While more people than ever are struggling, the most recent CDC data finds the number of teen girls dealing with feelings of persistent sadness and thoughts of suicide is climbing.
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"I was dealing with a lot of bullying throughout school," said 18-year-old Franchesca Zepeda, whose pain and hurt turned into persistent feelings of sadness. "It was just overwhelming for me. I felt high anxiety all the time. It was hard for me to talk to my mom because I knew she was going to be mad at me for it."
Her mother, Nicole Merkelbach, said the teen has always been isolated and said she suffers from depression.
When Zepeda was 14, Merkelbach knew her daughter had been struggling, but a call from school shook her. She remembered the words.
"You need to come pick her up. You know, she's threatening to harm herself," Merkelbach recalled.
Dr. Ashley Zucker, a psychiatrist with Kaiser Permanente San Bernardino, said they've been seeing a rise in mental illness and adolescents, even before the pandemic. Zucker said what she's seen in her practice tracks with data from the Youth Risk Behavior Survey.
Researchers found about 57% of U.S. teen girls felt persistently sad or hopeless in 2021 - double that of boys. It's the highest level reported over the past decade.
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"The most concerning was the significant increase in suicidal ideation and suicide attempts, particularly in adolescent girls," Zucker said.
It's common for kids to feel this way, but Zucker's advice is to be persistent.
"Even if you think you know what's going on, you have to just keep checking in and making sure that your kids are okay," she said.
One suggestion is to create an emoji code system for a child to communicate to an adult they feel safe with.
"Pick an emoji that you rarely use or one that is kind of random, and that's like your 'Hey, I need help emoji,'" said Zucker.
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Zepeda finally opened up to her mom and stayed a few days at a behavioral medicine center. She's also been going to therapy ever since.
It's a decision that's made the teen stronger and she hopes it's one other families will consider.
"I know what it's like to be alone and it's okay to ask for help," Zepeda said.
If you or someone you know is struggling with thoughts of suicide - free, confidential help is available 24 hours a day, 7 days a week. Call or text the National Suicide and Crisis Lifeline at 988. Even if you feel like you're alone, you're not.