Physiology First
13 min readMay 2, 2021

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The Kids Aren’t Alright: A Practical Approach to Improving Youth Mental Health in 2021

By David J Bidler

The skyrocketing rate of anxiety, depression, and suicidal ideation among our youth should grip the attention of the entire nation.

1/4 of our children being diagnosed with “mental health disorders” should create an outpouring of resources to solve a problem that will undeniably impact our collective future.

The fact that suicide is the second leading cause of death among adolescents should shock us all into action.

The paragraph above is one that I would have written several years ago, before eliminating the world “should” from my vocabulary.

If the above statistics “should” produce the responses outlined, they would.

The question to ask if we truly want to alter these statistics on youth mental health is:

Why don’t we see a national outpouring of support to improve youth mental health?

First off, the issue is complex.

It exists at the intersection of physiology, neurology, psychology, and technology. The complexity of the human mind is impossible to study with the same level of scrutiny-or certainty-as broken bones or biological agents.

A biological agent such as a virus is a comparatively straightforward problem.

The debate that invariably arises is how to best contain the virus.

The very term “mental health” is a cultural artifact, not an observable biological phenomena.

To demonstrate this point, attempt to define the term yourself, and ask others around you to do the same. The chances that two individuals come up with the same definition are extremely unlikely. Now, imagine that we were to poll the entire nation. What this experiment might reveal is a need to have a clearer conversation on one of the greatest issues of our time.

As pointed out in the journal, Nature, the ambiguity of our current approach to mental health is not only preventing a proactive and unified approach to supporting our youth, it is resulting in a crisis of classification with a high rate of error in the diagnostic process.

“Currently, diagnosis of major depressive disorder primarily relies on subjective identification of symptom clusters by psychiatrists, resulting in a high rate of misdiagnosis.”

We have the ability to study the brain through advanced imaging technology. We have the ability to measure physiology through wearable devices that track sleep, respiration rate, heart rate variability, activity levels, and the bodies ability to recover from stress. We have the ability to gain insights into the mind through conversation with skilled professionals.

What we do not have the ability to do, in most instances, is combine these critical lenses into the mind, body, and brain to form a cohesive picture of 21st century mental health.

If the term “mental health” were not used as a catch all for neurology, psychology, and physiology, we would still face the problem of identifying a model for a mental state that represented “an appropriate” response to multi-factorial influences, both internal and external.

What is a “healthy” response to a global pandemic?

What about a year spent in varying degrees of isolation?

How is the developing brain and body designed to respond to the 4x6 inch screens signaling our current levels of social approval with each heart shaped notification?

What response would represent a “disorder” and which would represent human physiology in action?

The challenge of youth mental health is that we have never been here, in 2021, with this set of challenges, lifestyle factors, and external technological stimulation before.There is no road map to improving mental health for youth in the 21st century.

This is why the crisis rages on while a concerned public watches helplessly from the sidelines.

What we do know is that sitting on the side of the road and watching the crisis unfold due the lack of a road map is not a viable option.

The New Terrain of 21st Century Youth Mental Health

Gaining an accurate appraisal of whether a psychological, physiological, or neurobiological state is “healthy” would require an expertise in a broad set of subjects, including modern neuroscience, stress physiology, nutrition, sleep, exercise science, and the latest advancements in technology.

This combined field of knowledge does not yet exist as a degree program of any kind.

However, experts in these increasingly intersecting disciplines are converging on the crisis of youth mental with a clear desire to make a positive impact.

The Link Between Technology and Neurology:

Many studies linking social media use to increased anxiety and depression among youth explore the surface level impact of exacerbating existing social dynamics. Although there is certainly value in exploring the amplification of social tensions through larger digital networks, it is the impact on the actual structure of the brain that may be the most critical-and under explored-territory in the new terrain of 21st century youth mental health.

This paper provides insight into some of these structural changes which will have an undeniable impact on mental well being. These changes in the fear and anxiety centers of the developing teenage brain are likely not being taken into account in the vast majority of traditional mental health assessments as this would require access to neuroimaging technology.

The title of this article is a reference to a podcast episode entitled “Are the Kids Alright?” featuring social psychologist Jonathan Haidt.

Jonathan focuses on the relationship between social media and youth mental health by observing trends in anxiety, depression, and suicide rates in conjunction with developments in technology.

This conversation between Jonathan and the hosts of “Your Undivided Attention”Tristan Harris and Aza Raskin, touches on another under explored, but integral, layer to understanding the impact of social media on both psychology and neurology-the algorithms used by social media companies to target user engagement, particularly among youth. These are critical pieces to the complex puzzle of understanding youth mental health in an increasingly digital world.

The film The Social Dilemma explores the impact of persuasive technology in brilliant fashion. Yet, the impact of technology on our bodies and brains is still a missing link in the conversation around youth mental health, particularly when the natural response to increased exposure to these technologies is labeled “an illness” or “a disorder.”

Perhaps an emerging field known as “stress physiologist” will emerge as a buffer between youth experiencing clear physiological responses to external and internal stimulation, such as changes in heart rate and breathing rate, and practitioners who are trained to assess patterns of thought, not measure physiology.

Maybe we will see a closer connection between neuroscience and psychology as is evidenced by the growing field of neuropsychology.

Until then, the chances that a young adult will benefit from an integrated approach to assessing and subsequently optimizing their physiological status as a first step towards analyzing their psychological profile is extremely slim.

The fact that the majority of drugs targeting anxiety, depression, and insomnia largely replicate the neurochemical effects of exercise, yet are routinely prescribed to sedentary children, despite the high rates of addiction and the potential side effect of increased suicidal ideation, demonstrate the chasm that exists between the professions responsible for helping youth manage their mental health.

The rate of children that we have worked with individually through Physiology First who have been diagnosed with a “mental health disorder” with no assessment of physiological resonance and no working knowledge of the criteria to maintain a state of brain and body health is alarming, to put it mildly.

In the state of Maine where our nonprofit organization is based 16.1% of all children have been diagnosed with an “anxiety disorder.” Through our ongoing work with Maine children aged 10–18 I have yet to meet a single student who has been taught the physiological prerequisites for not experiencing anxiety or presented with a tangible skillset to influence their own nervous system and regulate states of anxiety with agency.

In this conversation with author and podcast host Joseph Powell I share more about our experiences working with Maine youth, as well as students across the globe. Through this longer form medium I share insights into how we can build 21st century solutions to improve youth mental health at scale.

By outlining the complexity of this issue I hope to provide a lens for proactive problem solving that calls for courage, urgency, and empathy.

We are facing a new problem-and it requires new solutions.

New solutions don’t have a proven track record. They are not guaranteed to work. They require an investment in innovation and a willingness to do something, instead of nothing.

We are facing an urgent problem.

A young man not far from the Physiology First University campus took his life at 16 years old this year. Suicide rates among youth have increased over the past year. In a recent CDC study 1 in 4 of the college students surveyed had “seriously considered suicide” in the 30 days prior to the study. The rate of antidepressant use among teens and adults increased 400% between 2005–2008. The rate of anti-anxiety medication prescriptions spiked 34% during the height of the coronovirus pandemic in the U.S.

We are facing the problem of a changing brain and body navigating a rapidly changing world. This is an unavoidable problem of the future, which is why we must address it with proactive solutions that have the ability to scale.

The world is changing rapidly and the impact on the human nervous system as well as the human psyche is being witnessed in real time. The problem is one that calls for innovative, cohesive, and integrated solutions that instill a passion for learning about the body, brain, and mind-along with a working understanding of what they need to function optimally.

“Where you find empathy, I guarantee you’ll find innovation.

-Christopher Della Fave, Hoboken Public Schools, NJ

Christopher Della Fave is one of the industry leaders who took a chance on an education based solution to improving the mental health of his community. Christopher reached out to Physiology First and brought one of our professional development offerings, the Breathe to Perform program, to his district at scale. Through a series of workshops with students, parents, and teachers we had the opportunity to share the latest science of stress physiology along with practical breathing exercises for reducing anxiety in a measurable and tangible manner.

Breathe to Perform for high school students in Hoboken, N.J
Faculty received the same training as students. Parents were included through a series of webinars in order to create a shared stream of learning, continuity of language and concepts, and multi-pronged approach to supporting youth in the district.

“A must for anyone interested in taking control of their stress levels and accessing their innate potential. A truly timely, knowledgeable, and necessary experience.” Christopher Della Fave on the impact of the Breathe to Perform program

Physiology First University: A New Solution to Improving Youth Mental Health at Scale

Prior to the pandemic we presented to schools throughout the North East. The events of 2020 prompted us to build Physiology First University and expand our offerings online.

The impact of the COVID-19 pandemic limited our ability to provide seminars and in-person outreach to schools. This is where the idea for Physiology First University came from. Our goal was to create an accessible online learning platform that provides resources on mental health and fitness to students and the larger community that supports them.

By setting up Physiology First University “pop-up campuses” members could create opportunities for ongoing social connection in their neighborhoods while sharing elements of the Physiology First curriculum designed by subject matter experts across the globe.

Physiology First University member Daniel Flahie hosting a “pop-up campus” at Mount Marty University in South Dakota

On May 1st we began a new chapter for Physiology First University by opening our first physical campus in Freeport, Maine.

This project was a labor of love by our community, especially the students who volunteered their weekends to peeling the old, stained carpeting from the floors, repainting walls, and bringing life, spirit, and heart to an old building with a lot of potential.

Humble beginnings.
Our future book case for the PF University Library.
A lot of potential…and a whole lot of work.
Local students after an all-day work party.
The wall mural was entirely the students idea. It adds so much life to the space! See finished pics below!
New art :)
The wall mural completed!
Opening day! It was wonderful to see the community come to help break in the new space.
Conversation. Connection. Coffee :)
Doesn’t that wall bring a new life to the space? Amazing what students can do with a paintbrush and no constraints on their creativity.
The Physiology First University Cafe is a space for students and community members to relax, catch up on work or homework-and have the casual conversations where critical life lessons are passed along from generation to generation.

The Future of Youth Mental Health Education Includes Educating Youth About the Future

The future is a puzzle, and we are the pieces. Our ability to create a cohesive vision of the world that we want to live into is the first step in reconnecting to one another-and to giving kids a future worth believing in.

Our organization, Physiology First, takes a new approach to youth mental health education. By teaching students and the larger community that supports them the latest science of how the body and brain function we hope to answer one of the most critical questions of our time: What are the physiological prerequisites for mental health in the 21st century?

Understanding our physiology is a first step towards having a proactive relationship with the state of our minds.

As the field of neuroscience presents a new understanding of how the brain changes due to behavior we are suddenly responsible for our own mental health on a structural level. The brain shrinks and grows. It strengthens and atrophies. It elicits chemicals responsible for how we feel and perform based on exercise level, sleep quality, nutrition, and a host of factors that today’s youth are largely unprepared to navigate. No one has taught them how the supercomputer in their skull functions, yet it’s function will define their life experience.

To be responsible for understanding our bodies and brains is to have agency over our own mental state.

Responsibility without adequate education, training, or skill development is a burden, not a blessing.

Our neurochemistry can be misinterpreted as a character flaw or personality defect-or labeled an illness-if we don’t have a working understanding of the network of neurons responsible for sensation, perception, thought, emotion, and action.

“Our lives change when we have a working understanding of the brain.”

-John Ratey, M.D Author of Spark: The Revolutionary New Science of Exercise and the Brain

Fortunately, a wealth of material from the best neuroscience labs in the world has been synthesized through accessible media (video, podcasts, ebooks, games) so that students do not need to be scientists themselves to understand how their brains function.

(This incredible podcast by Stanford Professor of Neurobiology, Dr. Andrew Huberman, presents an overview of how the brain works and changes in less than an hour. This is an example of the material that students and families will find in the PF University library.)

Students need more effective bridges to learning about their body and brain. These are resources that we provide through Physiology First.

However, the social realities of our time present challenges that extend beyond physiology and neuroscience.

An increasingly divided society being torn further apart on the ideological battleground of social media presents a threat to the already worn fabric that ties us together as a nation.

The age of automation is redefining the economic landscape entirely.

Uncertainty looms over every industry.

At the same time, we live in an age of new opportunities that emerge out of unprecedented waves of innovation.

The future is moving fast. We need to learn quickly-and with increasing clarity-if we hope to ride these waves of change with agency, and help our youth do the same.

“We’re entering an age of acceleration. The models underlying society at every level, which are largely based on a linear model of change, are going to have to be redefined. Because of the explosive power of exponential growth, the 21st century will be equivalent to 20,000 years of progress at today’s rate of progress; organizations have to be able to redefine themselves at a faster and faster pace.” -Ray Kurzweil

Along with physiology based education and ongoing workshops on the mind, body, and brain, we are hosting a “21st Century Skills Camp for Students” that invites them to apply this increased knowledge of self to exercises in innovation and entrepreneurship.

Will Physiology First University work?

Will it improve the mental health of youth in our community, and beyond?

We don’t know.

Here’s what we do know…

Learning works. It is how we share skills and pass along critical lessons from generation to generation.

Social connection works. It is how we co-regulate our physiology with others, test our ideas in the real world as opposed to on screens, and form critical bonds that are essential to mental well-being.

Exercise works. Making it more accessible for youth to access physical fitness creates structural changes in the brain and body that have been demonstrated to have a powerful impact on improving mood, focus, and energy levels.

Finally, involving students in the process of building new things in the world works. It works no matter the outcome, because we learn most effectively through lived experience. Reminding our youth that they do not have to be passengers on the road to the future, that they possess the capacity for creativity, innovation, and leadership, is a lesson that can only be taught by reminding ourselves of the same, and then taking action.

Our mission is to scale Physiology First University campuses into communities across the globe while developing our online learning platform into a valuable resource for students, parents, educators, and community leaders.

The future of learning is learning about ourselves, together. You never graduate from the school of life, and our curriculum is designed to support the physical and mental fitness of adults as well.

We meet weekly in our online social lounge, share resources and stay connected via our SLACK channel for members, and add new material to the library and athletics department regularly!

Two of our newest editions are a weekly coloring class for students, families, and anyone who wants to break out the crayons and connect with others, and Brazilian Jiu Jitsu class for kids led by Shaun Durfee, owner of StoneCoast BJJ for Kids in Portland, Maine.

Join us at Physiology First University, either in-person or online, and be part of a movement for positive, proactive, and empowering youth mental health solutions that scale.

To support this work please consider a tax-deductible donation to Physiology First. We are a 501c3 nonprofit organization. We rely heavily on the generosity and investment of supporters who believe that the kids can be alright, if we simply invest the resources to build solutions that scale to the size of the problem.

Visit our website to make a donation today.

David Bidler is a speaker, author, and President of Physiology First.

David has presented to Universities, companies, schools, and organizations across the globe on the latest science of stress physiology.

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Physiology First

Physiology First University provides brain and body based education and 21st century skills. Be part of the evolution of education and #learndifferent.