4 Mental Health Challenges Teenagers Face

4 Mental Health Challenges Teenagers Face and How a Therapist Can Help

4 Mental Health Challenges Teenagers Face and How a Therapist Can Help

Being a teenager these days is extremely challenging. As a therapist working with teenagers and a mom of two teenagers, I am aware of the many psychological issues that they face and the stress that this causes many parents. According to Mental Health America, the rates of depression among teens is increasing at an alarming rate. Each year, almost 5,000 young people between the ages of 15-24 take their own lives. In 2015, about 3 million teens ages 12 to 17 had at least one major depressive episode in the past year. According to the Department of Health and Human Services, more than 2 million reported experiencing depression that impairs their daily function. About 30% of girls and 20% of boys totaling 6.6 million teens have had an anxiety disorder according to data from the National Institute of Health. In the past 15 years of working with teenagers, I’ve noticed an increase in rates of depression and anxiety and requests from parents seeking mental health therapists for their teenagers. In the following article, I will discuss the four main mental health challenges that teenagers face with the hope that it will increase awareness of these issues that cause many of our teens to experience mental health illnesses. It’s also my hope that awareness will lead to action. In many cases, a mental health therapist can provide a teenager with the support they need to work through their struggles, but it’s difficult for a young person to recognize when they need help and even more difficult for them to ask for it.

Challenge # 1 Peer pressure

teenagers walking together in school

Primarily during middle school and high school, many teens feel very stressed because they are trying to be like their peers and fit in. This is nothing new, and I’m sure you can remember it from your own high school days. These pressures lead to teenagers dressing and behaving in ways that may surprise you as a parent or caregiver. Middle and high school teens are well known for forming cliques and groups that have their own norms and rules that people have to follow to fit in. Those who are not included feel a lot of pressure to be in certain groups so they may do things out of their comfort zone to fit in. Since the adolescent years are filled with teens struggling to define and discover who they are as a person, this pressure leads to feeling confused, stressed, and overwhelmed. Just because peer pressure is “normal,” it doesn’t meant that every teenager is going to be able to cope with it in healthy ways. For some, the pressure is too much and can lead to destructive behaviors.

One of the most prominent figures in psychology, Erik Erikson, proposed a psychosocial theory comprising of eight stages of development. I am not going to bore you with all the stages — although I think they are very interesting and can add great value to your knowledge as a parent, educator, or anyone who is interested in human development — but I want to give a basic overview as it relates to teenagers. Basically, during each stage, a person experiences a psychological crises, which could have a positive or a negative outcome for personality development. For the purposes of this article, I will jump right into the fifth stage that is relevant to adolescence.

During the fifth stage (ages 12-18), the adolescent searches for a sense of self and personal identity, through an intense exploration of personal value, beliefs, and goals. This is an important stage where teens are becoming more independent and begin to look at the future in terms of career, relationships, and families. They also have the desire to belong to a society and fit in. Erikson suggests that two identities are involved during this stage: The Sexual and the Occupational. (Yes, he is influenced by Freud for those of you who are familiar with Freud’s work). Erikson also claims that if adolescents are successful in this stage, it will lead to the virtue of fidelity, which involves being able to commit oneself to others on the basis of accepting others, even when there may be ideological differences. If adolescents fail to establish a sense of identity within society, this can lead to role confusion, which can result in identity crisis and most likely feelings of unhappiness. The good news for you as a parent or a caregiver is that while your child is going through whatever it is with relations to their peers, including negative feelings, stress, or anxiety, it all should somehow help him or her learn how to function in our society and grow into the person that they are meant to be. This might not make sense if you are currently a parent of an adolescent child, however.

During such an important stage, a mental health therapist can provide an outlet to process emotions. In addition, a mental health therapist has coping mechanisms and strategies that will help an adolescent deal with societal peer pressures.

Challenge # 2 Grades and school performance

teen experiencing mental health issues

Teens are under constant pressure to perform well academically while trying to become their own person and be independent of their parents. This pressure to succeed and the comparison to other students who might be doing better can lead to depression and other mental health issues. A study by NYU examined the top high school stresses of 128 private school students in 2015. The results showed that nearly half (49%) of all students reported feeling a great deal of stress on a daily basis and 31% reported feeling somewhat stressed. Females reported significantly higher levels of stress than males related to grades, homework, and preparing for college. And 26% of participants reported symptoms of depression that were clinically significant.

Sometimes as parents, we don’t realize when we are part of the problem. Wanting your child to succeed academically is normal, but how do you know when you are adding too much pressure? It can be easy as an adult to be consumed with your own stress at work or with taking care of your family, and oftentimes we dismiss how much pressure our kids are under at school. A mental health therapist can help a teenager when the pressure gets to be too much.

Challenge #3 Physical and hormonal changes

The adolescent years are characterized by rapid physical and emotional changes that affect teens in different ways. This period is marked by increased attention to body image, sexuality, and acceptance that often leaves the teen feeling confused, stressed, and depressed. Teenagers are known for their “raging” hormones and drastic mood swings. If you are a parent of a teenager or if you are around teenagers in any capacity, then you must have noticed the mood fluctuations between excitement, anger, anxiety, and depression. Teenagers’ self-esteem is often affected by their appearance or how they might see themselves. The combination of your body changing so rapidly with peer pressure and the desire to fit in is a lot for someone to deal with.

Challenge #4 Family issues

All families experience varying degrees of stress at different times and for different reasons. Being a teenager is hard enough as it is, and when you add familial stresses such as divorce, illness, abuse, separation, merging of families, and financial struggles, it only makes the stresses greater. All these stresses can cause many mental and physical illnesses. Some examples of common triggers and types of stress include career stress, financial stress, personal health concerns, managing parenting responsibilities, and marital and relational stress, among others.

How Can a Mental Health Therapist Help Teens with these Issues?

Now that you are aware of some the biggest challenges that teens struggle with, you might wonder how mental health therapists can help them. A mental health therapist can help your teen learn how to better manage their stress, get more sleep, and make healthier choices. One of the best gifts that you can give your teen is to provide them with a safe space that they can share their thoughts and feelings so that they can reduce their stress and  anxiety and focus better on school and other important areas in their life. In this era of social media where both teens and parents spend so much of their time staring at screens, providing your teen with 45 minutes of quality talk time with a professional can help tremendously.

Many teens are struggling with issues related to control. A therapist can help them understand that their thoughts affect their feelings and behaviors. By explaining that concept and practicing this with teens using examples from their lives, the therapist can help redirect their thoughts to a healthier more productive place. Mental health therapists can work with teens individually, in groups, and with their families. While some teens benefit from individual attention, others might benefit from taking part in group therapy or getting support with the whole family. In some cases, teens might need to work with a therapists individually, in group, and with the family. For example, I am working with a 14-year-old who is struggling with bulimia, and at the same time, one of our family therapists is working with the whole family as well as the teen participating in group therapy with other teens who struggle with bulimia and binge eating.

If you are wondering about the length of treatment the answer is not always easy. Some teens might need to be in therapy on a regular basis as they benefit from speaking to a professional and need the guidance and support. Others can benefit from a shorter term therapy, like cognitive behavioral therapy or dialectical behavioral therapy. Regardless of what you might think your teen needs in terms of the length of the time, it is paramount that you know that it takes anywhere from 12-30 weeks to change a behaviors So if you start working with a mental health therapist, you have to make a commitment to yourself and to your therapist in order to see a change in your behavior. If you are not sure, you can always get another professional opinion, but whatever you decide, you must know that it takes times and commitment for your teen to see a change in behaviors.

It is also important to know that while your teen is the one who will be going to therapy, parents play a very big role in the psychological treatment. When your teen is displaying a challenging behavior, parents often need to take an active role and be just as committed in working in collaboration with the therapist and the teen for best results. Furthermore, the therapist can provide parents with techniques and ongoing support to help them with their teen. For example, if the teen is working on anxiety related to his/her parents constantly fighting and screaming, then the therapist might provide the parents with some skills and tools that might help them change the behavior that causes the teen anxiety.

Some therapists will include some less orthodox ways of working with teens, like getting out of the office and doing some activities that can encourage the teen to open up and feel more connected to the therapist. I once worked with a teen who always worried about not looking proper and if she didn’t have time to fix her hair or put makeup on, she would get stressed and depressed. After spending a month with her in my Fifth Avenue office, I realized that she needed something different. So I decided for our next session we would meet at Central Park and spend the time walking around in super casual clothes. I wasn’t sure if my client was going to actually listen and show up casual, but I promised her that I would also be super casual and wear my sweatpants and hair back without makeup. Of course my client stared at me in disbelief, but our next session in the park was spent practicing mindfulness. It was one of her best sessions yet. After that, she said that she felt the most connected to me and that she was able to see me in a different light and be more open and honest. My point is, with teens and adults too sometimes, we have to think outside the box and come up with creative ideas to help and support them. If you or anyone you know has a teenager who is in need of guidance or support, don’t hesitate to ask for help.

If you would like me to connect you with one of our expert therapists or dietitians, please contact me. I look forward to hearing from you!

What To Do About JUUL in Our Schools?

Teenager JUULing in Class

What To Do About JUUL in Our Schools?

Are our teenagers getting addicted to nicotine in class?

What can parents do about it?

It was brought to my attention today that in at least two middle schools near my Manhattan home, kids are selling JUUL in the school bathroom. This is a major problem! Now, I know what you may be thinking: “Limor, kids have been selling pot and other drugs in school bathrooms for years — why are you so up in arms about it now?” Well, first of all, I would be alarmed if my 13-year-old were smoking in any capacity. But there is a new trend sweeping the country that allows kids to buy drugs and smoke them in class literally at their desks without adults noticing, because it doesn’t give off an odor, and it looks like a USB flash drive. It’s widespread, and it’s scary.

Here’s what’s happening: Something that apparently “blew up” last summer is a trend called JUUL. I’d never heard of it before, and I’m assuming this is new to many of you as well. In this blog, I’ll go over what JUUL is, what the health risks are, and what we can do to stop it. My goal is to start a discussion among parents so that we can all be more knowledgeable and address the problem before it becomes even more rampant. My oldest daughter is 13 and she is the one who brought it to my attention. Raising teenagers today is just insane!

Unfortunately, schools are often limited in what they can do to help out with the problem, but I definitely suggest bringing it up to your school boards and principals. This is not just a “trend” or a “fad” that is going to go away. It’s something that could lead to long-term health problems and more serious drugs with severe consequences.

First off, here’s a brief guide on JUUL that I’ve compiled so we can help our kids by getting to the bottom of this.

What is JUUL?

JUUL is just another form of vaping — but it’s sleek and trendy. The JUUL vaporizer looks like a USB flash drive, and it charges when plugged into a laptop. It can be filled with marijuana, a homemade concoction, or JUUL “pods,” which are vaporizer products that have more nicotine than any other vaping product. One JUUL pod has the same amount of nicotine as an entire pack of cigarettes! JUUL vaporizers were apparently made for adults who are trying to quit smoking, which might be true, but it’s also interesting to consider the fact that the oils have flavors like mango, creme brulee, and chocolate — pretty kid-friendly options, if you ask me.

JUUL entered the market in 2015 and gained quick popularity over the summer of 2017. Currently, many teenagers say that a majority of their peers own a JUUL device, and they even smoke them in school.

On the company’s website, it states,  “The JUUL Labs’ mission is to eliminate cigarettes by offering existing adult smokers with a true alternative to combustible cigarettes.” It goes on to say, “…smokers who want to switch are looking for something that does not look or feel like a cigarette.” For their part, they do talk about sale to minors, and how they are trying to combat it: “While we are dedicated to our mission of helping adults switch off cigarettes, we are also incredibly focused on combating underage use… Underage use of certain product categories remains a persistent problem, and at JUUL Labs we are committed to combating underage use of our product. While we have made strides, we are working on new approaches to address the issue more effectively.”

My question is, how can we all address the issue more effectively as a community, including parents, lawmakers, and the DOE?

Why do kids use it and how do they get it?

People get addicted to JUUL the exact same way they get addicted to cigarettes — they try it once, love the immediate buzz, and keep doing it. Eventually the buzz wears off after each hit, and then they feel like they have to take hits just to feel normal. According to one Yale study, 25% of U.S. high schoolers had tried e-cigarettes, and 3.5% of U.S. middle schoolers had tried them. Many kids stated that they were less afraid of e-cigs, saying that they wouldn’t try real cigarettes but would try e-cigs.

According to the JUUL website, “The Starter Kit” includes a rechargeable JUUL device, a USB Charger, four JUULpods (Virginia Tobacco, Cool Mint, Fruit Medley, and Creme Brulee), and a one year limited device warranty. All for $50.

Kids cannot order JUUL from the JUUL online shop or buy it in a store, but keep in mind that kids can’t buy pot or alcohol in stores, yet they get those anyway. Think of any way that a high schooler might get their hands on weed or liquor — fake IDs, stores selling illegally, older siblings, black market, you name it. We talked to a store owner on the Upper East Side who claimed that they never sell JUUL to underage kids, but that adults sometimes do come in and buy in bulk. The store wondered if those adults were selling to minors. You only have to be 18 to buy nicotine products like cigarettes and JUUL, so many high school seniors can legally purchase these products.

A bit of online research landed us at a Reddit thread titled, “How to get Juul as a minor,” in which teenagers comment on each others’ posts so they can figure out how to purchase a JUUL. Responses included the following: “eBay,” “Just talk to the cool vaper kids at your school lol. Almost every single middle school/high school these days tends to have such a group, and I am sure they have means/would be glad to sell you a real juul,” “Literally any gas station ever. As long as you look like you’re old enough to drive, most workers don’t [care]. If they ask for ID just give them ‘your birthday.’” “Go from gas station to station to gas station that’s how I got mine.”

You get the picture. If a kid wants to find a JUUL, he/she can figure it out.

What are the health risks of JUULing?

There is a common misconception among teens that JUULing and e-cigs are safe because they were designed to help adults quit smoking. While they are safer than smoking cigarettes, they are far from safe. The same cancer-causing lung issues are in e-cigarettes. Nicotine is damaging to brain development, which is especially worrying for people whose brains are still growing, like high schoolers. Nicotine is also addictive.

E-cigarettes are also very new, which means that there are fewer regulations in place. For example, the FDA has banned other flavored drugs such as cigarettes and tobacco products, but not yet in e-cigs.

E-cigs have a different health issue than cigarettes, which is a result of the inhalation of vaping liquid. The liquid is usually a combination of propylene glycol, vegetable glycerine, flavors, and nicotine or hash oils. The long-term effects are still unknown. Think about how people started getting lung cancer from non-stop cigarette smoking in the 50s and 60s — the generation that is mostly in their 80s and 90s now. They had no idea that cigarettes could have such negative effects because long-term research hadn’t been done yet, and that’s exactly what I’m worried about with our kids today. None of us knows the consequences, and we won’t know them until the current batch of teenagers is older.

According to the American Lung Association, diacetyl, which is found in e-cigarettes, causes Popcorn Lung. You may remember diacetyl from popcorn products, when it was linked to factory worker death and bronchiolitis obliterans, which is a serious lung disease. It caused such a stir about a decade ago that it was quickly removed from all popcorn products… but the same chemical is found in most e-cigarettes today, along with two other harmful chemicals: pentanedione and acetoin. Diacetyl scars the tiny air sacs in the lungs, resulting in the thickening and narrowing of the airways. Even if there is no nicotine present, kids are still breathing in hot liquids full of chemicals, which is harmful by itself.

What bothers me the most is that sales of regular cigarettes to teens have dropped in the past few years. To me, this means that vaping companies are using innocent, young children to make money, which horrifies me. Many experts also say that e-cigs are a gateway to regular cigarettes, which have been widely found over the years to be a gateway to other drugs as well.

In addition, we know that kids are using e-cigarette devices to smoke pot. Why? Well, for one, the smell is much more disguised so it can go unnoticed.

Another scary thing that kids do with e-cigs is something called “dripping.” Dripping is a more labor-intensive way to vape, in which a user manually puts a few drops of liquid directly on the exposed heating coil of the e-cigarette. The flavor, direct hit, and cloud intensify the user’s experience of vaping, which is why people take the extra time and effort to drip. Studies have shown that dripping also releases much more harmful chemicals than just smoking the e-cigarette.

How do I know if my child might be using JUUL?

  • Dehydration – Propulene glycol is a major ingredient in vaporized liquids. This chemical holds water molecules in the body, which results in increased thirst.
  • Aversion to Caffeine – One of the side effects is not wanting caffeine, so if your kid all of a sudden doesn’t want the coke they always ask for, it could be a sign.
  • Needing a Hit – If your child is addicted, they may need a hit every hour, or even less. They may disappear to the bathroom or their room every so often to vape.
  • Nosebleeds – The same effect that causes dehydration also dries out nasal passages, which sometimes leads to bloody noses.
  • Change in Habits – Some parents told us that they recognized the signs after the fact — their child had been doing well in school, and all of a sudden started getting Cs and Ds. Keep in mind that this could be related to something entirely different, so it’s always good to look into it.
  • Scents – There isn’t a distinct odor like with weed or cigarettes, but sometimes you can catch a whiff of flavors like mint, fruit punch, or candy. If there is no gum, candy, or juice around, there is reason to be cautious.

What are schools doing about the problem?

To be clear, this is happening in public schools and in private schools. It’s happening within all demographics, across the entire country. Don’t think that your child is exempt from this trend.

I talked with the assistant principal at my daughter’s school and he said that, unless they are specifically told who the people using are, the only thing that the school can do is monitor bathrooms and other parts of the school in which kids are likely to sell JUUL. I also went to the governor’s office, and they said that a lot of people have been complaining about vaping in schools. In middle schools, administration is trying to be proactive, incorporating drug-related education into the curriculum, monitoring hallways and bathrooms, etc.

However, as parents, we know that those steps simply aren’t enough and unfortunately, not being informed is the worst thing we can do

What can I do?

How do we raise healthy kids in this society where things are so accessible? I strongly feel that this is about the community! We all have to work together to fix this. I want to call on each and every one of you to help me out.

I started a list of helpful tips from my friends who have teenagers. Here is the start of an eventual longer list of suggestions:

  1. Urge schools to bring addiction specialists to speak with students about the dangers of drugs.
  2. Urge schools to perform random searches in bags.
  3. Urge schools to monitor areas where kids sell, and take actions that will prevent kids from selling drugs in schools.
  4. Get involved in the DOE, and invite other parents to as well.
  5. Talk to your kids about the dangers of e-cigarettes, whether you think they may be using them or not. Some kids told me that they didn’t know there were any dangers because it “didn’t seem like as bad of a drug as cigarettes.” Talk to your kids!

Here’s a suggestion I love from a friend. At first, it might seem like over monitoring or policing your kid too much, but you may find that it helps your relationship with your kid, and turns into a positive thing. I definitely think it’s worth a try. She bought a nicotine tobacco testing kit, which can be found on Amazon for under $10, and she told her son that she may use it in the future. She hasn’t used it, but the fact that her son knows that she has it means that he doesn’t want to smoke or vape. He told her that it actually helped him get out of being pressured by his friends because he could use the excuse that his mom would test him at home if he vaped. It passed the blame to someone else other than him, which gave him an easy out.

What else can you do? Here’s a huge one — let’s come together as a community and figure this out! If you are a parent to a teen, let’s get together in a room with other parents to brainstorm as a team! Let me know if you’d like to join. I am forming a parent group to come up with bigger and better ideas about how we can take action NOW to make a change. To start, we will meet monthly in person with a Facebook Live meeting.

Are you concerned about vaping? What can you do as a parent, and what can we do as a community? I want to start a discussion. We can work together as a community, whether you live near me in Manhattan or across the country. If you want to get together and make a change, message me! Tell me your stories. Tell me your challenges, your advice, your worries, your successes!

Let me know if you’re interested, no matter where you reside. Make your voice heard! I can’t wait to get this started!

If you would like me to connect you with one of our expert therapists or dietitians, please contact me. I look forward to hearing from you!