Every child’s path to adulthood is different, and often difficult or uncertain — even in the best of times. Add an unprecedented pandemic to the mix and the challenges for today’s generation of young people are uniquely hard to navigate.
COVID has brought with it death, fear, economic instability and physical distancing – the effect of which has been “devastating” to adolescents’ mental health, said Dr. Vivek Murthy, the U.S. Surgeon General who detailed the crisis in a December 2021 53-page report. And that was on the heels of another report from the fall in which top children’s health organizations declared that adolescent mental health a national emergency.
Among the most recent findings – a “significant” increase in self-reports of anxiety, depression and more emergency room visits for mental health issues. Even more alarming, ER visits for suicide attempts rose more than 50% for adolescent girls in 2021 (and 4% for adolescent boys) compared to 2019, researchers found.
“Our obligation to act is not just medical — it’s moral," Murthy said. “Mental health challenges are real, and they are widespread. But most importantly, they are treatable and often preventable.”
Mental health challenges are real. They’re also treatable.
In North Carolina, “There has been a tsunami of need,” said Dr. Michael Clark of Novant Health Psychiatric Associates - Huntersville. The psychiatrist, who specializes in children and adolescents, said patient referrals have nearly doubled.
“The adolescents I see tend to have a mixture of anxiety and depression. And that happens with a disturbance in routine. The pandemic has affected their friendships, social interactions and how they attend school. So, it’s tough when you’re a young person in that situation,” Clark said.
Clark suggested five best practices for parents navigating tough conversations – with a ‘don’t’ and ‘do’ for each. He also offered guidance for seeking professional help.
1. ‘Are you worried about…?’
With teenagers especially, don’t label things before they have a chance to speak. Asking, ‘Are you worried about COVID? Are you worried about the test or what your friends are saying?’ puts your own words to their feelings.
Instead, try asking open-ended questions. Something like, ‘You look worried today. Is there something going on?’ or maybe, ‘You seem withdrawn lately. Do you want to talk about it?’ Let the child express themselves before jumping to conclusions because it’s far better coming from them.
And they might not say anything at first but knowing that you're there and willing to listen – without being heavy handed about it – keeps the door open. Maybe you say, ‘You know, if there’s something on your mind, I am here to talk about it.’ Just having that ongoing human connection is valuable in and of itself.
2. ‘Don’t sweat the small stuff.’
Parents shouldn’t discount their child’s fears. And a statement like, ‘Don’t sweat the small stuff’ can trivialize what they’re worried about. Also, telling someone not to be anxious isn’t going to make them less anxious. There are ways to be supportive without causing more distress.
Validate what they’re concerned about. I think adolescents’ worries are grounded in real, legitimate things. Acknowledging it doesn’t mean the parent is saying, ‘You ought to be really worried about this.’ It just means, ‘OK, I understand that.’
Let’s say they’re worried about a test. Try relating it to a personal experience; share a time when you were worried about school and how it turned out OK. Or maybe you just totally bombed but look where you are now.
If it didn’t make any difference in the long run, stress that you learned from it and life moved on. I think that’s a far better approach than saying, ‘Don’t sweat the small stuff.’
Is your child struggling? The pediatrician is a good place to start.
3. ‘I’m stressed out, too.’
In some ways, creating a comparison can also be kind of dismissive. It’s not very helpful. Instead, relate their ongoing worry to something they’ve dealt with in the past and remind them of how they got through it. Emphasize that it’s not a forever thing.
Let’s say they tell you, ‘I’m worried about the omicron variant closing schools again.’ A parent could follow up with something like, ‘I understand that. Remember, we’ve been down this road before and if it were to happen again, I think you have the tools you need. You got through it last time and I’m really proud of how you handled it.’
4. ‘You’ll be fine.’
Blanket statements like, ‘You’ll be fine’ aren’t a solution to a specific problem. A parent may say this trying to lift up their teen’s independence, like ‘You’ve got this. I don’t need to jump in here,’ but children may interpret that as, ‘This isn’t my problem.’
When someone is having intense feelings about something, help them link it to a specific thing. Try those open-ended questions I mentioned earlier to help them identify what they’re concerned about.
Validate their feelings with something like, ‘I know this isn’t easy and I can see you’re having a tough time with it.’ Offer support and let them know you’re there for them. I think that’s far more helpful than a tough-love approach.
5. ‘I don’t know what to do.’
All of us, at all ages, occasionally experience fear, worry, sadness or distress. In most cases, these symptoms are short-lived and don’t affect our ability to function. But, at other times, symptoms can cause serious difficulties with daily functioning and affect our relationships with others.
If you see a change in a child or teen’s behavior that lasts more than a couple of weeks, seeking professional help makes a lot of sense. Especially if the changes are dramatic – maybe they’re isolating, their grades are dropping, they seem tearful or aren’t sleeping. And, of course, seek immediate help if they express suicidal thoughts.
I think the best way to approach this conversation is making it clear that everyone needs help now and again. No one is an island or an expert in everything. Let your child know it’s natural to talk with someone when you’re in tough times. Try something like, ‘Let’s see what we can do to get back to the way things were when you seemed happier and enjoyed life more.’
Other expert advice:
- Your pediatrician is a great place to start if you think your child needs professional help. Ask for a referral. And if the wait for a psychiatrist is too long, remember they can also see a counselor or psychotherapist. It doesn’t have to be a psychiatrist.
- Adolescents thrive on routine. Trying to keep some sort of regular rhythm to their day – be it sleep, school or extracurricular activities – is valuable.
- As you help your child navigate life’s difficult moments, try visiting the Resource Center from the American Academy of Child and Adolescent Psychiatry.