Mental health: Is Denmark's youth living up to the country’s happiness claims?

The scene at Amalienborg Palace Square, in Copenhagen, Denmark, April 16, 2020.
The scene at Amalienborg Palace Square, in Copenhagen, Denmark, April 16, 2020. Copyright Niels Christian Vilmann / Ritzau Scanpix via AP
By Avi Gopani
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The average prevalence of mental disorders for adolescents in Europe was 16.3% in 2019.

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"We have clean air, our human rights are covered, I have a great family, and yet, I can't completely enjoy these things,” Ulrikke Pedersen, a 22-year-old student in Aarhus, Denmark, told Euronews, alluding to her continuous struggle with anxiety.

In 2020, the Danish Health Authority found 15% of Danish young adults are diagnosed with a mental disorder by 18 years of age, showing how an increasing number of Danish children are experiencing poor mental health. 

That appears as a possible contradiction: Denmark is the second-happiest country in the world, according to the World Happiness Report.

The annual survey ranks 146 countries on their corruption level, dystopia, generosity, freedom, healthy life expectancy, social support, and GDP per capita. Denmark has been among the top countries for a decade, so how can this increasing trend of anxiety be explained? 

Young Danes are struggling

“Young people tend to look inward and blame themselves for not being successful,” said Anne Görlich, co-author of the study, ‘Dissatisfaction in the light of pace, performance and psychologistic'. “In interviews, young people who experience some sort of mental illness often feel fine in some areas of life and struggle in others.”

Youth struggles are often triggered by the pressure towards being adults. Many gain stability quickly after breakdowns because of the quality of life around them. However, when such issues add to pre-existing life complications, it causes recurring mental health issues with periods of struggles and good days. 

"Young adults’ experience of mental health is very challenging. It is prolonged and needs considerable help to overcome. Classic risk factors in their families like alcohol, drug abuse, violence, or conflicts add to these issues and affect them for a longer time," said Gorlich.

Pedersen narrates a similar story. Diagnosed with Attention-deficit/hyperactivity disorder (ADHD) and anxiety, she said that “there are moments where I have a lot of energy. My ADHD medicine makes me more energetic. But it can also make me too energetic, and while recovering from it, I get down in an extremely sad and tired hole.”

Pedersen believes the number of Danes undergoing mental health issues has always been high - only now, there is more access to help and less stigma around it. “Many people in my close circle struggle with mental health challenges too, I have only a few friends that are just happy and functioning.”

Denmark is not alone in this battle. The average prevalence of mental disorders for adolescents in Europe was 16.3% in 2019, as per UNICEF- suggesting that many European countries have a higher percentage of mental disorders.

Why is the rate of mental un-wellbeing increasing?

When Pedersen was young, she faced stigma around her mental health issues. But not anymore. This open acceptance is not present in many countries today, possibly leading to a larger amount of diagnoses in Denmark.

Increased mental health expenditure in the country is also seen as part of the reason for the higher number of diagnoses. In 2019, Denmark invested around €657 million in mental health, up €127 million from 2010. 

The Danish society also encourages a culture of drinking that adds to the complexities. In 2017, Johannessen identified links between symptoms of anxiety/depression and alcohol-drinking behaviour among Nordic youth. The correlation was stronger for those who started drinking before the age of 15 - a trend common in Scandinavia. 

“I started taking drugs after my mom died, I was still a child,” said Pedersen. “It ruined my brain in some ways. I am currently four months sober. But as a teenager, we drank and smoked. We would spray things directly into our mouth to get high faster, but this kills your brain cells.”

Clinical psychologist, Dr Adriana del Palacio, looks at the surveys themselves to understand this phenomenon. 

“Psychological research tells us that the older we become, the better we get at regulating emotions. This can help in improving well-being. There is a development effect. When you see high levels of happiness in the general adult population, it does not mean that youth are as happy as the average adult in Denmark," she said.

One should consider that the happiness surveys compare countries at the same given time but not the same countries across time. Therefore, Denmark can still be happier than others, but less happy than before. “What we see is a time effect amongst Danish youth, where they have poorer well-being now than before,” she said.

Getting help in Denmark

Sigurd Lauridsen is the lead researcher analysing the effectiveness of the Danish government’s programme - Coping with Anxiety and Depression. It is centred around people aged 15–25 years- to get help in a Danish community setting through support groups. The programme showed good promise. The moderators are not psychologists, but individuals who have dealt with anxiety and depression themselves, encouraging the participants to heal through peer-to-peer therapy. 

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“Anxiety does not go away, but you can learn how to manage it better,” Lauridsen said. The programme, like many community-based initiatives in Denmark, aims to do so.

The clinical sphere can be a hit or a miss. 

Pedersen, in her previous residence in Sjælland, was wrongly diagnosed with paranoid schizophrenia. “It was hard to deal with this diagnosis. Plus, I had to wait up to a year to get help,” she said.

This also differs by city. “In Sjælland, the waiting period was a year. But in Aarhus, I had to wait only two weeks. I was quickly and correctly diagnosed with ADHD. Thankfully I never had to take the wrong medicine.”

In the past two decades, the EU has witnessed a two and a half times increase in the use of antidepressants, according to Organization for Economic Cooperation and Development (OECD) data. In Denmark, 75.7 out of 1000 inhabitants used antidepressants in 2017 — roughly double the rate observed in 2000 — but lower than in 2010, suggesting a potential decrease. 

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In the past, Pedersen suffered from depression but over time, with the help of medication and support, depressive feelings' control over her have lessened. Routines and medications are integral, and during winter, a sun lamp is a saviour.

Denmark is far from alone as the increased focus on youth mental health is part of the global movement to create more awareness about the stressors in mental well-being.

European Commission President Ursula von der Leyen called for "a comprehensive approach to mental health" in her September 2022 State of the Union address, in which she outlined her priorities for the coming years. She said an "EU Action Plan on mental health" should be developed to provide long-term Mental Health Strategy across the 27-country bloc.

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