How To Help A Teen Or Young Adult With Anxiety With Marc Azoulay

This episode helps parents or loved ones support a teen or young adult with anxiety with certified psychotherapist Marc Azoulay LPC, LAC, CGP, ACS.

Here are just some of the questions answered in this episode:

• What are the signs of anxiety in a teenager or young adult?
• Can puberty or teenage hormones cause anxiety and depression?
• What is the difference between anxiety and depression?

Marc is a psychotherapist in private practice in Boulder, CO and the past President of the Four Corners Group Psychotherapy Society. He helps clients that have a harmful relationship to their inherent aggression or who are stuck in the pain of their repetition compulsions. Many of his clients struggle with addiction, anxiety, and self-sabotage. Marc helps people uncover and destroy the unconscious barriers that cripple them by using a blend of Modern Psychoanalytic and Contemplative Psychotherapy. His therapeutic style can best be described as irreverent with surprising moments of profound depth.

Learn more about Marc Azoulay. 

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Well, if you have a teenager, you just struggle with, right, which is mainly around social situations, especially when you're in that middle school, high school, you know, entering into college. It's, you know, do I fit in? Do people like me? Am I normal? Or am I weird? You know, like, Am I a good person or a bad person? All these big societal pressures really come crashing down on individuals when they reach that age. Welcome to the sandstone care podcast where we help teens, young adults and their families overcome the challenges that come with substance use addiction and mental health conditions. Welcome to the sandstone care podcast with me Clint Mally. Today I'm joined by Mark azulay. Mark azulay is a psychotherapist in private practice in Boulder, Colorado, Colorado, and he's the past president of the four corners group psychotherapy society. He's helped clients that have a harmful relationship to their inherent aggression or who are stuck in the pain of the repetitive compulsions. Many of his clients struggle with addiction, anxiety and self sabotage. And Mark helps people uncover and destroy the unconscious barriers that cripple them. By using a blend of modern psychoanalytic and contemplative psychotherapy. His therapeutic style can best be described as irreverent, with surprising moments of profound depth. Mark, thank you so much, and welcome to the podcast. I'm happy to be here. Thanks. That was an epic introduction. And I love the end irreverent with surprising moments of profound depth. So I'm guessing we're gonna get some real honest answers to questions that people are people are having around depression and anxiety, am I right? That's what I hope for Yeah, we'll focus on the profound depth for this interview. Today's topic is mostly around depression and anxiety. So just to get like a scope of this whole field, what percentage of teens or young adults have anxiety? God, I would say, almost 100%. Like, I think the generations are getting progressively more anxious. As you know, society gets more complicated as social pressure gets more complicated as things like you know, the spread technology, social media, etc, etc, get more ubiquitous. I've seen, the younger, the kids tend to have more anxiety, which can manifest as, you know, shutting down as you know, being very nervous as twitching as saying things that don't mean, as you know, being afraid of situations, I don't think I've met a teenager that doesn't have anxiety in some way. And so what are like the things that you feel like, these teenagers or young adults might have anxiety around as it is, like a commonality between the things? Or is there some unique situation that's unique to our time, in which they have anxiety? Mostly? I think, well, if you have a teenager, you struggle with, right, which is mainly around social situations, especially when you're in that middle school, high school, you know, entering into college, it's, you know, do I fit in? Do people like me? Am I normal? Or am I weird, you know, like, Am I a good person or a bad person, all these big societal pressures really come crashing down on individuals, when they reach that age? Unfortunately, I do think that really gets ramped up with the technologies that we're seeing in the younger generations. Because now not only is that little, you know, young adult, comparing themselves with their local community, they're comparing themselves with the global community. So they're looking at something like how their body image compared to Instagram models, right? They're looking at how their family's wealth or success compares to people that are shooting videos on boats, right? Or they are, you know, comparing how smart they are to these little success stories of kids school, their age, like starting companies, right, or changing the world. I think the comparison thing is, is intensified by the current era that we're living in by far. Yeah, you know, I didn't think about comparison, but that's true. Like, you know, do we feel as a teen or young adult that we should be farther along than we actually are right like that somehow, we're actually missing out on the best that life has to offer. And I know adults have that, especially when they're thinking about their career when they're thinking about the next step of starting a family and stuff like that. But I that's a completely accelerated version. And when you start so young, when you haven't had a chance to learn life skills yet when you're still figuring out who you are. So that blend of that combination of Who am I and also how do I compare with everyone else seems super intimidating, what are the signs of anxiety in a teen or a young adult? So the signs that I see most common, or the most common and most dangerous, I think the most common ones are social anxiety. So being afraid to talk to adults being afraid to go out being afraid to be in the actual world, I think, again, we talked about the technology piece, interacting more through a screen rather than in, you know, physical space. I think that's the most common, I think a lot of teams are going through that type of thing, the most dangerous one, which I think you know, sands don't care definitely plays a big role is around things like substance use or self harm, where you have a team that you ramped it up to the next level to, you know, we would call it like the clinical level. And now this team is acting out in a significant way. They're self medicating through drugs and alcohol, you know, or they're so shot in, and they have so much self hatred and shame that they're self harming, they're trying to sue some control maybe manifests as an eating disorder, if it comes out of, you know, around body image issues, or early childhood pain, things like that. So the runs the gambit, I think, anxiety, I mean, a better way to say it, it's just fear, right? anxiety is just what we're calling fear in the modern era. And I think it's really safe to say that a lot of young adults are very afraid right now. Man, you hit the nail on the head, when you're talking about just calling it what it is anxiety is fear, right. And when I'm thinking about myself, working remotely, and you know, with the pandemic, not being able to interact with people on a regular basis, and not being able to hug people not being able to, you know, just shake hands with people, it has this undescribable effect on you, it makes you feel more isolated. And the thing that I keep feeling is, you know, I'm married, and so I was quarantining with my wife. But if I wasn't right, if I was, by myself, for the majority of that time, I would have felt completely alone, I would have felt really, really sad, really, really depressed, I would have felt anxious myself. And so, you know, especially post COVID, like, work through COVID. Have you seen that kind of stuff, ramp up? isolation, isolation is through the roof. And I think, you know, so you said, my bio, yeah, I do the group therapy thing. I'm a big proponent of group therapy, but not just group therapy, but groups in general. And again, I think we're talking, you know, kind of modern civilization groups don't naturally form the same way they used to, because we're able to be isolated, like, yeah, you can quarantine when you're single. But you don't have to talk to people because you have Amazon to deliver everything, or you have doordash, you have grub hub, right? Like many of us have the privilege me included to be able to work from home, right, I did my whole job remotely. We don't have to go out into community, like I think most humans did for most of human civilization. Right? And, and being that we are social creatures, we have to create those groups ourselves, instead of them being given to us by society, right? So example would be, you know, back, you know, back in the day, right, you'd have like hunting groups, or you'd be working in teams, or you would, you know, have your basket weaving club, right, or you would be like sharing childcare, or whatever it was. But as technology gets more, you know, convenient, which is great. It means that we have to make the group's ourselves. And I think many people didn't have those structures in place. Right? They didn't realize how much social connection how many of those hugs, he talked about how many of those, you know, just people that know who you are literally, right? Just know who you are, came from their work environment, and came from the commute. And when that all went away, they realized, Oh, my God, not only am I alone, but I don't think anybody knows me, I feel anonymous, and invisible in my own community in my own life. And that's a very scary place to be. Yeah, you know, anything remote, it's hard to have those water cooler or walking the class conversations, those times in which you are not expected to be learning something or digesting something, that you're just existing around another human being. And that, to me, is where I made a lot of my friends growing up. But that, to me, is where I, you know, got to know a lot of the people who became foundational and me forming my identity and understanding the world. Right? And so when we take that away, and I know that there's, you know, advancements in technology, but when we take that away, it becomes super hard, it becomes hard to to recreate those things. Those are, those are important things that if they're not there, make it really difficult to make friends. Yeah, totally. Totally. I think people really need each other. How do you help a teenager or a young adult with anxiety? So the number one thing to do is just to listen, right just to listen, and to try to enter their world as they allow Right, I was gonna say as much as possible, but it's more like as they allow, because then that's a little bit invasive. But what that looks like, is being interested in what they're interested in. Even something that might be boring to you as an adult, right? If they're really interested in, you know, a video game or, you know, a streamer, or, you know, they're interested in some esoteric hobby or whatever, right, or fashion you don't quite understand. I think as the adult, it's really on you to take a step back. And to put all that aside and just be interested in your child. And especially with young adults, they're not going to tell you the emotional content first. Right? If you go to your kid, you're like, hey, you're really anxious, you want to talk about it? That's way too intense. It's way too intense for them. Right? I mean, to be fair, it's way too intense for most adults, right? Like, no one wants to answer that question, especially if your relationship with your teen or young adult is maybe a little bit Rocky, or maybe a little bit distant, they're not going to go straight to the core. So a lot of relationship building needs to happen, which means, again, entering the world, and you'll see that it will come up if you sit and watch a YouTube video with them that they really enjoy. At the end of that they might just share something with you about how that view relates to their life or something that they're afraid of at school or a situation that's arising because they're going to feel that level of connection with you, they're going to feel closer. And I think it's a mistake that a lot of parents make is that they try to bring the kid into their world, which is part of your role as a parent, right? You want them to grow up and learn about the world and being an adult, but also on, on the parents job to come down into their world and, and to play, really, you know, to play with them. So that that safety and trust can be built out. I think it's critical because that's how they process the world. Right? Like, you know, a kid presses almost entirely through play. And I used to work I did some child therapy early in my career. And it's wild that once you build safety with these kids, they would start playing, you know, house or playing with dolls or playing with cars. And they would be telling the stories of their family through their play, because their brain wasn't developed enough to communicate it effectively. But they'd be like, oh, here's like the mommy doll. And that daddy doll and like they're fighting and oh, no, like the kid is hiding in the basement, or I mean, they would like that would be the game that they were playing, you know. And it was also clear just to watch it and see how that would happen. The same thing is gonna happen with your teen young adult, right? I remember. I mean, I think once we got this big project, I had this parents client, we're like, the music you listened to as a teen speaks for your soul. And if you as a parent, if you just listen to some of their music, you're going to understand so much about their about your team. Even if it doesn't sound like a genre that you like, or you don't understand what it's really about. Just listen, and you're gonna be like, Whoa, like, my team is really sad isn't a lot of really sad stuff, or Well, my teams listen to a lot of angry stuff, wonder what they're angry about, you know, you can start to see what's going on underneath the hood, if you can get more into your teen young adult world, and try to understand what what draws them, right, like what they're interested in. Mark, when you mentioned music, I immediately knew exactly what you were talking about. I remember as a kid, you know, especially listening to the radio. And the radio is kind of a unique situation. And because it's it's constantly putting music out there that you may not know about, right? Like, you're not searching for it. It's just kind of putting it out there. And I would always look for these songs that were kind of able to express what I didn't yet have warrants for. Right? That would be the way I would connect. Because here I had people who were adults, I'm assuming because they're making music, right? And they're famous, they're on the radio, and they're eloquent enough to be able to describe their emotions. And so much of what I struggled to do as a kid was just to describe how I felt. And so when you found an artist, or when you found a song that was able to do that, it was something that was sublime, right, it made you feel so happy because you felt understood. And so much of what we wanted to do is feel understood. I don't know do you can relate to that. 100% No, 100% I watched my so it started my kind of a credit the start of my whole kind of introspective therapy self whatever journey was watching the wall, the Pink Floyd movie, right, which is essentially a giant music video for that album. And just seeing that and seeing how closed off that character was seeing how chaotic that character was seeing how much pain and it's both put through you know, the incredible music and through just like really intense visuals that just broke me open. I remember crying like just breaking down and crying and being like, Oh my God, I've never I didn't know I felt this I kind of same thing you said right. It's like this thing is putting into words and visuals what I've been feeling for a long time. And I felt so much not alone because like at least there's one person or there's someone who wrote the song and it feels that way. Not to mention you know that movies out there and people enjoy it. So there's many people that feel the same way. really life changing. I think it really started me on getting in touch with my emotions at all. Yeah, and when I think about the animal kingdom, even, you know, plays such a huge part of how they learn how to do things, how they learn how to hunt, how they learn how to communicate with each other, how they learn how to do the essential things that are so important for them. And if they don't spend that time playing, and they don't learn those essential skills, right. So, you know, you see a lion cubs talking, it's, you know, it's a butterfly through the grass, right. And it's doing this to be able to try and learn how to do this skill, right, it's mimicking what it sees. And so having a chance to play allows us to lower our defenses allows us to be able to be in the moment, and also allows us to just do an experience with someone, right, which is something that is hard to do with social media, because you're kind of putting something out there seeing responses, but it's not this coinciding thing. It's not like a conversation, kind of like we're having right now, which the two of us are, you know, just talking to each other. So, I can see that as being so important. I never thought about that way. Yeah, no, I think you're hit the nail on the head, it's so true. And also creates bonding moments with your team, it creates memories that you can share together, feel like oh, remember, we did that, and I fell over. And it was funny, right? You know, or like, Oh, my God, like you really knocked out the park with that one or whatever, right? Those are those moments that their kid is going to remember a lot more than even a conversation that you have, or you know, a lesson that you tried to impart to them, they're gonna remember those little moments of play that happened spontaneously, that are generated through, you know, the freedom from inhibition, like you talked about, that's what they're gonna remember. And that's what's going to help them feel more connected to you. And guess what, that doesn't stop when it comes to, you know, the relationship between parent and child, right? Like, you get married, or you're in a relationship with someone. Oftentimes, if you want to be able to connect with that person, you have to engage in similar interest, right? If you want to build a friendship, you have to engage in similar interests. And sometimes those are things that you're comfortable with, that you have experience with. But then sometimes they're not right. Sometimes throughout that process, you learn that this actually is kind of interesting, every parent who I've ever seen do a tick tock with their kid, like a dance with their kid, like hats off to them, because they're engaging in a platform that is, you know, different, they're willing to look silly or Goofy, and at the same time, they're doing something that's interesting to their kid, now, your kid may not want to do a tick tock with you. Right. But that doesn't mean that you can't be willing to engage in whatever interests they are willing to do with you. Yeah, and that's what we're talking about right to loop back around. That is what helps them with anxiety, because you're entering their world, you're interested in what they're interested in. And I would imagine, after going through that Tiktok, shooting, and a couple times, you know, having a couple bad takes, your kid's gonna feel a lot closer to you, and over time will trust you enough to reduce the fear level. Right, right to trust reduces fear of safety reduces fear, so that they can start to talk to you about what's actually going on for them, right, you can become a safer person for them to connect with. And if I help them feel less anxious in the house, right? Yeah, totally. Let's talk about the differences. And maybe I'm wrong, and there's no differences. But one of the things that I hear parents are constantly questioning is for their specific gender, right. And I know that gender is kind of a fluid thing, right? There's it's a spectrum. But you know, are there any things that we should be thinking about? For helping anxiety within females or males? Like, let's start with females? What are the ways that you can help to reduce anxiety within your daughter? Yeah, I think in general, working with female clients, a lot of it is around body image. That seems to be the big thing that comes up when you're looking at those young adults in those teams. Again, social media, but it's even more than that. I'm sure some parents are aware of this. But it's probably worth just saying on the air, that you should look at some of the apps that are out there for young girls right now, download some of them on your phone, you can see how they can edit photos, you can see how they can put filters on you can see how they can start to beautify themselves. And there's nothing wrong with wanting to beautiful, right and enjoying that. But I had a teenager client, share with me something really interesting where she was using these apps, and you know, enjoying playing with different makeup and different filters. But she's like, then there's this moment where the filter goes away, and you just see, you know, what I look like or you just see yourself in the camera. And by definition, that person is less attractive, right? Or that person is less touched up than what the filter does. So there's this kind of constant reinforcement of like, look at what you could be, right look and look at what you're not. And they're getting that impulse. They're getting that little piece of conditioning almost all the time, especially if they're on their phone. A lot. they're engaging in social media a lot. And, you know, it's kind of tough, because I don't think social media is going anywhere, if anything is only going to get more intense. So I don't think restricting it or taking it away is super helpful. I think it's more about listening, understanding, doing some education, joining them on some things, looking at some of these apps trying to understand what it's like from their side. Because I see that being like, really the big thing, and I'm laughing, as I'm saying this out loud, because I think every generation feels this way. But I feel like sex and sexuality that keeps hitting younger and younger and younger. In my opinion, right? I see that the idea of being attractive, being a sexual object wanting to get a boyfriend, right, or wanting to get a partner doesn't have to be a boyfriend, but wanting to get apart, I want to be in a relationship wanting to find love. I've seen, you know, female identifying clients talk about that at 11, you know, 12, even earlier, whereas I don't remember hitting that early for me, I remember that stuff coming online around like 1415, you know, a little bit later. just seems like that kind of hypersexuality hits a lot earlier. And nobody is equipped to handle that at that age. Right? The brain just isn't developed enough place. Yeah. And so if I'm thinking about a parent, and you know, you got a dad or a mom out there, and they're saying, Hey, I tell my daughter all the time that she's beautiful, right? Like, I tell her like you are beautiful, honey, you are perfect. Just the way you are. Is that enough? Or when we're trying to combat this type of body issue? When we're trying to, to combat this ideology, this mentality around body image? How does it How does a parent help with that? Same thing, I think it's listening. Look, I think telling your you know, daughter that she's beautiful is great, right? Definitely don't stop doing that. I think all women need to hear that much more than they do. But I think what can happen is, especially if your kid doesn't feel beautiful, or maybe he's getting bullied in school, or you know, getting cyber bullied or whatever, for something, they're gonna, they're gonna think that you're lying to them, right? Or if they don't feel it on the internal way, they're gonna be like, why is my mother or father saying this? To me? I don't feel this way. It's be very confusing. So anything where you're telling your kid and again, this is I think this is where parents struggle? Because this is a developmental difference, right? I think from a child and a baby, telling them educating them doing a real top down solution. That's what you have to do. Right? What do you have to do as a parent, but as your kid gets older, they gain more autonomy to gain more responsibility. And it becomes a slightly loosening of the reins and a slightly, you know, leveling of the hierarchy. So instead of telling them something and ending the conversation, right, because that's what that's the end of the conversation. What you want to do is start a conversation by being curious about what's going on being curious about the things that she's interested in what fashion she likes, you know, what her friends are doing, you know, like, there's a whole world there, right? I think it's, again, we're doing gender norms, but I think it's specifically difficult for men to understand this. And I've, you know, gone through this as a partner, you know, dating women, and being like, Whoa, like, the amount of time and energy and attention that goes into beauty, and goes into body and fashion is like, almost uncomprehending for me. Because of our place in society, we don't really have to do that we work hard on other things, for sure. We don't have to do any of that. So really trying to understand that world and a non from a non judgmental place. is important, right? It's one thing to say like, Oh, you don't need to put on makeup, like you're beautiful without it. That's one thing, but saying like, Hey, what are you doing in the bathroom for an hour and a half? Right? Like, what are you actually doing? What is going through your head? What's that process? Like for you really getting curious and entering into it? Instead of telling her that she shouldn't be doing it? Or that it's a bad thing? Yeah, there's two things that stuck out to me with what you said. One is opening the conversation, right? So not saying Hey, honey, you're beautiful. By and also coming from a non judgmental place. Because if you come into the conversation is, why are you doing this to your face? Why are you doing this, then immediately within your facial expressions, your nonverbal cues, what you're signaling is that they're doing something wrong, instead of and they're gonna want to close up and not open up and talk to you. If they're, they're feeling attacked, right. So coming from just a curious non judgmental place would allow you to be able to actually have a dialogue in a conversation to go a little bit deeper. Is that right? Absolutely. Absolutely. I think that's very critical. Okay, so let's flip the script. So for someone who's a I love how you said it, a male identifying person write, teen or young adult. How can I help a teen or a young adult boy cope with anxiety? Yeah, so a lot of that I see. In the younger, you know, men that I work with, is around. Am I good enough? There's a lot of shame. As far as you know, am I a man? Am I tough enough? Am I strong enough? Am I going to make? You know, I think that's what I think these are just stereotypes. But I think that they're true. In a lot of cases, the male hierarchy seems to be very linear and very, like pecking order, right? Like, you look at like a sports team, right? It's like, who was the fastest runner who's the least fastest runner, and most guys will be able to place themselves within that linear thing of like, yeah, I'm like, you know, I'm in like, the top fourth, right? Or like, I'm better than average, like, yeah, I'm kind of in the bottom third. Whereas when I look at, you know, female hierarchies, I tend to be concentric circles. So there's groups of women that have some place in the hierarchy, but it's not so linear, it's a little bit more networked. So for guys, they're always especially young boys. I think men too, if we bring on it's like, assessing where they stand in the hierarchy, right? Like, am I high value, or am I low value, and the boys are struggle with anxiety are going to be feeling more low value than anything else, right? Maybe they're not as strong, maybe not as good sports, they don't feel as smart. Maybe they're not as good talking to talking to girls, right? Maybe they have a hobby that people say they're a nerd, right, like something like that, right? They're kind of like lower on that hierarchy. And I think the important thing, for them again, it's the same advice, but just listen to your kid, you know, listen to your kid, understand that. But I think with boys in general, try to move them towards connection with peers, because I don't think boys do that as naturally as girls seem to. Right, I think kind of were talking before, men can isolate a lot easier than girls can. Or they can fall into communities that don't really give them that emotional connection, whether that'd be like an online gaming community, which is really popular right now. Or, you know, becoming like getting into Twitter, right, or getting into, you know, being a forum post or all these, like discord is a big one, or just like a lot of one way communication, but not really having deeper emotional connections with boys. The thing that I think is critical for boys in general is finding older men that can be mentors. I think and this is true, I think for probably for both, but, you know, surrounding your child with as many healthy adults and healthy is like, I can't underline that enough, right? You as a parent, you have to screen and figure out who's healthy and who's not, that is part of your job as a parent, right, but struggling with as many healthy adults as possible, whether that be you know, coaches, tutors, mentors, people that they can do an internship with, you know, camp counselors, whatever it is, so that they can start to learn from other people and make those other people can make up for flaws that we all have as human beings. And I think boys in general really respond to older males that are able to take them underneath their wing, teach them, you know, a new skill, teach them a sport, teach them how to survive in the wilderness, teach them how to make something. I think that's kind of how we tend to bond and we can start to feel a lot of value if there's for getting the approval of an older man. Yeah, when it comes to the archetypes or the figures that we see within the media, one of those archetypes is that strong, silent type, right, the action hero who doesn't want any help, right, but the action hero who wants to go to love the lone wolf, right. And that can be a really damaging perspective to have when you're in formative years. Because if you're having a problem, a tendency can be, I should be able to figure this out by myself. And then the next question is, if I can't figure this out by myself, what's wrong with me? I've talked to, I've talked to a lot of teens and young adults and, and that was the thing that they kept coming in contact with when they're thinking about substance abuse, when they're thinking about mental health is, you know, I shouldn't be able to figure out how to stop. Stop thinking this way. Stop drinking, stop smoking, whatever it is, I should be able to figure it out. And if I can't figure it out, what's wrong with me? Right. So I could totally see how that whole isolating premise can be something that permeates through everything. Yeah, I think that's huge. And I, we talked a lot in this podcast about listening to your kid, I think talking to your kids, but talking to your kid about yourself, and about what your experience was like when you were their age, and being vulnerable. Right? You know, listening is probably number one. Number two, if a parent wants to help their child, it would be to do their own work, right, getting therapy themselves, joining supportive groups getting around their own healthy adults, right, like learning how to do introspection, doing journaling, whatever it is. Because if you can talk to your kid from a place of emotional stability, about emotional things, and I'll say that in a different way, right? Sometimes parents share with their kids something that's emotional, but they are dysregulated. Right? They're screaming, they're lecturing. They're Mudi, right, because they're humans just fine. But if the kid doesn't connect with you that way, right then of taking responsibility, they want to fix it, or they get kind of shocked. So if you do your own therapeutic work, you can talk to your kid about emotional things, while you're stable, so you can hold your kid. Hopefully that makes sense to your listeners out there. That makes all the sense. And the thing that I think about from a, from a male perspective, or any parent perspective is, when I was your age, I did this, I did that. And that speaks to that exact beer and anxiety that we talked about, right? If you feel like your child should be in a place that they're not in the you use your own experience, to be able to explain to your child that they're not as far along as they should be, you are triggering and creating an anxiety within them. Right? Like that. They're not good enough that they don't measure up. Instead of like you said, almost empathetically saying, Hey, you know, when I was your age, I also went through this, like, this was so hard for me, or this was a big challenge for me, suddenly, now, you're more relatable. Now you're, they don't feel so bad about themselves. Right? Like, they feel like they're not measuring up. And, you know, you turned out okay, so if you turned out okay, maybe I can turn out okay, too, right? Absolutely. Yeah, you hit the nail on the head, right? sharing those moments of vulnerability with your kid have, yeah, I went through a bad breakup too. And like, here's what it was. And here's actually the details about it. Here's who this person was, here's what they looked like, Here's a photo of us together. Here's how I felt, here's a song I listened to, that helped me get get me through the breakup, like really getting into that personal level, and connecting with them on their level, instead of talking from, you know, on high, the idea is that you want to meet them where they're at is, is critical, and can be such a healing moment for your team going through something difficult to feel like they're not alone. And just like you said, Clint, that if you got through it, they can get through it, too. Yeah. So this is this next question is for everybody, right? So can puberty or teenage hormones, cause anxiety or even depression? Um, I don't know what the direct link is. I know that puberty and hormones just kind of scramble the whole system. Right. And I think a lot of that is that it turns sexuality online. I mean, we talked about that a little bit earlier, but all of a sudden start having feelings. You know, for other people, you start going through changes, right, you start having like, intense emotions, things you get messed up as far as eating and sleeping schedules. And I think all of that, if not talked about, or not managed correctly, can be causes of depression, anxiety. Absolutely. I think, I guess, you know, you said you pull these questions from the internet of what people are asking. And I guess what I want to say to listeners is I wouldn't write off mental illness or depression. Anxiety is like, Oh, it's just hormones. Oh, it's just puberty. Oh, they're going to get over it. That that's, I guess what I hear when I hear that question being asked, because there's often something underneath that I don't think it's just like a phase. You know, what I'm saying? There's something that needs to be attended to in the moment. Yeah, and I think you are kind of getting close to the triggers that prompt somebody to want to ask this question, right. So if if something's going on, and that I can't understand, as an adult, as a parent, then to write it off, that it's about sexuality or hormones, is not doing justice to the events that the child is actually going through. Am I right? Yeah, exactly. That's, that's what I'm hearing. Yeah. Yeah. And so I want, I want to make sure that I'm super clear on this. We can have hormones that can scramble things within us that can make us feel confused, right, especially around sexuality when, because sexuality is about feeling desirable, feeling attractive feeling, you know, good enough. So would you say it's relatable to the other conditions that we might see within general anxiety? But it scrambled or do you think that, you know, someone might, might be more likely to be anxious when they're, when they're going through this because of chemical imbalances or whatnot? Like, what does that look like? Yeah, I think it just would amplify what's already there. You know, and I think it's also you know, you look at puberty, when it tends to happen, individuals, it's also connected to when they're entering larger social groups, right? They're leaving the family system and entering into something like a high school, where there's a lot more people that to deal with, right? Things like competition are coming online in a way that isn't really true when you're younger. So you're competing over getting into a good college, you're competing in a sports team, you're competing, you know, in the chat Club, whatever it is, right, like stuff, like stuff gets way more intense. And I think what's important for adults to hear, right is that, especially adults that are that are burnt out, or that have dealt with depression and anxiety, right, like a lot of adults, we have real problems, we have real problems, you know, that adult problems like around things like death, right, or chronic disease, or losing a job, or moving to a place where you don't know anybody. So if we're in a place where those problems are, you know, overwhelming us, and we see our team talking about, like, Oh, I made a tic toc, and not let people liked it, we're gonna be like, what's wrong with you, if you don't understand what it's like to be an adult, and I see adults kind of lash out in that way. So the idea is to really, again, listen, meet them where they're at, do your own work, to understand that your team's problems, your teen sources of anxiety and depression are probably gonna seem like kind of dumb to you. But they're not they're like, very important, and the most important thing that your team has probably gone through, up into this point. You know, even though as adults, we may, you know, quote, you know, know better or something, or have more perspective, it doesn't invalidate the feeling that your teen is going through. And I think the hormones are going to ramp up alive that especially around partnership, right, especially around dating is really the big thing that I think comes up and body size. Right? Like being being strong being fit being active. Yeah, so what I hear you saying is, one Don't let your perspective on being an adult, diminish your child's problems. And to to understand that part of the reason why it might feel like it's the end of the world for a teen or young adult is because that their hormones are amplifying things, that does not mean that we need to dismiss them. But it does give us some credence to be able to have a deeper understanding. Or why right. And when we come in with that sense of understanding, we're more likely to listen and less likely to be dismissive. Totally, you got it. Cool. I'm learning here. Okay. So question, you know, does teenage anxiety go away? I mean, I guess when they get older, they get adult anxiety. Yeah, I think like, I think there's a couple ways to manage anxiety, right. So there's a top down, there's a bottom up. So the bottom up, dude, what's most effective for younger people. bottom up is also we've talked about right, which is to kind of loop it all together is creating safety, creating trust, making the fear go down, whatever you can think of to make fear go down, you know, injecting comfort, anything that that is what is going to help it and bottom up is from the emotional way. Right? That is a lot harder for parents to do, because they want to do the top down stuff. The top down stuff is effective for adults, right? It's some of the work that I do with adults when I work with, you know, startup people, or executives or whatever. But that's like, organizing, right? Like actually cleaning your room, right? Or getting a calendar or doing to do list or figuring out how to prioritize or making a business plan. Right. I think parents want to do that for their kid. But their kids brain just like can't just can't do that. Right? I've worked with so many pastors like oh, like I got him a planner? Like, Shouldn't he be more organized and less anxious, like you shouldn't miss performance if he has a planner? And it's like, no, because he's afraid all the time, he's not going to use your planner, if he's afraid to go to school. Right? So all that to say is that I think if you can work with the bottom up stuff, it can get better. And I think it leaves the you know, kind of treads the ground for that top down kind of executive functioning as what's called in the field, but, you know, organization planning, hygiene, stuff like that, that comes later. So I think anxiety can go down. But it's often pupil things that you have to manage all the time. Because again, it's fear, like fear is gonna come up. And if you're not feeling afraid of stuff, you're probably not pushing yourself enough, right? You're not on that edge of experience, you need to be out of your comfort zone in order to grow, which usually means, you know, feeling fear and working through it, right, moving through it in a healthy way. So how do you walk that line? Because one of the things I heard you say is you need to help your child feel comfortable, right? You need to help them feel like, like things are okay. Like we, I understand you, but at the same time you're saying hey, fear is something that helps to drive us to make us better. So there might be a parent out there is like, I don't want to be soft on my kid because the real world is hard, right? The real world is tricky. And and if I'm not this way, then they're going to be soft, right? Like what would you tell? How do you make that balance? I think it's really boils down to open communication. I when I hear you say I'm gonna make my kids soft, the word that I use is like enabling right? You don't want to enable your kid to, you know, continue to fail or not to understand the consequences of their actions or to you know, Kind of minimize or dismiss things, I think that's really common. It's like the hover parent kind of stereotype. And it's not it's not effective because the kid doesn't doesn't learn about the real world. So there's a thing that's kind of a good rule of thumb that's used in the clinical world, which is just called natural consequences. Right? And the idea is like to educate your kid of like, Okay, this is what will happen in the world, if you make this mistake, right. And I think the harder thing, especially for, you know, our generation, like millennial generation parents is watching your kid fail and watching a kid get hurt, like, actually, you know, lose, right? or watching your kid, you know, go through a breakup. And the main thing is, yeah, you don't want to take away that pain. But you do want to walk beside them, right? parallel, be with them be always available, be there, they can talk to you, but not try to fix it or change it. And I feel like I'm a broken record. But that really does require doing your own therapeutic work as a parent, and getting yourself into therapy and learning how to be more emotionally stable, so that you don't end up, you know, getting triggered yourself, right, and wanting to pull them out of it or wanting to make it worse, or whatever your current thing is. I yeah, I think it's really critical. You know, there's kind of this stories of like, male initiation. And the story is like, you know, you have the young boys like off into the woods or whatever, right, and they're terrified. And so you got to survive for three days with no food and disappointed steak. But around that, or the older men, right. And they are making sure the predators don't come in, they're always there. If something happens, the young boys don't know that they're there. And I think that's the key point, right, is that the kid doesn't always need to know that you're hovering, but you're always there. And you're always able to watch and always have a step in if something really actually bad happens. But you're letting them be in a just dangerous enough situation that they can learn how to figure it out for themselves. And I wish I had a way to tell you how to do that. But it's an art. It's like literally an art form. And I think every situation is different. And it just requires a lot of presence, communication and attunement and being able to really be available to the adapting situations. Yeah, and just because something is an art doesn't mean that it's not learnable, right? So we often times think about artists or art as something that's just in doubt, genetically, right? But all of these things can be learned, right? So I used to be an educator. And the word education needs to draw out, right? So you're not so much downloading, it's not the matrix, right? You're not just plugging somebody in so that they can learn this new skill, you're actually drawing out the skill or the character or, you know, the new thing that they're trying to figure out about themselves from within them. And when you can do that, then it sticks because then it's ownership. Right, then it's like, I did this, I made this happen, like, I should feel good about it. And yeah, so you know, you're saying therapy is like good for young adults, teens, but also, especially for parents, right, like, you need to learn how to do this happen. It takes some practice, is that right? Exactly. Yeah. I mean, I think similar models, I think what therapy does, and yeah, you know, take parent coaching and go to education and read books, there's so many resources out there, I think what therapy does is it helps you get out of your own way. Because everybody has unprocessed stuff from their childhood. And just like you're saying, Clint, the idea to draw out, if it gets blocked by your own pain, or your own fears, or own insecurities, as a parent, that is what is going to hurt your kid the most. Right? So the more you become a clear channel or a clear vessel, then you can be more available for your kid. Love is so good. And it's so important, you know, and this next question, especially in light of kind of what we've been talking about might seem silly, but I think it's important because I think that it is a tendency to do with parents. And, you know, the question is, what can I give my 14 year old for anxiety? And to give some context with that, like, you know, 14, hey, they feel like they're, you know, a teenager now. They're feeling anxious, they're in high school, right? Things are really hard. Parents are wondering, is there anything I can give them to just give them to help them with anxiety? And I think a lot of times people are thinking about this from like, a substance perspective. Yeah, thinking from like, like a medication perspective is where I think of when I when I hear this question or something, but, I mean, I think the answer we've been coming to is like give them time and attention, right? Want to give them something try that first. Right however, that being said, I'm not anti medication, I think 14 is a little young. But if you have a child psychologist or sorry, a child psychiatrist that really has been specializing in that specific There may be, you know, something we're doing there. I'm not a psychiatrist, I'm just a psychotherapist. But I do think that there is a little bit of genetic component, you know, I do think that some mental illness is biological and, you know, anti anxiety medications, anti depressive medications can be helpful. But I would personally, if I was a parent, if I was advising a parent, I would want to exhaust all the non medication options first, and try to work on you know, time and attention, try to work on giving them another way, giving them a more stable home environment. You know, I see parents, like want to know, parents, people in general, they want to find the easiest solution, I want to take the pill, they want to, like, do the new workout routine, they want to buy the planner, to hope. But it's like, if you and your spouse are fighting every weekend, and screaming at each other like that is what's causing the anxiety, right? It's not that your kid has like a brain issue is that that the house is has a lot of fear and tension in it. Right? If you have, you know, like, a family that comes into town, and everybody is dreading it. And they're all gossiping about each other. And there's a lot of like, you know, back talk and smack talk and etc, like that is what's causing it right. It's not that there's not that the brain is broken, right. Like if you're putting your kid in sports, and they hate the sport, and you're like, it's a fight to get them into the car every day to go to their soccer practice. And it's like a screaming knockout drag out fight. Like that's having a bigger impact than their brain chemistry. So I think looking at those things, first and foremost, you know, with a, you know, Family Therapists is a great place to start. And just being just honest and non judgmental with yourself and with your family and being like what's working here, what's not, if you can, honestly tell us and honestly tell us psychiatrists that you have a stable, and like emotion, nurturing home environment, and your kid is still having these symptoms, then yes, medication is probably where you want to look from there. There's a lot of work to be done before you start changing brain chemistry, especially at a young age. Awesome. So you know, this last question for today? You know, it might seem like it's kind of a progression question. We've been talking a lot today about anxiety, right. But one of the questions that parents are having is they're trying to figure out, is this depression? Or is it anxiety? So what is the difference between anxiety? and depression? Right? It's a great question. So anxiety is fear, right? anxiety is literally being afraid of something like we said, mostly, it's social when it comes to teenagers. Especially if you have some level of privilege in America, there's not like a lot of like, fear of getting hurt or getting sick or anything, right. I mean, there are kids that do you struggle with chronic illness, for sure. And there's probably data around that. But for the average, I think listener of this, it's going to be around social, and around worthiness and around shame. So you're going to see that fear is what's going to be coming through some symptoms we talked about earlier, depression, the great way that I look at that is depression is suppression, right? So depression is that your kid doesn't want to feel something, and is shutting down. And the way that the brain works is that it can't turn off one emotion, it turns off all the emotions at the same time. So your kid's not going to look like nervous, you know, he or she or they are going to look, you know, numb, they're going to be spending a lot of time in bed, they're going to be, you know, talking with almost a monotone. You know, they're going to when you ask them what's going on, and you say nothing, or you know, I'm fine, like not a lot of depth. But what they're doing is they're oftentimes, especially as a teenager, they're often feeling a lot, but trying to push it down. Right? And what the two main things that I see that are suppressed in teens are grief, and anger. So if your household and if you yourself, again, this is the benefit of doing on therapy, if you yourself are uncomfortable with grief and anger, which many people are, especially in our culture, and those are not able to be expressed, your kid is learning how to shut those down and in shutting that down, they're gonna shut down everything. Right, and that's gonna look more more like depression. And again, depression could be linked with, you know, over eating a Keyblade. with substance use, it could be linked with self harm. But depression isn't sadness. I want to make that clear, right? sadness is an emotion that's worth feeling. Depression is just like numbness, it's numbness. It's almost like, like death. You know, it's a very different feeling. It's not that they're sad. Right? They're depressed. And I know we're short on time. So I'm going to make this as quick as possible. But, you know, when you said they're pushing it down, they're suppressing it. Is that a choice? Or is that something that is almost unconscious? I think at that age, it's unconscious. And I think it comes from a parent conditioning, right because that's who they learned from it learn from you as the parent right? So for instance, you know, grief as an example, if you are unable to agree, which a lot of Americans are right, I think our culture does a really kind of piss poor job at helping Let's grieve. But if somebody died or there was a big loss or they changed schools, I mean, it was a big loss for them right or a pet died or they went through a breakup, and they've never seen you or your spouse as a parent grieve like healthily grieve, they're not going to know what to do with it. And they're going to feel grief is a really powerful emotion and their brain is going to be like, nope, we're not going to go here, shut this down. Right? The same thing with anger, right? If the only anger they've seen is either no anger, right, which is like, Hey, we never fight, our family's always happy. Bah, bah, blah, or like, destructive, you know, emotionally abusive anger, which is also common, right? screaming, yelling, breaking things, whatever that kid is gonna be like, I don't know how to express this, I'm gonna shut this down. Because either I have no experience, or it's very scary. And I don't want to express this. And in that shutting down process is where the depression will come in. Because that, that emotion can flow freely. so helpful. Mark, you have been a source of wisdom helping us, you know, kind of navigate this maze, this labyrinth that might seem like for a lot of parents when they're dealing with their child, and they know that they're anxious, they know that they're depressed. Where can people learn more about you and kind of the stuff that you do? Oh, for sure. Yeah, thanks. I really enjoy being on the podcast. The best place to find me is the website. Mark dash azulay. Calm that's ma RC dash HZO eu la y calm up there. I got on at least all the services. I have videos, I run my own podcast. There's a bunch of stuff there. It's kind of the hub for everything that I do. Yeah, I hope it was helpful for your listeners. And I hope that you all become better parents and humans because of it. Awesome. Well, Mark, thank you so much, and listeners, we will see you on the next episode. If you want to learn more about treatment options for you, your teen or young adult, then tell us about your situation on a confidential call using the number in the show notes or live chat with us at Sam's don't care.com we'll connect you with the treatment that you need. And if we're not the right bit, we'll get you where you need to go. Be well and remember that change is possible.