What Happens to a Young Brain in Solitary Confinement

Psychology has long known the danger of being ‘alone in the hole’ — but the side effects are even worse for the minds of young adults, experts say. (Illustration: Erik Mace)

Sure, being sequestered to a room is a common punishment for teenagers — but it’s not the same as being locked away all alone for days, weeks, and sometimes even months at a time, as is the case for minors who are placed in solitary confinement while serving time in prison.

As highlighted in a recent New York Times article, the act of putting minors in solitary confinement is more widespread than realized. In 2011, Human Rights Watch and the American Civil Liberties Union estimated that more than 95,000 youths were in prisons. The report, “Growing Up Locked Down,” included interviews from 127 kids under the age of 18 and stated that “a significant number of these facilities use solitary confinement — for days, weeks, months, or even years — to punish, protect, house, or treat some of the young people who are held there.” Even more: It found that 49 of the 127 kids spent between one and six months in solitary.

One of those kids described the experience to Human Rights Watch:

“The only thing left to do is go crazy — just sit and talk to the walls. … I catch myself [talking to the walls] every now and again. It’s starting to become a habit because I have nothing else to do. I can’t read a book. I work out and try to make the best of it. But there is no best. Sometimes I go crazy and can’t even control my anger anymore. … I can’t even get [out of solitary confinement] early if I do better, so it is frustrating and I just lose it. Screaming, throwing stuff around. … I feel like I am alone, like no one cares about me — sometimes I feel like, why am I even living?”

In U.S. prisons, solitary confinement usually consists of spending 23 hours a day in a 7-by-12-foot cell with little to no interaction with anyone — and having food slid under a steel door. Once a temporary solution for inmates, solitary is increasingly being used as a punishment for breaking rules or for protection. In 2005, it was widely accepted that 25,000 people were in solitary confinement. Today, most believe that number could be closer to 80,000.

Mental health professionals and human rights experts have long spoken out about the dangers of solitary confinement. In an NAACP conference last month, even President Obama asked, “Do we really think it makes sense to lock so many people alone in tiny cells for 23 hours a day, sometimes for months or even years at a time?”

Experts will tell you that in many cases, it doesn’t. But a growing consensus suggests that while solitary confinement is harmful for many people, children are particularly susceptible to harm, Jamie Fellner, senior advisor of the U.S. program for Human Rights Watch, who has been writing about solitary confinement for more than 15 years, tells Yahoo Health.

In fact, last year the American Medical Association (AMA) approved a resolution opposing solitary confinement for juveniles in most cases. David Fassler, MD, a clinical professor of psychiatry at the University of Vermont, who recommended that decision to the AMA, tells Yahoo Health: “The solitary confinement of juveniles in correctional facilities is a dangerous practice with the potential for significant psychiatric consequences including depression, anxiety, and psychosis.”

But to understand those side effects, you have to understand how children wind up in solitary confinement in the first place.

Under 18 and All Alone

Today, more and more kids in the U.S. are being tried as adults. The laws vary from state to state, Terry Kupers, MD, a psychiatrist and author of Prison Madness: The Mental Health Crisis Behind Bars and What We Must Do About It, tells Yahoo Health. In California, a judge has to rule, case-by-case, that the crime is serious enough to warrant trial as an adult. In Michigan, all defendants 17 or over are tried as adults automatically. But depending on state law, children anywhere from age 13 to 17 can be tried as adults and thus jailed in adult prisons instead of juvenile facilities.

This, he says, “puts them that at risk for solitary confinement.” Here’s why: In men’s prisons, particularly, young prisoners tend to be victims of sexual assault and violence, says Kupers. Some research suggests that imprisoned minors in adult prisons face gruesome odds when compared to their counterparts in juvenile establishments: They are “five times more likely to be sexually assaulted, twice as likely to be beaten by staff, and 50 percent more likely to be attacked with a weapon.”

In an attempt to “protect” adolescents — or perhaps because they are unsure of what else to do — guards tend to segregate them in solitary confinement and other forms of isolation right off the bat, Kupers says. In other cases, young prisoners land there due to their own actions: They hit another inmate or guard and are then punished with solitary, he explains. They may do this intentionally, either because they think it’s safer to be in solitary or as an act of toughness — if they already have a long sentence, they may think “it’s more ‘manly’ to do this,” says Kupers. “But it also presents another problem: Now they’re in isolation.”

Related: The Scary Thing Anger Does To Your Heart

And choosing between solitary confinement and a dangerous adult prison setting is a choice of two terrible alternatives for an adolescent, says Kupers: “The reason we have this bind is because we are putting juveniles in adult prisons.”

Of course, in some states, kids are tried as just that: kids. And if charged, they can wind up in juvenile facilities — where solitary confinement does still happen. But there, the rules are different. Human Rights Watch states juvenile facilities have maximum limits on isolation that are way below those that exist in adult facilities (in some states, juveniles must spend at least four hours out of their cells a day; in other states, it’s eight hours). The juvenile justice system is also designed to better address the specific needs of adolescents, Fellner says.

To this point, Fellner says, adolescents shouldn’t ever be charged as adults — which would then mean being punished as an adult, in an adult prison — as adolescents and adults have different needs, and the brains and bodies of adolescents are still developing, she says. And research shows that these very factors play an indisputable role in the negative effects of solitary confinement.

An Adult Brain Versus an Adolescent Brain

“When we think about adolescence, we think about a time when children are getting used to being adults — they’re being socialized, but they tend to be more impulsive,” says Kupers.

If you look at the adolescent brain, you’ll notice similar features. The temporal lobe of teens (which fires when various emotional, passionate experiences are occurring) fires far more aggressively than the prefrontal cortex (responsible for considering repercussions, cognitive processing, and organizing your thoughts). In adults, the opposite is true, says Kupers. The habit of thinking about repercussions grows stronger and stronger with age and socialization, he says. In fact, this brain region is one of the last to fully mature — sometimes not reaching “adult” status until someone is in his or her 20s.

Research like this, in part, led to the decision against giving life without parole to a child (as seen in the 2012 United States Supreme Court case of Miller v. Alabama, below):

“Children are constitutionally different from adults for sentencing purposes. Their “‘lack of maturity’” and “‘underdeveloped sense of responsibility’” lead to recklessness, impulsivity, and heedless risk-taking. They “are more vulnerable … to negative influences and outside pressures,” including from their family and peers; they have limited “contro[l] over their own environment” and lack the ability to extricate themselves from horrific, crime-producing settings. Ibid. And because a child’s character is not as “well formed” as an adult’s, his traits are “less fixed” and his actions are less likely to be “evidence of irretrievabl[e] deprav[ity].”

The Dangers of Missing Out on Childhood

“We have empirical studies of the damage that solitary confinement can cause,” says Kupers, who spends a lot of time in court and in prisons, interviewing inmates, and conducting psychological tests. For one, there are certain symptoms that regularly occur in healthy adults in solitary confinement: mounting anxiety, anger, compulsive acts, pacing, problems concentrating, and memory problems. “Those symptoms are empirically worse in adolescents,” he says, which goes back to the idea of an underdeveloped brain.

Adolescents also have a lot of energy that has to be constructively directed — which is exactly what schools try to do. If you put young adults in a little cell, that energy works against them, says Kupers. “Young people are at particular risk for such adverse reactions due to their impulsivity, limited frustration tolerance, and overall cognitive and emotional immaturity,” says Fassler.

Experts argue that we must also consider everything that young adults are missing while in solitary confinement. “We think of adolescence as a period of training — you learn social and educational skills, how to relate in a socially positive way, how to relate in a positive way to the opposite sex, how to deal with authority, how to be empathetic. All of this stops in solitary confinement — there’s a total cessation of socialization, education, and social skill learning,” says Kupers. And that has real consequences: “If someone comes out missing that period, they will likely be dysfunctional as an adult,” he says.

But the dysfunction that solitary confinement may cause can also lead to real and lasting mental health woes.

The Mental Health Dilemma

Kupers says that even when being interviewed, prisoners in solitary confinement often still put on a front of “the tough prisoner” for their own protection. But sometimes he’s able to get a glimpse into their lives — and many times this involves a picture of mental illness. In fact, studies suggest that people with no history of mental health issues can develop psychological symptoms in solitary confinement.

Adolescents, particularly, are at a higher risk of mental illness, tend to have more severe outbreaks and sharper mood swings, and are more likely to have a mental health condition exacerbated by isolation, Kupers says. They’re also less likely to have been diagnosed before being locked up, since they’re younger. So a large number of adolescents enter prison suffering from a mental illness without even knowing it, he says. But the stats of teens who knowingly suffer exist, too: In 2012, Manhattan’s Department of Corrections estimated that about 48 percent of kids between 16 and 18 in custody suffered from an already diagnosed mental disability, according to Human Rights Watch.

Related: Study Finds 1 in 5 Americans Lives With a Mental Illness

Loneliness and Suicide

Of course, one of the most painful mental health elements of all might boil down to loneliness. One adolescent in solitary confinement spoke to Human Rights Watch about the loneliness of solitary confinement:

“I wish I had better words — I was really, really lonely. … I [would] try to put covers on my head — make … like it’s not there. Try to dissociate myself … I don’t think they should do that to a juvenile. It’s impossible for any person to cope with anything like that. I couldn’t help myself.”

When issues build in isolation, they can go south quickly. While Kupers estimates only between 3 and 8 percent of prisoners are in solitary confinement, it’s where 50 percent of suicides occur, he says. “When we get depressed, we want to be alone. In treating people with depression, we say, ‘Don’t let yourself get isolated — even though you don’t feel like relating to others, call someone and get together,’” he says. In isolation, that’s impossible — and there is an extraordinarily high rate of suicides in adolescents in solitary confinement, he says, harkening back to both a lack of social outlets and a lack of that “training” period.

There are, of course, some systems in place to prevent inmate suicide, but they are far from perfect. To start, for the most part, solitary confinement cells don’t have cameras in them, Kupers says — though there are cameras in the hallways. So if a guard suspects someone is suicidal in solitary confinement (or if someone attempts suicide), they may move that person to what’s called an observation cell, where guards can observe prisoners and check in on them every 15 minutes or so, Kupers explains. Sometimes, monitoring can be done via video. But after a certain amount of time, Kupers says, patients are checked in on and can be sent back to solitary. The problem is that this back-and-forth can become a cycle with a lack of mental health treatment. And prison cells are “far from suicide-proof,” Kupers notes, pointing out that there are many ways to kill oneself and that prisoners — while not allowed to have tools that can cause self-harm — unfortunately do find ways.

In Kupers’ interviews, he’s also noticed a strong sense of shame and low self-esteem: “Young prisoners will say things like, ‘Look how I’ve messed up my life — I’ve gotten myself locked up and even here I can’t handle day-to-day activities of prison.’”

The thing is, shame and low self-esteem are normal — we’ve all likely felt both at times. The problem? “We correct shame and self-esteem issues through social interaction,” says Kupers. For example, if you’re feeling down about a recent review at work, you might go to a friend and gain a new perspective, raising your spirits. But in solitary confinement, there are no relationships. There are no friends. There is no support.

“Loneliness breeds despair,” Kupers says. “And it’s relationships that help people learn constructive instead of destructive habits.”

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