During the pandemic, emergency rooms across the country reported an increase in visits from teenage girls dealing with eating and other disorders, including anxiety, depression and stress, according to new data from the Centers for Disease Control and Prevention.

The report provides new detail about the kinds of mental health issues affecting a generation of adolescents.

Mental health experts hypothesize that the pandemic prompted some youth to feel isolated, lonely and out-of-control. Some coped by seeking to have control over their own behavior, said Emily Pluhar, a pediatric psychologist at Boston Children’s Hospital and instructor at Harvard Medical School.

“You take a very vulnerable group and put on a global pandemic,” she said. “The eating disorders are out of control.”

In the CDC study, the agency said that the proportion of eating disorder visits doubled among teenage girls, set off by pandemic-related risk factors, like the “lack of structure in daily routine, emotional distress and changes in food availability.”

The agency said that the increase in tic disorders was “atypical,” as these disorders often present earlier, and are more common in boys. But the CDC, reinforcing speculation from other clinicians and researchers, said that some teenage girls may be developing tics after seeing the phenomenon spread widely on social media, notably on TikTok.

“Stress of the pandemic or exposure to severe tics, highlighted on social media platforms, might be associated with increases in visits with tics and tic-like behaviour among adolescent females,” the CDC wrote.

In a related report, the CDC also said Friday that the increase in visits for mental health issues occurred as emergency rooms reported sharp declines overall in visits during the pandemic. As compared with 2019, overall visits fell by 51% in 2020 and by 22% in 2021, declines that the agency attributed in part to families delaying care, and a drop in physical injuries from activities like swimming and running.

There was a decline in overall emergency room visits for mental health conditions among all youths, up to age 17. Increases occurred for particular maladies and, particularly among teenage girls.

More broadly, the surge in adolescent mental health distress appears to have intensified during the pandemic, but it began earlier. Emergency room visits among youths related to depression, anxiety and similar issues rose by 28% from 2007 to 2018, according to another report by the surgeon general.

In its report Friday, the CDC said that mental health-related emergency room visits for teenage boys fell in both 2020 and 2021 as compared with 2019. But the CDC also reported that the data was nuanced and that the visitation patterns for boys, as well as girls, depended on specific mental health condition and time period.

“These sex differences might represent differences in need, recognition and health care-seeking behavior,” the CDC wrote.

For teenage girls, weekly emergency room visits rose for eating and tic disorders during 2020; and for those conditions and obsessive compulsive disorders in 2021. During January of 2022, the CDC said there also was an increase in anxiety, trauma and stress-related issues.

This article originally appeared in The New York Times.

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