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Natasha J. Thomas, MD

8 Things Your Teen Needs for Mental Wellness (Not One is Electronic)

Updated: May 11, 2021


A few days ago, a mom asked me how to help her teens navigate the current landscape of our world. It’s a fair question, becoming more common daily. School shootings, cyberbullying, and social media overshadow the world of a high school experience that used to be about classes, friends and Friday night football.

I went to Mainland High School in Daytona Beach, FL in the mid-1990s. It was an idyllic experience. We had great athletes, an awesome marching band, and a huge community of teachers and parents that supported us. Our biggest worries had to do with the social things in school like lunchtime seating, picking the right outfit and making plans for homecoming dates.

And the biggest threat to our safety was never anything more severe than a thunderstorm that ruined hairstyles or sneakers. Anyone who was there then would tell you the exact same thing. Mainland High School in the mid-90s was safe and fun. I could never imagine that two years after graduation, I’d be sitting in my college dorm with my roommate watching news coverage of the Columbine shooting.

Now, I’m aware that growing up in 1990s suburbia afforded certain comforts and security that might be missing from other times in US history and from urban areas in the country. But the thing is, I work and live in a small suburb - in some ways similar to Daytona, now. And despite being affluent, well-loved and integrated, kids in suburbia are NOT alright.

An unprecedented number of teens are experiencing depression, anxiety, panic about school assignments and exams, and school absence due to fear of bullying, failing classes and social awkwardness. Some are worried about gender and sexuality issues. Others are scared for their safety. For the first time I heard a high school student say she was “officially afraid to go to school” a week after the Parkland shooting.

At one point, it was reported that as many as half of our teens were harming themselves intentionally to deal with their emotions - with cutting and burning being the most common forms of non-suicidal self-injury. Teens are trying to navigate the world of physical intimacy. They may be experimenting with drugs. Many have abandoned their faith or religious upbringing. That is not totally unusual in adolescence. But my concern is that in place of their faith, spirituality or beliefs, some teens are deciding life has no purpose.

They believe that following someone’s social media posts or gaming with them online is “the same thing as hanging out with friends.” They are more “connected” than ever but repeatedly relate to me the feelings of emptiness and loneliness. These are the reasons they are killing themselves, with suicide being the 3rd leading cause of death in people ages 15 to 24 in the US.

The children are always the future of a nation. Looking at things, I’d say we’re in a bit of a national crisis. Our kids don’t need another iPhone release, they need reconnection to themselves, their minds, their families and their purpose, today!

When I talk with my adolescent patients, I notice different kids from different schools mention the exact same struggles. They feel they’re lacking something but can’t quite put their collective finger on it. After our talks, here’s what I see they need most:

1. A Sense of Self

Understanding and defining the self is an essential first step to mental wellness. It requires the insight that one has essential traits distinguishing them from others - traits that we come to love or tweak to improve. Through experiences, we understand our beliefs, values and direction in life. In the best case scenario, we become satisfied with the type of person we are. But if not, that's a set up for poor self-esteem.

Developmental psychologist Erik Erikson's well-known Psychosocial Stages theory states that in adolescence, achieving identity is the major milestone. Failure to complete this level of development not only leads to confusion (Erikson called it Role Confusion) but it also impairs further development in adulthood - such as the ability to have close relationships, be productive in life and gain wisdom that promotes understanding of life's course and purpose.

To help your teen develop a sense of self, promote times of self-reflection. This is essential in a world with an overwhelming amount of external stimuli. Teach them to take time, even 5 minutes or less a day, to reflect on themselves. Some cultures call for a nightly ritual of reflecting on one's actions during the day. In the US, we might be more inclined to keep a journal of sorts. You can start a routine in the evening where the family takes 5 minutes of silence to reflect on their day and how they "showed up" in the world. You can provide prompts for the family to ponder, asking things such as, "Did you meet an opportunity for kindness today? How did you respond?" Emphasize that this is not a time for judgment or criticism of the self, it is a chance to attune the mind. It is a time to make the person you are and the person you want to be line up - promoting self-love and acceptance. Teens can record their responses in an actual journal, on their phones or even make a video.

2. A Sense of Community

I have noticed a stark absence of community in many teens' lives - and it's concerning. Outside of participating in school sports, the sense of belonging to a group seems very thin. In my opinion, community does not just mean a group of friends. Instead, community should comprise children, adults and elders as a continuum of being - each group supporting, encouraging and learning from the other. The value of living with a strong sense of community is that it validates you. It says you matter to us, you represent us, we exist because of and for you. In a teen that is developing their self-concept and self-love, community promotes the drive to do well, a sense of purpose, and makes them feel accepted.

There is a traditional Zulu word, Ubuntu, which is loosely translated to mean "I am because we are." It speaks of the bond between all humanity, starting first with your family and local community.

If your teen cannot point to children, adults and elders to whom they are connected, you may consider helping them to find their village. But, if they don't have a community or village, that means you probably don't either. Some find it in social groups, faith communities, neighborhoods or in reconnecting with friends (and their children). And if you don't find it - create it! Reach out to others, invite people out, create a neighborhood group. Be intentional.

3. A Sense of Faith

I know this topic may be one of debate. However, it is very simple. For most people, having something to believe in is a comfort. As a psychiatrist, I can say that I have found healthy faith to be very helpful in my patients' recovery. Healthy faith is faith that doesn't fantasize about "going to be with Jesus" or other such thoughts as a way to romanticize suicide. If you hear those types of thoughts in your teen, seek help right away.

In my sessions with patients I usually ask these two questions:

  • "Are you part of a religion, spiritual system - or not really?"

  • " Does your belief system help you cope when you're having a hard time?"

My role in a person's life is not to judge or engage them in theological debate. In my office, your beliefs are your beliefs. My job is to help you find ways to find meaning and strength as coping tools.

Most teens tell me they're "not really" religious or spiritual or say, "I'm still trying to figure that out" (a very honest answer). Some find their faith doesn't really help at all - which might speak to many different things that result in them not feeling connected to those specific "beliefs."

However, some researchers have found that children and teens raised within faith traditions (doesn't matter so much which one) have less depression, less incidents of suicide, and actually have identifiable changes in the structure and thickness of the brain that are thought to prevent mood difficulties and cognitive decline in adulthood. Dr. Lisa Miller, author of "The Spiritual Child", is one such researcher.

4. A Sense of Purpose

Do you ever ask your teen why they feel they're here? This is a question that I garner a lot of information from in teens and adults alike, although it's much different to me when an adult responds to the "what's your purpose" question with "I have no idea." In teens, I expect that response. In fact, I'm excited to usually be the first to ask them that question. Even if they have no answer, it puts a spark in them. I can see it happen.

Imagine you have a 15-year old kid in front of you that seems to hate everything about life. You ask why they're in your office, they shrug and look at their mom. You ask them how they've been feeling and they again look at mom and say, "I don't know, they [parents] think I'm depressed, I'm fine. They just get on my nerves." You abandon that line of questioning, it's just a tester to see what kind of conversation you're going to have. With most teens, starting at who they see themselves to be helps to lower their resistance to talking. So you ask about class and friends and hobbies. And when you ask about purpose they say they don't know or don't have one. I love this part!

I respond by pointing their attention to a container of pens on my desk and gently say, "how could you not have a purpose - even this pen has a purpose?! You have a purpose, you just don't know what it is yet." And they stare at the pens. A seed is planted and it's my hope that they never lose sight of that symbol, no matter how low they may feel. Usually we discuss natural talents and gifts from there, as possible indicators of purpose. And they completely engage at that point. It's a beautiful thing to see.

Ask your teen about their purpose. If you need to, you can use the pen thing!

5. A Sense of Service

Service to the community in the form of volunteerism is one of the best things your teen can do for their mental health, the community and their academic future - even setting them up for success in their chosen career. Studies have determined that there is a direct correlation between volunteerism and reported levels of happiness. The more we serve, the happier we feel.

Just as in adults, volunteering offers teens the ability to see how they can be positive change agents in the world, impacting the lives of others for the better. It enhances their feelings of purpose, while teaching empathy, appreciation and generosity. It will also give them an opportunity to meet new friends, enhancing their sense of community. As an added benefit, many volunteering opportunities develop skills that can be used once your teen has completed their academic training and is becoming part of the workforce.

6. A Sense of Accountability

Stop and answer this question: what are your teen's responsibilities? I could be wrong, but I imagine the majority of readers will list things that are school-related. Perhaps your answers have to do with extracurricular activities at school. And most likely, you've thought of "getting an education" as their primary responsibility.

However, some believe that based on comparative research that looks at US teens' level of responsibility, our kids could definitely benefit from taking on more. Yes, I know, they are overburdened with school assignments. But just working on school assignments does not build a complete picture of skills that will be needed in adulthood. In fact, aside from potentially teaching self-discipline and perhaps providing slightly increased mastery of subject matter, homework may be of limited value in character development. As such, many school models have moved away from nightly homework.

Consider adding more to your teen's plate. On top of their household chores, enlist them in helping with essential household functions (like preparing meals) or even allow them to help you where they can with your work.

Building a sense of accountability builds self-agency. Having a responsibility and meeting it builds confidence. It gives teens the acknowledgement of the journey they are traversing - moving from childhood to adulthood. Accountability can help prevent feelings of powerlessness - and the anger and depression that follow. When you hear your kids raging against your lack of trust in them, it is not freedom but accountability they're seeking.

7. A Sense of Ritual

Why is it that we lack ritual in general American culture? I don't mean something specific to your family, church, or sports teams - I mean something that we all do? Cultures and religions that promote the Coming of Age ritual in early adolescence instill an invaluable gift in the heart of the teens that are able to experience it.

I am of the very strong opinion that so many American teens feel lost because they never complete rituals that mark transition from childhood - and mark the beginning of the journey to adulthood. Marking the ending and beginning of things is human nature - but unless you are practicing in certain traditions like Judaism (and have a Bar Mitzvah) or Latina and have a Quinceanera, you may go from childhood, through puberty and right out of high school without a single ritual before graduation marking your transition. Graduation is great, but the transition happens around age 12 or 13, not 17 or 18.

If you are not part of a culture or community that has a recognized Coming of Age ritual for your adolescents, seek one out or create one! Ritual is symbolically rich - and therefore massively important in the human psyche for understanding all transitions and major events in life.

8. A Sense of YOU!!!

The major accomplishments of adolescence center primarily around the development of identity, as well as acquisition of skills necessary to live independently. It has been theorized that conflict between teens and parents is a natural side effect of adolescents gaining their independence. Different people hold very different ideas of whether this conflict, "teenage rebellion" and other complications, are actually necessary - or if in accepting this idea, we give our teens an excuse to be disrespectful. We're missing the point with that debate, though. Despite all our postulating on why they struggle with parents, my clinical experience shows teens are often behaving badly when they lack one powerful thing from their parents - authenticity.

I truly believe that no one will ever know us as well as our children. They know our public faces, work voices, and because they hear mostly everything we say, they know how we truly feel about most things - things we'd never say in public. However, often in assuming the role of parent, we stop being human with our children. We can be a bit like wardens. We parent from fear - fear that our kids will fail, which we think will make us look like failures, too.

When our kids are teens, we become focused on grades, extracurricular activities, the SAT/ACT crunch and college applications. We want to know why they're struggling in this or that class - but only to the degree that it helps us figure out if they need a tutor. And in a last big effort to indoctrinate them, we force feed them every virtue we think they may have missed over the past 15 to 16 years, lecturing as we drive them to activities.

But what our kids really need (and surprisingly want!) is us to show up as ourselves. Our true selves. Not the selves we put on at work, PTA meetings or church. They need us to share what life was really like for us as teens and young adults (you be the judge on the level of detail - certain boundaries don't need to be crossed). They want to know they can tell us things and we'll be able to relate - because just maybe we've gone through a similar experience. I have so many teens say, "I can't tell my mom this, she'd go nuts." Or "my mom THINKS I tell her everything...she thinks we're close, but she panics every time I try to be honest with her, so I just tell her what she wants to hear now."

By the time your child is a junior in high school, they don't really need you to highlight their mistakes (big or small). Instead, they need to hear (or see) how you pick yourself up from wrong choices in life. When you are authentic with them, you give them the permission to be authentic with you. It's only through authenticity that you can understand them. Truly knowing your teen, knowing their thoughts and feelings, will help you give guidance they'll actually use.

Let's hear from you. Comment below to share your tips for promoting mental wellness in your teens!

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