Teenagers graduating from high school this summer have struggled to stay motivated as COVID-19's extended school closures and online classes stifle social interaction at a pivotal time between adolescence and adulthood.

“Y'all there's 6 weeks left and IDK HOW I'M GONNA GET THROUGH IT,” Isabella Tao, a Grade 12 student at the Dr. Norman Bethune Collegiate Institute in Toronto, exclaimed at the start of a recent Reddit post seeking tips on staying tuned in after she accepted a spot in McMaster University’s kinesiology program.

Tao said her interest dropped sharply in this last quadmester — a half-semester in which students take two subjects instead of four — in Zoom calls, schoolwork and even the exercise that was keeping her active, or the video games and baking she used to enjoy.

“My typical day is pretty much just me attending online classes, doing my work, eating when I need to and going on my phone,” she later told Canada's National Observer. “I don't do much else anymore, including the things I usually find fun.”

With six weeks of mostly virtual classes left, some of this year’s graduating class has accepted university and college placements and hit a wall, while others fret about dwindling options. Many are recovering from the collective trauma of the pandemic and the social isolation that came with virtual school and stay-at-home orders.

"Social isolation is a huge stressor for everyone during the pandemic," said Mary Bartram, the director for mental health and substance use at the Mental Health Commission of Canada (MHCC), noting it and financial stress top most surveys of pandemic mental health concerns. "But it is really heartbreaking in high school age and early university age young people.

"Those are our peak years for socializing, and developmentally, that's what we're supposed to be doing at that age: learning about ourselves and the world," she added.

Almost half of the young people who took part in a recent MHCC study reported feeling isolated and lonely as a challenge, while a third of respondents were struggling to deal with in-person school closures and the move to remote learning.

The harmful effect COVID-19 has had on this class of 2021 will likely take years to be adequately measured (so far, existing research only tracks until around July last year). But discussions on online forums such as Reddit hint at the challenges young students face as they prepare for graduation and a new chapter in life amid the ongoing public health crisis, and clinical evidence is also emerging.

“My typical day is pretty much just me attending online classes, doing my work, eating when I need to, and going on my phone,” says Isabella Tao. “I don't do much else anymore, including the things I usually find fun.” #COVID19 #MentalHealth #Teens

"There is a huge increase in mental health presentations in my area, which is eating disorders," said Monique Jericho, a clinical lecturer at the University of Calgary's department of psychiatry and head of the Alberta Health Services' eating disorder program. "Overall, there is a huge increase in presentations to the emergency department for mental health concerns in youth.

"This is a much larger story than people may realize," she added. "Ask anyone working in child and adolescent mental health, and they will tell you that this is a crisis."

Jericho's University of Calgary colleague, Dr. April Elliott, said there has been a national rise in anorexia nervosa diagnoses among young people since the start of the pandemic.

The Alberta Children's Hospital received nine acute eating disorder presentations in the four months between June and September 2019, a figure that jumped to 23 in 2020, Elliott and Jericho pointed out in a recent presentation to help health-care providers support younger patients.

Anecdotally, Elliott said, common triggers for these diagnoses include social isolation, school closures, the reduction of sports and other extracurricular activities, lack of routine, fat-phobic social media messaging, and disrupted health-care service delivery.

The MHCC study also found almost one in 10 young people were having a hard time finding mental health and other health-related support.

“The scariest part of it all was when I lost my sense of feeling,” said Juhi, a Grade 12 student in the York Region District School Board, describing a depressive episode she experienced earlier this year. “The hobbies I used to love suddenly felt boring, the food I used to eat tasted bland, the schoolwork I used to get stressed by didn't even affect me anymore.”

Juhi only wanted her first name used because her South Asian family considers discussing mental health taboo and she feared any hint of anxiety on her health record might hurt her professional prospects.

“When it comes to mental health, I'm kind of handcuffed,” she said. “I've had anxiety my entire life, however, due to a multitude of reasons, have not been able to receive help for it.”

One in five young people in Ontario will experience mental health difficulties before reaching adulthood, the Canadian Mental Health Association estimates, with only a third able to get help.

Elliott said being able to safely reopen schools and restarting outdoor activities would go a long way to offsetting the worst of these effects and get adolescent development back on track.

"Children and youth need to be back in school and be able to have these milestones in person," she said. "The mitigation responses need to be specific and nuanced. The one-size-fits-all (approach) at this point in the pandemic has damaged the well-being of our youth," she added, noting there is no evidence that measures to limit outdoor sports and other activities actually decrease spread. "What it has done, however, is dramatically increase learning, development and mental health problems at all ages."

Without access to social interaction, this cohort is finding it more difficult to complete the developmental tasks of adolescence, they say, which include declaring autonomy from parents, meaningful social and peer relationships, seeking vocational goals and forming an identity and value system, many of which rely on social exposure, comparison and time with peers.

"As best as possible, teens needs access to each other, to activities that are meaningful to them, and to opportunities to contribute in the world," Jericho said. "Teens are wired to explore and take risks; they are wired to have more interest in relationships and to be discovering who they are and what their passions are. The pandemic restrictions have challenged all of these critical aspects of teen need that are developmentally really important."

Juhi said a wave of sadness affects her for two weeks after each new school closure, along with the other limitations imposed over the past 15 months. But she and her friends have also more recently developed new ways to hang out, coming up with "most likely to" quizzes and revealing them in group video calls, and putting on presentation nights on random topics such as which rom-com each of them personifies.

“I'm big on fitness, so I've been taking the extra time to learn more about nutrition and begin weight training,” she added, something she’d been uncomfortable trying before. “I also meditate and do yoga to help with my posture, since COVID has made me very stiff.”

Morgan Sharp / Local Journalism Initiative / Canada’s National Observer