Listening to my patient, it was a question about an unpredictable future that seemed most salient in her suicidal ruminations. This girl, who I will call by her first initial, B., to protect her privacy, spoke passionately about climate change, about racism and inequality, about all the “mental health” issues of her friends who were on this medication and that medication, and had eating disorders, attention disorders, self-harming behaviors and depression. Her burgeoning sexuality was also greeted as a threat — how can I be a sexual woman in this environment? Yes, the pandemic exacerbated a groundless feeling, but the way adolescents investigate their world for its failings means they touch an open wound in this country: What happens when we realize the escalator — so crucial to the American dream — didn’t go anywhere (and maybe never really worked, at least not for many)?

B. also spoke to the contradictions of her parents, who seemed unhappy in their work, in their role as parents, in the privileges accorded to them, along with those denied to them, and were enraged by the political environment on all sides. Yet, she proclaimed, they were pushing their daughters toward the same kinds of achievements and the same lifestyle, and any sign of negative emotion from their children was seen as an attack, as if they were pointing out that the life they were given wasn’t any good, when the reality of everything these parents said pointed to the fact that, well, life wasn’t so good. Why, she proclaimed, would she want any of this, and why do they want her to pretend as if she wants it? “They don’t even pretend they want it, really!” she exclaimed.

On first glance, this feels like your age-old adolescent trying to define a personal space away from their parents’ values, attentive to the hypocrisies of any family, and time and place. What felt new was how quickly this became a fantasy of withdrawal, as if she couldn’t sustain a sense of self or place. B. wants to move to the countryside and raise dogs: “beautiful, innocent, fluffy dogs, just like mine!” She doesn’t want to work, or make money, or have children, or be with anyone really.

While she took on the sweet air of a much younger child, it didn’t take much to hear the depression. Many adolescents I see immediately want to exit the world stage, as if all options are already on the table, played-out, disenchanted, and the only choice is to disappear, or take medicine, get famous, detach — other versions of disappearing, suicide being the most extreme.

Article after article shows us that America’s teenagers aren’t doing well, without putting their finger on what is wrong beyond issues of individual “mental illness” and the usual bugbears trotted out — social media, video games, the weakening of the family unit. But what are the teenagers telling us is wrong? We seem to have forgotten that adolescents are lightning rods for the zeitgeist. They live at the fault lines of a culture, exposing our weak spots, showing the available array of solutions and insolubilities. They are holding up a mirror for us to see ourselves more clearly.

Mmmm... I wonder what could it be.