Post on 06-Feb-2018
transcript
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