The number of teenagers reporting severe anxiety in Ireland has doubled since 2012 according to My World Survey 2 - the largest ever study of Ireland's youth mental health, conducted by UCD School of Psychology and the Jigsaw charity.
he survey was carried among 19,000 adolescents and young adults and shows that both males and females are generally more anxious, more depressed, less optimistic and less resilient, with lower self-esteem, than they were seven years ago when the first My World survey was carried out.
That is grim reading. What the report also shows is that, in the adolescent portion of the research, there is a gap between the sexes.
Adolescent girls score significantly lower than boys in crucial areas such as self-esteem and personal competence, with smaller but still noticeable gaps in optimism and satisfaction with life. In addition, girls are less likely to use problem-solving as a coping mechanism, and more likely to use avoidance techniques - something that correlates to poorer mental health.
Resilience - something parents have been trying to foster in their kids for years now - is lower in girls and declines significantly as they progress through secondary school, from first year to sixth year.
It looks as though, after a decade or more of public soul-searching around how to improve self-confidence and self-worth in girls, we aren't yet succeeding.
The results are no surprise to Professor Barbara Dooley, UCD lead researcher, who points out that the report is consistent with international findings.
"If you look at data internationally, you will see gender differences; Ireland is not lagging behind in this regard".
Or to Dr Gillian O'Brien, chief clinical officer at Jigsaw, who says: "We weren't surprised by those findings, because females are still proportionally much more likely to access help through our services than males. Typically the breakdown is 60:40, and that's pretty consistent since we've opened. The peak age of young people coming to Jigsaw is 16/17, which again corresponds with the survey."
Social media, that obvious bug-bear, has a role to play, but is not the definitive villain of the piece. Of the young women who access Jigsaw services, Dr O'Brien says "when it comes to self-esteem and body esteem, we know that young females are spending more time on social media than young males, and we find that a lot of young women who come in to us are really caught up in this negative comparison with idealised versions they see online.
"But we also see that a lot of anxiety in young women is related to school and the desire to do well, to achieve. An awful lot of them are achieving, but they have very high standards. They are very self-critical. It's good to want to achieve, but we try to help them gain some perspective, to pick apart the expectations they have."
School in general can be a great source of anxiety, and some of this is around the social dynamics of girls.
"A lot of the young women we see coming to Jigsaw have issues related to school and peers," says Dr O'Brien. "There are lots of unwritten, unspoken rules that govern female friendship, and this makes it particularly confusing. Male peer groups tend to operate differently. The many swift changes in female friendship underscore feelings of not being safe and secure in school. We see a lot of young women who are upset by being excluded, isolated. You can imagine how that would influence your self-esteem."
However, as always, the picture close up is more complicated than at first glance. Prof Dooley says: "Gender is extremely complex. You could argue that boys over-estimate their sense of self-confidence and self-esteem, and that girls are more realistic." Everything, she points out, "is a balancing act. If you over-puff-up your adolescent and tell them they are fantastic, when in reality they are good but not fantastic, at a later stage this may backfire when they encounter something they thought they could achieve, and actually they can't."
When it comes to resilience, "both males and females scored above the average," says Prof Dooley, "so it's not like resilience is shockingly low, although males are certainly ahead of females."
Girls, says Dr O'Brien, "are more self-critical. They are less likely to recognise their strengths. A lot of young women we meet, when we dig a little deeper actually do have good resilience, but they may not recognise it. It's about trying to help them identify the things they are already doing to cope well."
The point here is not to prioritise girls' mental health over boys. Dr O'Brien points out: "There are two ways you could spin this - on the one hand, young females are still experiencing high levels of anxiety, depression, self-harm and low self-esteem. But they are coming forward for help, and that's a positive thing. Young men are less forthcoming. I'm always most concerned about the young people who don't reach out for help."
However, neither should we ignore the gap, or the very real difficulties that lie behind the statistics.
For 19-year-old Rachel White, part of the Jigsaw youth advisory panel, transition from primary to secondary school was difficult.
"I went to a very small primary school where we all played together. I didn't have to wonder who my friends were. Then, in secondary, there were so many more people, and they broke down into smaller groups. It was hard to feel that I fit in with any particular group of girls," she says.
"It was a co-ed school, and the guys seemed to have one big group - at lunch they all sat together at one big table, while the girls split into smaller groups of fours and fives. I'd have loved to be a guy growing up.
"I drifted between friend groups a lot. I was on the edge of a lot of groups: you get the seat over at the side, you're not really fully accepted. I was always shy, awkward, nervous, anxious. I was finding myself, through secondary school and I had a tough enough time trying to figure out where I fit in. I wasn't exactly being bullied - it's a lot more subtle with girls. Nothing is straight out there. Girls bond over excluding."
And, she points out, "girls can be really petty. There was so much drama. How they talked was very bitchy, and I couldn't get my head around that. A lot of the time that's how girls bond - by bringing other girls down.
"I've seen girls pull up some other girl's Instagram and scroll through the photos and just pull them all apart. Being around that, you start to think 'what are they saying about me?' Or you start doing the same thing to yourself. If you hear them going off on a girl, saying 'she's really fat', and you look at yourself and think, 'I'm bigger than that…'. I was definitely lacking self-esteem."
Life settled down briefly for Rachel after TY. "In fifth year I became friends with two girls, who are still friends now." But in her last two years, Rachel experienced more significant bullying. "It was so widespread, it became everyone's business."
When she left school, Rachel deleted her Instagram "so I wouldn't have anyone from school on it, and made a new one, so I don't feel anxious looking at it." Now in college, Rachel's life has transformed.
"I'm so happy," she says. "I love college, it's brilliant. I've settled in and made friends. I'm actually a really social person, and that feeling, when you chat to someone, and they chat back, it raises your self-esteem. You think 'maybe I am worth talking to'. You meet new people, who see you in a new way. That has helped me see myself as being worth more."
What can parents do?
⬤ If you notice something that bothers you, try to open the lines of communication around that.
Dr O'Brien says: "The number of parents who contact us and say 'I'm really worried about my daughter' and we say 'have you spoken to her about it?'… the answer so often is 'no,' because they worry about making it worse.
"But you know your daughter better than anyone. Create an environment where you can have a conversation. Pick your moment and say things like 'I notice you seem upset…' 'I think you haven't been yourself later…'
⬤ "If it doesn't go well, come back to it another time. It takes a lot of courage for a young person to tell their parents what really goes on."
Reassure them that you will not be angry/upset. Teenagers worry about being judged. Tell them you will not do that. If you have a strong reaction to what they tell you, manage that elsewhere. You will shut down the conversation before it really begins if you start shouting, or crying. Some of the behaviours, especially around sexual behaviour and relationships, may be very difficult for parents to hear.
⬤ Don't rush to solve it. You want to get alongside your daughter: 'What can we do together?' They have a fear that you'll march into school or ring other parents - that's their worst nightmare.
⬤ Ensure they get more sleep, more physical activity, and spend less time on social media. Girls tend to get less quality sleep, less activity, and spend more time on social media than boys. All of these things are detrimental to their health.
"We still hear a lot about young people bringing phones and iPads to bed," says Dr O'Brien. "Parents find it difficult to put boundaries around that, but they will be doing their child a favour."