Adolescents and Mental Health

Johanna Parra, MA, PPS.

Orange County Dept. of Education

jparra@ocde.ud

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

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?

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

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

That’s a lot of stress!!

• 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?

Stress has always been with us. It can keep us safe and alert to danger.

Stress Performance Connection

I’m in the zone!

A certain amount of stress is a normal part of life.

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

Chronic Stress

• Impairs working memory

• Impairs social skills

• Impairs habit changes

• Impairs decision making

Jensen, 2011; Galvan, 2011

My kid isn’t THAT stressed.

• Childhood Experiences and home life also

contribute to stress.

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.

Three Types of ACEs

http://www.npr.org/assets/img/2015/02/20/aces-1_custom.jpg

As the Number of ACEs Increase, the Risk for Health Problems also Increases in a Strong &

Graded Fashion

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

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)

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.

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)

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

• 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

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.

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?

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

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

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…

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?

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

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

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.

Resilient Youth • Make positive friends

• Know their strengths

• Learn new things

• Talk through their

problems

• Set goals and take

action

• Take care of

themselves

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

http://www.futureswithoutviolence.org/trauma-informed-approaches-to-domestic-violence-exposure-adverse-childhood-experiences-and-resiliency/

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.

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

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

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

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

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

See Handout for Local Orange County

Resources

Get to know your campus and

community resources

Reso

urces

ocde.us/healthyminds

Resources