Teens Unhappy with Their Looks Risk Adult Depression

During adolescence, teens are sometimes self-conscious about their bodies. But being truly unhappy about their looks raises their risk of adult depression.

It’s sometimes called the awkward years — the time when adolescents’ bodies go through multiple changes as they move from childhood to young adulthood. Teens can be a bit self-conscious and concerned about their height, skin, weight, or countless other physical changes they note.

In fact, over 60 percent of adolescents worldwide express dissatisfaction with the way they look, according to researchers from the University of the West of England and the UK Medical Research Council, who are studying the problem.

However, if teens’ negative appraisal of their appearance (which doctors call “body dissatisfaction”) is chronic, this self-critical attitude may result in eating disorders and other unhealthy behaviors during adolescence. Now a large study by the UK research team has found unhappiness with physical looks as a teen significantly raises the risk of depression when a boy or girl reaches young adulthood.

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Worries about appearance in teen years raise later depression risk

The British research team zeroed in on young people who are Millennials (the population group defined as being born between l981 and l997) and have grown up during a time when social media became a pervasive part of their lives.

The researchers used information from about 4,000 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based long-term tracking study of children born between l991 and l992 (placing the youngsters in the Millennial age group) in Somerset, England.

At age 14, 1,675 of the boys and 2,078 of the girls who were research subjects in the ALSPAC project were asked to rate if they were satisfied with their looks. On a five-point scale, with five being “extremely satisfied“ and zero meaning “extremely dissatisfied,” the youngsters rated their physiques and specific parts of their bodies — from stomach, waist, breasts, and legs to face and hair.

The girls and boys were only mildly satisfied with their physical appearance, and the girls had more complaints than the boys. Girls tended to dislike their weight, stomach, and thighs but were mostly pleased with their hair and hips. Boys, on the other hand, were primarily dissatisfied with their stomach, hips, and overall body build — but weren’t particularly interested in their hair, legs, or weight. Almost a third of the girls were upset about how much they weighed, while 14 percent of the boys had that complaint.

When the same group of youngsters reached age 18, the researchers used a formal psychological assessment to look for symptoms of depression — and they found a strong association between how critical the research subjects were about their looks at 14 and the frequency of episodes of depression, some severe, they experienced as they entered young adulthood.

The results of the study, published in the Journal of Epidemiology & Community Health Analysis, revealed that body dissatisfaction at age 14 predicted significant increases in depressive episodes of all degrees of severity among the girls, and both mild and, especially, very severe depressive episodes among the boys by the time they were 18 years old.

The results suggest it isn’t only females who are influenced by non-realistic perceptions of attractiveness often promoted by social media.

"It is possible that in the era of social media and increasing pressures on body ideals, male adolescents have also become sensitive to idealized body image pressures, which may translate into later depressive episodes," the research team concluded.

The link between body dissatisfaction and increased depression

In a paper published in JAMA Facial Plastic Surgery, Boston Medical Center (BMC) researchers noted photo-editing is now so widespread in social media that manipulated images have become the norm — and that can harm self-esteem and trigger body dysmorphic disorder if people, including teens, think these pictures are how they are supposed to look.

Body dysmorphic disorder (BDD) is a mental health problem marked by a person being fixated and anxious about one or more perceived physical defects or flaws they think they have, despite the flaw being minor or not even noticed by anyone else.

The BMC researchers noted teenage girls who are worried about their physical image often manipulate their own social media photos because they are seeking approval.

"A new phenomenon called 'Snapchat dysmorphia' has popped up, where patients are seeking surgery to help them appear like the filtered versions of themselves," said Neelam Vashi, MD, director of the Ethnic Skin Center at BMC and professor of dermatology at the Boston University School of Medicine. "Filtered selfies can make people lose touch with reality, creating the expectation that we are supposed to look perfectly primped all the time.”

This can be especially harmful for teens and those with BDD, she added. Vashi and colleagues recommend psychological help such as cognitive behavioral therapy for BDD and note that it is important for doctors to understand the implications of social media on body image so they can better treat and counsel patients.\

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