The youth mental health crisis & what parents can do about it
Dr. Krysti Lan Chi Vo and Komal Gulati

While the world continues spinning against the effects of a global pandemic that remains seemingly evasive to our efforts, a second pandemic has been inflicting our youth for much longer. Over the past decade, rates of depression, anxiety, and suicide among youth have increased significantly.

While the world continues spinning against the effects of a global pandemic that remains seemingly evasive to our efforts, a second pandemic has been inflicting our youth for much longer. Over the past decade, rates of depression, anxiety, and suicide among youth have increased significantly. More recently, between 2019 and 2021, rates of depression and anxiety among children doubled, with 25% of kids reporting depressive symptoms and 20% endorsing anxiety.

According to a new 53-page advisory from U.S. Surgeon General Vivek Murthy’s office, America’s youth are no strangers to mental health challenges prior to the pandemic, but he says, “the COVID-19 pandemic further altered their experiences at home, school, and in the community, and the effect on their mental health has been devastating.”

Like physical health, mental health is malleable and amendable to the nourishment we provide. In light of this, the report Protecting Youth Mental Health focuses on practical strategies that young people and their care-givers (both within and outside of the home) can use to safeguard their well-being.

For Young People:

For starters, it’s important to remember that mental health and its challenges are real, and you are never, ever alone in your struggles. Mental health is shaped by so many factors that are out of our control, but there are some we can shape.

Even at the first signs that you may be struggling, please ask for help. Support is out there in so many different forms. It may be a good friend, trusted adult, or any other relationship that makes you feel safe. It is always good to get a professional opinion from a mental health professional, such as a licensed therapist or psychiatrist; the threshold to do so should be minimal. Young people can advocate for themselves by requesting professional help through their primary care pediatrician, school staff, or their parents.

Another powerful way to make connections is through service and volunteering. During times of isolation, like COVID, service can be an incredible reminder that we bring value to the world and can be a source of support for others.

It goes without saying that the last piece is to take good care of yourself. Nourish your body and mind with healthy food and activities. Be intentional about your use of media (social or news). Be mindful about what you consume and how it makes you feel.

Of course, it’s easier said than done. But it’s worth remembering that you do not have to struggle alone, and you can feel better.

For Parents and Caregivers:

One of the ways to foster healthy mental health in our children is to be the best role model you can by taking care of your own mental and physical health and maintaining healthy relationships. Young people soak in what they see around them when it comes to self-care, self-respect, healthy relationships, and behaviors. Be a good resource for your kids.

Encourage your youth to build healthy social relationships with peers. Provide them with a supportive, stable, predictable home and neighborhood environment.

Do your best to minimize negative influences and behaviors in young people’s lives by having tough conversations early – be it about substances or sexuality.

Most importantly, look out for warning signs of distress and encourage help-seeking. Part of this might mean being more attentive to changes in your child’s behavior, socialization, or media use. Make sure they know they are not being policed, but rather supported by you.

Putting it all together:

Psychologically speaking, the single greatest predictor of our happiness and well-being is the social support and connectedness we foster. That means we all have a role to play in supporting one another, in being kinder and more compassionate, especially when it comes to raising our future leaders. As Dr. Murthy says, “The future wellbeing of our country depends on how we support and invest in the next generation."

Rise Above: Second Thoughts Better than the First
Mike Fogel, MA, ATR-BC, LPC

As a child and adolescent therapist, a session sometimes starts with a recounting of the day as follows: Sarah spilled her cereal this morning. “This is going to be the worst day ever!” On the school bus, her best friend had extra bags and couldn’t make room for them to sit together. Sarah simultaneously thought and muttered “Jerk!”. Arriving at school, her first class was her least favorite, math. Sarah’s mood plummeted and she talked back to her teacher. And so it went…

Her day wasn’t dashed because of the cereal or the school bus seat, but because of her immediate thoughts about those experiences. We all have quick, automatic responses to our world, and they can trigger our behaviors.

As a child and adolescent therapist, a session sometimes starts with a recounting of the day as follows: Sarah spilled her cereal this morning. “This is going to be the worst day ever!” On the school bus, her best friend had extra bags and couldn’t make room for them to sit together. Sarah simultaneously thought and muttered “Jerk!”. Arriving at school, her first class was her least favorite, math. Sarah’s mood plummeted and she talked back to her teacher. And so it went…

Her day wasn’t dashed because of the cereal or the school bus seat, but because of her immediate thoughts about those experiences. We all have quick, automatic responses to our world, and they can trigger our behaviors. Sarah called her only friend a jerk today. She felt horrible about it.  I call these FIRST THOUGHTS. They are informed by the emotional parts of the brain and not the rational part. Here are some examples of FIRST THOUGHTS (with the nature of the instinct in parentheses):

  1. I only want what I want, and I want it now. (Inflexibility)
  2. I'm bad at this activity; I must avoid it! (Insecurity, low self-confidence, anxiety)
  3. Hey! You jerk! (Egocentrism, reactive frustration/anger when things don’t go their way)
  4. no, No, NO!! (Uber-control=oppositional defiance)
  5. Everything stinks! This is the worst day EVER! I hate this school! (Distortion, negative thinking cycles)

When your child reacts ineffectively to something or someone, they reveal their FIRST THOUGHT. In teaching child-friendly Cognitive-Behavioral Therapy coping skills over two decades, I noticed a fabulous trend. After an emotional eruption or social miscue, with time and space to think through the reaction, my clients like Sarah were brilliant at identifying resilient thoughts and coping plans. It’s almost as though Sarah said to me, “on SECOND THOUGHT, I could have asked to sit in the seat behind my friend.” Brilliant!

I contemplated, “What if I taught my clients the process of gradually moving their “SECOND THOUGHTS” closer to real time? Perhaps they could even eliminate the unhelpful FIRST THOUGHT entirely.”

Inspired, I began teaching a coping skill called, "RISE ABOVE: SECOND THOUGHTS BETTER THAN THE FIRST”. My clients brainstormed for SECOND THOUGHTS and loved it! Here are sample SECOND THOUGHTS to RISE ABOVE the sample thoughts I listed above. "On SECOND THOUGHT"...

  1. Maybe I can compromise or get may way later to keep everyone calm and happy. (Flexibility and compromise)
  2. I can watch the activity for a while and then try it. (Realistic expectations, self-compassion)
  3. I'll get help from a grown-up or take a break. (Coping)
  4. I will cooperate, so I don't cause an argument or get in trouble. (Anticipating and avoiding negative consequences)
  5. Well at least I still can/have ______. (Seeing the silver lining and resilience)

If you would like to reinforce this for yourself or with your child, here are helpful discussion questions:

  • Why are SECOND THOUGHTS usually better than FIRST THOUGHTS?
  • What are your usual/predictable FIRST THOUGHTS (behaviors) that you make you need to RISE ABOVE?
  • Build on existing strengths. Ask your child what they "ROSE ABOVE" today. Some kids have a hard time remembering. You can dig deeper with, “Was there something you could have gotten upset about but you didn’t?” or “Tell me when you started having an unhelpful reaction, but you THOUGHT AGAIN.”
  • If your child faces adversity or heads down an unhelpful path, redirect with, "Can you RISE ABOVE THIS? Your FIRST THOUGHT IS ____[name it]_____. What’s another way to THINK about this situation?"

A final note: some kids’ SECOND THOUGHTS arrive minutes or hours after the fact. Don’t view that as a failure. Treat any SECOND THOUGHT, even hours later, as a baby step in the right direction and give congratulatory high fives and hugs liberally. With ample repetition and positive reinforcement, your child can move realistic SECOND THOUGHTS ever closer to real time. Keep RISING ABOVE!!

Mike Fogel, MA, ATR-BC, LPC

Author of the Social Emotional Guidebook

Founder/Director of the Art of Friendship Social-Coping Program & Camp Pegasus

 

The Keys to Success for Children with ADHD
Dr. Russell Barkley

All parents want their children to grow into successful adults. Each of us may define success slightly differently, but it’s likely that we all hope our children will grow up to be independent, responsible, self-supporting, and content. The question, when ADHD is in the mix, is how to get them there. As you’ve just read in the Introduction, ADHD comes with a group of challenges that at times may make your child’s prospects of achieving success seem somewhat dim. The impulsiveness, inattention, disorganization, deficient emotional control, and other effects of executive function deficits can make it difficult for your child to make good choices in the moment and plan for a good future, whether that’s later today or 10 years from now.  How can your son or daughter get around these challenges?

All parents want their children to grow into successful adults. Each of us may define success slightly differently, but it’s likely that we all hope our children will grow up to be independent, responsible, self-supporting, and content. The question, when ADHD is in the mix, is how to get them there. As you’ve just read in the Introduction, ADHD comes with a group of challenges that at times may make your child’s prospects of achieving success seem somewhat dim. The impulsiveness, inattention, disorganization, deficient emotional control, and other effects of executive function deficits can make it difficult for your child to make good choices in the moment and plan for a good future, whether that’s later today or 10 years from now.  How can your son or daughter get around these challenges?

THE PROBLEM: It’s very hard to predict outcomes for children with ADHD with any precision—but the absence of a few key factors will make growing into a successful adult much more difficult.

Follow-up studies of children with ADHD into adulthood suggest to some extent that better outcomes are linked to: 

  • Greater intelligence 
  • More education
  • Milder symptoms of ADHD
  • The absence of any other psychological disorders
  • Better family socioeconomic circumstances
  • Having a two-parent household
  • Better neighborhoods 
  • More friends in childhood

If you looked at that list and thought these factors are probably helpful to all children while they’re growing up, you’d be right. But in my decades of experience with families I’ve found that having parents who are active advocates for their children, who recognize that their children have a disorder and need extra support, and who eagerly focus on their children’s strengths is a more important and fundamentally huge benefit.

ADHD is not a gift.  Yet its symptoms may interact with other talents or gifts of the individual, high intelligence, a supportive family or social environment, treatment, and special resources so as to promote success.

And there definitely are success stories among adults with ADHD. A closer look at these successful adults often reveals that they’re doing well today because they have had supportive loved ones surrounding them, particularly their parents.  In fact, I have come to believe that the role of their loved ones is absolutely critical to the success of children with ADHD.

A notable example of how important this kind of support and dedication can be comes from Olympic swimmer Michael Phelps, whose mother and sisters helped him:

  • Channel his energies
  • Focus and develop his athletic talent
  • Find area resources that could further develop his athletic gifts
  • Buffer him from the difficulties he was having with school and provide him with more individualized academic assistance
  • Support him financially and emotionally
  • Keep him so involved and organized that there simply was little if any time for him to get into trouble most days

In general, he advises parents to work as a team with their children and teens with ADHD to help them through their difficulties with handling work and life challenges.  If Michael is any example, and there are thousands of other ones (just Google ADHD success Stories) the loved ones around people with ADHD clearly can have a constructive influence on them.  Most of the children and teens with ADHD that I’ve worked with needed just the right tailoring of a treatment package of medication, educational support, alternative educational routes, parent training in child behavior management, family support, and cultivation of talents to become independent, self-supporting adults.  What they illustrate is that parents need to persevere and often think outside the box.

Looking closely at the role of loved ones—especially parents—in the lives of children with ADHD led directly to the 12 principles in my latest book for parents. But it also helped me identify four keys to success that serve as their foundation: 

Get a Professional Evaluation, Diagnosis, and Treatment

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Identify and Promote Special Talents and Aptitudes

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Find Community Resources to Develop Them Further

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Believe in, Accept, and Support the Child with ADHD