Sometimes when you’re reading mental health articles for teens, you might notice that there’s an underlying assumption that all teens have a home to live in, parents that care about their well being, or that all teens have their basic needs met. But this isn’t true. There are many teens who are homeless, without families, and who struggle with poverty.

The challenges of these situations aren’t only the obvious ones, but these circumstances also create emotional and psychological stress as well. Chronic stress can leave a lasting impact on anyone, whether adult or child. However, the child and the adolescent are vulnerable to the effects of stress because their brains are still in development.

In fact, chronic stress in childhood can lead to teen depression, anxiety, bipolar disorder and many medical diseases, according to many research studies. Depression is a psychological illness that has been increasing in numbers among teens and adults, and the same is true with anxiety. According to the National Alliance on Mental Illness (NAMI), approximately, 8% of teens meet the diagnostic criteria for major depression. Across the length of adolescence, one in five teens have experienced depression at some point in their teenage years.

There are many reasons why teens might experience poverty. Perhaps their parents were abusive or violent and a teen decided to leave home. In these cases, many adolescents end up on the streets and without access to medical or psychological care. The National Coalition for the Homeless indicates that homeless adolescents suffer from extreme forms of anxiety and depression, along with low self-esteem. In fact, they found that the rates of major depression, conduct disorder, and post traumatic stress disorder to be three times higher in homeless teens than other adolescents. Furthermore, homeless teens are prone to suicide attempts and self-harming behavior, such as cutting their wrists, burning the skin, and self-tattooing. According to the National Network for Youth, suicide is the leading cause of death among homeless adolescents. While for the general adolescent population, suicide is the third leading cause of death. Sadly, although many homeless teens are suffering from depression and other forms of mental illness, very few have access to mental health services.

It seems as though poverty, homelessness, and other difficult circumstances seems to compound and create a downward spiral. Once a teen leaves home, they end up on the streets. The difficulty of living without a home might bring drug use as a way to psychologically escape, prostitution as a means of making money, and/or finding oneself in physically violent situations. Out of desperation to survive, homeless teens will commit crimes such as theft, assault, and trespassing. One fifth of homeless adolescents have admitted to stealing. Many have needed to break into abandoned buildings in order to find a place to sleep and/or live temporarily. Living on the street is not easy and it can create great stress for an adolescent.

Psychological researchers have been studying the brain and the effect of stress in early life. Research shows that forms of early stress, such as child abuse and/or poverty affects the size of two important regions in the brain – the hippocampus and the amygdala. According to the University of Wisconsin-Madison, children who experienced chronic stress such as in abuse or poverty had smaller hippocampai and amygdalae. These smaller regions in the brain were also related to behavioral problems during adolescence and adulthood.

Early stressful experiences of children are leaving a lasting and not-so-healthy impression on the developing brain. Certainly, despite early experiences, with treatment, support, and the right coping mechanisms, teens can change, grow, and ultimately live fulfilling and rewarding lives. They don’t need to let their past limit their future.

However, breaking out of the downward spiral of homelessness, poverty, drug use, and illegal activities can be very difficult. Teens need support in these situations. They need people, organizations, and friends that care about them. At the same time, although it might be difficult to understand, some teens refuse the support. They might have some animosity towards the rest of the population, towards their families, or towards those that want to help them. They might feel fear to accept such services if only to be disappointed later. Other teens might not know what it’s like to live off the streets because they’ve been homeless for so long. The change might be too frightening for them.

The challenges of poverty among American teens is a great social problem. However, community organizations, schools, and people who care are working towards making it better for homeless teens.