When many of today’s parents were kids, making friends required proximity and opportunity.

We gravitated toward those who lived nearby or attended the same schools we did, and who liked to do the same things. If we were lucky, casual interactions turned into friendships that supported and enriched our lives.

For today's kids, however, the widespread use of technology and the lingering impact of the pandemic have significantly reduced these kinds of interactions. Not only are opportunities for spontaneous friendships more rare, but many kids have little experience navigating new or potentially awkward social situations. It’s not surprising that young people report higher levels of loneliness and social isolation -- conditions that contribute toward worsening mental health outcomes.

U.S. Surgeon General Vivek Murthy recently described the youth mental health crisis as the “defining public health issue of our time.” Suicide is the third-leading cause of death in people aged 15 to 24, and is rising sharply for certain demographics, along with increased rates of depression, anxiety and loneliness.

Friendship is key to our happiness: Forming social bonds is crucial for healthy human development and positive mental health. But it’s not an intuitive process for everyone. Children have to learn self-regulation and emotional skills in order to develop social competence. They also need real-life practice using these skills.

It will take multiple strategies to address this social problem -- from improving access to therapists and doctors to reducing the conditions that cause childhood traumas. A preventative approach should also include taking a more proactive role in nurturing friendships and positive social bonds -- things that we might take for granted.

One promising program, the Teen Connection Project at St. Louis' Wyman Center, teaches high school students how to make and maintain healthy relationships with one another using a trained facilitator and an evidence-based curriculum.

Eric Hillgren is the project's director and currently runs a 12-session program at University City High School. Students taking physical education or health classes can sign up for the optional weekly sessions.

Hillgren described an activity from one of the classes. As a group, students brainstorm an inventory of “emotional masks” -- ways in which people present themselves that are different from how they actually feel. For example, a person wearing a “spectator” mask watches and observes people silently but wishes someone cared to ask what they think. A “joker” may act silly or goofy to hide their true emotions. A “rebel” may act like they don’t care about fitting in, but they actually do. Someone wearing a "chill" mask may be using an unbothered appearance to conceal the tough things they're dealing with.

After creating this type of list, the students anonymously write down one of these masks they have used or seen others use. It’s a way to safely share their experiences and recognize how common these behaviors can be among their peers.

“They are learning that masks can be a barrier to connecting with others,” Hillgren said. Each session includes ways of breaking down these barriers and establishing trust among the students. Interestingly, several students who participate in the program will ask if they can take part in it again, Hillgren said. In addition to making stronger connections with one another, it builds confidence in their communication abilities and empathy skills.

The Wyman Center offers the program, training and resources for free to any schools across the country that want to replicate the Teen Connection Project. Providing these kinds of social and emotional learning opportunities in schools can help address some of the root causes of increasing loneliness.

The society we’ve constructed for young children -- one in which we are all connected to our devices and driving them from one structured activity to the next -- makes in-person interactions significantly different than what we experienced growing up.

While the way we form connections has changed, the need for friendship endures.

Menopause is having a cultural moment.

A growing number of influencers, podcasters, celebrities and entrepreneurs are talking openly about the experience leading up to and following the end of menstruation.

Selene Yeager, 54, has built a large community of women looking for reliable information around these issues. She co-authored “Next Level: Your Guide to Kicking Ass, Feeling Great, and Crushing Goals Through Menopause and Beyond,” hosts the podcast “Hit Play, Not Pause” and writes the “Feisty Menopause” newsletter.

“The overwhelming response has been incredible,” Yeager says. She says women are always telling her “You saved me” or “I thought I was alone.”

As an athlete, she noticed her body changing rapidly, including muscle loss, as she got closer to menopause.

After interviewing several doctors and specialists and reading scientific studies and medical journals, she made significant changes to her diet and exercise routine. She added heavier weights to her workouts, made some swaps in her diet and began using vaginal hormone therapy and the herbal remedy ashwagandha.

She encourages her readers and listeners to look at this time of life through a more positive lens. It’s a time to take stock and reflect about what one actually wants in life.

This means advocating for one’s health in a medical establishment that may dismiss our concerns.

Many women are unaware that a cascade of symptoms related to the decline of estrogen can begin as early as our 30s. More commonly, a range of menopause symptoms -- including hot flashes, interrupted sleep, joint pain, loss of libido, brain fog, hair loss, weight gain, anxiety and depression -- arrive in our 40s.

Kate Colton was in her late 30s when she noticed she was having her period more frequently. Her gynecologist did a checkup and said everything looked normal. By the time Colton was in her mid-40s, she was having hot flashes, difficulty sleeping, anxiety, joint pain and missed periods. She realized her symptoms had to be related to menopause.

Her ob-gyn prescribed a low-dose estrogen patch, which alleviated some symptoms, but anxiety and fatigue still plagued her. She sought a functional medicine nurse practitioner, who gave Colton a testosterone cream -- but also wanted to lower her estrogen patch dosage.

Then Colton, now 47, found a doctor who specializes in treating peri- and postmenopausal women. That doctor adjusted her treatment to her specific needs.

Since then, she says she has felt considerably better.

“No wonder people get divorced or leave jobs in midlife,” Colton says. “You feel miserable.”

She knows many women suffer needlessly for years.

“This is a midlife health crisis,” Colton says.

Dr. Becky Lynn, a gynecologist certified by the North American Menopause Society as a menopause practitioner, says the vast amount of misinformation and conflicting information about how to treat peri- and postmenopausal symptoms is often overwhelming for women.

Dr. Makeba Williams, gynecologist and director of midlife and menopause medicine at the Washington University School of Medicine, said she has treated patients who have spent more than $10,000 over the course of their menopause transition before coming to see her. Her research focuses on disparities in care and on the experiences of African American women going through menopause. A review of 20 years' worth of literature found that African American women report more severe symptoms -- for instance, hot flashes and night sweats that are more frequent and last longer -- and are less likely to get treated for them.

William is on a mission to let women know that better and more effective care is available to them.

“You do not need to suffer and have diminished health during this period of time,” she says.

Thanks in part to heavy marketing, the use of estrogen therapy for menopause symptoms took off in the mid-1970s. Demand skyrocketed, and Premarin, a brand of estrogen treatment, became the No. 1 prescribed drug in the United States by 1992.

Some studies began to challenge the effectiveness and safety of hormone replacement therapy (HRT). A study conducted by the Women’s Health Initiative, launched in 1991, was prematurely stopped in 2002 due to safety concerns: Researchers noted a small increased risk of breast cancer, heart disease, stroke and blood clots among women taking combined HRT.

That was a watershed moment: Physicians backed off from prescribing HRT, and many women became afraid to ask for it. Practitioners stopped teaching medical residents and students how to safely prescribe hormones.

But menopausal symptoms did not magically disappear.

Instead, an unregulated “wellness” market rose to fill the void. A lucrative cottage industry has sprung up selling untested and unregulated treatments to women who are desperate to feel better.

Subsequent critiques of the WHI study have challenged the initial headline-grabbing takeaways. Lynn points out that the data, when broken down by age, revealed a window of opportunity when women could still benefit from HRT.

Now that the culture around menopause is beginning to change, the medical establishment needs to catch up.

Even though he grew up in Minnesota, Danny Santulli chose to follow his older siblings’ footsteps and attend the University of Missouri.

He loved sports and hanging out with his friends and family, and never got in any serious trouble.

But early in his freshman year at Mizzou, a horrific hazing incident destroyed his life.

When Danny started college in 2021, he wanted to join a fraternity like his older brother, Nick. Nick had pledged Pi Kappa Alpha; he'd had a great experience and made lifelong friends.

Danny pledged Phi Delta Gamma, known as Fiji. Within weeks of joining, a hazing event left then-19-year-old Danny with severe brain damage -- unable to see, walk or speak.

Several members of the fraternity were later charged in the incident, including Ryan P. Delanty of Manchester, Missouri, and Thomas Shultz of Chesterfield, Missouri. Danny's family settled a civil lawsuit against the fraternity and 23 members.

Lawsuit documents detail the events leading up to Oct. 19, 2021, when Danny attended “pledge dad reveal night” at the Fiji house. Delanty handed him a bottle of Tito’s vodka, which was then taped to Danny’s hands. He was ordered to drink it. Another member poured beer into his mouth with a funnel and a tube. Members left Danny sitting on a couch with a blood-alcohol level of 0.468%. He ended up lying face-down on the floor with blue lips and pale skin, the lawsuit says.

No one called 911. Fraternity members eventually drove him to the hospital. The incident was recorded on surveillance video.

Danny's family offered victim impact statements at Delanty's sentencing hearing last week. He pleaded guilty in Boone County Circuit Court to supplying liquor to a minor and to a reduced misdemeanor charge of hazing.

Prosecutors recommended six months of jail time for Delanty.

David Bianchi, the family’s lawyer, has represented hazing victims for decades and says Danny's are the worst hazing injuries he’s ever seen. He says curtailing hazing on campuses requires, first, that universities take swift action to expel the students involved.

“They almost never do that,” he said, because the schools fear pressure from the Greek community and donors.

Secondly, Bianchi said, prosecutors must act aggressively in bringing charges rather than offering plea deals that are just a slap on the wrist for these serious crimes.

Danny’s aunt Chrissy Prioleau says she has connected with families whose children have died due to hazing incidents. Most of them are still waiting for any kind of justice, she said. In some states, hazing is a misdemeanor offense.

“People have died, and it’s like giving a traffic ticket,” she said. One of the most heartbreaking experiences for her family has been the silence from Danny’s so-called “brothers” in the fraternity.

"You want someone to say, 'I’m sorry,'" she said. "We never got it." In fact, even the families they had known prior to the incident who had sons in the fraternity went silent. She is convinced that if there hadn’t been video evidence of that night, no one would have faced any consequences for her nephew’s life-altering injuries.

“It’s been 31 months that we’ve been waiting for justice for Danny,” she said.

Tom Santulli, Danny’s father, said they had no idea how Danny was being treated during the monthslong initiation. In texts discovered on his phone after he was hospitalized, Fiji members had frequently ordered Danny to the house, telling him to bring them booze and weed -- even when he would say he needed to study.

They told him to stand in a garbage can with broken glass that led to him needing stitches on his foot, Tom said. They indoctrinated members on a code of silence.

Tom wants college students considering Greek life, and their parents, to do research on the groups before they join. He had coached Danny's basketball team and dreamed of his son’s bright future. Danny had considered majoring in business like his older brother.

Now, he requires 24-hour care at home.

“I’m still devastated,” Tom said. “His life was taken away.”

University of Missouri spokesman Christian Basi said the university acted swiftly when it learned about the incident. They removed the Fiji frat from campus. The MU police arrested several of the members involved. The school instituted training and education on alcohol poisoning for students, along with information on how to recognize hazing and report it.

Changing the culture around hazing requires stronger action from universities and prosecutors, better awareness among parents and students, and a complete mindset change among Greek leadership and members.

A “brotherhood” does not seek to humiliate, harm or hurt its brethren.