Everyone knows that bullying is tough on kids but, we assume, most will grow up and get over it. Unfortunately, researchers have found that bullying may be more psychologically damaging than anyone thought, with effects that last long into adulthood.

Adults, both men and women, who were bullied as children are at greater risk for depression, anxiety disorders, and suicidal thoughts, according to a new study.

There is no magic bullet to help parents deal with bullying, William Copeland, lead author of the study, tells TheDoctor. He recommends that parents talk about bullying with their kids and ask them about their experiences, with questions such as, "How are things going with your friends?" and, "Is anyone picking on you or giving you a hard time?"

Part of the problem is that bystanders very rarely speak up and say something; when they do, it can have a powerful effect.

Parents should talk with their kids about ways to deal with bullies. Children need to learn how to avoid situations that could lead to bullying, says Copeland, an assistant clinical professor of psychiatry and behavioral sciences at Duke University School of Medicine.

Copeland believes that part of the problem is that bystanders very rarely speak up and say something; when they do, it can have a powerful effect. "We all need to take a less tolerant view of bullying, and when we see kids bullying other kids, feel that we can step in and stop it, and kids should feel that if they see a friend being bullied, they can intervene."

A Tendency to Anxiety and Depression

Using data from the Great Smoky Mountain Study, researchers followed a group of 1,420 children ages nine, 11, and 13 from 11 counties in western North Carolina. The kids and their parents or caregivers were interviewed every year beginning in 1993, until the children turned 16, and then periodically thereafter.

Children (and their caregivers) were asked, among other things, whether the child had been bullied or had bullied others in the previous three months. Among the participants, 421, or 26 percent, reported being bullied at least once (victims); 887 said they were never bullied or teased. Nearly 200 children, or 9.5 percent, said that they had bullied others; 112 were bullies only, while 86 were both bullies and victims.

Of the original 1,420 children, more than 1,270 were followed into adulthood. At subsequent interviews, they answered questions about their psychological health. Adults who said they had been victims, plus those who were both bullies and victims, were at greater risk for psychiatric disorders compared to those with no history of being bullied. Young adults who were victims were more likely to have depressive disorders, anxiety disorders, generalized anxiety, panic disorder, and agoraphobia (fear of public places).

People who had been both bullies and victims had higher levels of anxiety and depressive disorders, plus the highest levels among study participants of suicidal thoughts, depressive disorders, generalized anxiety, and panic disorder. Bullies were also at increased risk for antisocial personality disorder.

The scientists are currently following the study participants to find out which kids have the most problems and which kids seem to do better. Can having a close confidant or friend, for example, make a difference?

"We do not really know the answer to this right now, and no clear set of recommendations exists for parents, except that bullying is something to be discussed, and parents should provide support for kids, and if need be, talk to schools and teachers about specific instances of bullying and what can be done about it," Copeland indicates.

Participants in the current study were bullied in the mid- to late-90s. The rise of the Internet and cyberbullying have made bullying a very different experience. Kids can now be bullied by peers at home. It is harder today to escape bullies' taunts. Says Copeland, "That is something we need to learn more about, too."

The study was published online recently in JAMA Psychiatry.