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Over the past decade or two, seasoned therapists who treat young people have been seeing some increasingly worrisome trends. Although solid statistics are hard to come by, one indication of a surge in troubled young adults comes from the reports of college mental health services. A 2010 survey by the Higher Education Research Institute (HERI) at the University of California, Los Angeles of almost 202,000 incoming college freshmen at 279 colleges and universities showed a shocking decline in self-reported mental and emotional well-being-at its lowest level since 1985, when HERI began conducting the surveys. In this recent survey, the percentage of students who rated their emotional health “above average” fell from 64 percent in 1985 to 52 percent. According to the June 2013 APA Monitor, 95 percent of surveyed college counseling-center directors said that the number of students with “significant psychological problems is a growing concern,” citing anxiety, depression, and relationship issues as the main problems. Another 2013 survey, the American College Health Association-National College Health Assessment, reported that 51 percent of 123,078 responders in 153 US colleges had experienced “overwhelming anxiety” during the previous year, 31.3 percent had experienced depression so severe it was difficult to function, and 7.4 percent had seriously considered suicide.

I regularly speak with tens of thousands of child professionals, parents, educators, and kids across the country, and as chair of a large nonprofit psychotherapy training and treatment agency, I compare notes with the directors of other centers as well. These extensive dialogues, though not as formal a means of data collection as the surveys above, allow me to see trends emerging just under the radar-the current one being a wave of intense anxiety and affective disorders sweeping through agencies and schools across the country, reaching deep down into elementary and even preschool. Of course, teens and young adults have always been vulnerable to the onset of serious mental illness, but these days they seem to suffer from a new kind of emotional fragility. It’s as if at a core level, their fundamental security, the very ground of their psychic being, is increasingly shaky and unreliable.

Many of these clients come into therapy initially giving few hints of standing on the edge of a deep chasm with the wind at their backs. But as treatment proceeds, we begin to hear about a range of troubling behavioral patterns that are now pretty standard: anxiety-fueled ruminations once considered to be in the realm of psychotic process, binge drinking as a regular social pastime several nights a week, even more over-the-top and exotic substance use on weekends (ketamine, molly, Xanax bars, increased-THC marijuana), random and unprotected hookups that may well include near asphyxiation-induced orgasms. We hear reports of ubiquitous cutting and growing numbers of young men who not only cut themselves, but fiercely and compulsively punch themselves. Almost all describe chronic sleep-wake reversals, up until 4 or 5 a.m. most nights. And while they may be foodies of sorts, they forget regular meals, engaging in catch-as-catch-can eating while in the midst of all-nighters watching every episode of every season of Breaking Bad, one after another.