From the moment our children are born and the doctor takes them to be weighed, measured and bundled, their health becomes one of our very highest priorities. As parents, most of us are instinctively attuned to every sneeze, scratch and sleep disruption. We are careful to never miss a check up or ignore a cough. Yet even as we worry over immunizations and stock up on hand soap for flu season, how often do we take the time to sit back and ask ourselves: how emotionally healthy are our children?
According to The American Academy of Pediatrics (AAP), "An estimated 21 percent of children and adolescents in the U.S. meet the diagnostic criteria for a mental health disorder...Yet, due to a shortage of pediatric mental health care providers, only 20 percent of these children receive treatment." In June, the AAP release a toolkit along with other resources to help pediatricians more effectively identify and manage mental health issues in children.
As important as it is this to get this message to pediatricians, it is just as important to help parents, who may have trouble identifying that their kids are hurting. On Dec. 4, I will be hosting the free Webinar, "How to Raise Emotionally Healthy Children" to help parents, caretakers, teachers, and professionals learn valuable tools for dealing with their children's emotional struggles. As parents in today's culture, we find ourselves encouraged to center our daily lives on our kids. Yet as we focus our attention on carpools, homework and play dates, we run the risk of becoming dangerously distracted from what's most important: how our children feel. While setting our schedules to make our children a practical priority is an act of genuine caring, nothing is as valuable or has the positive impact as staying attuned to a child's feelings, asking her how she is and allowing her to open up about her thoughts, impressions and fears.
In general, many of our children's emotions get overlooked, as we tend to pay more attention to how they are behaving than how they are feeling. By maintaining an awareness of our children's psychological state and keeping in mind the following parenting principles, we can become more attuned to our children and learn ways to raise an emotionally healthy child.
Don't ignore signs that your child is struggling
Be aware of behavioral changes that could indicate a child is struggling. If a teacher tells us our child has had trouble getting along with other kids in class, we shouldn't just shrug it off as being out of character and hope for the best - just as we shouldn't chuckle at how silly our child looks while throwing a temper tantrum. What may start off as small behavioral patterns can elaborate into later behaviors that are concerning. For instance, an exaggerated focus on food or video games can be signs a child is using these things to cut off pain. If left unaddressed, these patterns can lead to obesity or an addiction to drugs and alcohol. And the fits that seem kind of cute coming from a 4-year-old will seem far less charming from a 14-year-old.
Don't trivialize how your child is feeling
It is all too easy for parents to fluff off our children's moods, chalking them up to developmental stages like the terrible twos or teenage rebellion. Though these stages do contribute to emotional behaviors, it's important to learn to sensitively relate to our children while they are in these states, and teach them how to cope with their emotions.
When we notice an emotional change in our children, it's important to try to understand what specifically is impacting them and to respond accordingly. Perhaps something has scared them that they themselves haven't made sense of or that they aren't comfortable talking about. For example, a friend of mine recently noticed his typically outgoing, independent 13-year-old daughter becoming quiet and anxious about being away from him and her mother. It was weeks before my friend realized that his daughter had been deeply shaken after a student at her school lost her parents in an accident.
As we let our children know we are interested in or concerned about their specific struggle, we invite them to investigate their own emotions and to better comprehend their source. By being open and nonjudgmental, we encourage our kids to be honest with us. When they do open up, it is important to react with both compassion and strength. Offering both of these responses helps demonstrate a constructive attitude that our kids can adopt toward themselves and thereby develop a resiliency that will serve them well in future struggles.
Be sensitive and attuned, not reactive or parental
From the moment they speak their first words, it's essential to encourage our kids to talk to us. When it comes to influencing our kids, just making rules never works, but maintaining an open and equal sense of communication does. However for this to work, we must be accountable: we have to live up to our word in order to gain our children's trust. If we invite our children to talk to us honestly, then are defensive or erratic in our responses, we give them very good reasons NOT to tell us what's really going on in their lives.
For example, a friend of mine noticed his 6-yeard-old son acting oddly angry and rebellious at the dinner table. Doing his best to react sensitively, he took the boy aside and asked if something had upset him that day. His son replied that his feelings had been hurt when his dad didn't play baseball with him that evening, as he usually did when he came home from work. Inadvertently, my friend reacted defensively: he said that he'd had to work late that day and besides, he hadn't promised to play catch with his son, and then he drove home the fact that just because he was disappointed was no excuse to misbehave at dinner.
Later that night my friend realized that his response had been insensitive. He immediately approached his son and initiated a second conversation with him. He told him that he knew that playing baseball together in the evening meant a lot to him. He said that it was one of his favorite times of his day and that he had also missed playing it that evening. He communicated to his son that he not only understood the boy's disappointment but also shared it. Then he encouraged his son to talk to him the next time he felt bad, so they could avoid a scene like the one at the dinner table. He also reassured his son that he would really listen to what he was saying about himself and not respond the way he had during their first conversation. Both father and son went to bed that night feeling happy and on good terms with each other.
As parents, we should do our best not to react defensively to our children or try to talk them out of their reality. Instead, we should apologize that their feelings were hurt and help them make sense of their unique perspective and experience. Then we can share our own feelings about how they acted and enjoy an equal, honest level of interaction. If we do slip up and react in a way that is insensitive or inappropriate, it is important to go back and undo the damage that we have done to our child's trust in being able to communicate with us.
Invite them to spend time with you
When it comes to spending time with our kids, quality is much more important than quantity. It is advisable to set aside a specific time in which we engage in activities directed by our children; a realistic time period during which we offer our kids our uninterrupted attention and let them know they are a priority. Letting our kids decide what we do does not mean allowing them to set unrealistic expectations about activities that cost too much in time or money. Rather it is an opportunity to share an activity with our children and create a situation in which they can talk to us.
We can learn about them from what they suggest we do or games they opt to play. Parents, who take the time to sit with their young children, while they play with dolls or action figures, are often surprised to hear Barbie saying the very things that Mommy does or Spiderman acting in ways that Daddy does. Games that involve make believe or pretend can be very telling when it comes to kids. And we shouldn't be surprised when one character reflects the role - and consequently, the thoughts, feelings and behaviors - of our own children.
If they won't talk to you, help them find a situation they trust
Many parents wonder what to do when their kids will not open up to them. This is especially true of parents with teenage children. Yet, even if our kids refuse our offerings, it's important to keep putting ourselves out there and to keep letting them know we are there whenever they want to talk. If we are consistently there for our kids, we never know when they may come around.
If our children do not feel comfortable talking to us, we must remember that there is no shame in helping them find someone they do trust who they can open up to. Each of us can think of someone in our lives who meant something to us as a kids - a warm uncle, a dear grandmother, an outgoing teacher or a trusted therapist. Parents aren't always the easiest people for children to talk to, especially if their struggles involve their parents in some way. Letting our kids know they can talk to someone besides us can help secure their trust in us and will encourage them to deal with whatever they are feeling outwardly with someone they feel comfortable to confide in.
If they are in real trouble get them the help they need
If a child shows an unusual amount of anxiety, fear, anger, stress or pain, it is important to get him the help he needs. As parents, we must not be too prideful when it comes to raising our kids. How our children feel should always outweigh how we are viewed as their parents. The best thing we can do for our children is to be selfless in our commitment to getting their emotional needs met.
Take care of your emotional health
Although it's important to prioritize our kid's needs, it's equally important to remember that little affects our kids more than how we ourselves are feeling. Children are naturally highly attuned to their parents' moods. Putting on a brave face or denying our frustrations will never fully mask what we are feeling, and these feelings, which our children undoubtedly perceive, are sure to impact them.
Therefore, taking care of our own mental health is a key factor in helping our kids feel happy. No matter how much we fuss over, worry about or take interest in them, if we are not feeling content and fulfilled in ourselves, we are very likely doing more bad than good in terms of our children's emotional well being.
That is why we, as parents, have to ask ourselves: How am I feeling? Am I getting enough support in my own mental health? How do the answers to these questions influence the way I am caring for my children? Am I focusing on them too much or too little? Am I putting too much pressure on them, looking to them to meet my needs instead of the other way around? Am I relating to them in a personal way? Although we may falsely label such self-reflection as selfish, looking deeper into ourselves and focusing on what lights us up is truly beneficial to the spirits of our children.
Thom Kessler, LMFT, RAS
Anticipating an initial session can create anxiety in many people and knowing what to expect can help alleviate that anxiety. This is why I offer a 30 minute telephone consultation before people come to my office. I listen to what your presenting issue is and provide you with an understanding of my approach to therapy. After our phone conversation if you feel we both feel we might be a good fit you fill out paperwork that is provided on my web site, so that we do not use valuable session time to complete paperwork.
In the first few sessions we are getting to know each other informally. I have found that no matter how knowledgeable or experienced a therapist may be there is little, if any therapeutic progress without a strong therapeutic alliance between the client and their therapist. You must feel safe, comfortable, not judged and hopeful that you have found a place where you can truly begin to understand issues that have been causing you challenges.
My process involves asking general questions about why you decided to obtain treatment as well as background information. Questions will include your relationship and work history, medical history, assessment of your symptoms and other psychological history, previous psychotherapy experiences, and questions regarding your cultural background and family, to name a few.
After a few sessions I share my initial impressions in order to determine if I correctly understand you. I also will begin to outline what your treatment plan might be, usually within the first one to three sessions. I will encourage you to think up some of your own goals for therapy. I believe goal setting should be collaboration between my clients and myself. I also encourage questions regarding my professional background, my experience working with your issues and any questions you have regarding the psychotherapy process.
As treatment progresses, one thing to keep in mind is that psychotherapy requires client engagement. In order for treatment to work for you – you must be engaged, or involved, in your treatment. The client and psychotherapist are both active participants, as opposed to the client being the passive recipient of treatment. The more engaged you are, the more you will get out of the process.
Psychotherapy can seem daunting initially, however, many clients feel more comfortable once they have had their first session. You are there to be heard, assessed, and engage in treatment so that you and the your psychotherapist can work together to help you feel healthier overall.
One in 4 people deals with mental health issues which impacts people emotionally, cognitively, their relationships, the workplace — and also medically. “Mind your Health” by keeping mental health in the forefront.
Thom Kessler, LMFT, RAS
Adolescence for many people is a wonderful, challenging time of life. On the one hand, it’s a time of emerging independence and identity, exploring new freedom and contexts. However, the changes during this time are many, and this can also bring about different challenges and struggles for teens. This is also a time when teens can experience a mental health condition being triggered, and also might begin using substances, which can lead to teen addiction and/or substance abuse.
Right now in the United States, about 1/5 teenagers has a diagnosable mental illness, such as Teen Anxiety, Teen Depression, Teen Bipolar Disorder, or Teen Eating Disorder. Of these, around 70% will wait between 8-10 years before telling anyone and/or receiving any sort of diagnosis and treatment. This delay between onset and treatment is one of the greatest vulnerabilities for teens, as symptoms continue to worsen over time, gradually affecting almost all areas of the teens’ lives. For instance, around 50% of teens with a mental illness drop out of school and about 70% of teens in juvenile detention have a mental illness and sadly, suicide is the 3rd leading cause of death for teens. Moreover, the likelihood of a teen abusing substances is drastically increased for those suffering with a mental illness, which often complicates teens’ symptoms and overall health, even further.
Types of Treatment
The most common types of adolescent mental health and substance abuse treatment include talk therapy approaches and medication, and most instances employ some combination of the two. Some of the different types of treatment I make available include: individual therapy sessions, family therapy, 12-step program therapy, peer group therapy, psychotherapy, behavioral therapy, and support groups. All of these therapeutic offerings can prove extremely helpful and truly life changing for teens, regardless of how intimidating things may seem, at the start.
Teen Treatment Statistics for Mood Disorders
Teen Mood Disorders are defined as a psychological illness that’s connected with a teen’s moods, and are characterized by a persisting low mood, which doesn’t alter, even over time. The most prominent cause for Teen Mood Disorders is a chemical imbalance in the brain, which causes disruption of properly functioning neurotransmitters. Mood Disorders affect about 11% of youth in the United States. Some examples of the most prevalent Mood Disorders among teens include Teen Bipolar Disorder and Teen Depression. Teen Treatment Statistics for Anxiety Disorders Teen Anxiety Disorders affect about 8% of teens ages 13-18 in the United States and are characterized by a constant state of anxiety, fear, and worry, which persists regardless of circumstances. Teens that have an Anxiety Disorder are so overwhelmed by their racing minds and anxious feelings that it disrupts nearly every aspect of their lives. Some of the most common types of Teen Anxiety Disorders include: Teen Generalized Anxiety Disorder, Teen Phobia, Teen Social Anxiety, Teen Obsessive Compulsive Disorder, and Teen Panic Disorder. Addiction Treatment Statistics Adolescence is also a time when many teens begin experimenting with alcohol and other substances and this can unfortunately lead to Teen Addiction.
Teen Substance Abuse and Addiction is especially dangerous because teens’ brains are still developing; therefore, substances can have more serious and/or even permanent effects on teens’ brains. Because of this, often teens vastly underestimate the potential risk of trying a substance even once, as they don’t usually understand the full ramifications. There’s also a strong correlation between teens with addiction suffering from a mental illness, and vice versa. In fact, the majority of teens who receive treatment for addiction also show symptoms for a Co-Occurring Disorder, such as Teen Depression or Teen Anxiety. In these cases, it’s common for teens to turn to substances in order to self-medicate for the uncomfortable symptoms they’re experiencing or in other cases, a mental illness can actually be triggered by use of a substance.
Technology and Teen Mental Health
As technology such as the Internet and social media continue to have an increasing presence in teens’ lives, it’s important to observe the relationship between teens’ use of technology and how it might be contributing to mental illness symptoms. While the Internet and social media can obviously serve helpful and positive purposes in teens’ lives, they can also be a vulnerability for teens to develop bad habits and/or even addictions, which have significant negative effects on their lives. For instance, teens can form an addiction to always checking their cell phones and/or investing too much of their self-worth in the way they are judged in their online profiles. This kind of constant obsessing over looking at a phone can create anxiety and chronic stress, which can be especially harmful for teens that are already struggling with a mental illness.
When considering the current environment and statistics of teen mental health in the United States, it’s imperative to recognize that there is treatment available for teens struggling with mental health and/or substance abuse disorders. As our knowledge and understanding of mental health and addiction continues to grow, so too does our ability to treat it effectively, which means helping teens gain substantial relief in a relatively short amount of time and it’s very possible for them to go on to live their healthiest, happiest lives. Even in circumstances where symptoms are advanced and teens are feeling overwhelmed, treatment will help. Feeling better is possible. And reaching out for help is truly the most important step.
If you are a parent or loved one of a teen who is struggling with a mental illness or addiction problem, please reach out and ask questions, get information, and don’t wait. Often in addressing the teen mental health state, experts continue to emphasize that the most important factor in treating adolescent mental health and substance abuse disorders is to decrease the time between onset and treatment, so that teens are not struggling alone for so long.
Thom Kessler, LMFT, RAS
Speaker/Listener ExerciseFind a quiet, distraction – free space in your home to sit across from one another and take turns sharing about the stressors in your day.
TAKE TURNS AS SPEAKER AND LISTENER
Speaker: talk about your stress in detail for 10 minutes. The topics must be about situations outside the relationship. This is not the time to discuss how worried you are about your financial life or your partner’s lack of organization and/or to complain about your partner.
Listener: provide support to your partner. This is not the time to try and solve your partner's problem. Clearly understanding the issues and feelings must precede any advice.
GIVING SUPPORT MEANS:
Show that you empathize and care:
Don't: Stonewall, ignore your partner, fail to respond, get defensive or criticize.
The Listener should ask The Speaker if they feel heard and understood. Example: "anything else? I want to make sure I get it."
If the Speaker says yes then you can ask if he or she wants help problem solving.
If the Speaker does not feel understood, and ask more questions.
SWITCH ROLES AS THE SPEAKER AND THE LISTENER
Repeat steps two and three.
Make a commitment to have a stress reducing conversation five days a week for 15 to 20 minutes each day.
Thom Kessler, LMFT, RAS
Marriage & Family Therapist and Registered Addiction Specialist