Understanding mental health in adolescents
Meet Swati! She is 16 years old and is studying in grade 10. She is a very chirpy girl with a happy-go-lucky attitude. She loves dancing, reading books and gardening. Swati lives with her parents and younger brother, who love her very much!
However, Swati’s parents have recently been noticing a change in her behavior, attitude and habits, which have them confused and worried. According to her parents, Swati constantly picks fights with them for extremely insignificant things and is rebelling. They have found cigarettes in her bag a few times and when confronted about it, Swati tries to cover it up with very obvious lies. They find her looking and talking to herself in front of the mirror for hours together, with an increased importance given to the way she looks. She always wants to spend time with her friends rather than with family. Her grades have been dropping as well and she does not seem too bothered by it.
Have you noticed similar changes in your child? Why do you think this is happening? Is it normal? What can you do to help?
The period between age 10 and 19 is called adolescence, which marks the transition from childhood to adulthood. This period is characterized by several biological, physical, cognitive, emotional and psychosocial changes.
One would typically notice characteristics such as a tendency to experiment and seek novel experiences, increase in high-risk behaviors and vulnerability, the want for independence, experimenting with romantic/sexual relationships and a search for their own identity. Besides, this is the period during which most of them attain puberty. This causes physical, biological and emotional changes in adolescents, which will drive their actions, habits, likes and dislikes. And this is completely normal!
From one perspective, adolescence is a phase of incredible growth in various areas such as academia, developing and maintaining relationships/friendships, exploring new social and personal identities and developing skills to lead an ‘adult life.’ On the other hand, the risk of developing psychological disorders, adjustment issues, thoughts about suicide, body image issues and self-esteem problems is also high.
Hence, promoting positive mental health during this period will ensure that adolescents have a smooth progression into adulthood.
Importance of mental health in adolescents
According to the World Health Organization (WHO), health is defined as “a state of complete physical, mental and social well-being and not merely the absence of disease.” Mental health is a huge part of general well-being and this has to be addressed in adolescents, even if they do not suffer from any specific problems because of the vulnerability that comes with their age. Hence, regularly staying in touch with them and encouraging them to share or visit a therapist is always a good idea!
About one-fourth of the Indian population are adolescents, according to the 2011 census and as per the National Mental Health Survey of India (2015-2016), 7.3% of the adolescents in India suffer from some form of psychological disorder and mental health problems. However, there is very little being done to address and support the adolescent mental health journey.
According to the WHO, half of all mental health conditions start by the age of 14 years, but most of them go undetected or untreated. Globally, depression is one of the leading causes of illness among adolescents and suicide is the third leading cause of death in 15 to 19-year-olds. Anxiety and mood disorders are 3 times more prevalent in female adolescents than in male adolescents and the reverse is true for attention deficit disorder. Eating disorders such as bulimia and anorexia are also very common among adolescents.
The consequences of not addressing adolescent mental health concerns extend to adulthood, impairing both physical and mental health and limiting opportunities to lead fulfilling lives.
How can parents support?
The stigma around mental health and seeking professional help is extremely prevalent in the Indian society. The transition from thinking of mental illness as something to hide and be embarrassed about to treating it just like any other physical illness is yet to happen.
In the Indian context, there are a number of interrelated risk factors that make an adolescent more prone to developing mental health conditions. These include pre-existing genetic factors, home environment, family type and dynamics, parenting and attachment styles, school environment, peer group and relations, neighborhood, availability and exposure to various types of media, social support, ambiguity in societal values, increasing gap between aspirations and possible achievements, substance misuse/abuse, etc.
In such a scenario, it would be extremely beneficial for adolescents to have parents/primary caregivers who can understand, support, know where to draw boundaries as well as guide them at the same time.
Some ways in which parents can be more supportive of their adolescents through their mental health journey are -
Attend parent training programs, where you will be trained in areas such as assertiveness, communication, goal setting and record-keeping, which will help you better understand your adolescent’s problems, and will provide you with effective skills to handle your adolescent. You can visit a licensed psychologist with a specialization in adolescent therapy to gain more information regarding the same!
Educate yourself about adolescent development, common mental health problems and intervention options along with the rights and resources you have as a parent. You could buy a book about adolescent development, or simply talk to your psychologist to get your questions answered!
Learn to communicate effectively with your adolescent, without judgment and sarcasm. By doing this, you will be creating a safe space for your adolescent, where they feel safe and comfortable to share with you. Talk to them like they are an equal, instead of talking to them like you would talk to a child.
Active listening means to listen attentively while someone else is speaking, understanding, paraphrasing and reflecting back what is said. Empathetic listening on the other hand, means listening to some with empathy (while putting yourself in their shoes). When it comes to talking to your adolescent, you need to practice both! Do not listen just to advice, counsel, reply, refute, change or fix. Listen to understand!
Constantly reassure the adolescent that you have got that back, no matter what! This will enable them that they can share with you, no matter how difficult the situation is, and that you will always be there by their side and support them.
Talk to your adolescent openly about topics that are often considered taboo - periods, sex, mental health, use of substances, gender & sexuality, etc. - and educate them about the risks involved and how they can protect themselves. Then, they will not have to hide anything from you!
Do not force them to open up to you, rather tell them that you are always there to listen, in case they want to talk. Encourage them to see a therapist or the school counsellor regularly. But do not push them!
Lastly, do not neglect yourself! You will have to take care of your own physical, mental and emotional health in order to be there for your adolescent. So do activities that you like, practice mindfulness techniques such as yoga or meditation, talk about what you are going through or what else you could do with a trusted friend/family and visit a therapist yourself!