Children, teens and young adults in Southern California had been grappling with rising rates of depression and anxiety for years before the pandemic. Then COVID-19 came along and made their mental health struggles even worse.

Among 1.7 million young patients who were part of the Kaiser Permanente Southern California health system, the prevalence of clinically diagnosed depression was 60% higher in 2021 than it had been five years earlier, according to a new study. The prevalence of anxiety among young patients who did not have depression also rose by 35% during that period, researchers found.

For both conditions, the annual rate of increase was significantly higher during the pandemic years of 2020 and 2021 than in the three years that preceded them.

What’s more, the trend was seen across all demographic groups regardless of age, gender, race, ethnicity or income, according to the report published Tuesday in JAMA Network Open.

“COVID initially was considered an infectious-disease crisis,” said Dr. Siddhartha Kumar, a child and adolescent psychiatrist at Kaiser and the study’s senior author. “This was another side of COVID. The side effects on mental health are long-lasting and impacted the society in a very major way.”

It’s no secret that young people have been suffering.

In 2016, when the National Survey of Children’s Health asked parents and other caregivers how their youngsters were faring, their responses indicated that 3.1% of kids ages 3 to 17 were depressed. By 2020, that figure was 4%.

That survey also found that the prevalence of anxiety among those children increased from 7.1% to 9.2% during the same period.

Another study of adolescents ages 12 to 17 who participated in the 2021 National Survey on Drug Use and Health found that 20% of them had experienced major depressive disorder in the past year.

And U.S. Surgeon General Vivek Murthy focused the nation’s attention on the issue by issuing a public health advisory about youth mental health in 2021. The advisory cited studies that found 25% of children and teens ages 4 through 17 from around the world had experienced symptoms of depression during the pandemic while 20% had symptoms of anxiety. Both measures had doubled since the start of the pandemic.

The new study is believed to be the first large-scale examination of youth mental health in the COVID era based on official diagnoses rather than survey data, according to Kumar and his colleagues from Kaiser Permanente Southern California, whose territory extends from Ventura County to the Inland Empire and from Kern County to San Diego.

The study authors focused on the roughly 1.7 million health plan members who were between the ages 5 and 22 on the first day of at least one of the years between 2017 and 2021.

Those children and young adults reflected the diversity of Southern California as a whole, the researchers wrote. About half were Latino, 23% were white, 8% were Asian and 8% were Black. (Data were missing for some plan members.)

Slightly more than half — 55% — were from households with an annual income of $50,000 to $99,999. An additional 29% were from households that earned less, and 16% were from ones that earned more.

The researchers checked whether the young patients had been formally diagnosed with some form of clinical depression. To qualify, a doctor had to determine that a patient was experiencing a “sad or irritable mood or loss of interest in activities” that caused “significant impairment in daily life.”

They found that 1.35% of the patients were newly diagnosed with depression in 2017. That figure rose to 1.58% in 2018, 1.76% in 2019, 1.84% in 2020 and 2.1% in 2021, with the incidence increasing for all groups regardless of age, gender, race, ethnicity or income.

Teens of high school age, 14 to 17, and young adults old enough to be in college, 18 to 22, had the highest incidences of depression throughout the study, the researchers found. Generally speaking, girls and women were more likely to be diagnosed with depression than boys and men, and the risk was consistently higher for patients who were white and who came from households with the highest incomes.

When the researchers tallied all the children and young adults with a new or existing depression diagnosis, they found that the prevalence was 2.55% in 2017, 2.92% in 2018, 3.27% in 2019, 3.53% in 2020 and 4.08% in 2021. The annual rate of increase was higher during the pandemic than before it, and the difference was large enough to be statistically significant, the researchers said.

They also examined patients diagnosed with anxiety, a condition they said was characterized by “excessive feelings of worry or persistent, even intrusive thoughts about certain fears or constant fear in general.”

Nearly 37% of the young patients with anxiety had also been diagnosed with depression. The researchers set them aside and focused on the ones who had anxiety alone.

By that measure, the incidence of newly diagnosed cases was 1.77% in 2017, 2.03% in 2018, 2.1% in 2019, 1.93% in 2020 and 2.32% in 2021.

College-age young adults had the highest incidence of anxiety without depression. The risk was also higher for people who were white and were in the highest income bracket, according to the study.

The prevalence of new or existing anxiety in patients without depression followed a similar pattern — 3.13% in 2017, 3.51% in 2018, 3.75% in2019, 3.61% in 2020 and 4.22% in 2021.

Both new and total cases of anxiety without depression increased significantly more in the COVID years than in the ones preceding it, the researchers found.

“Anxiety, mild depression, hopelessness, disappointment — these are common feelings all of us have from time to time. But it’s another thing when it reaches a clinical level,” Kumar said.

And when that happens to young people, the effects can be enduring.

“The teenage years are when you build your sense of self,” he said. “When adults go through stressful situations in their lives, often their reactions are based on how their sense of self was when they were young.”

Christina Bethell, a social epidemiologist and director of the Child and Adolescent Health Measurement Initiative at Johns Hopkins University, agreed that the pandemic had exacerbated a mental health crisis affecting young people nationwide. But she said medical records could not capture the full scope of the problem.

Patients with depression or anxiety may not have access to a doctor, and those who do might not feel comfortable seeking treatment, she said. Primary care doctors are supposed to screen adolescents and adults for depression, but that doesn’t always happen. Even when it does, patients may not answer screening questions honestly. Sometimes doctors make mistakes that lead to misdiagnosis. And sometimes a patient who was correctly diagnosed recovers from depression or anxiety, but their medical records aren’t updated to reflect that.

“Medical records are often wrong, incomplete and only available for those in healthcare,” said Bethell, who wasn’t involved in the study.

In her view, the most important question isn’t whether someone has a diagnosis of depression or anxiety, but how they are actually faring.

“There are a whole bunch of people with a diagnosis who flourish, and there are people without a diagnosis who don’t flourish,” she said. “We want to keep our eye on the prize, which is youth well-being.”

SACRAMENTO — A ban on all hemp products with “any detectable quantity of THC” is in effect under an emergency order by Gov. Gavin Newsom and the California Department of Public Health (CDPH). In response, the state is facing a lawsuit.

Retailers can no longer sell any products made with hemp THC to California customers, which includes non-intoxicating CBD medicinal products used by millions of people statewide.

Those who rely on CBD as medicine say the new emergency regulations do more harm than good, hurting some of the most vulnerable populations in the state.

Before the ban took effect, CBS13 first interviewed the mother of a child with disabilities who relies on daily CBD to calm her violent seizures.

Advocates add that California, home to the largest population of United States veterans, are among the most impacted.

“This is hitting veterans disproportionately hard,” Army and National Guard veteran Will Wisner said. “We’re losing guys at the rate of 22 or more a day to suicide to where we have lost over 150,000 veterans since 9/11 to suicide. Think about that number, that is huge.”

Wisner is the executive director of the California-based nonprofit Grunt Style Foundation that helps support veterans.

“I would hate to think we are going to lose lives over this kind of decision, but people do drastic things when they are in pain, when they are feeling hopeless,” Wisner said.

Like many veterans, he found CBD to be a huge help on his long journey to physical and emotional healing after war.

“I had to figure out how to take my own health care into my own hands,” Wisner said. “I have to self treat with CBD. Luckily, CBD is wildly effective on my auto-immune disorder and helping me fight inflammation and pain.”

CBD advocates argue that Newsom’s emergency regulations slapped onto the hemp industry are too broad. Though they agree that industry regulations are needed, they say they should not punish people who rely on non-intoxicating CBD products.

“I mean, it’s completely cut off the access currently. Everything is on a 180 days pause since the emergency order went into place,” Wisner said.

A lawsuit has now been filed by six hemp companies and one nonprofit against California’s Department of Public Health, its director and 50 unnamed “John Does” in the suit.

“This draconian regulation alone will essentially devastate an emerging industry that consists largely of small business owners. It’s akin to requiring candy to stop containing sugar… starting tomorrow,” the lawsuit reads.

Among the plaintiffs are some star-studded stoners: Cheech and Chong. The comedy duo brought cannabis culture to Hollywood and now, Cheech Marin and Tommy Chong’s cannabis company is among those pushing back against Newsom’s new regulations. 

“Overnight, major swaths of the hemp and hemp products industries in California became immediately illegal,” the lawsuit reads.

Gov. Newsom, in the emergency regulations he first announced on Sept. 6 at a press conference in Sacramento, wants to crack down on industry bad actors. Newsom said too many are taking advantage of an unregulated market and enticing kids with THC products marketed to a young audience through THC gummies, candies and drinks.

“Intentionally trying to manipulate our children. Available everywhere. Gummies directly targeted to our kids. It’s a disgrace and it’s a shame,” Newsom said at the press conference.

“We’re going to take it to the next level and make sure enforcement is out there, so young people in particular are protected,” added Dr. Mark Ghaly, secretary of the California Health and Human Services Agency.

But now advocates ask in response: what about medicinal access for children with disabilities who rely on CBD to calm their seizures, products that contain only a trace amount of THC, used daily by veterans like Wisner?

“Taking options away from us seems like madness. No matter how well-intentioned it may be,” Wisner said. “Frankly, it’s insidious. We are now playing with the lives of a very vulnerable population that has grown dependent on this natural and holistic healing modality.”

CBS13 reached out to both Gov. Newsom’s office and the CDPH for comment on this story. Both agencies responded by saying that they do not comment on pending litigation.

The emergency regulations took effect on September 23 and will remain in place until March 25, 2025.

Today, California Governor Gavin Newsom vetoed SB 906, which aimed to amend California NIL law. The bill, introduced by State Senator Nancy Skinner (D – Berkley), sought to implement novel transparency measures that would mandate public disclosures from all California schools regarding the total funding NIL collectives and other entities spend on NIL services from student-athletes at each respective university. The proposed legislation would have made California the first state to dip its toes into the water of public NIL disclosure. My previous article on the details of the proposed legislation can be found here. 

The now kyboshed bill would have allowed fans, recruits, and members of the media to see just how large of an NIL war chest each California school has at its disposal. As the economic dynamics of college sports continue to evolve, the amount of money schools’ NIL collectives have to pay their athletes is paramount to the successful recruiting and retention of revenue-sport athletes.  

The bill introduced by Skinner was rooted in principles of gender equity. According to a news release, the state senator hoped that the bill would pressure “NIL entities to do the right thing and boost funding for women athletes.”

The proposed legislation would have required public disclosure of the aggregate amount of money athletes from each team received and noted discrepancies in compensation between genders. According to industry estimates, roughly 95% of NIL collective payment goes towards male athletes. NIL collectives are legally separate entities from the institutions they support and, therefore, escape the scrutiny of Title IX mandates of equal funding across gender. 

Governor Newsom cited two reasons for his veto in a statement released today: “College sports are in a period of transition as many schools are changing athletic conferences and relevant issues are currently pending in the courts. As Governor, I want to ensure California’s colleges continue to be competitive with other states. Further changes to this dynamic should be done nationally.”

Newsom believes that transparency in NIL funding may put California schools at a disadvantage to schools outside of the state that do not face the same disclosures. Athletes looking to compete at the college level could easily see the robustness of a school’s NIL program through such disclosures and could choose to pursue other programs that can be alleged to have superior resources outside of the state. 

Newsom also indicated that due to the massive uncertainty around college athletics’ future structuring, like institutional revenue sharing, any further NIL reform should be addressed at the federal level. 

With a patchwork of state NIL laws being the only regulation on athlete compensation in the college athletics space, further splintering and disparate regulation presents challenges to athletes and those looking to tap into NIL for brand partnerships. 

Newsom’s anti-federalist mindset is a change of pace from his approval of the 2019 Fair Pay to Play Act, also presented by Skinner, that made California a trailblazer by codifying the nation’s first law enshrining the right for athletes to profit from their NIL.