The pediatricians of Palo Alto Medical Foundation are deeply saddened by the local recent events. The loss of a young person's life is always a tragedy but especially so when preventable. As a medical group and a community we must ask ourselves what we can do differently.
Although many teens in the area are doing well, many are not. Each day in the office we see students who are stressed, anxious and depressed. Depression is a significant factor in teen suicide. But what is causing the depression? What are the factors putting our youth at such high risk?
While we are not education specialists, as pediatricians we do recognize dangerously unhealthy lifestyle patterns and habits that are known to exacerbate stress, anxiety, depression and physical illness. These include chronic sleep deprivation, lack of unscheduled time for thought and relaxation, unhealthy eating habits, lack of exercise and unrealistic pressures (real or perceived) to achieve. Those unrealistic pressures include excessive homework, overly ambitious course loads and a seeming demand for perfection in grades, sports and extracurricular activities.
We see these problems day after day in our teen patients. We believe there are specific factors that could be targeted for change.
Sleep: Surveys have shown that Palo Alto teens sleep an average of six and a half hours per night. Studies have shown that teens need nine hours of sleep to function at their best. Inadequate sleep has a strong correlation with mood disorders, poor cognitive retention and increased distractibility. Later school start times are recommended by the American Academy of Pediatrics.
Electronics: Excessive screen time contributes to inefficient time management. Constant interruptions make it virtually impossible to finish homework in a timely fashion. Excessive screen time also plays a role in unhealthy sleep habits. Teenagers should shut off electronics at least 30 minutes before bed to ready their brains and bodies for sleep. Too many teens go to bed with their tablets or phones and would be better served by an old-fashioned alarm clock. Parents should enforce and protect an electronic-free bedroom for their children.
Academic pressure: Some ideas have been proposed to decrease stress at the school level. The district homework policy, which limits the amount of homework each night, should include honors and AP classes. In addition, many schools limit the number of AP classes a student takes during the high school years. Having more non-traditional course offerings, which allow students to pursue their interests, could encourage creativity and enhance the school experience. Limiting the time commitment of sports teams, both at school and at the club level, should be included in this discussion. Finally, mindfulness classes in schools may help students better manage stress. However, in an ideal world, we would first try to address the causes of the stress rather than creating classes to help our teens cope with these escalating levels of stress.
Home and family: The stress level at home and the role of parents should also be evaluated. We recommend that families find ways to protect family time and create opportunities for rest and leisure for their teenagers. We also encourage parents to strive to keep their expectations for their children realistic and healthy. Ideally, discussions of plans after high school should include a variety of options. For the college-bound students, the wealth of excellent universities in this country should be emphasized, rather than narrowing the focus to a few of the elite.
How can we as families, schools and as a community support our teens? Clearly, we must listen. We must provide hope, acceptance and encouragement. Overall, we must take a hard look at our goals as a society. Our culture is focused on achievement, but studies have shown that long-term happiness comes from giving, from meaningful relationships and from purposeful work. Modeling these priorities as adults can help shape our youth's values.
It is a very challenging time. In this area known for innovation, surely we can work together to make positive changes for our teens. Let us appreciate and celebrate them as individuals and collectively. They are our future, so let us help them get there.
This piece was written and endorsed by the Palo Alto Department of Pediatrics at the Palo Alto Medical Foundation, which consists of the following physicians:
Cara Barone, M.D.
Rebecca Benton, M.D., MPH
Mary Ann Carmack, M.D., Ph.D.
Ross E. DeHovitz, M.D.
Harry L.E. Dennis, M.D.
Erika Drazan, M.D.
Charlotte Drew, M.D.
Robin Drucker, M.D.
Allen Eskenazi, M.D.
Kellen Glinder, M.D.
Erica L. Goldman, M.D.
Richard Greene, M.D.
Amy M. Heneghan, M.D.
Pamela Ison, M.D.
Kimberly Jones, M.D.
Stephanie Lai, M.D.
Frederick (Rick) A. Lloyd, M.D.
Kelly A. Look, M.D.
Tina McAdoo, M.D.
Linda Strain, M.D.