Coping With Your Teen During a New School Year

 By Ana Radovic, MD, MSc, Fellow, Division of Adolescent Medicine, Children’s Hospital of Pittsburgh of UPMC

radovic-stakic_anaSchool is back in session. For many parents of adolescents, the back to school transition can be hard. How can you help your teen prepare so he or she is ready for the exciting opportunities ahead?

Along with growth spurts, the adolescent brain is developing by leaps and bounds. Thanks to new technologies such as functional MRIs or brain scans which show us which parts of the brain are active during different brain activities, we have learned the adolescent brain has some amazing superpowers. This is due to the brain’s plasticity — its ability to make and remake new connections over and over again. Once the adult brain is formed, these connections are more ingrained, and as they say, “it’s hard to teach an old dog new tricks.”

So adolescence is the best time to help develop those good brain connections. But how do you know if your teen’s behavior is normal and when you should worry?  One way is to think about what it takes to help your teen’s growing brain stay healthy.

Adolescents should be:

Sleeping a regular amount. Some teens need less sleep than others, but most function the best on 9 hours of sleep at night. Teens’ body clocks change. They may not be able to fall asleep until later at night, and they may feel cranky if they have to wake up too early in the morning.  A cause for concern is a teen who sleeps a lot, to the point of missing activities he or she normally would have thought were fun. Or a teen who has a very difficult time waking up, or one who seems to be very active for several days on little to no sleep.

Interested in new activities. Adolescence is a time of exploration, identity-formation, 89692194_smalland growing independence. Teens should be excited about learning to drive, new social opportunities, and more independence from their family. Some teens say “I’m bored” but in fact they show enjoyment and pleasure in a variety of activities — even video games or talking to peers. A cause for concern is if a teen says “I’m bored” and doesn’t seem to find enjoyment in much at all. Other causes for concern are a teen who blames him- or herself for different problems, or a teen who is having difficulty concentrating, staying on task, or has an overall lack of energy.

Having a growing appetite. Adolescence is a time of rapid growth. Research points to an increased need for calories during this time than in adulthood. A low appetite in an adolescent may be a sign of a medical or mental health illness. Girls in particular need balanced nutrition for bone development and menstruation. Teens may start to worry about their body image, but may need to speak with their doctor if they are restricting food, dieting, or purging (diet pills, laxatives, excess exercise, or vomiting).

Appropriately anxious. Many adolescents experience some heightened stress surrounding changing school environments, peer groups, becoming more independent from parents, and thinking about how others will respond to their changing appearance and behavior.  This anxiety or worry should not prevent the teen from going to school or participating in social activities. It should not lead to panic attacks.  Some teens have a hard time recognizing that they feel anxious. Instead or in addition to, they may have physical complaints such as headaches, abdominal pain, or abnormal periods. Anxiety can contribute to and worsen many physical complaints, and treating the anxiety can improve these symptoms. There are effective treatments to decrease anxiety and related physical symptoms so that your child does not have to miss school. Often, missing school can make these symptoms worse.  Promoting structure and regular activities can lead to improvement.

Avoiding substances. Most adolescents do not abuse alcohol, marijuana, or drugs. Not only are these substances illegal for teens, but they put the growing adolescent brain at risk. The latest studies show adolescent rats exposed to marijuana have greater difficulty learning as adults. Abusing substances may be a way for a teen to deal with uncomfortable feelings like anxiety or depression. Alcohol and other drugs can put adolescents in risky situations including violence and legal involvement. Parents should talk to teens about ways to stay safe if they find themselves at a party where there is alcohol or other drugs (like a code word when your son or daughter calls you, so you know your teen needs you to come pick him or her up).

Not threatening suicide. For most parents, it is difficult to believe that your child would ever think of harming him or herself. Some comments said in passing or in a fit of emotion like, “I just wish I wasn’t around anymore” may be easy to chalk up to an argument. It is important to explore these comments and understand what the adolescent means. Asking about suicide does not lead to an adolescent harming him- or herself. If your teen makes a comment like this, let him or her know you care and are concerned. Ask if he or she can tell you more about how he or she feels and try to listen closely. Your child is more likely to be open with you if you show him or her you can listen without lecturing. If you feel you are in a crisis situation, or just need help trying to figure out what to do, you can always call the RE:SOLVE Crisis Center hotline toll-free at 888-796-8226.

dv1644065As always, trust your intuition.  If you think your teenager is changing, and something doesn’t seem right, talk to your child’s doctor. It is not normal for a teen to want to miss multiple days of school. This may be a sign your son or daughter is suffering from anxiety, depression, an interpersonal conflict at school, or another medical or mental health problem. Talk to your primary care physician or visit us in the Adolescent Medicine Clinic. A physician can have a confidential conversation with your teen or perform assessments to identify if there is something else going on. Even if your child never had problems before, mental health disorders such as depression and anxiety usually make their first appearance during adolescence. Suicidal behavior or thoughts and cutting or self-injurious behavior should not be ignored. There are people who care and who are trained to help so that all teens can be healthy and thrive.

To schedule an appointment in the adolescent medicine clinic, call 412-692-6677 or visit www.chp.edu/CHP/am.

For further information and guidance visit:

http://store.samhsa.gov/product/Navigating-the-Teen-Years-A-Parent-s-Handbook-for-Raising-Healthy-Teens/PHD1127

– A great and free handbook from the substance abuse and mental health services administration about raising a healthy teen.

http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Keyword.aspx

-American Academy of Child and Adolescent Psychiatry fact sheets on various topics such as when to seek help or school refusal

http://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/pages/Mental-Health-Tips-Teens-Graduating-High-School.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

-Mental Health Tips for Teens graduating High school

http://www.nami.org/Template.cfm?Section=Child_and_Adolescent_Action_Center&template=/ContentManagement/ContentDisplay.cfm&ContentID=24806

– The National Alliance on Mental Illness’ guide for what families should know about adolescent depression and treatment.

http://www.worrywisekids.org/node/40

– What schools can do to accommodate children with anxiety