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Adolescents and Mental Health
Johanna Parra, MA, PPS.
Orange County Dept. of Education
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What we’ll talk about today • Normal teen behavior
• Stress and how it affects
development
• What happens when stress
negatively affects development
• How to deal with stress in a
healthy way to build resiliency
• What parents can do to help their
teens healthy development
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Think About Your 8th Grade Experience…
• Who was your favorite teacher?
• Were you dating or not dating?
• Who was your best friend?
• How would you have described your parent/caregiver?
• What did you do for fun?
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What is your child going through at this age?
Read the bookmark to learn about what you can
expect at this age (11-13 years old):
- Establishing a sense of self worth and individual identity
- Hormones leading to rapid physical, mental and emotional growth
- All these changes have great social significance and affect self
esteem
- Seeking friends approval for self image
- Tend toward conformity because my friends make fun of me if I
make mistakes
- Learn by making mistakes
- I may take it out on you because you are
the safest place for me to release my
fears and frustrations
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Normal Difficult Behavior • Moodiness!
• Less attention and affection towards parents
• Extremely self involved
• Peer conflicts
• Worries and stress about relationships
• Testing limits
• Identity Searching/Exploring
• Substance use experimentation • Preoccupation with sex
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That’s a lot of stress!!
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• They are trying to make bigger
decisions on their own when important
parts of their brain aren't fully
developed yet
• As the brain matures, teenagers can
reason better, develop more control
over impulses and make better
judgments.
• How does stress affect my child’s
development?
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Stress has always been with us. It can keep us safe and alert to danger.
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Stress Performance Connection
I’m in the zone!
A certain amount of stress is a normal part of life.
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Persistent Stress Changes Brain Architecture
Source: C. Nelson (2008)
Normal
Chronic stress
Prefrontal Cortex and Hippocampus
Bock et al Cer Cort 15:802 (2005)
Typical - neuron with many
connections
Neuron damaged by toxic stress – fewer
connections
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Chronic Stress
• Impairs working memory
• Impairs social skills
• Impairs habit changes
• Impairs decision making
Jensen, 2011; Galvan, 2011
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My kid isn’t THAT stressed.
• Childhood Experiences and home life also
contribute to stress.
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What is the Adverse
Childhood
Experiences (ACE)
Study?
• Decade long CDC / Kaiser San Diego
Study N= 17,000
• Looked at effects of adverse childhood
experiences over the lifespan.
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Three Types of ACEs
http://www.npr.org/assets/img/2015/02/20/aces-1_custom.jpg
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As the Number of ACEs Increase, the Risk for Health Problems also Increases in a Strong &
Graded Fashion
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ACE and Risky Behaviors
• The higher the ACE score, the more we see risky
health behaviors in childhood and adolescence
including: o Pregnancies
o Suicide attempts
o Early initiation of smoking
o Sexual activity
o Illicit drug use
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Cries for Help- Ages 13-18 • Sexual promiscuity
• Suicidal/homicidal ideation
• Self-mutilation
• Frequent displays of temper
• Withdrawal from usual activities
• Significant change in grades, attitude, hygiene, functioning, sleeping, and/or eating habits
• Delinquency
• Excessive fighting and/or aggression (physical/verbal)
• Inability to cope with day to day activities
• Lots of somatic complaints (frequent flyers)
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How do things go so wrong?
- Teens are under a lot of stress because of the
changes they are going through.
- It’s the way we handle stress that can take us down
one of these paths.
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Unhealthy Coping with stress Can
Result in a Range of Problems
• Poor academic
performance
• Conduct problems
• Anxiety
• Depression
• Suicide
• Eating disorders
• Violence
(Kovacs, 1997; Matheny et al., 1993)
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Not all students need therapy or medication.
Mental health occurs on a continuum
Everyone fluctuates on this continuum throughout their life
“Normal” is a relative term based on an individual’s experiences
Understanding Mental Health and Illness
Mental Health Mental Illness /Disorder
Mental Health First Aid USA
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• 1 in 5 children experience a mental health condition during childhood o 50% of all adults with a lifetime
mental illness report having symptoms by age 14.
• Only 1/3 receive any kind of treatment
• Suicide is the 2nd leading cause of death in ages 10-34 o 90% of those who died by
suicide had an underlying mental illness.
Behavior/Conduct Disorder (10%)
Substance Use Disorder (10%)
Anxiety Disorder (8%)
Learning Disorder (5%)
ADHD (5%)
Depression (5%)
Statistics on Mental Illness children & teens
Mental Health First Aid USA; National Alliance on Mental Illness
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Angel Stadium seats 50,000 people
You can fill 3 stadiums with
OC kids, and that's how
many have a diagnosable
Mental Health Disorder.
750K Kids in OC = 150K with a MH disorder
Only 1 stadium full gets the help they need.
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STIGMA:
A mark of disgrace
A stain on someone’s reputation
An attribute, behavior or reputation that is
socially unacceptable
SELF-STIGMA
Negative attitudes held by the stigmatized individual towards
oneself
Prejudice is internalized
Leads to :
•Decreased treatment seeking
•Lowered self-esteem
•Lower self-efficacy
Why do so many go untreated
and undiagnosed?
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General Early Warning Signs
• Impulsiveness
• Inflexible behavior
• Resists change
• Too many worries
• Sense of worthlessness
• Very sad or teary
• Can’t control emotions
• Doesn’t seem to have feelings
• Frequent physical complaints
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Classroom Warning Signs • Missing too much school
• Challenges authority
• Immature class behavior
• Slow starter, or can’t complete work
• New or ongoing academic underachievement
• Trouble following directions
• Can’t handle criticism
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Social Warning Signs • Aggression – physical or verbal
• Lies often
• Can’t make friends
• Lack of interest
• Social isolation
• Overcritical of self or others
• Inappropriate sexual behavior
• See your handout for more info…
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Common Questions:
• How can I make sure they are handling their stress the right way?
• How do I talk to my child about this?
• Where can I take them for help?
How can I help my child?
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Handling stress
effectively can
reduce risk of a
mental health
disorder. Educators Guide to Children’s Mental Health
Minnesota Assn. for Children's Mental Health
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Build Resiliency to Overcome Stress
Findings suggest that building resilience—
defined as “staying calm and in control
when faced with a challenge,” for children
ages 6–17—can ameliorate the negative
impact of adverse childhood experiences.
Bethell, C., Newacheck, P, Hawees, E. & Halfon, N.,10.1377/hlthaff.2014.0914 Health Aff December 2014 vol. 33 no. 12 2106-2115
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Resilience
Being resilient is adapting and being flexible in the face of difficulty, trauma, and major sources of stress. It means “bouncing back” from difficult experiences.
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Resilient Youth • Make positive friends
• Know their strengths
• Learn new things
• Talk through their
problems
• Set goals and take
action
• Take care of
themselves
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Factors That Help Resilient
Children-Teens Bounce Back
• Loving relationship with at least one adult
• Belief in one’s own effectiveness
• Ability to assist the family
• Connections to adults outside the immediate family
• Effective problem solving skills
• Belief in ability to make things better for himself/herself
• Spiritual resources
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http://www.futureswithoutviolence.org/trauma-informed-approaches-to-domestic-violence-exposure-adverse-childhood-experiences-and-resiliency/
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Key Understandings
• Children can learn to be resilient and bounce back from life’s daily challenges.
• To be successful in school and in life, children need to learn about themselves, how to get along with others, and how to negotiate with the world.
• Kids experience stress and can learn to handle it.
• Parents can model and teach healthy stress-coping strategies.
• Handling stress well can reduce risk of mental health disorders.
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Parent Power #1 essential
parenting skill is the ability to provide love and affection.
#2 essential parenting skill?
Parents ability to manage stress was a good predictor of the quality of their
relationship with their children.
Epstein, 2010. Scientific American Mind
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Helping Your Child & Teen
Cope with Stress
Love, affection, & support
Vigorous exercise
Talk through problems
Practice relaxation & self-calming skills
Teach that mistakes OK
Clear rules and consequences
Teach how to handle difficult situations
Tell stories of effective coping
Be a role model dealing with stress
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Asking Kids How They Cope
52% play or do something active
44% listen to music
42% watch TV or play video game
30% talk to friend
29% try not to think about it
28% try to work things out
26% eat something
25% hurt themselves
23% lose their temper
22% talk to a parent
11% cry
Nemours Foundation, 2012
9-13
year
olds
For Teens…
• Smoking
• Alcohol
• Other drugs
• Sleep
• Family Connections
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Feelin’ Frazzled
Listen to
calming
music
Laugh
Exercise or
Play sports
Yawn and
Stretch
Take a walk
Talk with
a friend
Picture yourself in a beautiful place
Draw
Play
with
your
pet
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Modeling Mental Fitness • Encourage child to talk about feelings
• Model problem solving
• Practicing thinking about solutions
• Encourage children to try new things
• Provide a safe place to work on independence
• Learn / practice stress reduction / mindfulness
• Encourage helping others
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See Handout for Local Orange County
Resources
Get to know your campus and
community resources
Reso
urces
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ocde.us/healthyminds
Resources
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