Empowering Teens and Parents: Navigating the Mental Health Journey with a Holistic Approach

Imagine navigating the complexities of teen mental health with a holistic approach that connects the body, mind, and spirit - and helps teenagers and their parents understand the power of their mental health journey. In our latest episode, I talk with healthcare professionals, Maria and Virginia, about the importance of empowering teens and parents in the mental health space.

Together, we discuss the significance of providing education and options for teenagers, creating an environment where they feel encouraged to advocate for themselves. Maria and Virginia also touch on the role of medications in mental health, and how understanding the neuroscience behind brain functions can help teens retrain their minds. Building trust between teenagers, parents, and mental health professionals is essential, and our guests share their insights on how to create a supportive environment.

As we explore the impact of COVID-19 on teenagers, Maria emphasizes the importance of having both parents and teens present in the first appointment, and how family therapy can address parent-teen dynamics. We dive into resources that parents can utilize to support their teens' mental health journey, and discuss the challenges of finding the right mental health care provider. Join us in this vital conversation packed with valuable insights and advice for parents and teens navigating the world of mental health.

Introduction to the Guests:

Maria Capriotti, CRNP  is board certified through the American Nurses Credentialing Center (ANCC). She has worked within inpatient, outpatient, and in residential treatment settings and brings years of experience as a nurse practitioner.

Transcript

Speaker 1: 0:00

Welcome to the podcast. Maria and Virginia, i'm so grateful for you know that you agreed to talk to me about this important aspect of our mental health journey. So, as parents and I'm a parent too, with being a mental health therapist we struggle with what the quote unquote right choices for our teens and their mental health struggle, especially after COVID. So I'm looking forward to this conversation. I'm excited to have this conversation. So, again, thank you so much for being able to, you know, talk to me today.

Speaker 2: 0:47

I had definitely a point for you, Nars, to do your podcast.

Speaker 1: 0:52

Maybe we can start with you, Maria, in terms of what motivates you in your practice and what brought you to your practice.

Speaker 3: 1:04

Sure, i worked inpatient for a really long time as a nurse and a nurse practitioner really nothing to do with mental health at all And then over the years I realized that all of these patients ultimately there was a lot of mental health stuff that wasn't getting addressed. So that's kind of how I got into it And I went to school to get my degree And then I started doing the outpatient part time while I stayed in the hospital And I found that I really enjoyed the one on one with people and the interactions And I think so much of your health comes from your mental health And I think that it's something that's so often put on the back burner that you know, that's kind of what got me into it And I think it's fascinating And I really like working one on one with the patients and seeing them get better.

Speaker 1: 1:53

Yeah, yeah, and that's something, you know, we all strive for, whether it's from the medical field perspective or whether from the therapeutic perspective of mental health. That's something that excites us. We want to be able to help people, individuals, our clients, patients get better. So, yeah, i can definitely see how that can be a huge motivating factor. Virginia, what brought you into this profession?

Speaker 2: 2:23

Basically for me. I've worked inpatient you know SNS And a lot of times in the hospital. We just focus on the physical symptoms, like what brought you here is like chest pain, shortness of breath or like pneumonia infection that kind of stuff.

Speaker 2: 2:39

But we never thought about like how the symptoms affected the patients mentally. So we kind of like ignore that part. Like if the patient is in the hospital for like seven to 10 days and they seem sad or depressed, you know, we kind of like ignore that like emotional, psychological part of them And I'm just focused on why they're there and discharge them. And even if we get a patient who was like they're unstable, or the psychiatrist who can give them their medication once they are medically stable, we'll get them like discharged. If there was nowhere to be, you know, for them to be sent, they would just stay in the hospital for like weeks and weeks until a spot opens. So that's so motivated me to go out there, go back to school, get my degree and, you know, start working and help them feel better mentally.

Speaker 1: 3:36

Yeah, And that sort of brings me to you know, both of you who have on your website have talked about like this holistic approach to mental health. Can you talk a little bit about that, what that looks like and how does it help teens themselves, but also like parents, right to understand sort of it, that it's not a separate thing, mind and body. So could you, Virginia, maybe you can start with that, and then I'll come to Maria.

Speaker 2: 4:12

Yeah, I believe holistic approach is better than like doing independent stuff Like the whole person is meant of, like the body, mind, spirit. So if we just focus on the body part and forget about the mind, the spirit, it kind of like discourages people and increases in stress, anxiety, depression. And I feel like Maria, like she said, she focuses more on holistic and in mental health everything is not about the medication. So I feel like doing like yoga, meditation, like physical activities, that's when it will start those neurotransmitters and make it pass on through.

Speaker 1: 4:54

Yeah, and it's also interesting like the whole brain right. A lot of times I use the brain constantly neuroscience in my work with teenagers, because when I tell them amygdala, they're like what, what are you talking about? And then, once I explain to them, they come back and they I have so many times I've had clients who say oh, you know what, rujita, my amygdala went off today. Okay, what did you do? So yeah, it's a really beautiful way of explaining what's happening in our brain's mind body and how all of that is connected. So yeah, maria, did you have?

Speaker 3: 5:38

any.

Speaker 3: 5:38

Yeah, i agree, i think Virginia said it pretty well We tend to focus I tend to focus on I do the medication piece when you come to see me.

Speaker 3: 5:47

But I think the most important thing that I try to get across to all my clients, especially teenagers, is it's a multifaceted approach to deal with depression, anxiety, that kind of stuff.

Speaker 3: 6:00

So there's no magic fix And I think that, yes, the medicine's going to help And the way I present it to the kids and the teenagers is that it's going to give you the boost that you need to do the work. And I think it's important when we talk about holistic, yes, health, nutrition, exercise, that kind of stuff but also describe a lot of the teens especially like work on retraining your brain, because a lot of your long-term success, i think as a teenager you still have so much potential to come as your brain's developing, to adjust the pathways kind of and change your defaults. So I try to get that across a lot, especially with teens, that the med's going to help but it's not a cure. And that I also think in the holistic sense, like if you're not using the multifaceted approach, you're not going to have long-term success, and I think you need to explain that And I think the teenagers, anybody needs to understand that to really buy into like a long-term, you know, wellness.

Speaker 1: 7:05

Yeah, so tell me a little bit more about that multifaceted approach. So if you were to explain it to a parent, for example, what would you say to them?

Speaker 3: 7:17

Sure, i always start with. I'm a big fan of therapy, so I recommend a lot of therapy to everyone. I think there's a lot of family dynamics, especially with teenagers, that need to be addressed. So I think the therapy piece is huge, whether it be individual, family, that kind of stuff. And then a lot of time these teenagers come in with anxiety and they don't have any behavioral outlets or techniques to work, to feel it. They just don't know what to do.

Speaker 3: 7:45

So in that sense, you know it is we get them on a sleep schedule. Sleep is so important And it's something that it seems simple, but you have to remind people, like, turn your phone off before you go to bed and make sure you're going to bed at the same time, and so sleep is important. And then diet and we have nutritionists, dietitians at our practice who also help. And then we I'm not a huge fan of supplements and stuff, but there are supplements and natural, natural things that people can take and to do to also help augment what they're going through. So I think it's what is a multifaceted approach, when you have to look at every aspect instead of just one little silo.

Speaker 1: 8:28

Yeah, and that makes a lot of sense to me as a therapist And I do have a lot of my teen clients who will come in and talk about supplements And since you mentioned Maria like that, you're not a big fan of supplements maybe you and Virginia can explain a little bit about what is it about? supplements that maybe are not that great Or maybe something that works? And a lot of friends, teens and even parents come in and they talk about magnesium and for sleep or so it is so much in our regular mainstream kind of approach to anxiety or sleep.

Speaker 2: 9:19

If either one of you both of you have any thoughts around supplements, i would love to hear that When I mentioned about medications and supplements, parents are more willing to try supplements instead of the medication. Most of the time is because of the side effects and they worry about, like, how long is my child going to be on this medication. So even if you explain them, like the side effects, you know the importance of the medication they're more willing to try the supplements. So instead of giving like anti-depressant, you can try these supplements. I use sometimes Synexin. It's a kind of lavender based. It's used in Europe as a prescription, but here you can get it like over the counter vital Amazon. A lot of other people use magnesium, like you say, to help them sleep. Yeah, so I feel like if we can start with the supplements first before we go into the medication, that would be helpful. And a lot of parents they're worried about insurance. Is it covered by insurance? Is it going to be like too expensive? We have to pay out of pocket, so that's another issue.

Speaker 1: 10:37

Yeah, yeah, so you mean in terms of medication, but for supplements?

Speaker 2: 10:41

Medication yes.

Speaker 1: 10:44

Okay, And supplements because they are easily available over the counter. That a lot of times parents are comfortable for their teens and maybe even for themselves to be able to. Yeah.

Speaker 3: 11:00

I think I agree with Virginia A lot of times parents and teens are much more open to doing supplements and I when I say I'm not a fan, i don't necessarily mean I don't like them or use them, but I think they have to be used kind of judiciously. And what concerns me is when these people come in, when patients come in on all different supplements and it kind of confuses like what are you on, what's this? They don't realize that some of these things interact with other things. But I I completely I love the selects and I offer that to almost all my patients And I think a lot of the natural stuff for sleep and that kind of stuff is great when it works. And I think I agree to Virginia with you know, a lot of times the teenagers are very nervous and hesitant to start a medication and their parents are as well, which I think is it's completely realistic.

Speaker 3: 11:50

And one of the things I like to do with my patients, especially teenagers, is to have a long-term plan. So I, when we're starting the medication, i explain to them look, this is what we're going to do. We're going to start here. My plan is to get you to a point where you're feeling better and we'll be on it for at least a year And then we can revisit where we are. Because I think a lot of times people start meds especially in younger people without a plan, and I think that's scary for people as well. So that's one of the things I know that's not a little off topic, but that's the one of things I think is really important, especially with the teenagers is to say like this is not a life sentence, this is not the rest of your life, this is to get you through what you're going through, and then we'll have a plan to try to come off, yeah, and that's.

Speaker 1: 12:38

Both those points are such important points And I'm glad that both of you have brought this up, especially Maria, what you mentioned about the interaction between supplements and medications or different supplements. But when we think of supplements, it's really like, oh, am I taking a multivitamin? The mindset is pretty much that sucks. I think it's important to talk about that, the interaction between different medications and the supplements. So thank you for bringing that up.

Speaker 1: 13:12

I love that you talk to your patients about having a plan, because teenagers, it truly is. When parents and teens come to me, even for therapy, it's almost like oh, is this going to be lifelong? Is this once they are coming into you? Are they going to be so dependent on you? And similarly with medication, right? So I think it's great to have that plan and to say, yes, this is the plan for the year and then we can navigate or work with what works and what doesn't work. So thank you, yeah, those are really important points And I think, in terms of parental concerns, right. So, yes, on one hand, they're very I think parents and teens are comfortable with taking supplements, but are really struggling, like you mentioned, virginia, in terms of medication, whether it's because of insurance or without. Maybe, culturally, some people are like medication is not their go-to. In those situations, how do you talk to parents, especially in terms of effectiveness, in terms of dependency, in terms of sort of medication? What are your approaches to that?

Speaker 2: 14:35

For me, normally is education Like when you are you are educated parents and their teens about the medication and they feel comfortable or they understand why they are taking the medication. I think that approach, i find it like, better for me, like if I was to give them the medication. I'll tell them this is what the medication is used for, this is what research has found out, based on trials the effectiveness, the side effects, what to look for in terms of if it's working for you or if you have an anxiety effects, or if it's not giving you the outcome you are looking for. So for me, basically, education is the most important.

Speaker 3: 15:18

That I agree with that, virginia too. I think for me, what I like to do with my patients, especially yours, is two-fold. I want to make sure they know that the teenager is the client. They are the one who's in charge and they're the boss. Obviously, i want the parents buy-in, but if I don't have the teenager, then there's no point.

Speaker 3: 15:40

And I think what I do with them and I think I try not to ever push medications I like to give them.

Speaker 3: 15:47

I go through all of my thoughts like here's what I'm thinking, this is what I'm thinking I want to do for you.

Speaker 3: 15:52

Here are all the things we could do, and if you don't want to do anything, that's fine too, but know that these are your options, because I think a lot of times again, like Virginia said, education is so important and it's not my job or my wish to talk anyone to do anything that they're not comfortable with, but I want them to have the information And I think that makes it easier and then more comfortable to accept trying a medication.

Speaker 3: 16:19

And the first thing I say is if you don't want to do a med, you don't have to, but here's what we can do and here's how I think it'll help you And I think that the patient, the teens and the parents both appreciate that And I think they like kind of having that education and also why? why I think you need this or don't need this, and I think that's a piece that's missing sometimes for a lot of people. They don't just want you to commit and say, oh, i'm going to put you on Lexapro and we'll see in six weeks, like, why are you doing this? What do you think's going to happen?

Speaker 2: 16:51

Yeah, i think when the teens understand why they're taking their medication, it increases their compliance. When they wake up in the morning, they know I'm supposed to take this medication because it's going to help me with this. Like for a lot of teens nowadays, they're taking ADHD medication, so they know if I don't take this medication, i'm going to be like brain scattered throughout the day And I give you stuff from the beginning, like you explained to them. Oh, it's going to help you focus, concentrate, you're going to do your homework, your assignment, your grades are going to look better And they start to see the changes like a week to week. Then they're more compliant to taking the medication And, like in the future, they'll be like oh, sometimes I don't need the medication. So they'll understand it's okay to skip this medication and not other medications.

Speaker 1: 17:45

Yeah, Sounds like the two of you take an enormous amount of time with your patients And, for one, appreciate that so much, because a lot of times when parents or teenagers you're like they're in the doctor's office and feel like, okay, i don't really get this, or I don't understand this, or how am I supposed to ask questions, i don't really know anything about this, it's such, it's of such value that doctors, nurse practitioners, when you take the time to actually explain to them, explain to us that, hey, this is how this goes. You have a choice, you have a say in this. I think that's incredible. Thank you for doing that. That's invaluable, right? So I appreciate that a lot.

Speaker 1: 18:38

And so one of the things that both of you mentioned is that teens, once they understand that, oh, this is going to help me, this is something that is of value to me. Are there ways in which teens can advocate for themselves? So, for example, if they do think like, maybe Lexapro is not something that might be helpful to me, i want to try something else. How can teens advocate for themselves without feeling like either they are not being heard or they're kind of scared to voice right In spaces that seem very overwhelming? So if you could talk to that a little bit.

Speaker 3: 19:29

I love that question because I feel very strongly about that kind of stuff And I think the first thing I tell again, especially teenagers, is you are the boss in here, You're in charge, I'm your partner. I'm not here to be to tell you what to do. I'm not here to boss you around. I'm here to work with you. So there's no wrong answer, There's no bad question And your job is not to make me feel better, Your job is just to tell me the truth.

Speaker 3: 19:58

And I think teens really respond to feeling heard, like you said, and I'll tell the parents like listen, it's up to this to him or her I don't, you're important and you matter and I want, obviously you're in charge. But if we don't have the buy-in from the teen, then there's not a chance for success. And I think that you need to build that rapport and you need to be very open, honest and straightforward with them. And a big part of what I tell them look, you don't have to make me feel good, You don't have to make your mom feel good, Like this is your space, This is your time And there's not. You can't say anything wrong. And I think that's huge because I think a lot of times they are afraid to say things They don't want to be insulting or mean or, like you know, they're embarrassed And I think it takes time to build that rapport, but I think it makes all the difference.

Speaker 1: 20:52

Yeah, for sure. What do you think?

Speaker 2: 20:57

Have you guys said. I do agree with Maria Once you tell them they're in charge of their health, they really do open up. And Maria said there's no wrong question, wrong answer. So it's whatever they say. However they feel, it's all based on themselves. Like sometimes, like doing the screening questions helps them like open up. So that's what I mean, like doing most of the time. I mean like telling them we say we're going to do like a screening questions. See how you feel, and a lot of questions are like open ended. That's why you give them time to like talk about themselves open up.

Speaker 1: 21:35

That way they're felt. Yeah, i love that both of you give the teenagers their space. They are the boss, they are the expert on who they are and give them space to ask questions. And it sounds like as soon as the teen walks in, you make them super comfortable That it's okay to be who you are, ask questions. There's no wrong or right question. So I mean, that's something I think is so kind of lacking right, because teenagers themselves feel like, oh goodness, how am I supposed to ask that? So when teens are able to ask, but parents are a little resistant towards care or towards, like, certain approaches, how do you work with resistant parents in your practice?

Speaker 3: 22:38

I kind of do the same thing that I do with the teenagers and I explain to the parents you know this, it's up to the teen, this is their issue, their problem. And I have a lot of parents who are like, well, i don't think I want them on meds, i don't want this, i don't want that. And I explained to them too, like listen, we don't have to. I think the big thing is to let people know like you don't have to do meds, you don't have to do anything. And sometimes you know they need you or me to say like, well, go to therapy, go talk to a therapist, work through that. And then if in a month or two months or three months you feel like, yeah, maybe I do want to med, then come back.

Speaker 3: 23:16

There's never an urgency to start and there's never again there's not a wrong answer. So I think I think really it's giving the education and the option to the parent and the teen. But I see more is parents coming in and wanting stuff for the teen and the teen's like, no, i don't want that, Like my mom, they don't know what's going on. And I think that's a little bit more challenging to educate parents to say like, look, this is. I know they're 14, they're 16, but like they have to be in charge of this, you know, because I think a lot of times the parents want to come in and fix stuff for the kid And if the kid's not engaged it's not going to work.

Speaker 1: 24:00

Yeah, yeah, absolutely. And what in here did you want to add something?

Speaker 2: 24:08

Yeah. I don't want to cover it all.

Speaker 1: 24:11

Okay, okay, okay. And so switching gears a little bit here. in terms of COVID, i personally prived during COVID times I've said it on another episode of the podcast only because I'm an introvert and I loved being at home But of course we see a huge mental health crisis during COVID and after COVID. I don't know after COVID, but anyway, whether we are still in it, whether we are, it's done. Have you seen, or how have you seen that in your practice with teens and mental health struggles?

Speaker 2: 24:57

For me, COVID had a huge negative impact on the patients just because, with the increased isolation, more teens became depressed because everything was online, They could not see their friends, So that, like the isolation just meant they're in a sighting crisis. they became more depressed. They even forgot how to be in a social situation once they were able to go back to school. And another teen started refusing to go to school because they were like, oh, I was used to staying at home. That one became like a comfort zone. So when the parents tried to push them to go to school, they were like no, I don't go to school. I started making excuse I have a headache, my stomach hurts. So that put a lot of stress on the parents. just because the parents had to stay home couldn't work, and they put a lot of strain and a lot of stress on the teens and the parents.

Speaker 1: 25:58

Yeah, i definitely did see a rise in anxiety and depression, for sure, even in my own practice, private practice, and yeah, it was definitely a struggle for teenagers And I think, at the same time, it was a struggle for parents to figure out what was happening with their teens because, as parents, not knowing what social media, what COVID, like all of this kind of intersected during that time of isolation for the kids. So definitely COVID really impacted hugely on teenagers. So, just circling back to how can parents, when they come to you, be prepared in a way Like what would help you in terms of as practitioners, what would help you from parents? What can they do? How can they prepare even teens? right, if you could talk to that a little bit.

Speaker 2: 27:04

For me, the best thing is for the parents to talk to the teen about what's going on in their life. Like if a teen is stressed or anxious, i feel like the parent should talk to them at home before coming to see me, because sometimes I will see the teen first and then the mom and then, towards the end, it will be like I'll be talking to both of them. So when the teen comes, they're like I don't know why I'm here. I don't know why my mom decided to bring me here. So I feel like if they can have the conversation before coming in and I agree on what to discuss, that will be much easier for me.

Speaker 1: 27:45

Oh, that's such a helpful point, Maria. you were going to say Yeah, i tend to.

Speaker 3: 27:54

I think the way I handle the appointments, especially the first appointment, is I always start with the parent and the teen in the room And I say to them both, kind of my spiel about like this is the teen, is the client, mom, i want, dad, i want your buy-in? And I tell them we start together And I say either one of you just tell me why you're here, what's going on, and I explain. You're going to have two totally different perspectives and that's fine. Each perspective is valid and neither one is right or wrong, and I think they need to hear that to understand.

Speaker 3: 28:30

And I think it's helpful for me to see the parent interact with the kid and to see what the parent saying and how the teen is reacting. And then you know, i separate them and have the teen by themselves And I think it gives for me that part helps give an idea of the rapport between the parent and what they're honest about, what they're not honest about, and that helps by that dynamic. So I don't know necessarily that they can do much beforehand, but I find that I really do like to have the input of the parent in the beginning, before I meet with the teen by themselves, because it also helps me get what I want to ask them as I move forward. You know address.

Speaker 1: 29:15

Yeah, yeah, no, that makes sense. And also I love the fact that, maria, with you, the dynamics between the family can be helpful, and what you said, virginia, in terms of talk to your child why they're coming here, because that shock of being in a doctor's office can be very jarring And as much as the two of you make your patients, your teen clients, patients, comfortable, being a little bit prepared, knowing why they are there, can be super helpful. Are there any resources that you know you would provide to parents, to our listeners, in terms of when they come to you, or parents from in terms of where to start? because a lot of times when teens are struggling and parents are struggling to find resources, whom do you contact? if your teen says, hey, you know, i don't feel that? well, all right, what do you do in terms of mental health?

Speaker 3: 30:21

I think the first thing I always recommend is to find again.

Speaker 3: 30:25

I'm very big into therapy.

Speaker 3: 30:26

The first thing I always recommend is to find a therapist and find a provider, and I understand in this day and age it's really hard to find a provider, both therapy and medication.

Speaker 3: 30:39

So I think it's hugely important to find a provider and to find someone that you click with, that you feel a natural rapport with on some level, because I think there's and a lot of times I'll have these teens come in and be like, yeah, i've been seeing this therapist but I don't like them, i hate going, i hate this and I hate that, and I think it's so important and it's exceptionally difficult but to find providers that you feel comfortable with and that you have a good rapport with And unfortunately that's really hard to do, especially when you're in a bad place. But I think, like Virginia said before too, the most important thing the parents can do is just listen to their kids and not try to fix things, but just hear what's going on and let the teens know like we're here for you or supportive, we're working together. And then there's all kinds of like programs and that kind of stuff that you can look into as well, but it's a very challenging climate for mental health right now.

Speaker 1: 31:40

Yeah, yeah, I agree.

Speaker 2: 31:43

Yeah, i do agree with Maria about finding therapists, so I feel like finding a good therapist will be like so much helpful For parents and teens. I always recommend family therapy There's another therapy instead of like individual therapy, because they can work out their dynamics. A lot of issues can be solved in therapy And I always give them, like crisis phone numbers, community resources, mostly for teens and parents too, and I think our practice has a lot of resources for our parents and teens.

Speaker 1: 32:25

Yeah, yeah, Yeah, no. thank you so much for talking to me, providing insights into how sort of the psychiatric world works a little bit for parents and teens, And it's such an immense pleasure to hear that the two of you take time talking to the teens. they are their own advocates, you give them that space and you provide parents who with recommendations and help and resources that they need. So thank you so much for talking to me. I truly, truly appreciate it.

Speaker 2: 33:04

Yeah, thank you so much for inviting us.

Speaker 1: 33:09

Yeah, absolutely, thank you.