Episode 6: The Silent Struggle: Recognizing Anxiety and Depression in Teens

In Episode 6 of Inside the Teen Mind, we explore the growing mental health challenges facing today’s teens and how anxiety and depression can often go unnoticed beneath the surface. From academic pressure and social media comparison to loneliness, sleep struggles, and identity development, this episode takes a deeper look at the emotional realities adolescents are navigating every day.

We discuss the important differences between anxiety and depression, how parents can recognize warning signs beyond typical teen moodiness, and practical ways to begin supportive, judgment-free conversations with their teens. This episode also highlights when it may be time to seek professional mental health support and how early intervention can make a meaningful difference.

Whether you are a parent, caregiver, educator, or someone who works with teens, this conversation offers insight, reassurance, and actionable tools to better support adolescent mental health.

Read the Blog!   This companion blog accompanies Episode 6 of Inside the Teen Mind: The Silent Struggle: Recognizing Anxiety and Depression in Teens and expands on our conversation about the growing mental health challenges adolescents face today. We explore the rise of anxiety and depression in teens, the impact of social media and academic pressure, emotional isolation, identity development, and how parents can recognize warning signs and start supportive conversations. This blog offers additional insights, guidance, and practical tools for parents, educators, and caregivers supporting teen mental health and emotional wellbeing. 

About Us: Inside the Teen Mind is hosted by Dr. Lisa Konick, Licensed Clinical Psychologist and Founder of Konick and Associates, and Amanda McMillen, LCSW, Executive Director of the Alive Center. 

Together, they bring a compassionate, real-world perspective to understanding adolescent development, mental health, and the systems that shape teen lives. Through clinical expertise, social work insight, and a shared commitment to supporting teens and the adults who care for them, Lisa and Amanda aim to equip listeners with clarity, empathy, and practical tools to help teens thrive. 

Transcript

SPEAKER_00 0:00

And episode of anti-deteen mind, we're talking about something many parents are quietly worried about anxiety and depression and pain.

SPEAKER_03 0:10

Today's adolescents are facing pressures that previous generations didn't experience in the same way.

SPEAKER_00 0:24

In fact, about one in 16 struggle with anxiety and about one in 12 experience depression.

SPEAKER_03 0:33

So, how can parents tell the difference between normal teenage moodiness and something more serious?

SPEAKER_00 0:39

What are the early warning signs to look for? And how can you start a conversation with your teen about emotional struggles in a way that actually helps?

SPEAKER_03 0:49

In this episode, we'll explore what parents need to know, what to watch for, and when it might be time to seek support.

SPEAKER_00 0:56

This is Inside the Teen Mind. Welcome to Inside the Teen Mind, where we explore the emotional world of adolescents and help parents better understand what's really happening beneath the surface. I'm Amanda McMillan, licensed clinical social worker and executive director of the Alive Center.

SPEAKER_03 1:23

And I'm Dr. Lisa Conick, licensed clinical psychologist and owner of Iconic and Associates. Today we're talking about anxiety and depression in teens. This is one of the most common concerns that brings parents into therapy. And parents often ask the same question Is what I'm seeing normal teenage moodiness or something more serious? And the reality is that emotional struggles during adolescence are more common than many people realize.

SPEAKER_00 1:55

Right. Let's let's start off with a few numbers because that really helps put this into perspective. As many people say, we're in a mental health crisis for youth, and this has been on the rise even before COVID and continues to ride post-COVID. Right now, among adolescents, 12 to 17 nationwide, about 21% reported anxiety symptoms, and 17 reported depression symptoms.

SPEAKER_03 2:24

Yes, and perhaps the most sobering statistic is that suicide is now the second leading cause of death among young people in the United States.

SPEAKER_00 2:34

If you imagine a classroom of about 30 students, this means six students may be struggling with anxiety, and five may experience depression, and several more may be dealing with other emotional challenges.

SPEAKER_03 2:49

And Amanda, I know for me, having kids over at my house, you got a handful of kids, that means at least one of them is probably silently struggling.

SPEAKER_01 2:57

Right.

SPEAKER_03 2:58

Um which is why understanding what teens are experiencing and how parents can respond is so important.

SPEAKER_00 3:06

Absolutely. One question we hear a lot from parents is why does it feel like there's more teens struggling right now than in the past? Um so Lisa, what are some of the biggest contributors that you're seeing clinically?

SPEAKER_03 3:23

Yeah, I I don't think this is going to be surprising. Um there is rarely just, you know, one cause of anxiety or depression. Um what we're seeing is a combination of pressures that seem to have intensified in teen life today. And some of the contributors that tend to come up again and again as we look at this are one is social media and that constant comparison culture.

SPEAKER_00 3:46

Right, yeah, with like influencers and things like that.

SPEAKER_03 3:49

Absolutely. And as Amanda and I are gonna talk about that in a lot more detail in a later episode because it is such an important topic. Um, another stressor that uh it contributes is academic and achievement pressure.

SPEAKER_00 4:00

Right, yeah, which we talked a lot about in the previous episode, and it's not only this pressure to succeed and not fail, but also not wanting to let down your parents. Absolutely.

SPEAKER_03 4:11

A lot comes into that, especially in the adolescent period. Um one that's underrated often is sleep, nutrition and lifestyle habits. Um, you know, just to let's take a second to talk about dysregulating, thinking about you as a parent when you haven't gotten enough sleep or you haven't eaten. You you the irritability that comes along with that. I'm hangry. Yes, you're hangry. I get hangry, my kids know when I'm hangry. Um but imagine you're expecting our our kids are expecting to have a high performance standard, yet they're not getting the foundational skills. And when they're not able to be successful that way, they're going to be very anxious.

SPEAKER_00 4:53

Right. And also they're packing their schedules like downtime is a bad thing. Yeah. Right? You know, like every second has to be accounted for, and that's very different than when we grow up.

SPEAKER_03 5:02

Yeah, and so when we talk about this in therapy, I uh I usually look at that as one of the first things, and the kids look at me like I'm nuts. But I'm like, yeah, let's try sleeping more. Yeah. Just bear with me here, and that makes a huge difference. So that can affect their their uh regulatory system. Um the other piece that's a big deal is social isolation.

SPEAKER_00 5:19

Right, yeah, because with social media you have this false perception that you are have hundreds of friends, but really when you um need to go and hang out and have a study buddy, can you name one person that would actually show up for you? Right type of thing. Or if you're really struggling with something, you know, that's the thing is like the difference between these false friends, uh virtual friends, versus a real authentic uh one or two really good friends and that kind of connection component.

SPEAKER_03 5:48

And just to say something, we're gonna talk about connection as well in another episode, but the idea of the chemical component of connection, you know, oxytocin is released when we are connected to people, and that's a good feeling chemical that we're not getting um when we're not with people, and that if that can be a precursor to depression.

SPEAKER_00 6:08

Right, yeah. So it's like that's probably one of the biggest contributors to uh reducing uh that feeling of loneliness is by having a genuine connection and building that oxytocin versus the dopamine which you get from like you know, getting a follower or getting some likes on a post. Correct, which is quick and short term.

SPEAKER_03 6:27

Yeah, and the last piece that I think is a big contributor here um is identity development. And Amanda and I are gonna talk about that as well in a later episode.

SPEAKER_00 6:34

Well, actually, we we started off really talking about that in the first couple episodes, uh diving into the various like the um early middle and late stages of adolescence. Um, but yeah, anxiety and depression, when you add that onto that, it becomes much more complex. Yes, it does. So let's uh go into actually defining what is anxiety and depression. I mean, people throw that word around all the time. Um, but what does it actually look like? Um, because you know, parents often hear that, um, but also teenagers can be very moody and shut off from their parents. So what's the difference between a moody teenager and you know, these actual signs of uh depression or anxiety?

SPEAKER_03 7:19

Yeah, let's let's define anxiety and depression first. It sounds kind of intuitive, but a helpful way to think about it is time orientation. Anxiety tends to be future oriented, it's you know consumed about worrying about what might happen. We think about these are generalized worries, whereas depression tends to be more of an overwhelm or hopelessness and is often tied to negative beliefs about oneself or the past.

SPEAKER_01 7:45

Right, okay.

SPEAKER_03 7:46

So if you think about anxiety, and and we've all had anxiety, anxiety itself is a normal experience. Um we need anxiety to kind of promote activation. So if you're anxious before a test, you a little anxiety might help you prepare. But problematic anxiety is gonna look like constant worrying, perfectionism. Uh you never can be good enough. Avoidance is a typical negative coping strategy that we see with anxiety. We get anxious, we avoid school, we avoid activities, we avoid people, gets worse. Um, reassurance seeking is another one we see a lot of in in kids getting anxious, not knowing how to make a decision. And they ask for a lot of reassurance from caregivers or teachers. Is this right? Is this okay? They're fear afraid of making mistakes. Um they may have a lot of trouble sleeping because of their worries, consuming them at night when their brains are supposed to be quiet. Um, and then common physical symptoms appear often as headaches or stomach aches.

SPEAKER_00 8:44

Gotcha. Yeah, that's that's really intense for a kid. And so I imagine, as you mentioned, that you know, anxiety is normal. Yes, right, absolutely. But it's when it's constant and actually gets into those like physical symptoms or per paralysis uh or avoidance components, that's when it really becomes something that really needs to be looked at further.

SPEAKER_03 9:04

I would agree, absolutely. Another thing I hear a lot of parents talking about is social anxiety in their teens. So I I do want to highlight this for one moment here. Um, social anxiety is the fear of being judged or evaluated by others.

SPEAKER_00 9:18

Yeah, and we really do see this lead to bigger issues like teens avoiding activities altogether, struggling to meet new people, or even refusing to go to school. Um, social anxiety is something we're really seeing more and more. Um, so let's talk a little bit more about that.

SPEAKER_03 9:36

Yeah, I want to speak to that a bit. So people often misperceive social anxiety as kind of that I I'm not social. Um, the the clinical definition of social anxiety is actually avoidance due to fear of being evaluated or judged in a situation. So it's not just one not wanting to be socially engaged, it's the fear of judgment and the fear of negative evaluation. And if we think about what's happening to kids and adolescents, they are being evaluated by each other, and this plays a lot into the school setting. Um, and if there's stressors in the school socially, we can see really high elevations of school anxiety, and that can lead to school refusal emerging because students are afraid to even communicate with their teachers. And this can develop into a clinical problem that we see kids coming into treatment for is not wanting to go to school. Um and I the thing that we highlight is the most beneficial for social anxiety from a treatment perspective is exposure-based treatments. We're we're teaching those kids skills such as how to evaluate the negative thinking patterns that they have, and then distinguishing their worry thoughts from facts. So are you afraid your friends are thinking that way about you? What are the facts? Are they really showing you that they care in other ways? Um, so the goal is to help them to advocate, use their voice, ask for help, and take some calculated social risks.

SPEAKER_00 10:58

Yeah, I I see that that's really important because you're not gonna get over social anxiety by continuing to avoid social situations.

SPEAKER_03 11:07

Absolutely. Right. It's a problem that kind of turns into a major loop.

SPEAKER_00 11:10

Right. So you have to face it. I'm sure you give them specific skills about recognizing their anxiety, how to many manage their anxiety, and then helping them realize that when they get to the other side, they're okay.

SPEAKER_02 11:24

Yep, exactly right, Amanda.

SPEAKER_00 11:26

Each time it gets a little bit easier and easier. What about depression?

SPEAKER_03 11:30

Yeah, let's talk a little bit about depression. Is you know, we don't we talk about I'm feeling depressed. My you know, my friends all ditched me today. That's kind of a typical expected response of your mood is low, is what that really means. I'm sad. Depression, when it becomes concerning, is gonna be persistent sadness. Um and in teens it can show up as irritability rather than sadness.

SPEAKER_01 11:52

Right.

SPEAKER_03 11:52

So unfortunately, we might misread a depressed teen as an irritable, moody, edgy, defiant teen and say they have just a bad attitude. Um but that might actually be a sign that your kid's somewhat depressed. The other thing we see with depression being a concern is that loss of interest in pleasurable activities. Things they used to enjoy doing, they really don't have any interest in doing anymore. And this isn't like I was in ban, but I don't want to do ban anymore. I want to move on to something different. This is something that kind of hits over the last couple of weeks. It it coincides with low mood and they're persistently not really engaged or interested. It may be accompanied with a lot of fatigue. You might be seeing them look kind of lethargic, sleeping a lot more, um, or having a lot of trouble sleeping, not sleeping well, withdrawing from things that they normally would be engaged in, so withdrawing from friends and family, not just hiding in the room talking to friends. They're actually withdrawing from friends as well, and that pervasive feeling of hopelessness, those would be concerns.

SPEAKER_00 12:53

Right. So this is like a real change in their behavior too, right? So, like, you know, if they were never really active in activities before, then that might not really be a big deal. But if all the you know, they were like the star baseball player and all of a sudden they um just don't even want to uh go to a game anymore. Yeah, that could be an indicator that you know something's really going on uh deeper here.

SPEAKER_03 13:18

Sure. Yeah. And I think parents they ask about how to tell the difference between this nor normal moodiness. Because these moods can last a little while sometimes. Brandon's got a couple of teens, and I have had a few times. It can last a f a little while when they're going through situational stresses. And mood swings are pretty normal.

SPEAKER_02 13:35

Right.

SPEAKER_03 13:36

But that normal moodiness should be temporary and situational.

SPEAKER_02 13:39

Okay.

SPEAKER_03 13:40

So if we think about um teens having episodes of joy and connection, that's pretty understandable. They're gonna seem like, you know, they may be frustrated about a specific event, but they can turn it around in a reasonable amount of time. Like, you know, they come home, they're really cranky, but then you kind of see them laughing in their room with friends. You're like, okay, they're they're enjoying themselves. So typical mood swings, you know, that would be kind of considered understandable. Um, they also might coincide with pubescent changes.

SPEAKER_00 14:10

Oh.

SPEAKER_03 14:10

So the typical change are real pains, yeah. They surely are. So typical mood swings with pubescent changes, hormonal changes, physical changes, like um changes in their body, growth cycles or menstrual cycles that are driven by fluctuations in hormones.

SPEAKER_00 14:25

Yeah, yeah, that can really um you know make you feel more tired or irritable as well. Um, so normal mood changes can also show up during uh specific stressful times, right? Like, you know, a finals week is a really big component, or maybe, you know, prom or graduation. I mean, like right now, this is a um, you know, we're recording this in uh April and May, you know, so it's like that's a really big time for a lot of teens, especially those seniors, um, having uh, you know, these moments of happiness and connections, and then other times of just like feelings of loss and fear of what's what's coming next, right? So that's that's normal for teens. Um and it's also normal that they might want more privacy and independence from the parents. They may spend more time in their room and focusing more on friends or becoming more absorbed in their own interests, but that's part of the healthy development. You want your teen to do that. What I don't want is a teen stuck in their bed all day uh with the blinds uh down, or um, you know, constantly screaming and yelling or getting into fights. You know, I know uh like you mentioned irritability, like it can actually uh for some teens, especially boys, can come out as physical aggression. Yeah, you know, they might get into more fights and stuff like that. And uh, you know, that's kind of a way of uh coping, kind of this feeling of like, what's the point? That hopelessness. Yeah.

SPEAKER_03 15:50

So I just to kind of summarize this a bit, typical teen mooniness is situational, sometimes chemical, but it's not pervasive. In contrast, those warning signs can tend to be persistent patterns that last for weeks or months. Um, and that's some of the things to look for when we're looking at these patterns are withdrawing again from friends or activities. You might see it through declining grades or school refusal, uh, losing interest in activities, like we said, that are previously enjoyable, sleeper appetite changes, persistent negative self-talk, hopelessness, apathy, aggression. Um your teens not themselves. Um and then these are notable changes in their typical typical behavior that doesn't really resolve when positive things come up.

SPEAKER_00 16:35

Yeah, we also see these uh you know physical symptoms, things like frequent headaches, stomach aches, or even panic attacks. These can be signs that something is deeper really is going on. So um let's take a short break, and when we come back, we'll provide suggestions on how to approach your moody teen.

SPEAKER_03 16:54

Sounds like a good idea.

SPEAKER_00 17:11

How parents can talk to their teens about mental health. Many teens don't initiate these conversations on their own, so let's talk about how parents can create opportunities uh for these discussions that feel more natural.

SPEAKER_03 17:26

Yes, there are several principles that I think we can really apply here. But before we get into these, I want to always encourage parents to reflect on their own beliefs about mental health. Many of us grew up in families or communities where anxiety and depression were not talked about openly or where they were misunderstood.

SPEAKER_00 17:46

Yeah, just like suck it up. You'll get over it. Yeah.

SPEAKER_03 17:49

And uh, you know, there can be gender differences here too, because I think females are believed to be acceptably more emotional, where boys do need to suck it up, put some dirt on it, right? Um and that's not a a reasonable thing because boys are struggling or males are struggling with this too, and so are um fluid individuals. This this there's no uh this this goes across everyone. Everyone's fair game to feel anxious or depressed.

SPEAKER_00 18:13

Yeah, and it creates that stigma or hesitation around seeking help.

SPEAKER_03 18:17

It sure does. And I think what we might want to think about is it's important to remember that mental health is part of our overall health and well-being. Just like physical health, anxiety and depression are not simply about attitude or willpower, and that can be very demeaning. It's just, you know, just try try harder to not be anxious and depressed. Um, research does show that brain chemistry and chemical imbalances can play a role in these symptoms, just as biological factors influence other medical conditions.

SPEAKER_00 18:49

Right. If you could tell your child um to just suck it up if they fell and broke their arm, you wouldn't do that. If their arm is broken, you would take them to a doctor and you'd get them treated, they'd probably get a cast and maybe some pain medication, and would have you'd have regular check-ins with the doctor until they fully recovered. So if your child is struggling with depression, taking a similar approach, recognizing this is something treatable by going to the doctor and or therapist and implementing treatment strategies like medication might be part of that, and therapy. It is an important component of protecting your teen's overall health. Because we also know that untreated mental health concerns can have real physical health impacts over time, affecting their sleep, immune functioning, energy levels, and even long-term health um outcomes. And for many families, there may also be genetic or hereditary factors that make someone more vulnerable to experiencing anxiety or depression. I mean, I have generations of anxious people in my family, and it's something that I struggle with myself.

SPEAKER_03 20:02

And I think a lot of parents, when we start talking about these things in in therapy, parents will say, oh, you know what, that that is something that runs in the family, for example. So it's it's um why would we not do that? Take care of our overall health. So we want to promote that mental health is part of your overall health. Um so when we begin to view mental health through this broader lens, it can really help reduce stigma and make it easier to approach these challenges with compassion, curiosity, and a willingness to seek support when it's needed. If your household looks at mental health negatively or makes negative comments about people that might be struggling, it's sending the message to your kid that that's not acceptable.

SPEAKER_00 20:46

Right. And versus there are treatment options and you can feel better.

SPEAKER_03 20:50

Absolutely.

SPEAKER_00 20:50

Right. So um let's go on to some specific advice for parents on how to talk to their teens about um mental health. Um, to start off, Lisa, the first one is about avoid closed-ended questions, right? And so let's do a little role play here. You pretend like you're a parent, and I'm going to be one of my teenagers, just checking in about the day. So give me a couple questions and typical questions, right? I'm ready. Okay. All right.

SPEAKER_03 21:16

Hey Amanda, how was school?

SPEAKER_00 21:18

Fine.

SPEAKER_03 21:19

Well, how was your test today? Fine. Did you, you know, um, you know, did you how would you how was soccer practice?

SPEAKER_00 21:29

It was fine.

SPEAKER_03 21:30

Huh.

SPEAKER_00 21:32

So you can see that these kind of questions are very close-ended that can easily be answered with one question. And I don't know about you, but that's usually the response I can do.

SPEAKER_03 21:40

Yeah, so we use the we consider these closed ended questions conversation killers. Right. So, regardless of the behavior I might see when Amanda comes in sulking and irritated, and I ask her how a school, I'm gonna be stuck because I've been just shut off by my teen. I They're going to close themselves off into their room, and I've missed the opportunity to find out what's really going on, and I've missed the power of connection, which we're going to cover in a later segment. So as you explore your connection with your team, consider whether you're developing a relation dynamic where they feel safe and comfortable coming to you, or do they think you're just going to give them advice and try to problem solve and just focus on things that you're interested in, like the academics and the you know the performance pressure? So let's talk, Amanda, about some things that we can do instead to open the conversation with our teens.

SPEAKER_00 22:37

Alright, great. So the recommendation here is to lead with curiosity, not interrogation, right? Um, so try to avoid accusatory or why questions like, why are you so upset? Um why do you have such an attitude all the time, Lisa?

SPEAKER_03 22:55

That certainly makes me feel like talking to my mother.

SPEAKER_00 22:59

Instead, lead with curiosity. You might say something like, Lisa, I've noticed you seem overwhelmed lately. I'm wondering what might be contributing to that. Do you want to talk about it?

SPEAKER_03 23:11

Yeah, I think uh this approach does feel a lot more supportive and less threatening because you're noticing me.

SPEAKER_00 23:17

Right. You're sticking to facts and your assumptions.

SPEAKER_03 23:20

And you're not dictating what you want me to talk about. So teens are often worried about how parents are going to react to them. They don't want them to be disappointed, angry, or minimize what they're feeling. So what we were they're worrying about that reaction, they're much less likely to open up. But if you give them a safe space to process, and you may not get this on the first time, by the way.

SPEAKER_00 23:40

Right. So unfortunately, sometimes we may get upset because it seems like they're just closing us off, they're not opening up to us. But we have to be mindful that if there's a pattern of poor performance in your teen, this could be driven by anxiety or depression. So if you had a previous pattern of being upset with your teen's behaviors and now realizing they be maybe experiencing serious anxiety or depression, you uh want to uh change your tactic. You could still do that, but your kid is going to be um cautious and closed off. So leading with curiosity is always a benefit.

SPEAKER_03 24:20

Yeah. And one of the things we tend to do in therapy is those repairing of rifts in relationships. So like parents do get anxious about grades and performance and they do ask those questions a lot, but then your kid's already having the pressure.

SPEAKER_00 24:34

Yeah. So our goal here when your kid is actually depressed, right, and they're kind of closed off, is to provide um kind of provide them with hope with facts. Okay. So it's like really focusing on like what are you observing, not making about you or them, and then giving them reassurance that it's going to be okay, that you're there for them. So reassurance, you know, helps reduce that fear, letting them know they're not alone and that support is available. Um, and information helps them understand what they're experiencing and what their options are.

SPEAKER_03 25:08

So Amanda, can you give us an example? Because I can see like that kind of being careful not to come across as dismissive here.

SPEAKER_00 25:15

Right, yeah. So um here's an example. I can see this has been really stressful for you. A lot of teens experience this, especially this time of year, and there's there are ways to get support. Um, we can figure this out together.

SPEAKER_03 25:30

Yeah, so that's not being accusatory, it's not being dismissive, it's kind of normalizing some of their stress. Right. You know, noticing that it is truly stressful, it's uh acceptable to be stressed about it, and it's not unusual.

SPEAKER_00 25:44

And you're not jumping in to fix the problem.

SPEAKER_03 25:46

Right. Yeah, I think that's a good point.

SPEAKER_00 25:48

Yeah, trying to fix their problem is going to shut them down right away.

SPEAKER_03 25:51

Which kind of goes into our next number three tip was validating before problem solving. Right, yeah. So we kind of we did a little bit of an example there, but if you listen to some of our other episodes, you'll hear us say this a lot about validating how somebody feels when they're opening up is make they're expressing vulnerability to you in that moment. And we don't want to start problem solving when someone's feeling vulnerable. So we we and want to acknowledge and have an empathic intent and say, wow, that sounds really stressful. And Amanda, you modeled that really well in your example. I can see what would make you feel overwhelmed. So you're kind of aligning with them and kind of being and sitting alongside of them in that moment. So having that empathic, compassionate connection with your teen is really important, and that's gonna reduce defensiveness and really build trust and rapport.

SPEAKER_00 26:42

Yeah, because as parents, our instinct is to fix things. We want to protect our kids and make things better for them. So it's natural to jump in with solutions, but especially as teenagers, you want to allow them to have the capacity to fix their own issues, right? But um when it's done too quickly of trying to fix things, it actually feels dismissive to the teens. Like they don't have the capacity to um uh figure things out for themselves, and that can shut the conversation down. Listening all the way through, like being quiet and just listening without jumping in, without jumping to assumptions, is really important, and it helps teens feel heard and understood, and that builds trust.

SPEAKER_03 27:31

I I agree, I think this is such an important time too, where we have you thinking about the elementary years where you do fix their problems. You're telling the teacher, you're contacting other parents, you're you know, helping them advocate for themselves. They are really wanting at this stage to build some autonomy.

SPEAKER_02 27:49

Right.

SPEAKER_03 27:49

And they don't have the skills to do it. So opening up the door to kind of explore with them what do they need from you? Um, asking what questions here can be really encouraging and helping them explore their options. Like, what do you think you need at this point? What are your options and giving them that autonomy and ownership to at least start the problem solving process because they might have some ideas of how they want to go about addressing the issue. Um, and then you can help them kind of think through maybe the outcomes of each of those to see if maybe they're they're likely to work.

SPEAKER_00 28:25

Yeah, well, I think that's that's brilliant because if it's their own idea, they're more likely to do it as well, right? Yes, yes. So this leads into uh tip number four avoid minimizing or giving advice. So statements like you'll get over it, uh you know what? I was a teen once, believe it or not, and I know exactly what you're going through. Or you know what you should just do? Yes. If you say you should just should, shoulda, woulda, coulda, those are um advice and judgment statements. They're opinions. Avoid them. Yeah, they're opinions, yes.

SPEAKER_03 29:00

This is hard to do for a lot of people. We work on this in cognitive behavioral therapy, the should statements. I usually say you're shooting all over yourself. It puts a lot of pressure, it's a pressure-driven statement. It means you're you're falling short because you're not doing this thing. So I like the woulds, but it in this case, I think we don't want to intentionally shut down or unintentionally shut down conversations. Right. Um, remember that whatever your kiddo is going through right now, it may not seem like a big deal from an adult perspective, but this could be the your teens' first time navigating this difficulty, and it is a really big deal to them. And they may never have experienced this before. Um so they're gonna probably you know, teens are catastrophizing, so we want to acknowledge and try not to minimize. We want them to feel supported and understood, not dismissed.

SPEAKER_00 29:51

Exactly, exactly.

SPEAKER_03 29:52

So so, Amanda, tell us what else we can do here in terms of managing those ongoing conversations.

SPEAKER_00 29:58

Yeah, so the the fifth point here is create opportunities for ongoing um conversations, recognizing that you're probably not going to get to the bottom of it in one conversation.

SPEAKER_02 30:08

Right? That's a good point.

SPEAKER_00 30:10

It's gonna be ongoing and it's gonna be on their time. Mental health conversations are not, you know, one big long talk, you know. Um, not usually. Right. But it's typically smaller ones over time that you're um providing that ongoing connection and not overwhelming your kiddo anymore. Like, you know, so they might just start telling you a little something to see how you're gonna respond.

SPEAKER_03 30:33

Yeah, they test just yeah, test you, right?

SPEAKER_00 30:36

And then, you know, as they realize then they might give you a little bit more.

SPEAKER_03 30:40

And this is kind of a tricky thing. I'm glad you said that, Amanda, because they might be testing the waters with information. And this is where it's really important to have that self-regulatory skill for yourself. Do that self-check is wow, they just gave me a a little load to carry here. How am I gonna listen to this? Because sometimes they may be depressed or anxious because of something pretty pretty serious. Right. It might be something you might need to escalate. So be mindful that your reaction, you want to help them. How do we get the information? Um, you know, and I think let's talk about when teens are likely to open up.

SPEAKER_00 31:16

Right, yeah, because the other uh trick that we learned um is that teens aren't really great usually about having kind of like that face-to-face conversation. It's the parallel conversations, like when you're sitting side by side in a car, right? Or you're playing with the city.

SPEAKER_03 31:34

Which is why if you listen to previous episodes, Amanda is the driver.

SPEAKER_00 31:37

Yes, I like to be the taxi driver because I hear about all the stuff that's happening with my kids' lives. Yeah. Um, these are casual moments that often create the safest space for a deeper conversation, and it takes the pressure off and allows things to come up more naturally.

SPEAKER_03 31:51

Yeah, I agree. I think if your teen also wants you to think about their interests, right? They're playing video games, they're watching anime, maybe, they they have, you know, their personal interests that they do. Your teen actually wants you to be interested in them and their world and their experiences, not just giving them advice, problem solving, and talking to them about school, academics, job, college. That's a real those are always going to be stressors for them. So I think it's really important to have regular connection times in your schedule with your teen if you can. Um taking an interest, for example, if they're playing video games in the basement, go down and ask us, sit with them. I know it's maybe difficult, but finding that time to sit with them and watching them play and saying, oh, tell me more about your game. Tell me about what you're doing. Why do you like this podcaster? Um, what why let's watch anime together? I'm I'm curious to what you're interested in. What is the music that you're listening to? That really sets the stage that they're important and the that you're connecting with them on everyday topics so that those heavy topics are a lot easier for them to broach because they're already feeling close to you.

SPEAKER_00 32:59

Right. And then you can also make connections to things that they actually care about uh to parallel with what's happening in their lives, right? Um and they're much more uh likely to open up when they feel emotionally safe. And uh when you do decide to share, it's usually on their time, not yours, right? Sometimes they'll come to you when you're tired or right before bed. That's that's my uh kids' favorite time. Uh but those moments matter. That's when they're choosing to be vulnerable, and it can be really important to give them your attention when they do. I'd agree.

SPEAKER_03 33:34

Yeah, I I think the challenge is you can't force them to share, right? But you can find ways to help them feel connected and safe. Um, you can foster this by sharing what you're noticing in a non-confront uh non-confrontational tone. Right, yeah, and then saying you're concerned and you really want to help, and when you're ready, I'm here for you.

SPEAKER_00 33:51

Yeah. Uh well, let's go ahead and um transition into talking about when parents should seek professional help.

SPEAKER_03 33:59

Yeah, because there are times where you do want to act. If you notice some safety or warning signs, you you may not want to take that slow path.

SPEAKER_00 34:07

Right. Yeah.

SPEAKER_03 34:09

Sometimes there are some the the most important warning signs I think about are self-harm or suicidal thinking. Parents should seek immediate professional help if a teen is talking about not wanting to exist. You know, they're searching online for ways to die, they're giving away their possessions, um, and they're engaging in any kind of self-harmful behavior, which can also include like restrictive eating patterns, um, you know, you're finding objects in their room that suggest they might be harming themselves or planning to do so. Um, yeah, and I think in this case, mental health conditions should be treated like a medical issue because we're talking about safety concerns.

SPEAKER_00 34:45

Right. Um, one thing uh, you know, I I'm a uh youth mental health first aid instructor, and we distinguish is that you know youth at self-harm it is a serious component. It doesn't necessarily mean they want to kill themselves, correct? But um there's a high risk because they could accidentally harm themselves. Yes. Um, or it could get infected or whatever, and it definitely needs um um like professional help. Yes. Um, so that's really important um to make sure that you're intervening and getting them to a doctor, a psychologist, a therapist, or you know, whatever professional feels best for your family.

SPEAKER_03 35:21

Let's talk a little bit more about professional help, Amanda, because I think there's a lot of layers and it can be very confusing.

SPEAKER_00 35:27

Right. I think parents uh can be hesitant because they might not know how to navigate it themselves. So you can break it down that beautiful.

SPEAKER_03 35:32

Yeah, yeah, let's demystify this. So I think when we think about the first line of approach, um many teens can benefit from outpatient therapy. What that means is you go and you call a practice, um, a licensed provider where they can learn, you know, and enlist your child in therapy. Uh Connikin Associates is an example. We provide therapy supports for children and families, teens. Um, in this case, you want to they they can learn coping skills. And when we talk about coping skills, those are strategies to manage depression, strategies to navigate their social life, and develop um safety plans if there is a risk. Outpatient therapy is the most common, it can be secured locally for individual family support. Um, usually therapists or counselors are experienced with teens and families. As I mentioned, they teach skills to manage symptoms and they can also help to understand the underlying roots of anxiety and depression. And they can also support you in referring to a prescriber, which is a psychiatrist or someone who can prescribe medications if that is needed to explore benefits of whether able to think more clearly to get through it. Yeah, and I kind of if you think about it this way, you know, therapy can help with the behavioral symptoms, so skills are actions. Right. Skills are behaviors, environmental situations, family dynamics that can be adjusted to manage those problems. The medications are going to help the internal chemistry that could be contributing to the challenge.

SPEAKER_00 37:03

Absolutely.

SPEAKER_03 37:03

So hopefully that puts that in perspective.

SPEAKER_00 37:05

Yeah, thank you. Um so if anxiety or emotional struggles are impacting your teens' school experience, there are also supports often available within the school system, right? A lot of schools have school social workers, counselors, sometimes psychologists, occupational therapists, you know, just kind of depending on um, you know, the the resources within the school. And this might involve meeting with the school team and putting accommodations in place, like a 504 plan or maybe usually a 504 plan if it's uh medical related, right?

SPEAKER_03 37:36

Correct, often the case, yeah. Short term.

SPEAKER_00 37:39

Yeah, short term. And that's important because teens are spending a large part of their day at school and having that support in place can make a big difference, like having extra time to take a test, or maybe taking a test in a separate place where they're not feeling judged by their peers or whatever. You know, that that can really make a big difference.

SPEAKER_03 37:54

It certainly can. And then it can also be an important piece to the therapeutic process for your child's overall health, is to have a therapist who's willing to work with the school. Right. And have that collaborative communication. Because some of those skills that you're learning in therapy can be um introduced into the school and vice versa, um, and they can be a holistic approach where you're having a family piece, a school piece, and your child's therapy piece be all integrated. So that's really important.

SPEAKER_00 38:21

So if uh personal safety is a concern, uh the first step is a level of care assessment.

SPEAKER_03 38:27

Yeah, that's if we're worried about high risk.

SPEAKER_00 38:30

Right, yeah. So that kind of helps determine what kind of support a teen needs. Um and this can be conducted by a behavioral health hospital intake department or emerging emergency department.

SPEAKER_03 38:40

Yeah, let me talk about this a little bit, because this is a pretty scary process, I think, sometimes for families with that have not experienced this. So if your child is at high risk and you're concerned about self-harm and safety, um, this may be something you I realize on your own at home, or if you're working with a therapist, you may have a conversation with your parent therapist and they may say, I think it's important that we get a level of care assessment. Um, and that is looking at is outpatient treatment not enough? And that may mean that there's more intensive treatment options available to get your child safe and to get those the emotions stabilized and the safety stabilized. So in more serious situations, it could be an inpatient setting, and that's may that may be necessary to ensure safety. So if you go to the hospital and you have a level of care assessment, they're going to assess: is inpatient care necessary for crisis stabilization, or can they go to a partial program, which is an intensive program, typically five days a week, where the client is in a what would be called a partial hospitalization or an in uh IOP intensive outpatient program. And that's skills-based support several days a week. Um, it can be day programming or afternoon programming. They often will collaborate with your school. Kids are often extremely stressed about missing school during these times. But remember, your child's emotional well-being is the primary focus here if there is a crisis. So schools will work with your student and manage that during medical leave.

SPEAKER_00 40:13

Yeah, so the primary focus here, Lisa, is about getting healthy, right? You can't expect to have optimal performance when your teen is not functioning at baseline, right? You know, if they're just so depressed or so anxious, um, they need to focus on their mental health so that they can then start incorporating into their regular routine. Um, and schools really are really great about working with students to manage workload during um this it's like a medical lead. It is a medical lease. Right? Sometimes they'll provide tutors to help them uh so they don't get too far behind in school. Um and then also what I think is unique about a PHP or an IOP is that it's more group therapy based. So the teens oftentimes feel like I'm the only one that's dealing with this. And then when you're in a group of like five or six other teens that are all struggling with that, it makes them feel less isolated, um, it normalizes their experience, and then together they're working on building those strong um coping strategies to help them re-integrate back into their um normal environment.

SPEAKER_03 41:24

Yes, and I think if you remember we we talk about teens really n being aligned with your peers. So this can be a pretty powerful process is to get the teens connected with other teens that have had similar experiences and that are really supporting one another.

SPEAKER_00 41:42

So once teens leave um a PHP or IOP program, they're still going to need um ongoing therapeutic help to help them can kind of reintegrate. And that's what your uh what you all do at Conic and Associates, right?

SPEAKER_03 41:58

We do. We uh we specialize in therapy and comprehensive psychological assessments for children, teens and families. And our clinicians can work closely with families to help them understand what their teens are experiencing and help them all develop skills that they need to manage anxiety and depression. And we also work with teens who are discharging, like you said, from the hospitals who need these accommodations and formal supports at school. So we can help that liaison process.

SPEAKER_00 42:25

Right, because usually the therapist they have in the PHP program doesn't follow them outside.

SPEAKER_03 42:29

Not typically. So we would be able to take that handoff. Um we also work very closely in making those referrals to the program. So we have an understanding of how this works, and we can help both teens and parents navigate this process and also collaborate with their school programs.

SPEAKER_00 42:43

So I want to dive into more about protective factors.

SPEAKER_03 42:46

I think that's a great idea.

SPEAKER_00 42:48

Well, it's important to talk about the risk. It's also um just as important to talk about what helps teens thrive with their um their uh promoting positive mental health strategies. Some of the strongest protective factors include supportive relationships with caring adults, you know, consistent sleep routines, we keep bringing that up, regular physical activity, boundaries around social media. I don't think it's uh realistic to take it away from them 100%, but setting boundaries um such as time limits um and like not at the table or not at night, and also hobby hobbities, hobbities, hobbies, hobbies, um, or creative outlets, right? I'm thinking about during the pandemic how many people took up a new hobby to help them get through that isolation period, like learning a guitar or learning to knit or things like that. And those are important. They are really important. They're good coping skills, right?

SPEAKER_03 43:50

Yes, and I think another really powerful factor is belonging. Teens do best when they feel connected and when they feel like they matter and Have a place to fit in. And organizations like the Alive Center can help create those spaces, Amanda. Mention a little bit about where teens what can they experience at the Alive Center that might help promote belongingness?

SPEAKER_00 44:13

Yeah, so uh the Alive Center, what we really focus on is building friendships, allowing them to have space to explore interests, and develop a sense of purpose without any kind of like um component of like you're gonna get a grade or your team is going to win or lose, right? You know, like you can just try sewing. You can just try dodgeball, you can just try this game. Um, and that kind of sense of lack of pressure um gives them uh more confidence and more autonomy to be able to try.

SPEAKER_03 44:51

Another thing I love about a live center is it's teen-led. So the kids kind of come up with their own ideas for what they want to do. There's a lot of independence, there's a lot of autonomy in this type of center, and then there are teen mentors. So they learn from each other and they kind of the younger kids, I'm sure, look up to the older kids. It gives them a sense of purpose, right?

SPEAKER_00 45:10

That allows them to be creative with you know, trying this idea like I would really like to start a chess club. Great, come to the Life Center, start a chess club. Um, and also uh, you know, engaging other people and helping them feels really good. Talk about ex oxytocin, right? That's right, like a sense of purpose, yeah. You know, like I am giving something back to my community.

SPEAKER_03 45:33

And that really builds confidence, which is a big protective factor over depression. Absolutely, huge, huge and then they're learning a lot of social interactions so that social anxiety can really be broken through through that supportive environment.

SPEAKER_00 45:47

Do not underestimate the power of play.

SPEAKER_03 45:49

Yes.

SPEAKER_00 45:49

You know, just being able to sit down and play a game or you know, Uno No Mercy, spoons, uh, you know, those kinds of games are really fun, you know, and it really brings joy uh to anyone. Yeah. I'm not gonna just say teens, it's anyone. Adults should remember that uh playing is important.

SPEAKER_03 46:09

I agree with that. As a stress reliever, yeah. So I think in closing, let's kind of talk a uh and and do a little summary here. Uh you know, as we think about adolescence, it is a time of enormous growth, but also vulnerability. And the important message for parents is that anxiety and depression are treatable conditions, and early support can make a tremendous difference.

SPEAKER_00 46:31

If you're can concerned about your teen's mental health, you don't have to navigate it alone. You can learn more about therapy and psychological services at Conic Associates at conicassociates.com.

SPEAKER_03 46:43

And if you're looking for ways for teens to connect with peers and build supportive community, visit the Alive Center and learn more about their programs for teens.

SPEAKER_00 46:52

Thank you so much for listening to this episode of Inside the Teen Mind, and we'll see you next time.