In the wake of rising anxiety and depression among children and families, Little Otter’s Co-Founder and Chief Medical & Scientific Officer, Dr. Helen Egger, dives deep into the root causes and lasting impacts of this crisis. From the upheaval of COVID-19 lockdowns to increased social media use and economic instability, Dr. Egger shares her insights on how these forces have converged to intensify mental health issues across generations. This Q&A explores the pandemic's lasting effects and the steps we can take to support children, families, and communities moving forward.

What's your main takeaway from this data? What caused anxiety and depression to surge between 2019 and 2022? 

The findings of this study are deeply concerning but, unfortunately, not surprising. We were already in the midst of a mental health crisis, particularly affecting children and adolescents, before the pandemic began. Now, with data showing a marked rise in anxiety and depression from 2019 to 2022, we see the toll of the pandemic period and its aftermath.

The pandemic disrupted daily life on an unprecedented scale, impacting children and families across the country. Children have faced worries about academic setbacks, the challenges of social reintegration, and lingering anxieties after extended time at home. Parents, too, have dealt with economic uncertainty, the trauma of loss, and illness. This period of upheaval can be seen as a collective trauma, affecting mental health across all ages.

It’s also essential to recognize that parental anxiety significantly affects children’s well-being. When parents struggle with anxiety, children can experience increased levels of stress and worry. Addressing children’s mental health means supporting parents as well. Without intervention, these challenges risk becoming lifelong mental health issues that carry through childhood and into adulthood.

To what extent did COVID lockdowns play a role, especially among young people? What else may have caused the increase? 

COVID lockdowns were a significant part of the pandemic’s impact, but the broader effects of COVID went far beyond the lockdown period. The pandemic introduced layers of stress and uncertainty that touched every part of life, and for young people, this took an especially heavy toll. Many children and adolescents experienced disruptions in daily routines, schooling, and social interactions. They lost out on key developmental experiences — from bonding with friends and mentors to learning how to navigate group settings — leaving gaps in social, emotional, and even academic growth.

Beyond lockdowns, economic instability, fear of illness, and the loss of loved ones created an environment of sustained stress for families. Children, who often pick up on their parents’ anxieties, may have experienced a heightened sense of insecurity during this period. Additionally, racial, geographic, and socioeconomic disparities in access to resources intensified these impacts for some families, making it even harder for certain children to access support when they needed it most.

Lockdowns, while difficult, were only one chapter in a larger story. For many young people, the cumulative effects of the pandemic have created a lingering sense of anxiety and disrupted well-being. Our task now is to acknowledge this impact and offer consistent, empathetic support to help them process these experiences and to identify and treat mental health challenges as early and effectively as possible.

How might increased social media use among young people have added to the problem? 

Increased social media use among young people during the pandemic amplified pre-existing vulnerabilities and created new challenges. Social media became a primary outlet for connection when in-person interactions were limited. However, while it offered a means to stay in touch, it also exposed young people to a steady stream of stressful content and often left them feeling even more isolated. The constant exposure to carefully curated images and narratives on social media can distort reality, making young people more vulnerable to feelings of inadequacy, loneliness, and anxiety. This effect is heightened in adolescence, a period when self-identity is still forming and social comparison is common

Additionally, social media algorithms are designed to capture and hold attention, which can lead to prolonged, passive consumption of content. This “doom scrolling” behavior—endlessly scrolling through troubling news, negative posts, or crisis updates—contributed to a pervasive sense of fear and hopelessness. For many, the isolation of the pandemic made it harder to break free from these online spaces, and prolonged screen time often disrupted healthy habits like sleep, physical activity, and real-world social engagement.

The intensity of these digital interactions and the lack of balance with offline experiences may have hindered the development of essential social skills and coping mechanisms, creating further emotional strain. As we emerge from the pandemic, it’s important to help young people develop healthier relationships with social media, encouraging them to build connections in person and engage in activities that promote resilience and emotional well-being. Social media can be a valuable tool, but only if we help young people navigate it with greater awareness and support.

 What does this report tell us about the state of US mental health coming out of the pandemic, and what should be done? 

This report underscores the urgent need to address the mental health crisis in America, for everyone from young children to adults. At Little Otter Health, we know that mental health challenges emerging today aren’t confined to teens and adults; they start in early childhood and often go unrecognized. We also know that we have to identify mental health challenges and provide care for every member of the family because the mental health of children and adults are intertwined. 

Early intervention can make an enormous difference in a child’s development. To truly address this crisis, we must begin mental health screenings in early childhood, equip caregivers with resources and services about their children’s mental health and their own mental health, and foster mental health literacy among parents, teachers, and pediatricians. At Little Otter, we’re focused on empowering families to recognize early signs of distress, teaching them evidence-based tools to support their child’s mental health, and connecting them to specialized care as needed, within a whole family model that takes care of everyone in the family.

This report also highlights the need for systemic changes in how we approach mental health. Schools and pediatric practices should incorporate regular mental health screenings that begin in early childhood to catch issues before they escalate. Accessible mental health resources in communities are essential, especially as families continue to face economic and social pressures in the pandemic’s wake.

Ultimately, I believe mental health care should be as routine and accessible as physical health care. With early screening, comprehensive support, and public awareness, we can help families nurture their children’s and their own mental health and well-being, ensuring that this generation can emerge from the pandemic with the tools they need to thrive.

How might pandemic restrictions be handled differently in the future to mitigate some of these issues?

Future public health responses should balance restrictions with an emphasis on mental health support for children, teens, and families. Restrictions were necessary, but they also revealed the importance of concurrent mental health support and care.

In any future pandemic response, we should prioritize mental health screenings and offer robust support resources in homes, schools, and communities. This will mean providing ongoing mental health resources, integrating early screenings, and effective evidence-based care. With better awareness and support structures in place, we can protect children’s mental health and reduce the long-term impacts of such crises.