Coping strategies among poverty-affected adolescents experiencing or at risk of depression and anxiety in Nepal: a qualitative study

Adolescents employ various coping strategies to manage stress, which can impact their short and long-term mental health. Economically disadvantaged adolescents are more prone to developing maladaptive coping mechanisms due to the persistent stressors associated with poverty. In Nepal, there is a lack of research on how adolescents experiencing or at risk of depression and anxiety cope with adverse situations. This study aims to explore how adolescents affected by poverty and at risk of experiencing mental health problems navigate difficulties within their homes, peer groups, and school environments. The study focused on adolescents aged 11 to 19 residing in informal squatter settlements in Kathmandu, Nepal. In-depth narrative interviews were conducted with 30 adolescents experiencing or at risk of depression and/or anxiety. In addition, journal entries documenting their experiences were collected weekly for 3–5 weeks post-interviews. Thematic and plot analysis were employed to identify the coping strategies utilised by adolescents in this context, which were then categorised according to coping theory. The results indicated that adolescents employed a combination of adaptive and maladaptive coping strategies across different settings (home, school, and peer interactions), with variation in coping strategies used within each setting. Problem solving emerged as the most prevalent coping strategy across all settings. Adolescents tended to exhibit more submission and helplessness at home, more isolation and opposition among peers, and more accommodation and opposition at school. Adolescents aged 14–16 displayed more maladaptive coping strategies compared to younger (11 to 13 years) and older adolescents (17 to 19 years). While girls and boys utilised similar adaptive and maladaptive coping strategies, girls leaned more towards avoidance-escape and helplessness, whereas boys favoured opposition and isolation. The results highlight the range of adaptive and maladaptive coping strategies used by adolescents to manage stress in circumstances of urban poverty in Nepal. The study recommends focused psychological interventions which equip adolescents with adaptive coping strategies and stress appraisal techniques that help them manage difficulties effectively.