Adolescence: A Second Chance For Lifelong Success

By Professor Alina Rodriguez

The first 1,000 days of life - from conception to age two - are often described as a critical window for shaping a child's development. During this time, the foundations of brain development and health are set. Nonetheless, adolescence - the period from 10 to 24 years old - represents another key developmental phase, a "second window of opportunity" to shape a person's future.

Challenges and Opportunities in Adolescent Development

Given the rapid changes during adolescence, this period is a crucial opportunity to address developmental needs while also guarding against potential risks. For example, teenagers need more sleep and nutritious food to sustain their sped-up growth. However, lifestyle factors, from the pressure to do well in school to online distractions such as social and other media, can disrupt these essential needs, which may have long-term health implications.

Importantly, the heightened plasticity of teenagers' brains - the ability to change, respond and adapt to the environment - makes them especially sensitive to experience, which can shape their cognitive, social and emotional development. This sensitivity makes them more vulnerable to mental health difficulties or to form unhealthy lifestyle habits.

All this means that they need healthy role models and support, and space for contemplation. To guide and empower them to face difficulties more effectively, we need to better understand the root causes of their physical and mental health issues. This work is particularly urgent as more adolescents around the world are struggling with mental health troubles.

Adolescents in the spotlight

Globally, there is great concern about the growing number of adolescents with mental health issues such as anxiety and depression, psychological distress and suicidal behaviour. The trend is so worrying that the United Nations launched the Global Coalition for Youth Mental Health in 2022 to call for action.

Singapore has not been spared. Last year, a first-of-its-kind study by the National University of Singapore (NUS), on the mental health and resilience of the country's youth aged 10 to 18, highlighted that 12 per cent of teenagers suffer from at least one mental health disorder. The team collected data from 3,336 adolescents for the study, conducted between 2020 and 2022.

When teenagers have poor mental health, it can affect them immediately and into the future. Research has uncovered that about 75 per cent of mental health problems in adulthood stem from the formative years before age 25. My work for example, shows that adolescents with attention deficit hyperactivity disorder face a higher risk of substance use in adulthood and premature death.

In fact, when my colleagues and I analysed data from 1990 to 2019 on the burden of ill health on adolescents in the European Union, we discovered that mental health issues are the leading cause of years lived with disability, and years of life lost as a result of premature death. This work was carried out before the Covid-19 pandemic, so the situation is likely to be worse now.

Poor mental well-being is also linked to worse physical health, and vice versa. As in many other countries, many adolescents in Singapore are already engaging in too little physical activity, possibly due to increasing screen time and parents' emphasis on academic success. The nation's obesity rates, especially among children and adolescents, are on the rise.

In a study I led, we found that being overweight or obese in adolescence is related to poor cardiorespiratory fitness and early markers of metabolic risk. As feeling tired keeps teenagers still, this lack of fitness can set off a negative spiral of less activity and further weight gain, and even have lifelong consequences, as health habits seem to be set in adolescence.

Seizing the second window

These findings underline that we need better strategies to support adolescents. This would also improve their long-term health. While many blame the Covid-19 crisis and social media use for the surge in teenagers' mental and physical woes, we need more, and more precise, information to understand the triggers, so we can craft targeted, useful early interventions.

Through the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study, which is a major collaborative research programme involving the Agency for Science, Technology and Research Institute for Human Development and Potential (A*STAR IHDP), National University of Singapore (NUS), KK Women's and Children's Hospital (KKH) and National University Health System (NUHS), we have shed significant light on early childhood development.

Now, as GUSTO participants enter adolescence, our approach is to maximise our knowledge by coordinating our efforts with other studies, creating an integrated adolescence research programme. We recently launched a new study focusing on mental wellbeing among 14-year-olds called iADORE.

Such projects are part of a broader ecosystem that spans other organisations, including public agencies and public healthcare institutes, all working closely together to broaden and deepen our understanding of adolescent health in Singapore and translate breakthroughs into interventions, such as strategies to boost open communication.

I came to Singapore to help lead this work. In future projects, I hope to enlist adolescents too, by asking them about issues important to them that we should look into, and incorporating their input to study design. This will allow adolescents to experience the scientific process and reap the benefits of the research findings.

Adolescents today are growing up in a never-before-seen world that is dominated by information technology with its barrage of stimuli and quickly-shifting environment. At the same time, they are undergoing their own rapid physical and mental changes, posing a double challenge to them.

Singapore, with its strong foundation in population health research, is well-positioned to make advances to support them. By expanding our knowledge on adolescence and leveraging this second developmental window through practical interventions, we have a powerful opportunity to help adolescents unlock their full potential and enhance their life trajectories, nurturing healthier, happier and more resilient future generations.

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