“Hey Mom, you know Josh, the junior I played basketball with last summer? He’s selling Adderall to ninth graders.”
The sudden appearance of controversial “news” mid-conversation is standard teenage behavior. You can substitute the revelation of any number of transgressions, from dangerous drinking to precocious sexual behavior, for the drug sales, but the result is the same: one speechless parent, one teenager waiting for a reaction. Get it right, and what started off as a dropped bombshell becomes an opportunity.
Option one: Hit the ceiling.
This would be the knee-jerk reaction for many of us. Understandably, because the news and its delivery signal at least two problems. First, we’ve learned that a local teenager is trafficking in a controlled substance. Second, we’re getting the impression that our own teenager thinks this is no big deal. A forceful response – launching into a lecture, threatening to call the cops or at least Josh’s parents – might serve to hammer home the message that the sale of drugs, prescription or otherwise, actually is a huge deal.
But here’s the problem. Most healthy teens have knee-jerk reactions of their own when a parent voices a strong opinion: they feel compelled to take up the opposing side. In fact, I’ve had teens in my practice explain to me that they will refuse to do something they were about to do, such as put away a backpack or take the dog for a walk, if a parent tells them to do it. Blowing a gasket all but invites a teen to retort that “lots of kids take Adderall, why are you freaking out?” even when the teen has his own doubts about Josh’s behavior.
Option two: Let it slide.
Your teen is actually talking to you and telling you about what’s going on at school. A tirade will certainly ruin the moment and might shut down the possibility of valuable future communiqués. Perhaps it’s best to follow your teen’s lead; be cool and leave the line open should other concerns arise, especially ones closer to home.
This isn’t good, either. In my experience, adolescents run other teenager’s behavior past their parents when they’re bothered by it. They usually know that their peer is out of bounds, and they’re confused by his or her apparent comfort with the misconduct, and maybe the fact that other teenagers seem to be too. So adolescents take a flat, even supportive, tone and float these scenarios by adults to gauge their reaction. When parents don’t respond appropriately — when grown-ups don’t act like grown-ups — adolescents feel uneasy.
Option three: Unwrap your present.
Your teen just gave you an opening to have a valuable conversation. Go ahead and accept that gift. Imagine that you’re a journalist who has just been handed a scoop, and begin your evenhanded investigation.
Consider starting with a head tilt and a, “Huh, really?” or gently inquire, “What do you think about that?” (Your child will feel less uneasy already.) Or invite your teenager to join you on a fact-finding mission. Hop online together and research the dangers of taking un-prescribed stimulants, and the legal implications of selling them. If it becomes clear that someone needs to do something, engage your teenager in helping to decide who should do it, and how.
What if it’s too late? You’ve already gone through the roof or taken the alarming news in stride, and the moment has passed. This is still an opening. My favorite parent-teenager interaction is one where the adult finds an opportunity to apologize to the adolescent. It makes the parent more real and imbues the adolescent with dignity, two essential components of any effective parental relationship with a teenager.
Find the moment to say: “It wasn’t helpful when I freaked out. We got distracted from the serious risks that those ninth graders, or Josh, might face if he’s selling his Adderall.” Or “I wasn’t tuned in when you told me about Josh. I understand that you’re not involved in this situation, but there’s some stuff I want you to know.”
Even when they aren’t in the mood for a discussion, there’s value in treating teenagers as the thoughtful young people we want them to be. One longitudinal study asked parents of seventh graders to share their opinions on teenagers in general, then examined how the parents’ views linked to their children’s late-adolescent behavior. Parents who believed teenagers to be difficult, and immune to adult influence, went on to have twelfth graders who were involved in more troubling behavior than those whose parents held a generally positive view of adolescence. In short, teenagers live both up, and down, to expectations.
When we engage earnestly with adolescents around provocative hearsay we are allowed to have critical conversations, communicate high standards and make it clear that we’re available to offer help when needed. Sometimes with teenagers, the best moments start off in the worst way.
ADOLESCENCE is practically synonymous in our culture with risk taking, emotional drama and all forms of outlandish behavior. Until very recently, the widely accepted explanation for adolescent angst has been psychological. Developmentally, teenagers face a number of social and emotional challenges, like starting to separate from their parents, getting accepted into a peer group and figuring out who they really are. It doesn’t take a psychoanalyst to realize that these are anxiety-provoking transitions.
But there is a darker side to adolescence that, until now, was poorly understood: a surge during teenage years in anxiety and fearfulness. Largely because of a quirk of brain development, adolescents, on average, experience more anxiety and fear and have a harder time learning how not to be afraid than either children or adults.
Different regions and circuits of the brain mature at very different rates. It turns out that the brain circuit for processing fear — the amygdala — is precocious and develops way ahead of the prefrontal cortex, the seat of reasoning and executive control. This means that adolescents have a brain that is wired with an enhanced capacity for fear and anxiety, but is relatively underdeveloped when it comes to calm reasoning.
You may wonder why, if adolescents have such enhanced capacity for anxiety, they are such novelty seekers and risk takers. It would seem that the two traits are at odds. The answer, in part, is that the brain’s reward center, just like its fear circuit, matures earlier than the prefrontal cortex. That reward center drives much of teenagers’ risky behavior. This behavioral paradox also helps explain why adolescents are particularly prone to injury and trauma. The top three killers of teenagers are accidents, homicide and suicide.
The brain-development lag has huge implications for how we think about anxiety and how we treat it. It suggests that anxious adolescents may not be very responsive to psychotherapy that attempts to teach them to be unafraid, like cognitive behavior therapy, which is zealously prescribed for teenagers.
What we have learned should also make us think twice — and then some — about the ever rising use of stimulants in young people, because these drugs may worsen anxiety and make it harder for teenagers to do what they are developmentally supposed to do: learn to be unafraid when it is appropriate to do so.
As a psychiatrist, I’ve treated many adults with various anxiety disorders, nearly all of whom trace the origin of the problem to their teenage years. They typically report an uneventful childhood rudely interrupted by adolescent anxiety. For many, the anxiety was inexplicable and came out of nowhere.
OF course, most adolescents do not develop anxiety disorders, but acquire the skill to modulate their fear as their prefrontal cortex matures in young adulthood, at around age 25. But up to 20 percent of adolescents in the United States experience a diagnosable anxiety disorder, like generalized anxiety or panic attacks, probably resulting from a mix of genetic factors and environmental influences. The prevalence of anxiety disorders and risky behavior (both of which reflect this developmental disjunction in the brain) have been relatively steady, which suggests to me that the biological contribution is very significant.
One of my patients, a 32-year-old man, recalled feeling anxious in social gatherings as a teenager. “It was viscerally unpleasant and I felt as if I couldn’t even speak the same language as other people in the room,” he said. It wasn’t that he disliked human company; rather, socializing in groups felt dangerous, even though intellectually he knew that wasn’t the case. He developed a strategy early on to deal with his discomfort: alcohol. When he drank, he felt relaxed and able to engage. Now treated and sober for several years, he still has a trace of social anxiety and still wishes for a drink in anticipation of socializing.
Of course, we all experience anxiety. Among other things, it’s a normal emotional response to threatening situations. The hallmark of an anxiety disorder is the persistence of anxiety that causes intense distress and interferes with functioning even in safe settings, long after any threat has receded.
We’ve recently learned that adolescents show heightened fear responses and have difficulty learning how not to be afraid. In one study using brain M.R.I., researchers at Weill Cornell Medical College and Stanford University found that when adolescents were shown fearful faces, they had exaggerated responses in the amygdala compared with children and adults.
The amygdala is a region buried deep beneath the cortex that is critical in evaluating and responding to fear. It sends and receives connections to our prefrontal cortex alerting us to danger even before we have had time to really think about it. Think of that split-second adrenaline surge when you see what appears to be a snake out on a hike in the woods. That instantaneous fear is your amygdala in action. Then you circle back, take another look and this time your prefrontal cortex tells you it was just a harmless stick.
Thus, the fear circuit is a two-way street. While we have limited control over the fear alarm from our amygdala, our prefrontal cortex can effectively exert top-down control, giving us the ability to more accurately assess the risk in our environment. Because the prefrontal cortex is one of the last brain regions to mature, adolescents have far less ability to modulate emotions.
Fear learning lies at the heart of anxiety and anxiety disorders. This primitive form of learning allows us to form associations between events and specific cues and environments that may predict danger. Way back on the savanna, for example, we would have learned that the rustle in the grass or the sudden flight of birds might signal a predator — and taken the cue and run to safety. Without the ability to identify such danger signals, we would have been lunch long ago.
But once previously threatening cues or situations become safe, we have to be able to re-evaluate them and suppress our learned fear associations. People with anxiety disorders have trouble doing this and experience persistent fear in the absence of threat — better known as anxiety.
Another patient I saw in consultation recently, a 23-year-old woman, described how she became anxious when she was younger after seeing a commercial about asthma. “It made me incredibly worried for no reason, and I had a panic attack soon after seeing it,” she said. As an older teenager, she became worried about getting too close to homeless people and would hold her breath when near them, knowing that “this was crazy and made no sense.”
B. J. Casey, a professor of psychology and the director of the Sackler Institute at Weill Cornell Medical College, has studied fear learning in a group of children, adolescents and adults. Subjects were shown a colored square at the same time that they were exposed to an aversive noise. The colored square, previously a neutral stimulus, became associated with an unpleasant sound and elicited a fear response similar to that elicited by the sound. What Dr. Casey and her colleagues found was that there were no differences between the subjects in the acquisition of fear conditioning.
But when Dr. Casey trained the subjects to essentially unlearn the association between the colored square and the noise — a process called fear extinction — something very different happened. With fear extinction, subjects are repeatedly shown the colored square in the absence of the noise. Now the square, also known as the conditioned stimulus, loses its ability to elicit a fear response. Dr. Casey discovered that adolescents had a much harder time “unlearning” the link between the colored square and the noise than children or adults did.
IN effect, adolescents had trouble learning that a cue that was previously linked to something aversive was now neutral and “safe.” If you consider that adolescence is a time of exploration when young people develop greater autonomy, an enhanced capacity for fear and a more tenacious memory for threatening situations are adaptive and would confer survival advantage. In fact, the developmental gap between the amygdala and the prefrontal cortex that is described in humans has been found across mammalian species, suggesting that this is an evolutionary advantage. This new understanding about the neurodevelopmental basis of adolescent anxiety has important implications, too, in how we should treat anxiety disorders. One of the most widely used and empirically supported treatments for anxiety disorders is cognitive behavior therapy, a form of extinction learning in which a stimulus that is experienced as frightening is repeatedly presented in a nonthreatening environment. If, for example, you had a fear of spiders, you would be gradually exposed to them in a setting where there were no dire consequences and you would slowly lose your arachnophobia. The paradox is that adolescents are at increased risk of anxiety disorders in part because of their impaired ability to successfully extinguish fear associations, yet they may be the least responsive to desensitization treatments like cognitive behavior therapy precisely because of this impairment.
This presents a huge clinical challenge since young people are generally risk takers who are more prone to exposure to trauma as a direct result of their behavior, to say nothing of those who were exposed to the horrors of the wars in Iraq and Afghanistan or the mass shootings like those in Newtown and Aurora. Many of them will go on to develop post-traumatic stress disorder, which is essentially a form of fear learning. Now we have good reason to think that exposure therapy alone may not be the best treatment for them. A recent study of children and adolescents with anxiety disorders found that only 55 to 60 percent of subjects responded to either cognitive behavior therapy or an antidepressant alone, but 81 percent responded to a combination of these treatments. And in another study, there was preliminary evidence that adolescents responded less well to cognitive behavior therapy than children or adults.
This isn’t to say that cognitive therapy is ineffective for teenagers, but that because of their relative difficulty in learning to be unafraid, it may not be the most effective treatment when used on its own.
And there is potentially something else to worry about with our anxious adolescents: the meteoric rise in their use of psychostimulants like Ritalinand Adderall. In theory, stimulants could have a negative impact on the normal developmental trajectory of anxious teenagers.
According to the health care data company IMS Health, prescription sales for stimulants increased more than fivefold between 2002 and 2012. This is of potential concern because it is well known from both human and animal studies that stimulants enhance learning and, in particular, fear conditioning. Stimulants, just like emotionally charged experiences, cause the release ofnorepinephrine — a close relative of adrenaline — in the brain and facilitate memory formation. That’s the reason we can easily forget where we put our keys but will never forget the details of being assaulted.
Might our promiscuous use of stimulants impair the ability of adolescents to suppress learned fear — something that is a normal part of development — and make them more fearful adults? And could stimulants unwittingly increase the risk of PTSD in adolescents exposed to trauma? In truth, we haven’t a clue.
But we do know this: Adolescents are not just carefree novelty seekers and risk takers; they are uniquely vulnerable to anxiety and have a hard time learning to be unafraid of passing dangers. Parents have to realize that adolescent anxiety is to be expected, and to comfort their teenagers — and themselves — by reminding them that they will grow up and out of it soon enough.
It’s that time of year again: daylight savings, when we turn the clocks forward and, ugh, lose an hour of sleep.
Already wondering how it’s going to go on Monday morning when your teenager’s alarm goes off? Probably not so great, says Sasha Carr, Ph.D., a certified sleep consultant with the Family Sleep Institute and founder of Off to Dreamland.
“If you have a teenager, you should be concerned,” explains Carr. “It’s going to be rough on them on Monday morning to get up for school.”
Carr has some suggestions for making the transition easier. These include:
Turn your clocks forward early on Friday evening, not late Saturday when you’re headed to bed. Yep, you read that correctly. By changing your household routine two days early, your teenager will have time to adjust to daylight savings over the weekend, making Monday morning all the easier. “Start daylight savings as of dinner on Friday. That gives that cushion of the weekend. It also helps that on Saturday and Sunday morning, your teenager doesn’t have to get up for school.”
Or, if you’d rather ease into it, you can move your clocks forward a half hour on Friday and then another half hour on Saturday, adds Carr.
Don’t let your teenager sleep in. Teenagers are biologically designed to want to go to bed later at night and sleep later in the morning than children and adults. But this weekend in particular, says Carr, parents should get their teenagers up at a reasonable hour. “When a teenager sleeps super late on Saturday or Sunday morning and then has trouble getting up on Monday morning, that’s called weekend jetlag,” explains Carr. “I would suggest, especially this weekend, trying to get them up around 8 a.m.”
Turn off computers, phones and any other devices, even the television, for 30 minutes before bedtime. “Staring at a screen does a number on melatonin, which is the most important sleep hormone we have,” explains Carr. “It’s been shown that just looking at a screen for even 10 seconds in the half hour before you’re trying to go to sleep will affect the secretion of melatonin in the brain … it’s like turning all the lights on in your house.”
The good news, says Carr, is that within a few days, your teenager should have made up for whatever sleep deficit daylight savings causes.
But in the meantime, anticipate some grumpiness.
“Unfortunately, I would put teenagers in the group that has the hardest time with daylight savings,” says Carr. “But they eventually make up for it because they’ll start to go to bed earlier once they make the adjustment.”
Daylight savings starts at 2 a.m. on Sunday, March 10.
Struggling to Talk to Your Teenager? The Greatest Lesson I Ever Learned.
By Andy Braner, President/CEO of KIVU
So many of my friends with teenagers complain about the one-word answers they get when they attempt to communicate. They find it incredibly difficult to cultivate meaningful conversations with the very people who live under their roofs. I’ve heard hundreds of parent/teen conversations that sound something like this:
“Hey Honey, How was school?”
“Did you have a chance to do your homework?”
“What did you think about the movie you went to last night?”
And those of us with teenagers understand how complex it is to crack open a conversation with our teens. It seems like just yesterday they were running through the house longing for our attention, and then one day they woke up and turned into the one-word Zombie clan. I know several parents who ask themselves, “Why should I even try?”
Not long ago, I learned a valuable lesson about talking with my kids. I have to approach their world where they are.
So often, I counsel frustrated parents who feel “Well, he should do this,” or “she should do that.” We all quickly forget that NOBODY wants to have someone tell them what to do. Why should our teenagers feel any different?
A long-time mentor friend of mine said once, “if you want to talk to your kids, you have to meet them where they are.”
So… I started to work this out in real time.
When my youngest son was growing through elementary school, I noticed he had a gift for engineering. He loved building things. Blocks, Forts and especially LEGOS were his passion. He loved doing math, following instructions and watching his creation emerge from the box of 1,000 pieces.
Can you imagine?
What do you do when you have a 5-year-old who can sit for hours on the kitchen floor putting together the Death Star Lego set with 5,000 pieces? If you have a kid like this, let me be an encourager for a minute and say you have a kid with a gift.
I remember hearing my mentor’s words echo in the stillness of my own desire to connect with my son: “If you want to talk to your kids, you have to meet them where they are.”
Now, for a little background, I graduated with a degree in Theater Performance. I’m an artist. One thing you must know about artists — we don’t do Legos! Our brain functions differently. Sitting down to count the number of nipples on a block to make sure it fits in another is the farthest thing from what I think is a good time. But for the sake of my son, I started sitting amongst his piles of Legos with him.
For years, I forced myself to sit and learn to be interested in what he was interested in, and guess what? Today we have an incredible friendship. All those hours I spent meeting my son where he was and trying to be interested in the things he found valuable are paying off now. Sure, we have our fights. I have to correct, mentor and parent him. But for the most part, we’re good friends. He knows I love him and value his opinion. I know better how his mind functions and what makes him tick. He knows I’m in his corner and am his biggest cheerleader and I know he respects what I think. This is the bottom line of what it means to develop meaningful connections in families, with friends and certainly with people we work with.
If you’re having trouble connecting with your teen today, step back, take a deep breath, begin to notice the things they find valuable and start to engage.
You’re never going to understand the heart of your student by just letting them “figure life out.” After all, we’re parents, right? It’s our job, our duty and our incredible responsibility to teach, to train and to mentor our teens so they can go on to have long-term healthy relationships. If you can model for your teen what it means to connect, they will take this lesson with them wherever life unfolds.
Be encouraged today.
There are answers to helping parents connect with their kids, even when it seems like you don’t.