February 18, 2021, 6:33 pm | Read time: 6 minutes

Anxiety, eating disorders, depression: Since the start of the coronavirus pandemic, more children and adolescents in Berlin are being treated in psychiatric clinics. This is according to a special analysis by the DAK health insurance company, which was made available to the German Press Agency.

In the capital alone, psychiatric admissions of young people nearly doubled in the first half of 2020. And it’s not just here that admissions are rising. “It’s a huge topic among colleagues,” says child psychiatrist Martin Holtmann, a board member of the German Depression Aid Foundation. Many wards are full this winter, and consultations are overflowing.

Just the Tip of the Iceberg

“Clinic admissions are the tip of the iceberg. If they increase, you can assume: Whoa, something’s happening,” says Christoph Correll, director of the Clinic for Child and Adolescent Psychiatry at the Charité Campus Virchow. The clinic is often the last resort. “You don’t go there for a minor mood disorder; you have to be really sick,” adds Holtmann, medical director of the LWL University Clinic in Hamm, North Rhine-Westphalia.

Also of interest: How to tell if the coronavirus crisis is overwhelming you mentally?

Increase Rate of 84 Percent in Psychiatry

The DAK figures are based on anonymized data from about 38,000 Berlin children and adolescents, according to the insurer. In the first half of 2019, 22 young people up to 17 years old were treated in clinic psychiatry for depressive episodes. In the first six months of 2020, there were 39. That doesn’t seem like much. However, in 2020, only 928 Berlin children and teenagers insured by DAK were admitted to a clinic at all during this period. The 84 percent increase in psychiatry is therefore seen by DAK state chief Volker Röttsches as a “worrying development.”

Charité medical professor Correll lists what is more common in his clinic than before the pandemic: “Very thin girls with eating disorders, even thinner than before,” he says. “Probably because teachers, friends, or pediatricians are missing as corrective influences.” He also notices more self-harm as a destructive coping strategy.

Open Letter to the Federal Government

“I believe in very few cases did the coronavirus or the lockdown cause depression,” Holtmann judges. “But they lowered the threshold for people who were already on the verge of a mental illness.” Last week, Julia Asbrand, a psychologist and researcher at Berlin’s Humboldt University, sent an open letter to the federal government on behalf of many colleagues. Nationwide, child and adolescent psychiatrists and psychotherapists are seeing more aggression, sleep disorders, school anxiety, eating disorders, depression, and drug abuse among young people, it said. It also concerns suicidality and experiences of violence in the home.

“What we hear from Berlin and all over Germany is an increase in crisis admissions,” says Asbrand. A clear, causal conclusion is not yet possible because a representative data basis is lacking. “We would need figures from all health insurance companies to get a good picture.” However, there is a lot to suggest that it is related to the pandemic.

More Stress, More Loneliness, and More Anger

“People are social beings who don’t just function within the nuclear family,” says Asbrand. For adolescents, this is a major issue. “Their task and goal is to differentiate themselves, to go out of the family and seek other contacts. And that’s precisely what’s not possible right now.” The psychologist also observes a new form of boredom among teenagers. “In the sense of listlessness. Like a depressive symptom,” says the professor.

For physician Correll, teenagers are also very dependent on school, friends, and family. “These are their three important areas of life. If something goes wrong there or is no longer available for balance, their own system can start to falter.” Charité is participating in a large international study on mental health during the pandemic (Coh-Fit). About 10,000 people in Germany have already been surveyed for this, including experiences of violence, the doctor reports. The analysis for children and adolescents is still ongoing. What has emerged so far for adults: About 30 percent felt higher stress levels, more loneliness, and more anger.

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Also More Depression Among Young People

Depression among young people existed even before the coronavirus, emphasizes medical professor Holtmann. The German Depression Aid Foundation estimates the rate of illness between 12 and 17 years at three to ten percent. But this proportion has increased during the pandemic. A person with mild depression needs a daily structure, distraction, pleasant activities, and contacts. But that’s precisely what’s been missing during the pandemic. “What you need outside for therapy is not available right now,” the doctor explains. It’s as if therapists have had their tools taken away. And then their patients sink deeper.

Charité doctor Correll sees another factor: During the first lockdown, the use of outpatient and inpatient services decreased somewhat, he reports. “Patients and families waited, also out of concern about infections. Delayed help-seeking or interruption of ongoing treatment can exacerbate mental illnesses.”

Also of interest: How to recognize depression

Stress-Buffering Factors Must Be Activated

In Holtmann’s clinic, medication is not the main focus in treating young people. “We try to do what is missing outside, now with us,” he reports. “The crazy thing is that we as a clinic can currently offer more than the normal environment: gyms, classes, group meetings on our premises.”

He also sees more people with eating disorders. But it wasn’t the coronavirus that caused anorexia. “Rather, the coronavirus conditions have led to a mild tendency becoming a full-blown condition.”

Also of interest: What is resilience–and how can I strengthen it?

There are many stress- and illness-promoting factors that are amplified by the pandemic and interact, says Correll. But there are also stress- and illness-buffering factors that can be activated or strengthened. “To help children and adolescents, parents, and family systems that are currently under a lot of pressure, to get out of it.” A prescription? “Contact with others, even over the internet, exercise, and a clear daily structure, even from home.”