How can I support a distressed teenager?
The road to adulthood can be long and winding, particularly during adolescence. This era of life entitled “teenage years” are ripe with change as individuals try on different hats in the enterprise of finding an identity. Teenagers are also taxed with experiencing the limitations of their once idealized and perfect caregivers, a painful recognition that entices enchantment in outside people such as friends and their families who always seem to have it better or easier. Being a teenager is not easy. Anxiety and depression are common in youths and can often co-occur (Cummings, et al., 2014). Hormonal changes, schooling, social pressures, life transitions, and increases in responsibility (to name a few) are tallied onto the experience. Parents often try to console their teenagers when they are disturbed. It is not uncommon for these efforts to be thwarted and disavowed as teenagers struggle between achieving independence, yet depending on parents for emotional or social comfort when distressed. A constant push-pull that can be frustrating for both parties. So, what is a parent to do? How can parents support their teenagers in a way that is beneficial to both parties? How do parents combat the belief that “parents just don’t understand”?
What if my teenager is anxious?
Anxiety can be an adaptive coping mechanism that is largely a future-focused emotion. It is a natural survival mechanism that alerts us of a situation where there is risk of harm (e.g., physical pain; punishments at home/work; negative social appraisal). Successful people often report they utilize anxiety to make deadlines, meet expectations, outperform their peers, and prepare for life’s twists and turns. Anxiety can be a good thing. However, when anxiety is intrusive and relentless, it can become maladaptive and negatively impede our natural enjoyment of life.
An effective manner of supporting a teenager with anxiety is by attempting to understand their mental state. Researchers from the Anna Freud Centre in London introduced a concept called “mentalization” wherein individuals try to perceive the mental state of another person in an attempt to create the sense that someone is “psychological nearby” (Fonagy, et al., 2002). Mentalization based treatments have proven highly effective in treating the most complex mental illnesses and have correlated with decreases in depression and general symptomatology, as well as increases in the client’s capacity for mentalization and trusting others (Bo, et al., 2016). In mentalization we focus on the thoughts, emotions, and behaviors of people as well as their desires, goals, wishes, reasons, expectations, and motivations. For instance, a teenager anxious about being negatively judged at school may experience anxious thoughts (e.g., “What if I mess up on this test?”; “What if my hair doesn’t look good?”; “What if I’m not cool?”). These anxious thoughts can inform us of important messages about what is meaningful to teenagers and could be motivating their anxieties. One suggestion could be that teenagers are motivated by obtaining a sense of belongingness in a time period wherein their separation from parents makes them feel like they no longer have a satisfactory home base. Moreover, teenagers are often motivated by a desire to be accepted and enjoyed by other persons. This continuation of positive social interaction has origins in infancy and childhood wherein children are celebrated and adored. If parents can attempt to mentalize their teenagers and ask if their attempts at mentalization are correct, teenagers can offer correction and, perhaps unknowingly, perceive that someone nearby cares enough to figure out with them the confusing emotions they’re experiencing.
Example of mentalization:
- “I wonder if you’re thinking that people will tease you at school (*thoughts*)? I imagine being teased can make you feel anxious and it goes against your desire to be accepted just as you are (*desire*).”
- “I notice you’re feeling stressed for your exam (*emotion*). There will be 100 questions, you can’t use your notes, it’s based on material covered throughout the whole semester, and you only have one hour to complete it (*reasons*). Do you feel overwhelmed (*clarifying emotion*?”
- “I see you keep adjusting your outfit and hair (*behavior). Do you hope other people will see you as attractive (*motivation*)? Do you think a part of you might expect that people won’t admire you if you don’t look picture-perfect (*expectation*)?”
What if my teenager appears depressed?
Much like anxiety, depression is shown to increase during adolescence, particularly “among female individuals to nearly a 3:1 ratio compared with their male counterparts” (SAMHSA, 2009). Depression can manifest from feelings of hopelessness, helplessness, guilt, and sadness. Common symptoms parents report is excessive sleeping, lethargy, a decline of interest in once enjoyed activities, self-harm, low motivation, and suicidal thoughts. It should be noted that if teenagers are experiencing depressive symptoms that could endanger their safety and security, parents should recognize this and contact a professional immediately.
Research has illustrated that a high-risk factor for developing depressive symptoms is the lack of a perceived supportive adult relationship in a teenager’s life. Job duties, family conflicts, and health concerns can render parents inaccessible and inattentive to their teenagers’ social and emotional needs. Research continues to suggest that an adolescent’s access to a supportive adult relationship may mediate depressive symptoms and cause symptom remission (Zisk, et al., 2019). This is an unsurprising finding as it appears every teenager has a favorite teacher, coach or adult mentor with whom they feel supported and naturally joyous when in their presence. In order to best support teenagers, parents are advised to “meet them where they’re at”. If your child is hopeless, mentalization can serve to help you understand their lost sense of faith. Herein, parents should be careful not to impose their motivation to cure their teenagers by preemptively bringing up a positive attitude or engaging in dialogue such as: “you shouldn’t think like that” or “how can you think that” . These phrases may make teenagers feel more defective or damaged, and thus, may appear unsupportive. It should be noted that during a depressive episode, many people benefit from simply being listened to and invested in by a caring other. Herein, becoming more attentive, responsive and supportive to your teenager is a powerful tool for combatting depressive symptoms.
Our emotions are often warnings that something within our psyche is unsatisfied or not receiving enough nourishment from the emotional and social spheres. Depression and anxiety are human conditions most people endure in isolated instances or episodes throughout their lifespan. Some may experience a constant, relentless backdrop of depressive or anxious symptoms and may necessitate professional care. Others may experience acute anxiety attacks or depressive bouts that render them paralyzed or fearful. No matter the context, if anxiety and depression appear unmanageable, individuals should consider reaching out to a mental health professional. If you feel as though your teenager is enduring symptoms related to anxiety and depression that are overwhelming and becoming maladaptive, please consider reaching out to a mental health professional on their behalf. As the research suggests, entering into a supportive, caring, and empathetic relationship can be monumental in battling anxiety and depression. You, nor your teenager, are alone.
Bo, S., Sharp, C., Beck, E., Pedersen, J., Gondan, M., & Simonsen, E. (2016). First empirical evaluation of outcomes for mentalization-based group therapy for adolescents with bpd. Personality Disorders: Theory, Research, and Treatment, 8, 396-401
Cummings, C. M., Caporino, N. E., & Kendall, P. C. (2014). Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychological Bulletin, 140, 816- 845. doi: 10.1037/a0034733
Fonagy, P., Gergely, G., & Target, M. (2007). The parent-infant dyad and the construction of the subjective self. Journal of Child Psychology and Psychiatry, 48, 288 –328. doi:10.1111/j.1469- 7610.2007.01727.x
Substance Abuse and Mental Health Services Administration (SAMHSA). (2009). Results from the 2008 National Survey on Drug Use and Health: National Findings (NSDUH Series H- 36, HHS Publication No. SMA 09 – 4434). Rockville, MD: Office of Applied Studies.
Zisk, A., Abbott, C. H., Bounoua, N., Diamond, G. S., & Kobak, R. (2019). Parent–teen communication predicts treatment benefit for depressed and suicidal adolescents. Journal of Consulting and Clinical Psychology, 87, 1137-1148. http://dx.doi.org/10.1037/ccp0000457