Young Adulthood: A Blank Canvas
- A Children’s Day Mental Health Series -

Dr. Mona Nongmeikapam / Dr. Meesha Haorongbam *

In the previous three articles, we have briefly discussed about the various phases of childhood. We have also discussed about the expected changes and challenges accompanying each phase and the psychological and behavioural impacts they can have on a developing mind and body.

As we come to the end of our special series on the occasion of Children’s Day, let us examine another magical, exhilarating yet confusing age- late teens and early 20s. From a protected and secure environment, well looked after by their parents and guardians, they are suddenly thrust into the “real world”. The increased expectations, responsibilities, and pressure can have an immense toil on their young minds.

The glorification of youth in our society especially through movies and social media has caused us to neglect the many difficulties and complications that often come with young adulthood. Young adults today face several challenges that can make the transition into adulthood quite a stressful time. Common stressors are:

o Finances: The “real world” is expensive. Establishing financial independence and stability is undoubtedly stressful for young people.

o College and/or Work: Academics and work are quite demanding on their own and in many cases, young adults juggle both. When obligations at work and/or college increase, sleep and wellbeing often take the backseat while tension, anxiety and exhaustion settle in.

o Relationships: Young adulthood is often a pivotal time for relationships. Friendships from adolescence may dissolve and new connections may grow. Familial ties may be tested or strengthened. Dating, intimate relationships and breakups can be an emotional roller coaster. Young adults often desire a sense of community and belonging but striking a social balance that is fulfilling and worthwhile can be a challenge.

o Indecision/Uncertainty: This particular phase of life is quite a decisive period which can feel overwhelming at times- “Which course should I study? Where should I study? Do I continue living with my parents or should I move to a hostel? Should I opt for a further degree or should I focus on finding a job and making some money? Am I ready for marriage/parenthood?” etc. There is constant agonizing about potential outcomes and worrying about a life in “limbo.”

We assume that once we’re out of high school, we’re done growing up. Physically, we’re probably as tall as we’ll ever get, and from this point forward, we may remain the same overall size throughout much of our adult life.

As we head off to college or join the workforce, we will likely gain a great deal of independence at this point in life, moving away from our parents and beginning to take care of ourself. While we still have a lot to learn, we’ll probably feel like the development process is over.

Mentally, however, young adults are still not fully grown. They are still experiencing cognitive development, and this is one of the reasons why mental illness can present at this time of life. The types of experiences, both good and bad, a young adult encounters can significantly shape brain development in this stage, potentially presenting as mental illness.

Mental illness encompasses a wide variety of disorders that exist on a severity continuum. Some can be temporary responses to crises or other experiences, while others are chronic conditions. Mental illnesses have various causes and triggers. Some common mental illnesses seen in this age group are:

1. Substance dependence- This phase oftentimes leads to experimentation with drugs and alcohol and they are more likely to continue this into middle and late adulthood. Various factors can lead to substance taking behaviour. For some it is seen as a part of identity exploration while others use drugs as a way to fit in with peers. Substance dependence affects every sphere of life- physical effects including vehicular accidents, delinquency, academics and work performance, economic and social consequences, inter-personal relationship etc. It may trigger or aggravate pre-existing mental illnesses.

2. Gender Identity Disorder- With the freedom to explore sexuality and the need to establish self-identity, there may be gender dysphoria in those who whose gender identity differs from their sex assigned at birth. Feeling “trapped in the wrong body” can cause significant distress and consequently affect their social, personal, academic and work life.

3. Mood disorders- Mood disorders such as depression and bipolar affective disorder are highly common among young adults. In fact, suicide is the second leading cause of death among young adults. Genetics and environmental stress can cause mood disorder. This isn’t surprising as young adults experience numerous stressors.

Fear of not living up to their own as well as their parents’ expectations, constant struggle to survive in today’s hustle-culture world, fear of missing out on experiences, constant bombardment of negative messages from social media etc can unfortunately trigger mood disorders.

While symptoms vary based on the individual, as well as type and severity of the disorder, it is important to identify warning signs which include, but are not limited to: social withdrawal, loss of interest or engagement in activities once enjoyed, drastic mood swings, confused thoughts or lack of concentration, detachment from people or surroundings, dramatic changes to sleep or eating patterns, peculiar or exaggerated behaviour, difficulty coping with everyday problems, and suicidal thoughts.

4. Anxiety- Apart from the normal pressures of college and work, young adults today have the added worries of a pandemic, economic uncertainty, global warming and the state of the world. Unrealistic standards set by appearances on social media is also a major cause for concern. All of these may cause anxiety.

Some common symptoms are: feeling nervous or panicky all the time, feeling overwhelmed or full of dread or out of control, having trouble sleeping, difficulty concentrating, change in appetite, palpitations, having a dry mouth, trembling, or having wobbly legs, feeling faint etc

5. Schizophrenia- A complex illness that interferes with a person’s ability to think clearly, manage emotion, make decisions or relate to others- schizophrenia typically emerges in late teens and early 20s.

Common symptoms are: hallucinations (where one sees, hears, smells, tastes or feels things that do not exist outside their mind), delusions (false belief held with conviction e.g. believing that someone is trying to kill him/her), confused thoughts (often described as hazy), disorganised behaviour etc.

6. Eating disorders (ED)- Anorexia nervosa (AN), bulimia and binge eating disorder are serious mental illnesses characterised by disturbance of body image and eating behaviour. It can derail social, psychological, and vocational development.

Common symptoms include: excessive fasting, counting calories and avoidance of food groups or types, binge eating, deliberate vomiting or laxative use, refusing to eat certain fatty or “unhealthy” foods, cutting out whole food groups such as meat or dairy, a sudden concern with healthy eating or replacing meals with fluids, weight loss or weight fluctuations, menstrual irregularities, dental discolouration from vomiting, extreme body dissatisfaction, distorted body image etc. EDs especially AN, can be life-threatening and warrants prompt intervention.

Ignoring the signs of mental illness is one of the worst things you can do to yourself and others. If you or a college-aged child you know is exhibiting unusual behaviour, do not hesitate to talk about it. There should be no stigma attached to mental illness. Getting professional help is an investment that will help you in the long run.

Parents too consider their job as a parent mostly complete by the time their child joins a college. Many young adults, however, need continued parenting through this last phase of development. While they embrace their new freedoms and responsibilities, it’s best to keep an eye on them and provide the guidance necessary to help them recognize and deal with the onset of mental illness.

Youth is only the beginning of our lives, and contrary to what has been propagated via social media, we should not be expected to have done and achieved everything by the time we are thirty. Youth is the time to make silly mistakes and learn from them. It’s the time to explore who we really are. It’s a blank canvas and we hold the pencil and eraser that’ll determine what’s drawn on the canvas.

Dr. Mona Nongmeikapam (pukningpothasang(AT)gmail.com)-
Assistant Professor,
Department of Psychiatry,
Regional Institute of Medical Sciences

Dr. Meesha Haorongbam (meeshahao(AT)gmail.com)-
Senior Resident,
Department of Psychiatry,
Shija Academy of Health Sciences