Ep. 146 | Parenting Teens: Practical Advice for Navigating Teen Mental Health and Social Pressure

Welcome to Everyday Therapy, where simple and practical concepts of therapy meet your everyday life. Hosted by licensed marriage and family therapist Brett Cushing and doctor Karen Ryan, we're here to help you unlock tools and strategies you need to become the best version of yourself. Whether you're looking for guidance, inspiration, anecdotes, or actionable advice, you're in the right place.

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Hello and welcome to another episode of Everyday Therapy. I am Brant Cushing along here with doctor Karen Ryan. Hello, hello. We are going to be talking about emotional challenges and adolescence, which seems kind of redundant to say that like the two do go together and I am happy to say I have successfully journeyed through this and have you you're kind of in the thick of it.

I am absolutely in the thick of it with the 12 and 14 year old. Yes, very exciting times. And that's a euphemism right there. This is really it can be challenging and stressful for parents. Like what is going on with my teen? What do I do? How do I respond? What do I say, what don't I say? Which is just part of adolescent working through?

When is it a mental health need kind of when do I seek help? How do I even know that? And so that that's kind of what we're hoping to talk about today. Just exploring a bunch of different things together. Right, Brett. Right. And we do we intend to give you some very tangible takeaways. So if you're a parent or if you know somebody who is a parent, please take note and share some of the takeaways that will be sharing in the episode today.

Yeah. So support and share the more we all get through this together right? Yeah it does. It does take a village. Yes, we are part of that village. So we are, we are. And this is a critical time for mental health with adolescents. And we seem to be hearing more and more about adolescence. And the mental health epidemic that is going on.

Some of that is perhaps cultural and some of it is physiological. So maybe we talk a little bit about the brain development is a big part. Yeah. So we're dealing with what the executive functioning of the brain. Big term. What. Yes. But there what what would you say? They're in the big term. Right. And adolescence is anything between like 1217, 1218.

Right. Those teenage kind of pre teenage years we're talking about. And during that time there's so much happening in our teens bodies and minds and emotions. Right. Brain development is still happening. So one of the most helpful things is to really think about the front of our brain is called our prefrontal cortex. And that is really our decision making.

Thinking through things, reasoning that when we are growing up that is not fully developed literally, our brains are still developing and it is this crucial period of learning where our brains go through. It's called pruning, right? So we have all these different connections in our brains, and those that are reinforced are really important, are stronger and other ones are filtering away.

So it's a huge learning time. So it makes sense then that our teens are a little more impulsive. They're making some decisions, some good ones, some ones that they learn from. They're trying to do that. So there's this huge brain development. And then we know there's a lot of other things are facing you. Right. Like social pressures.

Right, Brett. Absolutely. And one thing I think that is helpful for people is if you have an adolescent who maybe has ADHD, their brain development is going to be a little bit longer. Yes. So, yes, you know, typically that executive functioning might develop in mature early to mid 20s for someone that has ADHD might be a little bit later than that.

Always good to keep in mind. I think a perfect parallel to that is when babies are born premature. The developmental markers are different and it's so helpful for parents. I think same sort of thing like be flexible in what your I'm using. Your developmental markers are for your kids. Yeah, exactly. And then your expectations with them. So social pressures now it's interesting.

I just was telling you I did a talk on adolescence and loneliness. And in adolescence, that is the time where loneliness peaks. It can be the time of life where typically people feel the greatest amount of loneliness. And so there's a lot of social pressure that contributes to that, as you were just talking about. And it's not like when I was growing up, we long ago, teens can have a lot of risk and vulnerability if they if they say something, if they post something that somebody doesn't like or is offended by, they could lose their whole social network overnight.

They're just ghosted. Yes. And that is significant. We can think, oh, you didn't need those friends anyway. You know, if they were really good friends. However, think about that as an adult. If I lost all of my social norms, that would be pretty difficult, to say the least. Yeah, well, and socially we might think, how can they be lonely?

They're always on snap. They're always on this. They're always connected. But sometimes it can be that real superficial connection. And so when that social pressures of being and acting in a certain way and being right, because we know fitting in is a socially like critical piece to development, like it feels like life or death when you were in high school or middle school, because part of it kind of is like that is socially how we are wired.

Yeah, if I am rejected from the group, I might not survive. And that sounds dramatic, but that is really what it can feel like. And so you can see this loneliness happening because they're scrolling or they're connected superficially, but sometimes it's missing those real deep connections. And then we are really responsive to those rejections for a good developmental reasons.

Yes. And then we have that go. And getting back to the physiological have all these hormones. And that's going to affect, the emotional state of a teen where they can be really high and, and suddenly really low, they're super nice. And then suddenly they're abstinent and they're against you and you're thinking, you know, what happened to getting whiplash?

And that's like what just happened. And then these social factors, there's so much riding on them that contributes. And then the emotions are really all over the place and it makes it hard for them. Makes it hard for parents. Yeah. But then you also have the emergence of mental health issues coming up. Right. During this phase of life too.

Yes. It's all so connected. One of my most helpful things I heard right, from an expert, was when they were highlighting about hormones, like you're saying, Brett and it. Our teens have adult level hormones pulsing through their bodies, but do not have that brain development or those social factors and social experience and life experience and to navigate it.

So when you see your teen kind of like have this huge reaction like, oh, they're having these tremendous hormone surges that they don't know what to do with, right? Right. Literally, my kids can be like screaming one minute and then they're skipping through the kitchen and you're like, Holy cow, what? What? But that is kind of part of it.

Right. And then you're highlighting Brett like, this is then we can also see an emergence of mental health issues coming up during this time. Absolutely. Yeah. And it when we think about these mental health issues, if parents if you haven't read this, I highly recommend The Anxious Generation's book. That's pretty popular and really talks a lot about what has been happening to teens.

There's seems to be more, mental health issues. I think since Covid, yeah, depression has been up about 150% in boys. And girls. Anxiety's been up, but 130% for while this is older, 18 to 25. But some of this starts, as we're seeing in adolescent self-harm and what should be a great topic for us some time to talk about, that's gone up, about 150% suicide, up 150%.

And why? Well, it's all of these factors. Plus, I think we talk about social media, gaming and all these other factors, smartphones that are available everywhere. So it's probably harder than ever to parent teens. Right? Like the average teen girl spends, what, 5.5 hours on her phone scrolling and the average boy, spends like four hours. So, like, our teens are being bombarded with expectation.

So it's not only fitting in socially, but then we are they are, marketing victims to societal expectations to get them to spend money and invest in things, whether that's a sweatshirt, whether that's makeup, whether that's the next right thing, medicine, sports gear. And they are experiencing that all the time. Like, am I enough? I'm not enough if I don't have.

Yes. And I love that word expectations and marketing that you said too, because I know, we did an episode way back on pornography, and teens are targeted with all these ads, to get them enticed towards using pornography. Yeah. I had looked this up, a number of times. Kierans is the guy who was kind of the foremost on sexual, addictions and things, and he had, said that today, boys and girls, almost half of boys and about 30 or 40% of girls are doing homework and watching porn because they're getting targeted.

Yeah. So when you look at all of this and all of these things are getting bombarded with expectations, we can really adjust our expectations that they are, in fact, under a lot. And it can look like they're just playing the victim. But it's not the same as when we grew up. Yes, it's a very different world. The language I use with my daughters, and I encourage any parent to do the same, is to have the conversation of when you see porn, when a naked picture pops up on your phone, please come and let me know.

We can talk about it. When they were young, like that was like, it's going to happen. You are going to see naked bodies. You've done nothing wrong. It is going to happen. Let me know. Not if, when, when and then for my older it is, how are you going to navigate this? How are you talk. What do we safety about pictures.

All those things. So don't be afraid to talk about porn, right? Talk about naked images that are going to come out. That can be scary, but I promise you, you won't regret it is there. And I love your proactive, take on that. It takes the shame out of it 100%. And when we don't and kids are watching porn regularly, we do have images of the brain that shows regular viewing of porn can have a negative impact on brain development, too.

So, yes, a lot going on. And so the good news is, right, Brett, that early intervention, early like care leads to better outcomes. So that is our hope today. Is that like you can recognize some of these things and kind of have some ideas. No. To the bottom and what care can look like. Right. Right. And so let's how do we know what's when when we want to seek that extra help.

Right. Yes. And it's it's a fine line too, isn't it. You know, they might start to isolate. They teens might start to, have all these big mood changes. They might look depressed. And it's a fine line of how much of this is normal, how much of this is something I need to be concerned about and have them start saying therapy?

Yeah. When is this serious? Yeah. And I would say it's never too early I agree, I agree, I agree everybody can benefit from therapy. Yes. And so life skills and yeah like where do you learn this. Sometimes I've had I don't know about you but I've had a lot of patients of mine say, oh, I wish I would have learned this when I was younger.

If somebody just would have taught me. And they're saying that as adults, so it's never too early to show any concern 100%. I absolutely agree with that. So what are some common reasons that they do start to seek therapy? Yeah. And any thoughts on that. Yeah. And like what do we watch for. What do we know. You know when we do we want to seek that help.

Right. So we know like we highlighted that there are emotional like we experienced emotional dysregulation. And that can go up and down that there's an irritability mood swings. We anticipate that. Right. So it's anticipating some of that with any big change that happens, especially like we're starting school time, we're going to be more tired. And you know our kids like to spend a little more time alone.

They like to isolate, you know, and kind of go in their room. But what we want to watch for, right, is when that mood stays down, when it's consistently staying down, when we're hearing more negative comments about themselves, right? When they're talking about hating things like hating everything, right. Those are some buzzwords to watch for when you know, they scroll away to their room and they don't want to come down, and they're refusing to come down.

At times when you see them stopping, engaging in their social activities that they used to. We know that friends can shift. That can be a really hard transition. So it can take a while. But do they are they able to start seeking some other like friendships and engaging, or are they still really shutting down and refusing to go to certain things?

You know, if they're sharing any sort of bullying, right? Or like real isolation, if they're navigating any challenges with like, identity, we know, like, like figuring out who you are, right. Like, how do you fit in the world? Who am I attracted to? How do I want to express myself? What kind of student am I? What kind of activities am I in?

Those are what all adolescents go through, and sometimes there can be added challenges with that. So those can be times when we seek, therapy. What else comes to mind for you? Well, I think just, typical things for any of us. Two life transitions, when there's been grief and loss in someone's life. Academic stress. For some of us, it could be work stress.

You know how that affects us? Yeah, definitely. Academic stress can be that far with that, moving and just even puberty is really confusing. Yes. And stressful. And you start to second guess yourself all the time. I remember in junior high I was so preoccupied with how should I walk down the hall in. All I did is look at the ground because I thought, okay, I don't want to look at anybody.

And then I thought, oh no, everyone's looking at me, looking at the ground. And I wrote down what I wore every day, so I didn't wear the same outfit too often. I'm sure people were not paying that close of attention as to which t shirt I wore on Tuesday versus the next Friday, right? Yeah. And yeah, it's very real.

Very real. So I think again, just it's okay. Take the stigma out of seeking therapy, make it normal that, yes, these are really hard things. We all need help. Yeah. Transitioning to a big sports team or not making a sports team. You're really. Yeah. That's a big you know kids who have we know kids of athletes starting athletics really young like.

And then if they have an injury and they don't get to be in their high school sports. So like any sort of transition, like you're saying those bigger things like therapists are there to help, like help that your teen walk through that figured out. Yes. And here's a novel idea. As the parent, if you don't know, go to therapy yourself.

Absolutely. And we focus so much as if the teen is the problem. And sometimes that's what they take away is, oh, I'm the problem. It's a wonderful opportunity and a great gift to give your teen by role modeling. So you know what? It's hard. It's hard being a teen. It's hard being a parent. I'm going to go see somebody try and figure this out because this is stressful.

I want to figure out how I can support you or go together, whatever. But yes, and I agree. And as parents, right. Like we there's no guidebook. There's no instruction manual for your specific model. Right. And each kid every child, every teen is a different model. Right. And I think sometimes that can be a barrier for parents of if my child is struggling or I'm noticing this mental health need, am I have I failed in some way?

And I get my answer is absolutely not. And I know that's your answer to absolutely not that it is. Sometimes we just need these skills. We need to figure out like what works for this my child and how do we help navigate this. And so that piece of parental coaching or coming in for therapy for yourself. Right. You figure out how can I best support my child 100%?

Here's one of the reasons to I think it's so important is for us as parents, I think a natural default for 100% of us as parents. It sounds like an overstatement, but everybody would agree we default to what am I doing wrong? Yes, yes. And so we assume culpability. Then we feel shame. Yes. And then we're modeling or not modeling, but we're parenting out of anxiety 100%.

And our kids pick that up and then they feel anxious. So get ahead of that and realize, I'm going to go figure this out. And it's not only modeling, but it's really empowering yourself. And functionally, what does that look like? It is literally for me, right. And what I guide others to taking a deep breath and saying, this is not about me.

We're figuring this out together. This is not a feeling. I don't need to feel any guilt or shame. What's another route? What are other options where can I get more support? And that's really that slowing down, noticing that reaction. Right. That shame and that guilt that like creeps in and then taking that deep breath like, nope, I don't need to do that.

That doesn't belong here. I love that it's because it is harder. I you hear sayings like this often, and I don't think this is an overstatement either. It's harder to raise teens today than perhaps ever before because of everything we've talked about. Yeah, yeah. And Brett, you do a lot of work with teens, right? I know that, and one of the things that I think can be a challenge is for parents to kind of navigate what if I feel like my child could use some mental health care?

I would love them to go to therapy, but my teen is saying, I don't want therapy. Yeah, like I yeah, I don't want to go. I'm not going. Yeah. It kind of. How do you very real. How would you like what are your thoughts on that? Well, one thought I already shared. Model it ahead of time, get ahead of it and model it.

I also think when they are very resistant to it. Again, it's not about you. And validate what's going on for them. Validate. Don't tell them what. Don't try to sell them on it. And don't make it a punishment. Don't make it a punishment. If you don't, you're going to therapy. Yeah, yeah. On behalf of all therapists, please do not make it as a mother who has done things like that herself.

Like I get it right. And like, so I think also, leading with validation and and asking yourself, first of all, have I changed in my parenting approach? We have to parent very much from a position of authority when our kids are real little. Yeah. And as they become teens now, we want to help them become more like adults.

So we need to transition to parenting more in terms of the strength of my relational influence. And if I'm not building my relationship with my teen, I am going to lose my ability to speak into them. So if I'm spending time with them, going out, doing things with them, going and grabbing a Coke or some ice cream, going to their sporting events, listening to them and not parenting them, late at night when they're just talking and just listening and saying, well, that's hard for you.

Yeah. You're building relational capital that you can cash in during times like this. So you might want to ask if they're resistant, how am I doing? And building that relational capital, if you will. And if you've done that then they're still resistant, which can happen. Remember, you still have I don't like this word, but power, you have it.

And I say that word because a lot of parents do feel powerless. Yeah. And so you're the one who pays the bills. You're the one who gives them heat and a door on their room and their cell phone and more. And you're the one that prepares their meals and does their laundry. And you can communicate to them that they have certain rights and privileges and responsibilities.

So if they're living up to their responsibilities, then they enjoy certain rights and privileges, which is preparing them for the adult world. So it's kind of all long, believe not trying to be short answer to your question. That's a great. Yeah. No. You covered so much, I, I hear you and really I'm hearing the importance of listening right.

That listening to them and validating versus telling what to do. Prescribing kind of critiquing or always giving feedback like that key piece of like listening to feel connected to them. And then I like your highlight of when we have a positive relationship, when they know that we care about them, that is the lens or the approach we can take to of like, I'm worried about you.

I'm noticing this. Like, let's can we just try it? Can we try that? We language like let's give it a try once or twice, right. I think can be helpful. And then also that piece of like you're saying, how do we use that power in a way that builds relationship and it's a dance and what comes to my mind is to say, you know, as your mom or as your parent, as your guardian, like, I love you and I care about you because I want you to get the support you deserve.

Like, I'm going to sign you up, and I'm really hoping that we can go together on Thursday afternoon. Yeah. And. Right. And so that piece of because sometimes it's again, like the decision making, that's why we don't let them choose what they want for dinner every night or just when they go to bed or whatever, because they're not in that ability to make that decision.

And so it's this balance of giving them autonomy, but also highlighting like as the parent, it is your job to make sure they're getting the care that they need and deserve. And basic behavioral psychology when they go, reward them afterward. It doesn't have to be something extravagant. It can just be some words of encouragement like, wow, that was great that you had the courage to do that reward.

What's behind the behavior? Yeah, not just going to therapy. Wow. That took a lot of courage. Or hey, let's go get some ice cream. I bet you're exhausted. I so respect that you're doing this. Or do you want to talk about it right. Okay. Yes. Okay. We don't have to respect their boundaries, because that brings up another idea that I think is important for parents and the teens in particular, to know what does teen counseling look like and what is that?

Because there can be some mistake in beliefs about what that's going to be. And so maybe be good to like talk about kind of what does that look like? You know, what does it look like when somebody comes in, Brett. That teen and they have a first session with you, like, what does that look like? What does that feel like?

Yeah, I first and foremost, it's a very safe, judgment free zone. Those might sound like buzzwords. I see him plastered at Planet Fitness, but it's really embodied in the therapist's office, and I think, teen is going to feel somebody understands. They're going to feel somebody cares about them and is not going to be pushy. So we would be very, very slow to try to work on change and start to build up the relationship from working with teens for, gosh, over a quarter of a century.

I know they don't care how much you know until they know how much you care. And so they're going to stand by you. Please. They don't. They don't care how much you know until they know how much you care. And so that's what a good therapist is going to be doing with an adolescent, is trying to communicate in tangible ways.

I do care about you. Yeah. And there's a lot of ways different therapists do this. I do Santry, which is really kind of fun and engaging. I like to play games with them, but use the games as therapeutic ways to help draw some things out that they don't even realize it's happening. Yeah, but then they realize, oh wow, I never realized that.

And then they draw a connection. This could be helpful maybe. Yeah. So and it's not always going to work either. However that's okay. We're all doing the best we can. Yeah. That's. Yeah. And really that therapists who work with teens and adolescents really enjoy and love working with teens and adolescents. They do it for a reason. And one of the things that happens right at the start of any therapy session, but in particular with when we have teens coming in, is we talk about confidentiality.

So right off the bat, that teen is having a conversation with the therapist. This is your space. This is your space to do work that you want to work on. And we share that with the parents as well. So helpful for parents to know. One of the things that really helps make therapy effective for your teen is when that teen feels like it is a safe and private space to talk with that therapist.

What's also comforting for parents to know, though, is that that therapist is on your team as well, right? And that therapist is going to let you know if there are any high risks or really dangerous behaviors or concerns going on. What that therapist does is first has a conversation with the teen, hey, I'm worried about this. I think we need to pull in mom, dad, grandpa, parent guardian and talk about this.

And so it's a conversation. But I think that key piece for teens to know this is their space to work on things and then parents to know, okay, the more I can respect those boundaries and that that teen do that work and trust that professional with this understanding of when they will let me know is a really helpful balance.

Right? And I think parents and teens can expect there's going to be a treatment plan. We're not just going to have coffee and a monster drink and talk about math. And you're not. Yes. And we're going to keep you totally in the dark. That's not the goal. Yeah. And so I've seen that sometimes teens it can take a long time.

Yes. And but sometimes it can take an extended period of time. And the teen doesn't seem to be getting better. And so then what I want parents to know is something called the Cassie Child Adolescence Severity intensity inventory. And have ask your therapist if they would conduct the Cassie assessment, because that will help the teen and therapist and parent know what level of treatment does my teen need?

It could be outpatient, which is pretty traditional therapy. It could be intensive outpatient, which is usually about three hours a week, or a partial hospitalization or even intensive residential treatment. So it's a really nice, objective tool that's very empowering for everybody to say, oh, okay, so this is what we need. Yep. There's lots of levels of care based on what your teen in your family needs.

Yes. Yeah. Well, I think we covered a lot a lot of topic. We thank you for hanging in there with us. We give you our love and support as you navigate teens and adolescence, in your life and want to leave you with a note of, a reminder of how amazingly resilient teens are and how they are navigating a lot.

And with love and support, they will get through it. We'll all get through it. But teens are really resilient. So if you do find your teen going through a hard time getting them that support and knowing they're resilient and, it's not always going to be that hard.

Thank you for listening to this episode of Everyday Therapy. We hope you're inspired to apply today's insights to your own life. Don't forget to subscribe so you never miss an episode! If you found this podcast helpful, please leave us a review. It helps others discover the show and join our community. See you next session!

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