem to be like thesepeople they want to be like?
That is so important to them.
(21:32):
And they will work very hard,whether it's a change of their
clothing or a change of theirhair color or a change of
whatever they can think of, toseem like they fit.
And I do think that that's oneof the factors also.
A lot of teenagers grow up infamilies that the parents do not
(21:52):
allow any kind of painfulemotion to be talked about.
Or they discount it as, oh,you're just an adolescent.
You'll grow out of this.
So, you know, a bit of along-winded question.
I mean, answer to your question,
SPEAKER_02 (22:06):
but...
No, I mean, it's a complicatedissue.
So there's not one easysolution, obviously.
But to talk about...
what people see for a second.
I think also it's important forpeople listening and watching to
understand that the signs ofpsychological distress in a
(22:30):
teenager or adolescent mayoftentimes look very different
from the same issue manifestingin an adult.
So explain...
A little bit about, and with theunderstanding that every
teenager will be different, andthere are some generalizations
between teenagers of differentgenders in terms of how they
(22:54):
tend to manifest mental stress.
But what are some of the uniquemanifestations of distress in
this population, in a teenagepopulation?
SPEAKER_04 (23:05):
What usually happens
when a teenager's
hospitalization or some kind ofcrisis or even tragedy occurs
with a teenager, what you'llhear in the media is they sort
of trot out these, how teenagedepression looks different from
adult depression.
And because there's moreisolation, there's more
(23:26):
conflict, there's more, youknow, they stay at home more or
they quit teams or they dothings like that.
You know, and hey, Haley's awonderful example of something
that I have seen in teenagersand adults, that we are a more
perfectionistic society than weused to be.
We are always comparingourselves to the social media.
(23:48):
And as Haley said, that's notnecessarily the most damaging
part of it.
But I do think that part of therates of perfectionism, and
maybe mom and dad areperfectionistic.
Maybe they want to look like thekind of family that would never
have a problem.
And that can really camouflage.
And Haley did a great job ofdescribing that.
describing exactly what she did.
SPEAKER_03 (24:06):
She
SPEAKER_04 (24:08):
was president of
this, running that.
I got control by making surethat I looked perfect on the
outside.
So I was so delighted to hearher story and that she did have
a counselor that helped herunderstand.
A lot of teenagers are also,they don't have anybody to talk
(24:29):
to about what's happened tothem.
And so they're carrying thataround.
And Right.
I
SPEAKER_05 (24:40):
just assigned Tarana
Burke's memoir, Unbound.
She's the original founder ofthe Me Too movement, and she
talks in there about how she wassexually abused as a
seven-year-old.
Long story short, by the end ofthe book, she realizes her
daughter is sexually abused.
is probably, she sees the signsin her daughter.
For her, so much of herinability to speak out was
(25:04):
shame.
She thought she had donesomething wrong.
She hadn't followed thedirections.
And she couldn't, even when hermother asked her, she couldn't
answer.
So with her daughter, what shedid differently was she gave her
a piece of paper and said, ifthere's something you want to
write down in your safe space,in your privacy, Yeah.
(25:26):
Definitely.
That's right.
Yeah.
What are the other ways,creative ways, to help them open
(25:50):
up when it's so powerfullyembedded, right?
And that shame is part of it,that somehow they're ashamed
they don't want to tell theirmother because they think
they've let their mother down.
So part of it is also justtrying to keep an awareness of
how to do that.
SPEAKER_02 (26:07):
As a professor.
Obviously, you're dealing with avulnerable population.
What have you seen work in anacademic environment and what
have you seen not work?
Anything jump out
SPEAKER_05 (26:19):
at you?
quite a bit.
(26:40):
And so the more I started seeingthem responding positively in a
negative way, right?
They're responding positivelybecause they can identify with
the depression issues, with theabuse issues, and they're
desperate to be able to open upabout them.
And so I'll get readingassignments and basically
(27:01):
confessionals of what they'restruggling with and how poorly,
in many cases, universitysystems are with dealing with
mental health or the wait timeto see someone.
It's just heartbreaking.
This particular topic of sexualabuse, because it's often not
talked about, sometimes theselittle girls aren't aware of
(27:24):
what's going on.
They don't have the language totalk about it.
My research, and I write aboutthe Larry Nassar case and how
many of these young gymnastsdidn't even know because they'd
never had these conversationsthat he was actually violating
them.
So having these kind of criticalconversations and, again,
respecting language and beingcomfortable talking about it
(27:48):
With the awareness that it ishappening and without the
language, we can't really doanything about it.
SPEAKER_02 (27:54):
A lot of the
listeners to this podcast will
be adults with a teenager intheir life in some way.
What would your advice be tothem, both of you, if you are an
adult listening and areconcerned about a teenager's
mental health?
I think it's about
SPEAKER_04 (28:12):
modeling.
I think it's about have youraised your children, reared
your children in an environmentin which you and your partner,
if you have one, actually talkabout your own struggles in an
age-appropriate way, obviously.
But if you are modeling that andif you show, I can talk about my
(28:36):
failures, I can talk about myfears, I can talk about my
struggles, then it grants themso much more permission and sets
the stage for them to say, well,Mom, I need to talk to you about
SPEAKER_02 (28:49):
something or
whatever.
But I've also heard you say,Margaret, that transparency is
important.
So for an adult who's concernedabout a teenager's mental
health, to say, this is whatI've seen.
I'm not an expert in this.
I don't necessarily have all theright answers myself.
But you don't have to go throughthis alone, and I'll help you
(29:11):
find the answers.
I
SPEAKER_04 (29:13):
think that's
wonderful, because it also
addresses this idea that, youknow, well, this couldn't happen
in our family.
You know, not to you and me, andyet it can.
It happens a lot.
And so that really...
gives the parent and child theopportunity to say, this is
(29:34):
about us.
This isn't about what we looklike to everybody else.
It's like, or what ourgrandparents might think about
it or an aunt and uncle or achurch or whatever.
This is between you and me.
And I
SPEAKER_02 (29:47):
want to tune in to
you.
there's also a lot of blame.
We somehow feel like when webecome parents, we should be up
to speed immediately and make nomistakes and always do it
perfectly.
And so if you have a child inyour life or a teenager that
you're responsible for who'sstruggling, it's so easy to feel
(30:07):
like you in some way contributedto that by failure or by a
mistake or by an action.
And I would say, as the motherof a 25- and 26-year-old, try to
be kind with yourself.
And as my mother, who's aretired nurse, used to say all
(30:28):
the time, you know, you didn'tcome with an owner's manual.
And when you were 16, I hadnever had a 16-year-old before.
When you were 17, I had neverhad a 17-year-old before.
And I think we can do ourselveswell to remember that.
I also think, however, when youcan, say,
SPEAKER_04 (30:45):
I didn't do this
very well.
That you talk to your teenagerabout it.
I really didn't do this verywell.
You know, I went through thatperiod of time where I drank too
much or when me and dad or meand mom got divorced, I was
really angry and I talked abouthim or her all the time.
You're right, that's soimportant.
(31:06):
And so just say, yes, it's likethis is what
SPEAKER_02 (31:08):
I didn't do very
well.
Yeah.
I can't thank you enough forhaving this important
discussion.
I know that it helped peopledirectly impact people's lives.
Thank you.
It's an honor.
Thank you.
And if you or someone you knowis struggling with thoughts of
self-harm or suicide, pleaseknow that help is available.
(31:29):
Reach out to the Suicide andCrisis Lifeline by dialing 988
or visit 988lifeline.org.
You are not alone andprofessional support is just a
call, click, or text away.
And thank you to our listeners.
We hope this podcast has helpedyou and your loved ones feel
seen and empowered.
(31:51):
If you found it valuable, pleasedon't forget to share it, like
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