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As a parents or caregiver, it is very important for you to be askable. What does that mean? How do adults become askable?
To be askable means that young people see you as approachable and open to questions. Being askable about sexuality is something that most parents and caregivers want but that many find very difficult. Adults may have received little or no information about sex when they were children. Sex may not have been discussed in their childhood home, whether from fear or out of embarrassment. Or, adults may worry about:
Not knowing the right words or the right answers;
Being out of it in the eyes of their young people;
Giving too much or too little information; or
Giving information at the wrong time.
Being askable is important. Research shows that youth with the least accurate information about sexuality and sexual risk behaviors may experiment more and at earlier ages compared to youth who have more information.[1,2,3,4,5] Research also shows that, when teens are able to talk with a parent or other significant adult about sex and about protection, they are less likely to engage in early and/or unprotected sexual intercourse than are teens who haven’t talked with a trusted adult.[6,7,8,9] Finally, youth often say that they want to discuss sex, relationships, and sexual health with their parents—parents are their preferred source of information on these subjects.[10,11]
Because being askable is so important and because so many adults have difficulty initiating discussions about sex with their children, adults may need to learn new skills and become more confident about their ability to discuss sexuality. Here are some tips from experts in the field of sex education.
Talking with Young People about Sexuality
Acquire a broad foundation of factual information from reliable sources. Remember that sexuality is a much larger topic than sexual intercourse. It includes biology and gender, of course, but it also includes emotions, intimacy, caring, sharing, and loving, attitudes, flirtation, and sexual orientation as well as reproduction and sexual intercourse.
Learn and use the correct terms for body parts and functions. If you have difficulty saying some words without embarrassment, practice saying these words, in private and with a mirror, until you are as comfortable with them as with non-sexual words. For example, you want to be able to say “penis” as easily as you say “elbow.”
Think through your own feelings and values about love and sex. Include your childhood memories, your first infatuation, your values, and how you feel about current sex-related issues, such as contraceptives, reproductive rights, and equality with regard to sex, gender, and sexual orientation. You must be aware of how you feel before you can effectively talk with youth.
Talk with your child. Listen more than you speak. Make sure you and your child have open, two-way communication—as it forms the basis for a positive relationship between you and your child. Only by listening to each other can you understand one another, especially regarding love and sexuality, for adults and youth often perceive these things differently.
Don’t worry about—
Being “with it.” Youth have that with their peers. From you, they want to know what you believe, who you are, and how you feel.
Being embarrassed. Your kids will feel embarrassed, too. That’s okay, because love and many aspects of sexuality, including sexual intercourse, are highly personal. Young people understand this.
Deciding which parent should have this talk. Any loving parent or caregiver can be an effective sex educator for his/her children.
Missing some of the answers. It’s fine to say that you don’t know. Just follow up by offering to find the answer or to work with your child to find the answer. Then do so.
Talking with Young Children
Remember that if someone is old enough to ask, she/he is old enough to hear the correct answer and to learn the correct word(s).
Be sure you understand what a young child is asking. Check back. For example, you might say, “I’m not certain that I understand exactly what you are asking. Are you asking if it’s okay to do this or why people do this?” What you don’t want is to launch into a long explanation that doesn’t answer the child’s question.
Answer the question when it is asked. It is usually better to risk embarrassing a few adults (at the supermarket, for example) than to embarrass your child or to waste a teachable moment. Besides, your child would usually prefer it if you answer right then and softly. If you cannot answer at the time, assure the child that you are glad he/she asked and set a time when you will answer fully. “I’m glad you asked that. Let’s talk about it on the way home.”
Answer slightly above the level you think your child will understand, both because you may be underestimating him/her and because it will create an opening for future questions. But, don’t forget that you are talking with a young child. For example, when asked about the differences between boys and girls, don’t get out a textbook and show drawings of the reproductive organs. A young child wants to know what is on the outside. So, simply say, “A boy has a penis, and a girl has a vulva.”
Remember that, even with young children, you must set limits. You can refuse to answer personal questions. “What happens between your father and me is personal, and I don’t talk about it with anyone else.” Also, make sure your child understands the difference between values and standards relating to his/her question. For example, if a child asks whether it is bad to masturbate, you could say, “Masturbation is not bad; however, we never masturbate in public. It is a private behavior.” [values versus standards] You should also warn your child that other adults may have different values about this subject while they will hold to the same standard; that is, they may believe it is wrong and a private behavior.
Talking with Teens
Recall how you felt when you were a teen. Remember that adolescence is a difficult time. One moment, a teen is striving for separate identity and independence, and the next moment urgently needs an adult’s support.
Remember that teens want mutually respectful conversations. Avoid dictating. Share your feelings, values, and attitudes and listen to and learn about theirs. Remember that you cannot dictate anyone else’s feelings, attitudes, or values.
Don’t assume that a teen is sexually experienced or inexperienced, knowledgeable or naive. Listen carefully to what your teen is saying and/or asking. Respond to the teen’s actual or tacit question, not to your own fears or worries.
Don’t underestimate your teen’s ability to weigh the advantages and disadvantages of various options. Teens have values, and they are capable of making mature, responsible decisions, especially when they have all the needed facts and the opportunity to discuss options with a supportive adult. If you give your teen misinformation she/he may lose trust in you, just as he/she will trust you if you are a consistent source of clear and accurate information. Of course, a teen’s decisions may be different from ones you would make; but that goes with the territory.
Being askable is a lifelong component of relationships. It opens doors to closer relationships and to family connections. It’s never too late to begin!
Kirby D. Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy, 2001.
Baldo M, Aggleton P, Slutkin G. Does Sex Education Lead to Earlier or Increased Sexual Activity in Youth? Presentation at the IX International Conference on AIDS, Berlin, 6-10 June, 1993. Geneva: World Health Organization, 1993.
UNAIDS. Impact of HIV and Sexual Health Education on the Sexual Behaviour of Young People: A Review Update. [UNAIDS Best Practice Collection, Key Material] Geneva: UNAIDS, 1997.
Alford S et al. Science & Success:Sex Education & Other Programs that Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections. Washington, DC: Advocates for Youth, 2003.
Thomas MH. Abstinence-based programs for prevention of adolescent pregnancies: a review. Journal of Adolescent Health 2000; 26:5-17.
Miller KS et al. Patterns of condom use among adolescents: the impact of mother-adolescent communication. American Journal of Public Health 1998; 88:1542-1544.
Shoop DM, Davidson PM. AIDS and adolescents: the relation of parent and partner communication to adolescent condom use. Journal of Adolescence 1994; 17:137-148.
Jemmott LS, Jemmott JB. Family structure, parental strictness, and sexual behavior among inner-city black male adolescents. Journal of Adolescent Research 1992; 7:192-207.
Rodgers KB. Parenting processes related to sexual risk-taking behaviors of adolescent males and females. Journal of Marriage and Family 1999; 61:99-109.
Hacker KA et al. Listening to youth: teen perspectives on pregnancy prevention. Journal of Adolescent Health 2000; 26:279-288.
Kaiser Family Foundation, Nickelodeon, and Children Now. Talking with Kids about Tough Issues: a National Survey of Parents and Kids. Menlo Park, California: The Foundation, 2001.
Written by Barbara Huberman, RN, MEd, and by Sue Alford, MLS
© 2005, Advocates for Youth
It's a fact! Research shows that children who learn about the risks of drugs and drinking from their parents are up to 50% less likely to use. We recommend beginning drug education early - and as a natural part of family projects and mealtime talks. If your kids are already in their teen years, thats ok too. It's never too late to begin the conversation. After all, your kids may not know as much as they think.
Conversations are one of the most powerful tools parents can use to connect with & protect their kids. But when tackling some of life’s tougher topics, especially those about drugs and alcohol, figuring out what to say can be a challenge. These scripts will help you get conversations going with your child. Read More...
Having trouble talking to your kid about the risks of drugs and alcohol? Television can be a great connecting point. Here are everyday examples of teachable moments, including television, that you can use to bring up the subject with your child, . Read More...
There’s no way you can shield your kids from finding out that illegal drugs, alcohol and tobacco exist—but you can help your child reject offers to try them. Read More...
The issue isn’t about your past. It’s about your children’s future. What’s important now is that your kids understand that you don’t want them to use drugs. Read More...
You and your child have a great support system surrounding you. Members of your community such as sports coaches, guidance counselors, school nurses and even near-by relatives can all help guide a child toward healthy choices at every stage of life. Read More...
Studies show that adolescents who haven’t tried drugs or alcohol are more likely to start during times of transition in order to cope with stress. This guide has everything you need to know to help keep your child healthy and even happy during transition periods. Read More...
Anxiety can be tough for anyone to deal with, but add in the whirlwind of changes that come with adolescence, and anxiety can feel like an intrusive mind hog that spends way too much time squeezing, surprising and overwhelming anyone it lands on.
If anxiety is making a menace of itself, the good news is that there are ways to take it back to small enough. First though, it’s important to understand the telltale signs of anxiety and where they come from. When you understand this, anxiety will start to lose the power that comes from its mystery and its unpredictability.
Teens With Anxiety. A Few Things You Need to Know
Anxiety has absolutely nothing to do with strength, character or courage.
People with anxiety will be some of the strongest, most likable, bravest people any of us will know. Anxiety and courage always exist together. Courage doesn’t mean you never get scared – if you’re not scared, there’s no need to be brave. What courage means is that you’re pushing right up against your edges. It doesn’t matter where the edges are. They will be different for everyone. The point is that courage is all about feeling them and making a push to move through them – and people with anxiety do it all the time.
Sometimes it drops in for absolutely no reason at all.
Anxiety happens because your brain thinks there might be danger, even when there is no danger at all. Brains are smart, but they can all read things a little bit wrong sometimes.
Anxiety is soooo common. Almost as common as having feet. But not quite.
On average, about 1 in 5 young people have anxiety. Without a doubt, someone you know or care about will also struggle with anxiety from time to time. Stats don’t lie. They don’t gossip and they don’t start scandals either, which is why they’re so reliable. They’re good like that.
Everyone experiences anxiety on some level.
Anxiety exists on a spectrum – some people get it a lot and some people get it a lot less, but we all experience anxiety on some level at some time in our lives – exams, job interviews, performances. Sometimes it can happen for no reason at all.
Anxiety is a feeling, not a personality.
Anxiety doesn’t define you. It’s a feeling – it will come, but it will always go, and it’s as human as having a heartbeat.
Your brain that is strong, healthy and doing exactly what brains are meant to do.
Your brain is magnificent. It’s just a little overprotective. It loves you like a favourite thing and it wants to keep you safe. And alive. Brains love keeping people alive. They adore it actually.
Anxiety can look a little something like this …
Here are some of the common signs of anxiety in teenagers. If you have some of these, it doesn’t mean that teenage anxiety is a problem for you. This list is a way to make sense of things that feel as though they’re getting in your way, but if you experience some of them and you’re travelling along beautifully, then there’s no problem at all. Something is only a problem if it’s causing you a problem.
Negative thoughts – what-ifs, thoughts about being judged or embarrassed, small thoughts that grow into big worries.
Excessive worry about physical symptoms (that a cut might become infected, that a headache might mean brain cancer).
An anxious brain is a strong brain, and anxious thoughts can be persuasive little beasts that stick to the inside of your skull like they belong there. Write this down and stick it to your mirror, so you see it every morning when you’re getting a faceful of your gorgeous head: ‘Thoughts are thoughts. They are NOT predictions. Let them come. And then let them go.’
Fearful, worried, overwhelmed, out of control.
Dread, as though something bad is going to happen.
Panic that seems to come from nowhere.
Feeling separate to your physical self or your surroundings. (This is called depersonalisation and it can be driven by anxiety. Manage this one by managing your anxiety. Keep reading for how to do this.)
Tightening in the chest
Feeling as though you’re going to vomit.
Dizzy or light-headed.
Feeling as though you want to burst into tears.
These are all because of the surge of neurochemicals that happen when the body is in fight or flight mode. They can feel frightening, but they are all a very normal part of the way your brain and body protect you from possible danger (more about this later).
Skin picking (dermatillomania).
Pulling out hair (trichotillomania).
Avoidance of people or situations, even if they are things that would probably be fun. (This isn’t necessarily about wanting to avoid the people involved and more about wanting to avoid the anxiety that comes with certain situations such as parties or get-togethers or anything unfamiliar.)
Feel compelled to perform certain habits or rituals that don’t seem to make sense (e.g. having to stack things in even numbers, having to touch the door handle a certain number of times before you leave, compulsive hand-washing, checking locks etc).
People with anxiety tend to find all sorts of ways to make their anxiety feel smaller for a little while. These self-soothing behaviors will often escalate with the intensity of the anxiety, but will ease once anxiety is under control. If you can manage your anxiety, this will help to fade these symptoms. (Sit tight – we’ll talk about how to do that.)
You might have a bit of …
Tummy trouble – (constipation, diarrhea, irritable bowel).
In the gut are hundreds of millions of neurons. This is affectionately known as ‘the brain in our gut’. These neurons are really important for mental health because they send information from the belly to the brain. When the environment in the gut is out of balance (not enough good bacteria, too many bad ones), the messages sent back to the brain can stir anxiety.
And those zzz’s …
Difficulty sleeping – either trouble falling asleep, or waking up and not being able to go back to sleep.
When you’re still, quiet and trying to relax, negative thoughts or worries will see it as an invitation. They’ll put on their fancy pants and get the party started in your head. Pushy little sleep-thieving pirates that they are.
Practical, powerful ways to help manage anxiety.
Understand why it feels the way it does.
Understanding why anxiety feels the way it does will be one of your greatest tools in managing it. Think of it like this. Imagine being in a dark room that is full of ‘stuff’. When you walk around in the dark, you’re going to bump into things. You’re going to scrape, bruise and maybe drop a few choice words. Turn on the light though, and those things are still there, but now you can navigate your way around them. No more bumps. No more scrapes. And no more having to hold your tongue in front of people who can confiscate your phone. Here’s what you need to know …
Anxiety happens because a part of your brain (the amygdala) thinks there might be something it needs to protect you from. When this happens, it surges your body with a mix of neurochemicals (including oxygen, hormones and adrenaline), designed to make you stronger, faster, more alert and more powerful so you can fight for your life or run for it. This is the fight or flight response. It’s normal and healthy and it’s in everyone. In people with anxiety, it’s just a little quicker to activate.
The amygdala acts on impulse. It’s a do-er, not a thinker – all action and not a lot of thought. It just wants to keep you safe, because safe is a lovely thing to be and because that’s been its job since the beginning of humans. The amygdala can’t always tell the difference between something that might hurt you (like a baseball coming at your head) and something that won’t (like walking into a party) – and it doesn’t care. All it wants to do is keep you safe.
When there’s nothing to flee or nothing to fight, there’s nothing to burn the neurochemical fuel that is surging through you. The fuel builds up and that’s why anxiety feels the way it does. Here’s how that works:
» Your breathing changes from normal, slow breaths to short, shallow breaths. This is because your brain tells your body to conserve oxygen on breathing, and send as much as possible to the muscles so they can get ready to run or fight.
You might feel puffed or a bit breathless. You might also feel your cheeks burn red (from the blood rushing to your face) and your face become warm.
» If you don’t fight or flee, the oxygen builds up in your body and the carbon dioxide drops.
You might feel dizzy or a bit confused.
» Your heart races to get the oxygen around your body.
Your heart can feel like it’s beating out of your chest and you might feel sick.
» Fuel gets sent to your arms (for fight) and to your legs (for flight).
Your hands, arms and legs might feel tense or shaky.
» Your body starts cooling itself down to stop it from overheating if it has to fight or flee.
You might feel a bit clammy or sweaty.
» Anything happening in your body that isn’t absolutely essential in the moment for your survival will shut down to conserve energy. Your digestive system is one of these. It shuts down until the ‘danger’ is dealt with, so the fuel it was using to digest your food can be used by your body for fight or flight.
You might feel butterflies in your belly. You might also feel sick, as though you’re about to vomit, and your mouth might feel dry.
» The amygdala also controls your emotions so when it’s in fight or flight, it’s switched on to high volume. This means your emotions can be too.
You might burst into tears or get angry.
Everything you feel when you have anxiety is to do with your body getting ready to fight or flee, when there is actually no need for either. It’s okay – there are things you can do about this. Let’s talk about that …
Dealing with Anxiety – The How-To
Here are some ways to manage anxiety by strengthening the structure and function of your brain in ways that protect it against anxiety. Remember though, the brain is like any other muscle in your body – it will get stronger with practice. I wish I could tell you that it would get stronger with pizza and tacos but that would be a dirty big lie and very unhelpful. Delicious maybe, but unhelpful. What isn’t a lie is that the following strategies have been proven by tons of very high-brow research to be very powerful in helping to reduce anxiety.
Mindfulness. But first to show you why.
A mountain of studies have shown that mindfulness can be a little bit magic in strengthening the brain against anxiety. In a massive analysis of a number of different mindfulness/anxiety studies, mindfulness was found to be ‘associated with robust and substantial reductions in symptoms of anxiety.’
Mindfulness changes the brain the way exercise changes our body – but without the sweating and panting. Two of the ways mindfulness changes the brain are:
by strengthening the connections between the amygdala (the key player in anxiety) and the prefrontal cortex (the part of the brain that can calm big emotions (and anxiety counts as a big emotion). The stronger the connections, the more the pre-frontal cortex is able to weigh in during anxiety and calm things down.
by teaching the brain to stay in the present. Anxiety is driven by a brain that has been cast into the future. Thoughts start out as ‘what ifs’ and turn into persuasive little beasts that won’t let go. Mindfulness helps to keep control over your brain so you can stop it from worrying about things it doesn’t need to.
Okay then. What else can mindfulness do?
Plenty. Mindfulness can improve concentration, academic performance, the ability to focus, and it can help with stress and depression. It also increases gray matter, which is the part of the brain that contains the neurons. Neurons are brain cells, so we want plenty of them and plenty of gray matter for them to hang out in.
So mindfulness hey? What is it exactly?
Mindfulness is about staying in the present and ‘watching’ your thoughts and feelings without hanging on to them for too long. It’s this ‘hanging on too long’ that gives them the juice they need to become something bigger. Minds quite like to wander, especially anxious ones, so staying in the moment can take some practice. Here’s the how:
Get comfy and close your eyes.
Notice your breathing. How does the air feel as you draw it inside you? Notice the sensation of the air, or your belly rising and falling. Notice your heart beating. If your mind starts to wander, come back to this.
Now, what can you hear? What can you feel outside of you and inside your body? If your mind starts to wander, focus on your breathing again.
Is there an app for that?
There are some brilliant apps that can guide you through mindfulness. Here are three (with links) for you to have a look at:
Smiling mind – a free app has tailored programs for different ages.
Stop, Breathe, Think – start by choosing words to describe how you’re feeling right now, and the app will suggest the best meditations based on where you’re at.
Insight Meditation Timer – another free app with guided meditations from over 700 teachers. It also has a very excellent feature that shows a map of how many other people are meditating in the world (using the app) at the same time as you. How to make the world feel a little bit smaller and a little more connected. Nice.
The effects of exercise on mental health are proven and powerful. The research on the positive effects of exercise on anxiety could probably cover a small planet, or, you know, a very big building. The point is that there’s tons of it.
Here’s how it works. Some neurons (brain cells) are born with the personality of puppies – very excitable and quick to fire up. We need these. They help us to think quickly, act quickly and remember. In the right amount and at the right time, these neurons are cell-sized bits of brain magic. Sometimes though, they can get a bit carried away with themselves. When too many of these excitable neurons get too active, anxiety can happen.
To stop these neurons getting over-excited and causing trouble, the brain has a neurochemical, GABA (gamma-aminobutyric acid is the name it likes to go by at scientific get-togethers and when it wants to make an impression). Neurochemicals are the suave little messengers in the brain that carry important info from one cell to another. GABA is the brain’s calm down chemical – kind of like a sweet lullaby for the parts of the brain that are in very serious lullaby need. When the levels of GABA in the brain are low, there’s nothing to calm the excitable neurons. Exercise is a really effective way to get the GABA in the brain to the right levels.
Once these neurochemicals are back to healthy levels, the symptoms of anxiety tend to disappear into the sunset, or into a box with a very tight fitting lid – we don’t know for certain but wherever they go, it’s somewhere far away from you which is the important thing.
Any activity that gets your heart going counts as exercise. This will be different for everyone. It doesn’t have to mean pounding the pavement with your running feet on to the point of that you’re gasping for sweet life and demanding an oxygen tank. Not that there’s anything wrong with this, but it’s just that there aren’t always oxygen tanks handy when you need them. A brisk 20-minute walk or 8-10 minutes of going up and down the stairs a couple of times a day will also do it. Whatever works for you. Try for something you can do at least five times a week.
If vigorous exercise and you are still in the getting to know you trying-to-like-you phase of your relationship, non-aerobic exercise like yoga can also ease anxiety.
Breathe. But practice, practice, practice. And then practice a little bit more.
Anxiety can feel like such a gangster at times, it can be hard to believe that something as simple and as normal as breathing can out-muscle it – but it can. Here’s why. Strong, deep breathing initiates the relaxation response. The relaxation response was discovered by a Harvard cardiologist to be an automatic response that can neutralize the surge of neurochemicals that cause the awful physical feelings of anxiety. Because it’s an automatic response, you don’t need to believe it works, it just will – but you do have to initiate it.
Breathing is the switch that will activate the relaxation response and start to put the symptoms of anxiety back to small enough. Once you start slow deep breathing, your body will take over and do the rest. Breathe in through your nose for 3, hold for 1 and then out through your mouth for 3. (If you’re the type who quite fancies a visual, imagine holding a cup of hot cocoa and smelling the warm, heady aroma for three, hold your breath for one, then blow it cool for one.) Make sure the breathing is going right into your belly, not just into your chest.
In the thick of anxiety, the brain is too busy with other things to remember to do strong deep breathing. To make strong deep breathing easier for your brain to access, practice it a couple of times a day when you’re calm.
Food. You’ve gotta look after your belly
We used to think that anxiety or depression caused tummy trouble, but increasingly researchers are thinking that it actually works the other way – an unhappy belly can make an unhappy brain. The good news about this is that it doesn’t take too much effort to put it right, but eating well is super-important.
We know there are trillions of microbes that live in the intestinal tract. These send signals to the brain that can change mood and behavior. If you eat too much processed food or too much sugar (or not enough good food) it can knock out the balance of good bacteria in your gut. This can upset the balance of everything and heavily influence your mood by sending funky messages back to your brain. Eating unprocessed, healthy food, and food that contains good bacteria (such as miso or yogurt) can help to balance things out inside your gut and put things back on track.
There’s absolutely nothing wrong with eating something unhealthily delicious now and then, but make sure that you’re not overdoing it. The healthier your gut, the healthier your mental health. Gut bacteria are the rock stars of the mental health world. It’s really important to keep yours happy, because, you know – cranky rock stars can be painful and annoying and cause more than a decent amount of trouble.
And finally …
Make sure you love yourself a little louder. At adolescence, you’re at a point in your life where the world is opening up to you. It’s a world that needs your wisdom, your courage and your interesting and very wonderful take on things. Anxiety can have a way of shifting the focus too often to the negative, but the things about ourselves that we would like to change often have very wonderful strengths built into them. Of course you would always rather not have anxiety, but there are so many strengths in you. Spend plenty of time noticing them.
Anxiety is something that happens, not something you are. What you are is smart, with truckloads of emotional intelligence, and a very wonderful and unique way of looking at things, as well as being the person people can count on, the one who thinks of things that other people haven’t, creative (even if you aren’t doing anything creative, it’s in you), sensitive, strong, and brave. You would be most people’s favorite type of humans.
Helping Students with School Anxiety
Worry, fear, meltdowns, inability to concentrate, refusing to go to school. Students’ outward behavior can often indicate an internal struggle with anxiety. And as the most common emotional disorder affecting kids today, anxiety is having an impact on thousands of classrooms nationwide.
But how can you know when students are dealing with anxiety? And what can you do to help?
To help you manage anxiety in your students, Rogers provides a comprehensive set of educational tools, helpful articles, anxiety-reducing exercises, and the new “Anxiety in Schools” podcast. In this six-part series, our expert medical staff share ways you can identify at-risk students, practical tips for addressing anxiety in the classroom, and clues for knowing when it’s time to seek professional help. Listen to the podcast and access a library of additional resources below to help your students. School Anxiety Podcast Series
Help for Parents of Troubled Teens
Is your teenager violent, depressed, abusing alcohol or drugs, or facing other problems? Here’s how to ease the stress at home and help your teen transition into a happy, successful adult.
Why do teens act the way they do?
Parenting a teenager is never easy. You may feel exhausted from lying awake at night worrying about where your child is, who they’re with, and what they’re doing. You may despair over failed attempts to communicate, the endless fights, and the open defiance—not to mention the moodiness, the intense emotions, and the impulsive and reckless conduct.
Sometimes it may be hard to believe, but no, your teenager is not an alien being from a distant planet. But they are wired differently. A teenager’s brain is still actively developing, therefore processes information differently than a mature adult’s brain. The frontal cortex—the part of the brain used to manage emotions, make decisions, reason, and control inhibitions—is restructured during the teenage years, forming new synapses at an incredible rate, while the whole brain does not reach full maturity until about the mid-20’s.
Your teen may be taller than you and seem mature in some respects, but often they are simply unable to think things through on an adult level. Hormones produced during the physical changes of adolescence can further complicate things. Now, these biological differences don’t excuse teens’ poor behavior or absolve them from accountability for their actions, but they may help explain why teens behave so impulsively or frustrate parents and teachers with their poor decisions, social anxiety, and rebelliousness. Understanding adolescent development can help you find ways to stay connected to your teen and overcome problems together.
It’s also important to remember that while teenagers are individuals with unique personalities and their own likes and dislikes, some traits are universal. No matter how much your teen seems to withdraw from you emotionally, no matter how independent your teen appears, or how troubled your teen becomes, they still need your attention and to feel loved by you.
Teens read emotions differently
Teens differ from adults in their ability to read and understand emotions in the faces of others. Adults use the prefrontal cortex to read emotional cues, but teenagers rely on the amygdala, the part of the brain responsible for emotional reactions. Research shows that teens often misread facial expressions; when shown pictures of adult faces expressing different emotions, teens most often interpreted them as being angry.
Source: ACT for Youth
When typical teen behavior becomes troubled teen behavior
As teenagers begin to assert their independence and find their own identity, many experience behavioral changes that can seem bizarre and unpredictable to parents. Your sweet, obedient child who once couldn’t bear to be separated from you now won’t be seen within 20 yards of you, and greets everything you say with a roll of the eyes or the slam of a door. As difficult as this can be for parents to endure, they are the actions of a normal teenager.
A troubled teen, on the other hand, exhibits behavioral, emotional, or learning problems beyond typical teenage issues. They may repeatedly practice at-risk behaviors including drinking, drug use, sex, violence, skipping school, self-harming, shoplifting, or other criminal acts. Or they may exhibit symptoms of mental health problems such as depression, anxiety, or eating disorders. While any negative behavior repeated over and over can be a sign of underlying trouble, it’s important for parents to understand which behaviors are normal during adolescent development, and which can point to more serious problems.
Typical Teen vs. Troubled Teen Behavior
Typical teen behavior: Keeping up with fashion is important to teens. That may mean wearing provocative or attention-seeking clothing or dyeing their hair. Unless your teen wants tattoos, avoid criticizing and save your protests for the bigger issues. Fashions change, and so will your teen.
Warning signs of a troubled teen: Changing appearance can be a red flag if it’s accompanied by problems at school or other negative changes in behavior. Evidence of cutting and self-harm or extreme weight loss or weight gain are also warning signs.
Increased arguments and rebellious behavior
Typical teen behavior: As teens begin seeking independence, you will frequently butt heads and argue.
Warning signs of a troubled teen: Constant escalation of arguments, violence at home, skipping school, getting in fights, and run-ins with the law are all red flag behaviors that go beyond the norm of teenage rebellion.
Typical teen behavior: Hormones and developmental changes often mean that your teen will experience mood swings, irritable behavior, and struggle to manage their emotions.
Warning signs of a troubled teen: Rapid changes in personality, falling grades, persistent sadness, anxiety, or sleep problems could indicate depression, bullying, or another emotional health issue. Take any talk about suicide seriously.
Experimenting with alcohol or drugs
Typical teen behavior: Most teens will try alcohol and smoke a cigarette at some point. Many will even try marijuana. Talking to your kids frankly and openly about drugs and alcohol is one way to ensure it doesn’t progress further.
Warning signs of a troubled teen: When alcohol or drug use becomes habitual, especially when it’s accompanied by problems at school or home, it may indicate a substance abuse issue or other underlying problems.
More influenced by friends than parents
Typical teen behavior: Friends become extremely important to teens and can have a great influence on their choices. As a teens focuses more on their peers, that inevitably means they withdraw from you. It may leave you feeling hurt, but it doesn’t mean your teen doesn’t still need your love.
Warning signs of a troubled teen: Red flags include a sudden change in peer group (especially if the new friends encourage negative behavior), refusing to comply with reasonable rules and boundaries, or avoiding the consequences of bad behavior by lying. Similarly, if your teen is spending too much time alone that can also indicate problems.
Seeking professional help for a troubled teen
If you identify red flag behaviors in your teen, consult a doctor, counselor, therapist, or other mental health professional for help finding appropriate treatment.
Even when you seek professional help, though, that doesn’t mean that your job is done—it’s just begun. As detailed below, there are many actions you can take at home to help your teen and improve the relationship between you. And you don’t need to wait for a diagnosis to start putting them into practice.
Keep in mind that whatever problems your teen is experiencing, it is not a sign that you’ve somehow failed as a parent. Instead of trying to assign blame for the situation, focus on your teen’s current needs. The first step is to find a way to connect with what they are experiencing emotionally and socially.
Tip 1: Connect with your troubled teen
It may seem hard to believe—given your child’s anger or indifference towards you—but teens still crave love, approval, and acceptance from their parents. Positive face-to-face connection is the quickest, most efficient way to reduce stress by calming and focusing the nervous system. That means you probably have a lot more influence over your teen than you think.
To open the lines of communication:
Be aware of your own stress levels. If you’re angry or upset, now is not the time to try to communicate with your teen. Wait until you’re calm and energized before starting a conversation. You’re likely to need all the patience and positive energy you can muster.
Be there for your teen. An offer to chat with your teen over coffee will probably be greeted with a sarcastic put-down or dismissive gesture, but it’s important to show that you’re available. Insist on sitting down for mealtimes together with no TV, phones, or other distractions. Look at your teen when you speak and invite your teen to look at you. Don’t get frustrated if your efforts are greeted by nothing more than monosyllabic grunts or shrugs. You may have to eat a lot of dinners in silence, but when your teen does want to open up, they know they’ll always have the opportunity to do so.
Find common ground. Trying to discuss your teen’s appearance or clothes may be a sure-fire way to trigger a heated argument, but you can still find some areas of common ground. Fathers and sons often connect over sports; mothers and daughters over gossip or movies. The objective is not to be your teen’s best friend, but to find common interests that you can discuss peacefully. Once you’re talking, your teen may feel more comfortable opening up to you about other topics.
Listen without judging or giving advice. When your teen does talk to you, it’s important that you listen without judging, mocking, interrupting, criticizing, or offering advice. Your teen wants to feel understood and valued by you, so maintain eye contact and keep your focus on your child, even when they’re not looking at you. If you’re checking your email or reading the newspaper, your teen will feel that they’re not important to you.
Expect rejection. Your teen may often respond to your attempts to connect with anger, irritation, or other negative reactions. Stay relaxed and allow your teen space to cool off. Try again later when you’re both calm. Successfully connecting to your teen will take time and effort. Don’t be put off; persevere and the breakthrough will come.
Roadblocks to connection
If your teen is under the influence of alcohol or drugs, their ability to connect emotionally can be compromised. The same may be true of prescription medications. For example, if your teen is taking antidepressants, make sure the dosage is no more than absolutely needed.
Tip 2: Deal with teen anger and violence
If you’re a parent of a teenage boy who is angry, aggressive, or violent, you may live in constant fear. Every phone call or knock on the door could bring news that your son has either been harmed, or has seriously harmed others.
Teenage girls get angry as well, of course, but that anger is usually expressed verbally rather than physically. Teen boys are more likely to throw objects, kick doors, or punch the walls when they’re angry. Some will even direct their rage towards you. For any parent, especially single mothers, this can be a profoundly disturbing and upsetting experience. But you don’t have to live under the threat of violence. Putting up with violence is as harmful for your teen as it is for you.
If you feel threatened by your teen
Everyone has a right to feel physically safe. If your teen is violent towards you, seek help immediately. Call a friend, relative, or the police if necessary. It doesn’t mean that you don’t love your child, but the safety of you and your family should always come first.
How to cope with teen anger
Anger can be a challenging emotion for many teens as it often masks other underlying emotions such as frustration, embarrassment, sadness, hurt, fear, shame, or vulnerability. When teens can’t cope with these feelings, they may lash out, putting themselves and others at risk. In their teens, many boys have difficulty recognizing their feelings, let alone expressing them or asking for help.
The challenge for parents is to help your teen cope with emotions and deal with anger in a more constructive way:
Establish boundaries, rules and consequences. At a time when both you and your teen are calm, explain that there’s nothing wrong with feeling anger, but there are unacceptable ways of expressing it. If your teen lashes out, for example, they will have to face the consequences—loss of privileges or even police involvement. Teens need boundaries and rules, now more than ever.
Try to understand what’s behind the anger. Is your teen sad or depressed? For example, do they have feelings of inadequacy because their peers have things that they don’t? Does your teen just need someone to listen to them without judgment?
Be aware of anger warning signs and triggers. Does your teen get headaches or start to pace before exploding with rage? Or does a certain class at school always trigger anger? When teens can identify the warning signs that their temper is starting to boil, it allows them to take steps to defuse the anger before it gets out of control.
Help your teen find healthy ways to relieve anger. Exercise is especially effective: running, biking, climbing or team sports. Even simply hitting a punch bag or a pillow can help relieve tension and anger. Dancing or playing along to loud, angry music can also provide relief. Some teens also use art or writing to creatively express their anger.
Give your teen space to retreat. When your teen is angry, allow them to retreat to a place where it’s safe to cool off. Don’t follow your teen and demand apologies or explanations while they are still raging; this will only prolong or escalate the anger, or even provoke a physical response.
Take steps to manage your own anger. You can’t help your teen if you lose your temper as well. As difficult as it sounds, you have to remain calm and balanced no matter how much your child provokes you. If you or other members of your family scream, hit each other, or throw things, your teen will naturally assume that these are appropriate ways to express their anger as well.
Red flags for violent behavior in teens
It only takes a glance at the news headlines to know that teen violence is a growing problem. Movies and TV shows glamorize all manner of violence, many web sites promote extremist views that call for violent action, and hour after hour of playing violent video games can desensitize teens to the real world consequences of aggression and violence. Of course, not every teen exposed to violent content will become violent, but for a troubled teen who is emotionally damaged or suffering from mental health problems, the consequences can be tragic.
Warning signs that a teen may become violent include:
Playing with weapons of any kind
Obsessively playing violent video games, watching violent movies, or visiting websites that promote or glorify violence
Threatening or bullying others
Fantasizing about acts of violence he’d like to commit
Being aggressive or cruel to pets or other animals
Tip 3: Recognize the signs of teen depression
Many troubled behaviors in teenagers can be indications of depression. These can include:
Problems at school. Low energy and concentration problems associated with teen depression can lead to a declining attendance and drop in grades.
Running away. Many depressed teens run away or talk about running away from home, often as a cry for help.
Drug and alcohol abuse. Teens may use alcohol or drugs in an attempt to “self-medicate” their depression.
Low self-esteem. Depression can trigger or intensify feelings of shame, failure, and social unease and make teens extremely sensitive to criticism.
Smartphone addiction. Depressed teens may go online to escape their problems, but excessive smartphone and Internet use tends to increase feelings of isolation and worsen depression.
Reckless behavior. Depressed teens may engage in dangerous or high-risk behaviors, such as reckless driving, binge drinking, or unsafe sex.
Violence. Some teens—usually boys—can become aggressive and violent when they’re depressed.
To learn more about the signs of teen depression…
And how you can help your child overcome the problem and get their life back on track, read our Parent’s Guide to Teen Depression.
Tip 4: Add balance to your troubled teen’s life
No matter the exact reason behind your teen’s problems, you can put balance back in their life by helping them make healthy lifestyle changes.
Create structure. Teens may scream and argue with you about rules and discipline, or rebel against daily structure, but that doesn’t mean they need them any less. Structure, such as regular mealtimes and bedtimes, make a teen feel safe and secure. Sitting down to breakfast and dinner together every day can also provide a great opportunity to check in with your teen at the beginning and end of each day.
Reduce screen time. There appears to be a direct relationship between violent TV shows, movies, Internet content, and video games, and violent behavior in teenagers. Even if your teen isn’t drawn to violent material, too much screen time can still impact brain development. Limit the time your teen has access to electronic devices—and restrict phone usage after a certain time at night to ensure your child gets enough sleep.
Encourage exercise. Even a little regular exercise can help ease depression, boost energy and mood, relieve stress, regulate sleep patterns, and improve your teen’s self-esteem. If you struggle getting your teen to do anything but play video games, encourage them to play activity-based video games or “exergames” that are played standing up and moving around—simulating dancing, skateboarding, soccer, or tennis for example. Once exercise becomes a habit, encourage your teen to try the real sport or to join a club or team.
Eat right. Healthy eating can help stabilize a teenager’s energy, sharpen their mind, and even out their mood. Act as a role model for your teen. Cook more meals at home, eat more fruit and vegetables and cut back on junk food and soda.
Ensure your teen gets enough sleep. Sleep deprivation can make a teen stressed, moody, irritable, and lethargic, and cause problems with weight, memory, concentration, decision-making, and immunity from illness. You might be able to get by on six hours a night and still function at work, but your teen needs 8.5 to 10 hours of sleep a night to be mentally sharp and emotionally balanced. Encourage better sleep by setting consistent bedtimes, and removing TVs, computers, and other electronic gadgets from your teen’s room—the light from these devices suppresses melatonin production and stimulates the mind, rather than relaxing it. Suggest that your teen try listening to music or audio books at bedtime instead.
Tip 5: Take care of yourself
The stress of dealing with any teenager, especially one who’s experiencing behavioral problems, can take a toll on your own health, so it’s important to take care of yourself. That means looking after your emotional and physical needs and learning to manage stress.
Take time to relax daily and learn how to regulate yourself and de-stress when you start to feel overwhelmed. Learning how to use your senses to quickly relieve stress and regularly practicing relaxation techniques are great places to start.
Talk it over. It’s normal to feel overwhelmed, helpless, angry, or frustrated when dealing with a troubled teenager. Talking about how you’re feeling can help defuse the intensity, so share your feelings with a trusted friend or find a therapist.
Don’t go it alone, especially if you’re a single parent. Find support from family, friends, a school counselor, sports coach, religious leader, or someone else who has a relationship with your teen. Organizations such as Boys and Girls Clubs, YMCA, and other youth groups can also help provide structure and guidance.
Remember your other children. Dealing with a troubled teen can unsettle the whole family. It can be especially hard on other children, so make sure they’re not ignored. Siblings may need special individual attention or professional help of their own to handle their feelings about the situation.
This won’t last forever
It’s worth reminding your teen that no matter how much pain or turmoil they are experiencing right now, with your love and support, and professional help when it’s needed, the situation can and will get better—for both of you. Your teen can overcome the problems of adolescence and mature into a happy, well-balanced young adult.
Get more help
Authors: Lawrence Robinson and Jeanne Segal, Ph.D. Last updated: November 2019.
Parent’s Guide to Teen Depression
It isn’t always easy to differentiate between normal teenage growing pains and depression. But here’s how you can recognize the signs and symptoms and best help your child.
Understanding teen depression
The teen years can be extremely tough and depression affects teenagers far more often than many of us realize. In fact, it’s estimated that one in five adolescents from all walks of life will suffer from depression at some point during their teen years. However, while depression is highly treatable, most depressed teens never receive help.
Teen depression goes beyond moodiness. It’s a serious health problem that impacts every aspect of a teen’s life. Fortunately, it’s treatable and parents can help. Your love, guidance, and support can go a long way toward helping your teen overcome depression and get their life back on track.
If you’re a teen feeling depressed…
Help is available—and you have more power over your mood than you may think. No matter how despondent life seems right now, there are many things you can do to change your mood and start feeling better today. Read Dealing with Teen Depression.
Is my teen depressed?
While occasional bad moods or acting out is to be expected during the teenage years, depression is something different. The negative effects of teenage depression go far beyond a melancholy mood. Depression can destroy the essence of your teen’s personality, causing an overwhelming sense of sadness, despair, or anger. Many rebellious and unhealthy behaviors or attitudes in teenagers can be indications of depression. The following are some the ways in which teens “act out” in an attempt to cope with their emotional pain:
Problems at school. Depression can cause low energy and concentration difficulties. At school, this may lead to poor attendance, a drop in grades, or frustration with schoolwork in a formerly good student.
Running away. Many depressed teens run away from home or talk about running away. Such attempts are usually a cry for help.
Drug and alcohol abuse. Teens may use alcohol or drugs in an attempt to “self-medicate” their depression. Unfortunately, substance abuse only makes things worse.
Low self-esteem. Depression can trigger and intensify feelings of ugliness, shame, failure, and unworthiness.
Smartphone addiction. Teens may go online to escape their problems, but excessive smartphone and Internet use only increases their isolation, making them more depressed.
Reckless behavior. Depressed teens may engage in dangerous or high-risk behaviors, such as reckless driving, binge drinking, and unsafe sex.
Violence. Some depressed teens—usually boys who are the victims of bullying—can become aggressive and violent.
Teen depression is also associated with a number of other mental health problems, including eating disorders and self-injury. While depression can cause tremendous pain for your teen—and disrupt everyday family life—there are plenty of things you can do to help your child start to feel better. The first step is to learn what teen depression looks like and what to do if you spot the warning signs.
Signs and symptoms of depression in teens
Unlike adults, who have the ability to seek assistance on their own, teenagers rely on parents, teachers, or other caregivers to recognize their suffering and get them the help they need. But that isn’t always easy. For one, teens with depression don’t necessarily appear sad. Instead, irritability, anger, and agitation may be the most prominent symptoms.
Signs and symptoms of teen depression:
Sadness or hopelessness
Irritability, anger, or hostility
Tearfulness or frequent crying
Withdrawal from friends and family
Loss of interest in activities
Poor school performance
Changes in eating and sleeping habits
Restlessness and agitation
Feelings of worthlessness and guilt
Lack of enthusiasm and motivation
Fatigue or lack of energy
Unexplained aches and pains
Thoughts of death or suicide
Depression in teens vs. adults
Depression in teens can look very different from depression in adults. The following symptoms are more common in teenagers than in their adult counterparts:
Irritable or angry mood. As noted, irritability, rather than sadness, is often the predominant mood in depressed teens. A depressed teenager may be grumpy, hostile, easily frustrated, or prone to angry outbursts.
Unexplained aches and pains. Depressed teens frequently complain about physical ailments such as headaches or stomachaches. If a thorough physical exam does not reveal a medical cause, these aches and pains may indicate depression.
Extreme sensitivity to criticism. Depressed teens are plagued by feelings of worthlessness, making them extremely vulnerable to criticism, rejection, and failure. This is a particular problem for “over-achievers.”
Withdrawing from some, but not all people. While adults tend to isolate themselves when depressed, teenagers usually keep up at least some friendships. However, teens with depression may socialize less than before, pull away from their parents, or start hanging out with a different crowd.
Is it depression or teenage “growing pains”?
If you’re unsure if your teen is depressed or just “being a teenager,” consider how long the symptoms have been going on, how severe they are, and how different your teen is acting from their usual self. Hormones and stress can explain the occasional bout of teenage angst—but not continuous and unrelenting unhappiness, lethargy, or irritability.
Suicide warning signs in depressed teens
Seriously depressed teens, especially those who also abuse alcohol or drugs, often think about, speak of, or make attempts at suicide—and an alarming and increasing number are successful. So it’s vital that you take any suicidal thoughts or behaviors very seriously. They’re a cry for help from your teen.
Suicide warning signs to watch for
Talking or joking about committing suicide
Saying things like, “I’d be better off dead,” “I wish I could disappear forever,” or “There’s no way out”
Speaking positively about death or romanticizing dying (“If I died, people might love me more”)
Writing stories and poems about death, dying, or suicide
Engaging in reckless behavior or having a lot of accidents resulting in injury
Giving away prized possessions
Saying goodbye to friends and family as if for the last time
Seeking out weapons, pills, or other ways to kill themselves
Get help for a suicidal teen
If you suspect that a teenager is suicidal, take immediate action! For 24-hour suicide prevention and support in the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK. To find a suicide helpline outside the U.S., visit IASP or Suicide.org.
To learn more about suicide risk factors, warning signs, and what to do in a crisis, read Suicide Prevention.
How to help a depressed teenager
Depression is very damaging when left untreated, so don’t wait and hope that worrisome symptoms will go away. If you suspect that your teen is depressed, bring up your concerns in a loving, non-judgmental way. Even if you’re unsure that depression is the issue, the troublesome behaviors and emotions you’re seeing are signs of a problem that should be addressed.
Open up a dialogue by letting your teen know what specific depression symptoms you’ve noticed and why they worry you. Then ask your child to share what they’re going through—and be ready and willing to truly listen. Hold back from asking a lot of questions (most teenagers don’t like to feel patronized or crowded), but make it clear that you’re ready and willing to provide whatever support they need.
How to communicate with a depressed teen
Focus on listening, not lecturing. Resist any urge to criticize or pass judgment once your teenager begins to talk. The important thing is that your child is communicating. You’ll do the most good by simply letting your teen know that you’re there for them, fully and unconditionally.
Be gentle but persistent. Don’t give up if they shut you out at first. Talking about depression can be very tough for teens. Even if they want to, they may have a hard time expressing what they’re feeling. Be respectful of your child’s comfort level while still emphasizing your concern and willingness to listen.
Acknowledge their feelings. Don’t try to talk your teen out of depression, even if their feelings or concerns appear silly or irrational to you. Well-meaning attempts to explain why “things aren’t that bad” will just come across as if you don’t take their emotions seriously. Simply acknowledging the pain and sadness they are experiencing can go a long way in making them feel understood and supported.
Trust your gut. If your teen claims nothing is wrong but has no explanation for what is causing the depressed behavior, you should trust your instincts. If your teen won’t open up to you, consider turning to a trusted third party: a school counselor, favorite teacher, or a mental health professional. The important thing is to get them talking to someone.
Helping a depressed teen tip 1: Encourage social connection
Depressed teens tend to withdraw from their friends and the activities they used to enjoy. But isolation only makes depression worse, so do what you can to help your teen reconnect.
Make face time a priority. Set aside time each day to talk—time when you’re focused totally on your teen, without distractions or trying to multi-task. The simple act of connecting face to face can play a big role in reducing your teen’s depression. And remember: talking about depression or your teen’s feelings will not make the situation worse, but your support can make all the difference in their recovery.
Combat social isolation. Do what you can to keep your teen connected to others. Encourage them to go out with friends or invite friends over. Participate in activities that involve other families and give your child an opportunity to meet and connect with other kids.
Get your teen involved. Suggest activities—such as sports, after-school clubs, or an art, dance, or music class—that take advantage of your teen’s interests and talents. While your teen may lack motivation and interest at first, as they reengage with the world, they should start to feel better and regain their enthusiasm.
Promote volunteerism. Doing things for others is a powerful antidepressant and self-esteem booster. Help your teen find a cause they’re interested in and that gives them a sense of purpose. If you volunteer with them, it can also be a good bonding experience.
Tip 2: Make physical health a priority
Physical and mental health are inextricably connected. Depression is exacerbated by inactivity, inadequate sleep, and poor nutrition. Unfortunately, teens are known for their unhealthy habits: staying up late, eating junk food, and spending hours on their phones and devices. But as a parent, you can combat these behaviors by establishing a healthy, supportive home environment.
Get your teen moving! Exercise is absolutely essential to mental health, so get your teen active—whatever it takes. Ideally, teens should be getting at least an hour of physical activity a day, but it needn’t be boring or miserable. Think outside the box: walking the dog, dancing, shooting hoops, going for a hike, riding bikes, skateboarding—as long as they’re moving, it’s beneficial.
Set limits on screen time. Teens often go online to escape their problems, but when screen time goes up, physical activity and face time with friends goes down. Both are a recipe for worsening symptoms.
Provide nutritious, balanced meals. Make sure your teen is getting the nutrition they need for optimum brain health and mood support: things like healthy fats, quality protein, and fresh produce. Eating a lot of sugary, starchy foods—the quick “pick me up” of many depressed teens—will only have a negative effect on their mood and energy.
Encourage plenty of sleep. Teens need more sleep than adults to function optimally—up to 9-10 hours per night. Make sure your teen isn’t staying up until all hours at the expense of much-needed, mood-supporting rest.
Tip 3: Know when to seek professional help
Support and healthy lifestyle changes can make a world of difference for depressed teens, but it’s not always enough. When depression is severe, don’t hesitate to seek professional help from a mental health professional with advanced training and a strong background treating teens.
Involve your child in treatment choices
When choosing a specialist or pursuing treatment options, always get your teen’s input. If you want your teen to be motivated and engaged in their treatment, don’t ignore their preferences or make unilateral decisions. No one therapist is a miracle worker, and no one treatment works for everyone. If your child feels uncomfortable or is just not ‘connecting’ with the psychologist or psychiatrist, seek out a better fit.
Explore your options
Expect a discussion with the specialist you’ve chosen about depression treatment options for your teen. Talk therapy is often a good initial treatment for mild to moderate cases of depression. Over the course of therapy, your teen’s depression may resolve. If it doesn’t, medication may be warranted.
Unfortunately, some parents feel pushed into choosing antidepressant medication over other treatments that may be cost-prohibitive or time-intensive. However, unless your child is acting out dangerously or at risk for suicide (in which case medication and/or constant observation may be necessary), you have time to carefully weigh your options. In all cases, antidepressants are most effective when part of a broader treatment plan.
Medication comes with risks
Antidepressants were designed and tested on adults, so their impact on young, developing brains is not yet fully understood. Some researchers are concerned that exposure to drugs such as Prozac may interfere with normal brain development—particularly the way the brain manages stress and regulates emotion.
Antidepressants also come with risks and side effects of their own, including a number of safety concerns specific to children and young adults. They are also known to increase the risk of suicidal thinking and behavior in some teenagers and young adults. Teens with bipolar disorder, a family history of bipolar disorder, or a history of previous suicide attempts are particularly vulnerable.
The risk of suicide is highest during the first two months of antidepressant treatment. Teenagers on antidepressants should be closely monitored for any sign that the depression is getting worse.
Teens on antidepressants: Red flags to watch out for
Call a doctor if you notice…
New or more thoughts/talk of suicide
Suicidal gestures or attempts
New or worse depression
New or worse anxiety
Agitation or restlessness
Difficulty sleeping (insomnia)
New or worse irritability
Aggressive, angry, or violent behavior
Acting on dangerous impulses
Hyperactive speech or behavior (mania)
Other unusual changes in behavior
Tip 4: Support your teen through depression treatment
As your depressed teenager goes through treatment, the most important thing you can do is to let them know that you’re there to listen and offer support. Now more than ever, your teenager needs to know that they’re valued, accepted, and cared for.
Be understanding. Living with a depressed teenager can be difficult and draining. At times, you may experience exhaustion, rejection, despair, aggravation, or any other number of negative emotions. During this trying time, it’s important to remember that your child is not being difficult on purpose. Your teen is suffering, so do your best to be patient and understanding.
Stay involved in treatment. Make sure your teenager is following all treatment instructions, whether it’s attending therapy or correctly taking any prescribed medication. Track changes in your teen’s condition, and call the doctor if depression symptoms seem to be getting worse.
Be patient. The road to your depressed teenager’s recovery may be bumpy, so be patient. Rejoice in small victories and prepare for the occasional setback. Most importantly, don’t judge yourself or compare your family to others. As long as you’re doing your best to get your teen the necessary help, you’re doing your job.
Tip 5: Take care of yourself (and the rest of the family)
As a parent, you may find yourself focusing all your energy and attention on your depressed teen and neglecting your own needs and the needs of other family members. However, it’s extremely important that you continue to take care of yourself during this difficult time.
Above all, this means reaching out for much needed support. You can’t do everything on your own so enlist the help of family and friends. Having your own support system in place will help you stay healthy and positive as you work to help your teen.
Don’t bottle up your emotions. It’s okay to feel overwhelmed, frustrated, helpless, or angry. Reach out to friends, join a support group, or see a therapist of your own. Talking about how you’re feeling will help defuse the intensity.
Look after your health. The stress of your teen’s depression can affect your own moods and emotions, so support your health and well-being by eating right, getting enough sleep, and making time for things you enjoy.
Be open with the family. Don’t tiptoe around the issue of teen depression in an attempt to “protect” the other children. Kids know when something is wrong. When left in the dark, their imaginations will often jump to far worse conclusions. Be open about what is going on and invite your children to ask questions and share their feelings.
Remember the siblings. Depression in one child can cause stress or anxiety in other family members, so make sure “healthy” children are not ignored. Siblings may need special individual attention or professional help of their own to handle their feelings about the situation.
Avoid the blame game. It can be easy to blame yourself or another family member for your teen’s depression, but it only adds to an already stressful situation. Furthermore, depression is normally caused by a number of factors, so it’s unlikely—except in the case of abuse or neglect—that any loved one is “responsible.”
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Authors: Melinda Smith, M.A., Lawrence Robinson, and Jeanne Segal, Ph.D. Last updated: October 2019.
What is depression?
Teenage depression isn’t just bad moods and the occasional feeling down or blue—it’s a serious problem that impacts every aspect of a teen’s life. For more information on understanding teen depression visit http://www.helpguide.org/mental/depression_teen.htm
These symptoms must last for at least two weeks and be present most of the day every day.
Feeling sad, teary, or grouchy – generally depressed. Depression is a strong mood that involves other emotions like sadness, discouragement, despair and hopelessness.
Losing interest in things you used to like
Trouble sleeping: Sleeping too much or too little
Changes in appetite or weight: Significant weight loss when not dieting or weight gain.
Feeling tired or restless all the time
Feeling guilty or worthless, like you’re a “bad person”
Difficulty concentrating in school
Preoccupation with death or dying
You find it hard to participate in everyday activities
Also, consider the physical signs of depression:
Body pains and muscle tension
Upset Stomach/Digestive Problems
Some differences between teenage and adult depression
Depression in teens can look very different from adults. The following symptoms of depression are more common in teenagers:
Irritable or angry mood – Irritability, rather than sadness, is often the predominant mood in depressed teens. A depressed teenager may be grumpy, hostile, easily frustrated, or prone to angry outbursts.
Unexplained aches and pains – Depressed teens frequently complain about physical ailments such as headaches or stomach aches. If a thorough physical exam does not reveal a medical cause, these aches and pains may indicate depression.
Extreme sensitivity to criticism – Depressed teens are overcome by feelings of worthlessness, making them extremely vulnerable to criticism, rejection, and failure. This is a particular problem for “over-achievers.”
Withdrawing from some, but not all people –Depressed teenagers usually keep up at least some friendships, while adults may completely isolate themselves. However, teens with depression may socialize less than before, pull away from their parents, or start hanging out with a different crowd.
What should you do if you feel depressed? It can feel difficult and sometimes impossible to take that first step to help yourself. With the right skills, support, and services you can get better! For more tips and tools on how to help yourself or a friend visit: http://www.helpguide.org/mental/depression_teen_teenagers.htm
Here are some helpful tips on ways to manage your depression:
Knowledge: Knowing the warnings signs and symptoms can help you identify if you are feeling depressed.
Don’t wait: The quicker you begin seeking help for your depression, the faster and more effectively you can work through it.
Stay active!: Exercise can assist in increasing endorphins in the body which assist in increasing your mood.
Connect: Surround yourself with trusted, positive people who you feel safe and comfortable in confiding.
Journal: Keep track of your moods through a journal. Track how you are feeling throughout the day in order to look at your improvements or growth areas. Learn more about journaling and the importance of documenting your mood!
Sleep well: Sleeping is essential for a healthy and balanced life style! Here are a few helpful tips on improving your quality of sleep.
Eat healthy: Lots of sugar, fast food and process food can make you feel sluggish and tired. Utilize more fruits, vegetables, and whole foods in your diet. Make sure to drink plenty of water. Find more tips on health and nutrition here!
Understand negative thinking patterns: Gain knowledge on negative thoughts, and challenge yourself to have a more positive outlook! Learn more about identifying negative thoughts and how to overcome them.
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Teen Suicide Prevention
Death is a difficult and sensitive subject to talk to children about. Most adults are at a loss for words. Since many don't know what to say or do for children who have lost someone through death, many adults wind up avoiding children's questions. Some adults won't talk to children at all about this very important subject or quickly change the subject. They are afraid of upsetting the child or fear that talking about it will be hurtful to the child. Yet we do know that "if it is mentionable, it is manageable."
Often children will share how angry or alone they feel at having their questions ignored or dismissed by adults. "Will I die too?" "Where is my friend now that he died?" "Are you going to die too"? "Who will take care of me?" "Did she suffer?"
When adults respond in a sensitive, caring and developmentally appropriate way, we help to normalize children's uncomfortable feelings, ideas and concerns. Acknowledging their questions is an important way to reassuring them and helping them feel safe. Children need to feel safe after something tragic happens. Often their world is shaken and anything we can do to help "ground" them will be beneficial to their healing process. Children enjoy routines and when we try to keep things in their lives the same, as much as we can, that helps them to feel that their whole life hasn't changed. The more things stay the same after a loss, the better in many ways for children.
Giving too much information or too many details can overwhelm a child as well. Also though, when adults limit responses to a few words or even refuse to answer children get the message not to talk about it. Death is a closed subject, don't ask again. This can create many problems for children. Many who can't ask questions or talk about their thoughts and concerns may manifest their grief in unhealthy ways or through acting out or somatic complaints, mainly stomach aches and head aches.
We want to create a safe environment for children where all questions are welcomed, accepted and responded to openly and without judgment. Sometimes our answer may be, "I don't really know the answer to that. What do you think?"
Children re-grieve at different developmental stages. During early childhood they are often satisfied with simple definitions and explanations. Many times children believe that they are responsible for the person's death. Magical thinking takes over and it is important that children be heard and also helped to understand that wishing someone to go away or even to die won't make a person die. A great book on the subject of Magical thinking is : I Know I Made it Happen by Lynn Blackburn.
As they get older they become more curious about the facts of the death, and may come back to it at ages 8, 9 and 10 and revisit the death with a new interest and more questions. In pre-adolescence and adolescence they have a strong need to look to their own age group for answers. Children at this age understand that death is not reversible. Life is finite. Young people begin to form their own spiritual belief system and look to peers for support and understanding. A great movie (DVD or VHS) that is in French but has English subtitles is : Ponette with Jacques Doilon. Can be ordered on Amazon. It is about a young girl who lost her mother in a car crash in which the little girl survived but the mom did not. Beautiful and won Best Foreign Film award.
When a young child dies because of accident or illness, most adults are faced with a terrible dilemma: should the child's friends and classmates be told what happened? How does one tell a child about the death of a child? Does hiding or avoiding the truth "protect" children or potentially harm them? How much information should children be given?
Children often understand death by their age or developmental stage. Children under five often don't grasp the concept that death is final and universal- that all living things eventually die. Children around 6-9 tend to think of death as a person- a shadowy figure, like the Boogey man who can be thwarted or outsmarted if they only knew how! By ten or older, most understand what death means and ponder such concepts as afterlife.
Be truthful. Keep explanations simple. Share the facts. Remind children it was not their fault. Define death. Alow children to be recognized mourners. Remember children grieve differently. Treat every child and their grief as unique. Include children in family illness. Honor a child's belief system. Prepare for funerals and memorials.
For more information on ages and stages of grieving children visit the page: Ages and Stages
Ages and Stages
Every child is different and their grief journey is unique. Each child responds to loss cognitively, emotionally, spiritually and physically in their own way. However use this chart as a general guide.
Infants: Even infants can sense when something is disrupted in their world. Having a grief stricken caretaker or having people around him or her who are grieving can be enough to affect them. Although they can't verbalize their grief, they often react by refusing to nap, increased night wakings, not eating well, irritability, excessive crying, increased need to be held and comforted, increased separation anxiety and an overall change in their behavior. Always rule out any possible illness with the doctor, but if the baby has a clean bill of health, it may be safe to assume that he or she is reacting to grief.
Giving the infant extra comfort, by holding him or her more, perhaps in a baby sling or a front pack or back pack, even around the house. Rocking a baby can help to calm him, as well as playing calming music softly in the background. Try to feed him in a quiet place and not have too many distractions. Remember that he or she needs to feel secure and safe more now than ever. Talking in a softer voice is also helpful. The best thing is to take care of the caretaker and help the caretaker to feel supported and attended to so he or she can care for the infant.
Children this age are egocentric naturally. They don't have the cognitive ability to understand death. They think death is reversible, not permanent. "I know Daddy died. Will he be at my birthday party next weekend?" A 3 year old at a wake seeing his grandpa in a casket told him to "wake up now, that is enough sleep."
May ask a lot of questions over and over again. Be patient and give factual information. No need for too many details.These children may regress, change their eating and sleeping patterns, wet their bed, be irritable and confused.
Gaining language, fantasy thinking and wishing. Concerns about guilt at this age. Death still seen as reversible by many. Feel responsible because of wishes and thoughts. "It's my fault she died. I was mad at her and wished she would go away". Great book : I Know I Made it Happen. Questions about how, why. May act as if nothing happened. There may be general distress and confusion.
What helps? Provide them with terms for some of their feelings such as numb, grief, sadness. Death play is normal and helps children integrate the reality of the death. You can join in the play and offer guidance.
Self confidence develops. Developing cognitive ability and logical thinking begins. Death is seen as a punishment. Fear of bodily harm and mutilation. Beginning to see death as final. They may ask specific questions. They want detail. Want to know the "right" way to respond. Starting to have the ability to mourn and understand mourning. Express grief through play. May "hang back" socially and scholastically. May see acting out, sleep and appetite disturbance. Concern with body. May have desire to "join"the one who died.
What helps?: Encourage expression of feelings. Answer questions. Explain options and allow for choices. Be available but allow alone time. Give physical outlets. TALK ABOUT IT! Children need permission to concentrate on mourning before they can be expected to forge ahead with the rest of their lives. Give them time. Offer "venting" alternatives. Support groups helpful.
They understand death cognitively, but are only beginning to grapple with it spiritually. May protest the loss by acting out and/or withdrawing. May feel life has been unfair to them, and act angry. May act out a search for meaning. May test own mortality. Problem solving and abstract thinking period. "Adult" approach. Work at making sense of teachings. Depression, regression common. More often willing to talk to people outside of family and seek peer support. Depression and anger common. Anger toward parents. Non-compliance. Rejection of former teaching. Role confusion, acting out.
What helps?: Encourage verbalization. Do not take control! Encourage self motivation. Listen! Be available. Do not attempt to take their grief away. Tolerate some acting out behaviors as long as teen or other isn't being hurt. Withdrawal is normal, in the short term (Long term withdrawal is a sign he/she may need extra help). A teen's normal egocentrism can cause him to focus exclusively on the effect the death had on him and his future. After he has had time to explore this, encourage him to consider the death's impact on the larger social group: family, friends, etc. Teens begin to really explore "why" questions about life and death. Encourage search for meaning unless it may harm the teen or others.
Teens still need a strong relationship with their parents. Although they are at a stage in life when social relationships are important (and they will likely place more emphasis on their friends right now over family, they will still need their parents to be there for them. Because of this it’s important to continue to keep the parent-teen relationship strong.
One expert and highly regarded researcher in the area of relationships is author Gary Chapman. In 1995, he wrote a book titled The Five Love Languages: How to Express Heartfelt Commitment to Your Mate, and it was a huge success. Essentially, the book explained that different people show their love in different ways. And if a couple could identify their primary love language they could perhaps express their love for their partner and strengthen their relationship.
Because Chapman’s ideas were so popular, he later developed the Five Love Languages of Teenagers. If you’re interested in strengthening your relationship with your teen, here are five love languages:
Quality Time – If your teen’s primary love language is quality time, then they crave your undivided attention. Your teen wants you to be there for them. They will feel loved and appreciated if you have the TV off and your mind on them alone. You’ll need to create time with your teen without distractions so that you can truly listen to your teen without thinking of other things. Create some uninterrupted time with your teen, and they’re sure to feel loved by you.
Words of Affirmation – Teens with this love language, they want to hear how much you mean to them. It’s not so much time alone or doing nice things for them, instead your teen wants to hear “I love you” and “I love having you in my life” or “I’m so glad you’re my child”. Any words of encouragement, love, and tenderness is the way that a teen with this love language will feel appreciated.
Acts of Service – If your teen has this love language, they most appreciate it when you’ve done things for them. They love it when you help them ease the burden of responsibilities. You might help them with homework, make their bed for them, or pack their lunch. Anytime you can do something that you normally wouldn’t for your teen will help them feel special.
Physical Touch – A teen with this love languages is going to love receiving hugs, pats on the back, thoughtful touches on the arm, or a gentle touch on the face. To this teen, physical touch is a way to show love, care, and excitement.
Receiving Gifts – It’s important to keep in mind that this love language is not about buying your teen’s love. A teen with this love language still wants to know that a gift you give them came out of how much you love them. It’s the way you give the gift and what you say to them when you do it that can make the difference. Teens with this love language aren’t keen on materialism, but they would like to receive something from time to time that says they are loved. This could be a card with loving words, an item that’s going to help them in their lives. To these teens, gifts are symbols of love.