Absent Fathers Can Lead To Depression In Teenage Girls

0e1380145_istock000002757055mFather’s Day is coming up and I recently read a study out of the United Kingdom published in the journal Psychological Medicine that suggests that young girls who grow up without their fathers turn into depressed teenagers later in life.

It’s well known that depression tends to effect teenage girls much more than teenage boys and that trend stays the same throughout adulthood. New research is suggesting that when young girls  grow up without their fathers, the risk of depression increases with 23% of teenage girls showing signs of tiredness or sadness if they’re separated from their father before the age of five.

According to the study, it also makes them 50% more likely to develop other mental health problems compared to girls whose fathers remained in their lives.

Preschoolers are especially vulnerable with dealing with divorce and separation poorly because they generally do not have a support system of peers or family members.

I took a quick survey of five teenage girls I am working with who have been diagnosed with depression, anxiety, bipolar disorder, bulimia  and substance abuse and four out of five of them were abandoned by or separated from their father at an early age. Some through death, others through divorce or separation.

Many of the teenage girls I work with are suffering from “daddy issues” and are dealing with them in unhealthy ways. Some through self-hatred, others through drugs and alcohol or being extremely promiscuous and unstable in terms of dating and relationships.

Boys tend to handle absent fathers better according to the study, but I would like to suggest that they just express themselves differently and may not show signs of depression we typically look for. Instead boys may be angry, “troubled kids”, or become more withdrawn and reckless. I also think boys have more outlets to let out their frustrations through rough housing, sports and other physical activities.

Both older boys and girls tend to handle separation and divorce better with less instances of depression later in their teenage years, but working with teenagers I have no doubt that the effects of growing up without an attentive and active father are powerful and far reaching.

This is not to say that separation from their father at an early age definitely leads to depression in teenage girls. There are too many other factors such as economic  and social factors that also need to be taken into consideration. Also, girls tend to be more susceptible to personal negative events than boys which can lead to episodes of depression.

I think the take away from this research is not to stay in unhealthy or undesired relationships for the sake of the children because that can also have detrimental effects, but I think it suggests that we need to pay closer attention to young girls who have been separated from their fathers as parents and as those who work with children.

Fathers should stick around and be active in their daughters lives, even if the relationship with the mother has failed. A lot of time men think that they don’t have to be as involved with their daughters, but nothing could be further from the truth.

Mothers on the other hand shouldn’t gloss over the fact that their young girl is growing up without a father and should start looking for signs of emotional or behavioral stress or changes that may warrant attention such as individual, family or group counseling.

The most erratic and unstable young women I work with tend to be the ones who grew up without their fathers and I can only wonder that if they still had good relationships with an active and supportive father, if they wouldn’t be more stable and focused.

Disordered Eating And Body Image Issues In Teenage Girls: Part 1

6a00d8341bf67c53ef014e8c0ffaab970d-800wi (1)Working in a high school with teenage girls, I come across teenage girls with body image issues regularly.

Take for instance, one of my 15 year old clients who is so convinced that she is fat that when I first met her she was only drinking water mixed with apple cider vinegar for breakfast and lunch.

For dinner she would have a very small meal. She was not overweight, but due to teasing about her “putting on some weight” by both her mom and peers, she see’s herself as fat and ugly.

Because of all this, her self-esteem is shot and it’s taken weekly individual therapy sessions and weekly support group sessions to get her to at least start eating a light breakfast and lunch, although she is still struggling with body image and self-esteem issues.

Society Creates Body Image Issues In Girls

Unlike boys, teenage girls are put under immense pressure to be beautiful, thin and feminine in most Western industrialized countries. However, biological changes and weight gain are natural parts of pubertal development.

Like the client I was talking about above, her weight gain seems to be more of a womanly weight gain. She seems to be filling out and taken on the body of a woman, compared to that of a prepubescent child. This natural weight gain that most girls experience during puberty, goes against our cultural’s  view of what being beautiful is, which for women includes extreme thinness.

These are conflicting messages for preteen and teenage girls.

On one hand, they are naturally developing and putting on weight, while on the other hand, they are getting messages from society that says their weight gain is unattractive.

Female identity in one part is defined in relational terms, society says they are supposed to be interpersonal and care about other peoples needs, feelings and interests which makes them more vulnerable than males to other people’s behaviors towards and opinions of them.

Another major part of female identity is beauty. In our culture, physical attractiveness contributes a lot to interpersonal success, which is one of the main reasons females strive to be beautiful, to assure popularity and respect.

Also, physically attractive girls are typically seen as more feminine compared to less attractive girls or girls who challenge our cultures traditional views on femininity through their political views such as feminist, or through their sexual orientation, such as lesbians.

Girls tell our society that they are feminine by being concerned with her looks and trying to achieve our culture’s ideal of beauty.

Because our culture demands that girls care about other people’s opinions and that they are defined by their physical appearance,  which society says includes being very thin, there’s no wonder girls are motivated to pursue thinness, at times by any means necessary including starving themselves to death.

Combine these issues with the natural weight gain of puberty and there’s no wonder many teenage girls develop body image issues.

Many teenage girls I’ve worked with who are physically perfect, not even slightly overweight, some were even underweight,  suffer from intense body image dissatisfaction.

A girl I’ve been working with since last year was naturally thin, yet wanted to be thinner so bad that she starved herself to the point of needing to be hospitalized. Like many of the girls I work with who have body image issues, her pursuit for thinness and beauty was so consuming that almost every other aspect of her life, including her education, goals and future took a back seat.

Eating Disorders

Not all girls with body image issues go on to develop an eating disorder like the young girl I just mentioned above, but many of them will.

Eating disorders are a major concern when it comes to the health of teenage girls with an estimated 1% to 3% likely to meet diagnostic criteria for either anorexia nervosa or bulimia nervosa.

Anorexia nervosa is when someone refuses to maintain a minimal average body weight and has body image disturbances such as feeling fat even when they are very thin, and in females who are menstruating, they may experience amenorrhea if their body weight is low enough.

Bulimia nervosa typically includes periods of binge eating, followed by drastic methods to compensate for the binge eating including excessive exercising, fasting, vomiting, using laxatives, etc., accompanied with body image disturbance such as thinking one is much more overweight or unattractive than they really are.

Besides these two eating disorders, there are some girls who have other patterns of eating that fall under disordered eating, such as laxative abuse, vomiting after eating some meals, extreme calorie restriction, and binge eating.

Eating disorders typically begin in early adolescence with much of it’s symptoms typically evident by the late teen years.

While not all girls with body image issues develop full blown eating disorders, there is little research into why some girls do and others don’t develop an eating disorder.

During part 2 we will look at some of the risk and protective factors for young girls to develop an eating disorder.

Motivating Your Unmotivated Teen Part 3: The Stages Of Change

iStock_000011734632XSmallAll changes has both negative and positive consequences, which is why it is normal for people to want to change and not want to change simultaneously.

That is the hallmark of ambivalence.

Indecisiveness is a natural part of the change process and something that often drives parents crazy when they are trying to move their teenager in a certain direction that may seem like the obvious better decision to them.

It is natural however to be ambivalent about change, to be hesitant and unsure if the change is worth making.

For example, while doing better in school may allow for a teen to have more freedom at home, get better grades and improve their chances of going to college, the extra time spent studying may come at the cost of less time available to spend with friends, for after school activities or with a boyfriend and that may determine if the cost outweigh the benefits in the teen’s mind.

That’s why it’s important to know that teens may both want to do better and at the same time, not want to do better and are probably unaware of this ambivalence. The indecisiveness has to be resolved in order for the teen to see the value in the change, or little to no improvement is likely to happen.

Helping your child resolve the ambivalence may be all that is needed. By having a relationship with your child that allows open, non-judgmental communication and acceptance, the indecisiveness may be resolved on it’s own which may be all that’s needed to get the teenager to reflect on their situations and decisions.

The Stages of Change

When change happens it’s not usually on motion, instead it usually happens in five stages, identified in Motivational Interviewing through research done by James Prochaska as pre-contemplation, contemplation, preparation, action and maintenance.

1. Pre-contemplation:

In pre-contemplation, the teen hasn’t given any consideration to change. They see no reason to change. They don’t see a downside to their current situation, so the thought of changing hasn’t even entered into their head.

Trying to force change when your teen is in the pre-contemplation is a battle you are not likely to win, and may even sabotage motivation and the possibilities of change.

Dennis Bumgarner, ACSW, LCSW finds it helpful to ask “what if” questions when your teen is in the pre-contemplation stage, such as, “What if your grades improved?”, “What wouldn’t be different?”, “What will happen if things continue in their current direction?”, “What would be different if you did improve?”

During pre-contemplation, you want to ask questions that don’t take a particular position, but questions that get your teen to think and this thinking is what is going to move them to the contemplation phase.

When your child starts considering making a change, remember that they are still considering making the change, so fight the urge to push them too hard or start making plans for their future or they are likely to pull back.

2. Contemplation

At this phase, your teenager is considering the pros and cons of changing. They are thinking, “Maybe I should do something about my current situation.” It’s easy for parents to get overly excited at this point and start helping the teenager make plans for what they need to do to make the changes. This push may be too much and cause your teen to not move forward.

Instead, ask questions that continue to get them thinking and reminds them that you are not the expert. You are here to listen to them, hear what they are thinking and not to offer or force your opinions. You are merely being an agent of change.

Ask questions instead of making statements. Try to avoid offering advice, but instead listen as your teen contemplates making a change.

You do not want to tell your teenager how to change or try to try to make them change at this point, but what you are doing is sparking their intrinsic desire for change. Remember, intrinsic motivation is more powerful and long lasting than extrinsic motivation, so this is what you want to elicit in your teen by guiding them to and allowing them to find their own motivations for change.

3. Preparation

At this phase, thanks to your guidance, your teenager has worked through much of the ambivalence. He or she has decided to start making some changes. Perhaps they have met a study buddy, signed up for the ACT or asked a teacher for extra help. They are literally preparing to make a change.

Once again, it’s easy at this stage to get overly excited and pushy, but don’t. Instead, allow your child to make the preparations and resist the urge to help unless asked, and even then don’t over do it. Show interest and ask questions that are genuine, but not questions that appear to be to intruding and critical.

The contemplation and preparation phases are considered to be the most important part of the change process and it’s easy to sabotage your teen’s motivation at this point by going back to old ways of dealing with their unapproved behavior.

It’s natural for people to go back and forth between preparation and contemplation, and so it’s easy for parents to see this as a sign that their teen is unmotivated or unwilling to change.

Instead of looking at this as a negative, understand that it’s a natural part of the change process as what may appear to be a simple change to you may be worth considerable contemplation by your teenager.

Don’t be frustrated or judgemental, but allow your teenager space to prepare for the change at hand. Continue to support them through genuine questions and as always, listening to their thoughts.

4. Action

At this stage, your teen is actually making the change. They are actually studying, doing homework, going to all their classes, whatever the change may be. They may from time to time revert back to one of the earlier stages, but for the most part, they are making steady change and progress.

At this stage, parents are thrilled that their teen is making better choices and that’s natural, but refuse the urge to become a cheerleader. Remember, this change is not about you, but about your teenager. It’s okay to ask them what has this successful change been like for them, and that simple question is saying a lot.

Your teen may stumble as they continue to find their way through this change and that’s okay. Don’t jump in to redirect them unless they ask for it.

It’s very important that they do this on their own so at the end of the day they will know that they were responsible for making a positive change in their life and they can do it again and again.

Helping them build self-efficacy is one of the greatest gifts a parent can give to a child.

5. Maintenance

When your child has maintained the change for six months, they are in the maintenance stage. You are very proud of the changes your teenager has made. There is likely less arguing going on and more peace in the house as you have made successful efforts in motivating your teenager!

Next post we will discuss key concepts of motivation including goals and empathy.

Motivating Your Unmotivated Teen Part 2: Understanding Change

Teen AngstIn part one we started discussing the importance of having a good relationship with your adolescent in order to help facilitate motivation and change.

Often times, too many parents try to motivate their child instead of developing motivation as a function of their relationship with their child. That means that you have to serve as a source of motivation in someway.

You can’t expect your teenager to want to do something different if you haven’t demonstrated motivation and change behavior in your own life, or if your efforts to motivate them include constant nagging and criticism.

Sometimes that is all that is needed, for a teenager to be in a relationship with other people that are inspiring.

For example, I have a running partner who is a much better runner than I am, yet running with him has motivated me. He encourages me sometimes, but for the most part, I run to not disappoint him and because I enjoy his company. In the process, I became a better runner which motivated me to continue running. The key factor in that is the relationship with my running partner that helped start the process and the motivation to continue it.

It would have been nearly impossible for me to find motivation in our running relationship if he was always cancelling or if he showed up just to show me up. The same principles apply for parents trying to help their teens find motivation. They have to have a motivating relationship.

Motivation Is Change Oriented Movement.

That is the simplest definition of motivation. This definition focuses on motivation as a matter of change that is directed towards behavior, not thinking. When it comes to motivation, it’s often more important to focus on changing the behavior and not the thinking, but changes in thinking generally follow changes in behavior.  But why do people change? What makes people, especially teenagers, decide to do something different? What factors and circumstances have to come into place to facilitate change?

Why Do Adolescents Change? 

Many people believe that people change to avoid discomfort. Often however, unpleasant feelings and experiences actually decrease the chances of someone taking action, which is another reason punishments often don’t have the long term effect they were intended to have.

There are three conditions that need to be in place for change to happen:

1. The change has to be associated with intrinsic value.

Even external consequences that have intrinsic value can work, but the teen has to find intrinsic value in the change in order for it to occur and be long lasting. You have to have a relationship with your child that allows you to discover what is intrinsically valuable to your child. Trying to do that through punishments and groundings is usually futile.

2. Your teen has to be able, willing and ready to change.

This is where a lot of parents fail, not understanding that their teenager won’t change until they are capable of making the change, are willing to make the change and then is willing to make the change. You can not push your teenager into making a change they are unwilling or not ready to make, all you are going to get is defiance and discord.

Change can not be forced on anyone, no matter how important you think the change may be or how much it makes sense. Change will only come when your teenager is willing, ready and capable of making the change required.

3. The teenager has to be in a safe, empowering and accepting environment.

Your teen’s primary environment is their relationship with you, which means you have to provide a safe, empowering and accepting relationship if you want to see your teenager make positive changes.

The number one factor in providing this type of environment/relationship is having unconditional positive regard, where your teen can feel free to express their thoughts and emotions without criticism. This doesn’t mean that you will tolerate uncivil or inappropriate behavior from your child, but it does mean that you will not try to change their thoughts.

Communication is also key in developing the type of environment necessary for change.

This means having open, non-judgmental conversations about the problem and sometimes this alone can be enough to facilitate the motivational and change processes. This can be hard for parents to do because they are used to talking, dictating and teaching, when listening to their teenager is often more  productive.

Your teenager wants to be listened to. Dictating to them what they need to do is usually a sure way to kill motivation, not induce it.

Accept your teenager for who they are.

By accepting your teen for who they are, you make room for motivation and change. If however, you criticize your teen for who they are, they are more likely to actually feel unmotivated to make any changes you would like to see them make. Acceptance facilitates change, but it doesn’t guarantee it.

Acceptance doesn’t mean that you approve of your teenager’s behavior, it just means that you are not going to criticize or judge them. There is a right time for useful criticism that we will discuss in another segment.

Next post we will discuss indecisiveness and the stages of change which are important to understand when trying to understand the change process.

Motivating Your Unmotivated Teen Part One: Understanding Motivation

Lazy-teenager-001The other day while counseling a fifteen year old boy with very little motivation, failing grades and a poor attitude that is driving his mother crazy, I found myself thinking, how can I motivate him to care about his life and future.

I realized immediately after I had that thought that I was making a critical error in my thinking, one that millions of parents make every single day. I was trying to figure out a way to motivate this young man, to make him want to change, when in actuality, we can’t make anyone change.

The subject of change is a very interesting one, as we all change multiple times throughout our lives and usually know when change is needed, but when it comes to working with adolescents, they often seem unwilling to change even when we as adults know that making a change for the better would be beneficial to them.

This young man’s mother had tried many different things to make him change, including giving him incentives like allowances or extra time playing his video games, to punishments such as taking away privileges and scolding him.

She has made the same mistakes that many parents make.

External Consequences Rarely Work

Applying external consequences works on some adolescents, but not on all, and even when they don’t work, parents continue to try them and are frustrated when they don’t work.

Think about the high recidivism rate among criminals or the way countries like Cuba and North Korea seem to thumb their noses at the world even in the face of increased sanctions. External consequences, positive or negative, rarely work.

If you have been trying punishments or rewards with your adolescent and aren’t getting the results you were hoping for, it’s time to start thinking about doing something different.

Talking Sense Into Them

Another thing parents often do that can backfire is that they hound their adolescent, trying to lecture them into change. Usually it’s with good intent, but lectures can actually have the opposite effect of what they were intended to do.

When parents lecture their teens, they tell them how smart they are, how talented they are, etc., yet if the teen doesn’t believe this about him or herself, they are usually going to think that their parents either:

  1. don’t really know them, which means that their parents will lose some credibility with their teen, or
  2. the teen will feel even worse for wasting their talents or intelligence and become even less encouraged and motivated.

Think about listening to a motivational speech. They usually motivate you for a short while or they demotivate you, making you feel incapable of accomplishing what you are being told you can.

These external influences work even less if the teen is already unmotivated, overwhelmed, disheartened, demoralized or anxious in the first place when it comes to school and/or their future.

Instead of lecturing, it’s good to listen more to what your adolescent values, feels and thinks about themselves and what they want. By listening more, you will learn and understand your teenager better so that when you do talk to them, you won’t come off as  patronizing.

You Can’t Motivate Anyone or Make Anyone Change

Over the years I’ve helped many adolescents change, stop using drugs, start making better grades and even graduate and go off to college, but I can’t say I motivated or changed any of them.

I know that what is going to motivate the young man I am working with, just like the teens I’ve helped in the past,  isn’t going to come from me. I know that I can only help to facilitate change and motivation, but I can not make him change or to become motivated.

Like most parents, his mom thought that she could motivate him to change. That if he got motivated, he would do the work, but that is not how motivation tends to work.

We rarely get motivated and then do something, but instead start doing something, like the outcome of what we are doing and then get motivated to continue doing it.

Think about when you are cleaning your house or trying to lose weight.

You may “feel” motivated to clean or lose weight, but usually once you see the house start looking a little cleaner, or the weight falling off, you get motivated to continue. That’s where the bulk of the motivation comes from. We do something and then get motivated.

For instance, if I waited until I was motivated to workout, I would rarely workout. More than half the time I don’t feel like working out, but I force myself to go to the gym and once there, I usually find motivation from seeing other people working out, or once I start my work out I just feel motivated to workout harder.

Your teenager may not be motivated to study, but if he or she sees their grades go up from studying, they will probably become motivated to continue studying.

Doing Something Different

So I know that I can’t motivate this young man and his mom had been trying unsuccessfully for years to motivate him. What we can do however is to try getting him to do something different that will hopefully inspire motivation from within.

Intrinsic motivation is far more powerful and long lasting than extrinsic motivation.

Parents often waste a lot of time trying to get their teenagers to change the way they think, and I too often do the same as part of cognitive behavioral therapy, but when it comes to motivation, this isn’t usually the most effective way to bring about change. Instead, what we want to do is try to change their behavior, at least to get the desired behavior started in hopes that doing something different will elicit motivation and thus change the way they think.

You never know where motivation is going to come from.

I once asked a teenager to try to study for one hour a day and one hour only (he had been studying none at all). By studying one hour a day, he managed to get a “C” on an exam when he had gotten “D’s” and “F’s” on all previous exams. His teacher then complimented him on his “C” and so did a girl he liked. He then started studying more than an hour a week and his grades rose to “A’s” and “B’s”.

His parents were elated at my “ability to motivate” their son, but I knew that all I did was move him in the direction of the desired behavior and the motivation came from himself and his world. Once he saw the results of his behavior, the motivation followed.

It’s important to have the type of relationship with your teen that encourages motivation. We’ll discuss more of that in part two as well as understanding change and the conditions that facilitate change in teenagers.

note: when I discuss the topic of teens, I often say parents, but this applies to anyone who has a teen in their life, no matter if they are family members, students or if you are a mentor in anyway. 

Does Your Teen Lack Empathy?

li-teen-boy-620-cpisI’ve been working with a fifteen year old male for the past few months who has been diagnosed with Attention Deficit/Hyper Activity Disorder (ADHD) and Oppositional Defiant Disorder (ODD).

He was referred to me because his mother was frustrated with his behavior. He was argumentative, physically aggressive, disobeyed rules and punching holes in his bedroom walls.

After a few sessions his physical aggression and property damage pretty much stopped, but he still had major problems following home and school rules and basically disobeyed his mother repeatedly, although not as violently as before.

His mother, was pleased about the decrease in aggression, but she was still frustrated with the fact that she had to repeatedly ask him to do his chores and often he would blatantly refuse to do anything until he was ready, which was usually never or until his mother was red in the face and hoarse from yelling at him.

It was during an exercise I was doing with him about the impact of his behavior on others, that I realized that part of his problem, besides his diagnoses of ADHD and ODD, is that he lacks empathy. He doesn’t really understand how his behavior impacts other people, especially his family. I had him list certain incidents where he got in trouble, and he wrote things like, “I didn’t do my chores”, “I stayed out past my curfew” and “I didn’t wake up on time for school”. When I then asked him to tell me how his behavior impacted his mother, his sister and/or his father, he replied “I don’t think it did” despite the fact that all those things had everyone in his family upset with him.

It became clear to me that in order to help change his disruptive behavior, I had to also teach him how to be empathetic.

Many people in the scientific community believe that teens lack the ability to be empathetic because the part of the brain that allows us to have empathy for others, the medial prefrontal cortex, is not fully activity in the teenage brain. Adults are much better at analyzing how their decisions will affect themselves as well as other people, which explains why some teens (and adults with empathy problems) make some very stupid decisions with little thought to how their decision will impact other people.

Research also shows that teenagers tend to have a harder time with, and take longer to recognize emotions expressed on other peoples faces.

Developmentally, adolescence are at a stage where things are largely about them, they are very self-centered and so empathy isn’t their strong suit. Yet, I know there are many empathetic teens, I see and work with them everyday. It is true that many teens have a hard time empathizing and the internet probably isn’t helping, as we can go to YouTube or a number of other sites and see people getting beat up, falling, or in a number of other uncomfortable, embarrassing situations, and view it as entertainment, instead of empathizing with the person. It’s possible that being exposed to those videos and images overtime, deadens our ability to be empathetic by desensitizing our neural circuits and this may spill out from the virtual world to real life.

The good news is, empathy can and should be taught. The younger, the better, but it’s never too late

Some Ways You Can Teach Empathy To Your Child

  • Develop a good relationship with your child that nurtures their emotions. Research shows that children who have parents that help them cope with their negative emotions in loving, solution-oriented ways, are more likely to show concern for other children.
  • Treat your child as an individual with a mind of his or her own. Talk with them about emotional and mental states and teach them how their thoughts influence their feelings and behaviors.
  • Model healthy emotional behavior and empathy towards others. This is a very effective way to teach your child empathy and take the time to check in with their feelings and show empathy during everyday life, such as while watching television together.
  • Give them the language to express themselves appropriately by teaching them how to use “I Statements”, such as “I felt angry when the other driver cut me off”.  You can also teach them reflective listening skills which will help them label their feelings. You can model this by asking questions like  “You seem down today, did something happen at practice?” This will help your child recognize their feelings as well as help them learn how to express them.
  • Help them discover what they have in common with other children. People tend to be more empathetic toward people they feel are similar to them, which is one reason whenever I start a new support group, the first activity I do is a game called, “I Have Something In Common With…”. The game basically elicits empathy for others in the group through showing that no matter how different they may seem from each other, they all have somethings in common with each other.

Teaching your child how to be empathetic, is like turning their mirrors into windows, where they can look out beyond themselves and put themselves in other  peoples positions  It’s also good to give your children opportunities to show empathy and to give through volunteering, helping a neighbor, etc. Children who are empathetic tend to develop into better adjusted adults with less interpersonal problems than children who aren’t empathetic, and tend to have multiple issues relating to other people, including bullying, antisocial traits and cruelty to animals.

Your Teenager Needs and Wants Your Guidance

Group of Teens_397

If you are a parent of a teenager, you probably have worried at one point in time about the many issues that face them including drugs, alcohol and tobacco use, dangerous driving, sexual activity, school, peer and social issues.

You’ve probably also worried about losing the influence you have over your teen as they start trying to branch out and find their own identity in the world.

We all know that teenagers face many challenges and changes in the world, and many teenagers like to act as if they can face and deal with these challenges alone.

As a matter of fact, many teens may actually believe that they don’t need any help, but as adults that care about the teens in our lives, we know that’s not always the case.

Teens need guidance. Teens actually want (although they may never admit to it) your help and guidance (just as they actually want rules and limitations).

As a parent, you may think that once your child becomes a teenager, you can sort of step back and let them grow up on their own, stepping in only when they get into trouble, but that is the wrong approach.

Your job as a parent isn’t over, it’s just changing.

Many parents who think like what I just described above, end up with spoiled kids who take no real responsibility for their lives and their actions.

They often believe that they are entitled to many things others have to work hard for and end up becoming young adults and adults with a host of intra and interpersonal problems.

There is some good news however.

If you watch the news or work with a certain population of teens as I do, it’s easy to think that teens today are worse than teens have ever been in history, but that’s actually not true.

Compared to their parents generation, teens today are less likely to become pregnant, smoke, use drugs and alcohol, drop out of school, or commit a violent crime.

They are more likely to volunteer and explore their spiritual side than ever. They are also more tolerant and are more likely to have friends of different races, socio-economic status, religion and ethnic groups.  They are also more likely to say tey have positive relationships with their parents.

All the hard work society has put into improving teens is paying off, but not without the help and involvement of parents.

Research shows that teens want and expect their parents to play key roles in their lives. They want advice and guidance and they remember your wise words, even when they act as if they are not listening.

The troubled teens I work with usually come from households where they are lacking parenting or have a parent or parents that don’t know how to be parents. Some are just “bad” parents while others are too busy with their own lives to actively parent their teens.

Despite all the good news about teens, the fact is, the dangers are still there. Any parent can attest to that. If they weren’t, there would be no need for my services  and I and all the counselors I know who work with teens, are largely overwhelmed with the number of teens that need counseling.

The problems facing teens are often similar and yet different for each one, and some may surprise you.

Like the fact that rural teens tend to have more drug and alcohol problems than urban teens, and that 30% of high school teens reported driving with someone who has been drinking at least once in the last month.

The teens years are much like when your child first learned to walk. Remember how they would look for something to hold onto such as a table or your leg to help steady themselves?

Sometimes they even freaked out when they couldn’t find something to hold on to, but you were usually their to help guide and protect them and make sure that they didn’t hurt themselves.

Although you stayed close enough to help them not hurt themselves if they started to fall, you also gave them enough room to learn and practice their new abilities and watched with joy as they grew in confidence from crawling, to walking, and eventually running.

Adolescence is very similar.

Your teen needs you to be there as they try to find themselves in the world, or they will find something else to hold onto just as they did as toddlers learning how to walk.

If you are not there for them to hold on to, they will potentially find drugs, alcohol, sex, bad influential friends, crime, you name it.

If you are lucky they will find good friends, healthy and safe adults, teachers, counselors, etc., but you want to be the person who guides your child.

You want to be the person that helps your child navigate through the barriers, which means you have to be close enough to give advice and to answer their questions honestly, but far enough away to allow them to start making and learning from their own decisions.

The adolescence are an exciting and scary part of life. Your teens are changing and growing and although they may start to look like adults, their decision making, risk/reward system are far from fully developed, so they still need you to be their for them, or they will look for and find something/someone else, good or bad.

Parental Favoritism Creates Stress, Anxiety and Depression in Adolescents

It’s very early in the school year and one thing I’ve noticed is that more and more of the students that are getting referred to me for counseling aren’t the typical “bad apples” or “lost” kids, but kids who are good students, are never in trouble, yet are miserable.

How miserable? One cuts herself and thinks about suicide often. Another felt disappointed when she found out she wasn’t pregnant because she thought being pregnant would make her feel alive and purposeful. And one is so depressed that despite appearing to have everything a 17 year old high school girl could ask for, she mopes around campus with her head down.

What do all these students have in common besides being female? They all have a sibling that they are constantly being compared to. A seemingly perfect sibling who makes their accomplishments appear minor in comparison.

These are students, who compared to most other students on campus, are successful. They have mostly A’s and B’s and no disciplinary infractions, yet when compared to a sibling who is making straight A’s , serving as class president and maintaining a thriving social life, they feel inept, especially when their parents are the ones constantly drawing the comparisons.

These students, despite doing their best, are never recognized for it since their best pales in comparison to their sibling’s best. They are often left feeling as if they aren’t good enough and have a diminished sense of self, while the favored child can begin to feel a sense of being special and entitled, often making the less favored child feel even more diminished.

Adolescents tend to be even more sensitive to favoritism by parents than younger children, since they are trying to redefine themselves from being a child to being a young adult.

In doing this they often distance themselves from parents and even have created some tension as they struggle for independence, yet they still want the approval that came along with childhood, approval that the more favored child usually still gets and it can create resentment.

What makes parental favoritism especially harmful is when it is intentional and creates preferential treatment and superiority/inferiority between children.

The disfavored child may begin to believe that they are indeed not as deserving, as good or as smart as the favored child and that could lead to a life time of self-esteem and psychological issues as well as bitterness towards the parents and the other sibling.

So far the students I’m working with, besides complaining about the favoritism and anger towards their parents and sibling, show profound anxiety, depression, self-injurious behavior, low-self-esteem, anger, suicidal thoughts, decrease in self-efficacy and drug use.  And these are the “good” kids.

Imagine if they were kids with more disadvantaged backgrounds and more complex psychosocial issues. They could be drop outs, delinquents, heavy drug users, you name it.

There are many different ways parents can show favoritism, including showing inequitable pride, attention and approval to one child, to giving the favored child more freedom and rewards.

To the disfavored child, they often feel as if their parents care for and think less of them.  This can cause the disfavored child to dislike the favored child and that can come out in the form of resentment that can continue for life.

At times parental favoritism isn’t done on purpose. It is actually very easy to unintentionally start showing favoritism to one child over another.

Parents need to start recognizing, listening to and accepting when one child is claiming to be treated unfair so that they can analyze the situation.

While sometimes it may seem like the child claiming to be treated unfairly is just nagging, they are often trying to tell the parent that they want some attention or are feeling left out.

Parents should try avoiding comparing their children and should let each one know that they are highly valued for their own unique individuality and that they are all favorites because they are all unique.

The period of adolescence is hard enough, the last thing a child needs is to feel discriminated against within their own family unit.

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections

There is a growing hypothesis that there exist in a small subset of children, a form of rapidly forming obsessive-compulsive disorder (OCD) and/or tic disorder known as PANDAS.

PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. According to research, these children literally go from “normal” to “abnormal” in the matter of hours. Parents are usually able to pinpoint the exact time and day their child’s behavior changed in the forms of tics (erratic movements or vocalizations), emotional irritability, bed wetting and lose of previous learned motor skills. This is thought to follow exposure to the strep virus (i.e. a strep throat) and appears to be some type of autoimmune reaction.

PANDAS was first proposed during observations and clinical trials by the US National Institute of Health and was verified by further clinical trials, where children, after having been exposed to the streptococcal virus, developed rapid, sudden and dramatic OCD and tic disorder symptoms. There isn’t a 100% cause and effect between streptococcal and PANDAS, or even clear evidence that PANDAS is a separate disorder from Tourettes/OCD, so research is ongoing. Because of this, PANDAS is not yet, or may never be considered a complete disease on it’s on, and there is some discussion that it should be called PANS, an acronym for Pediatric acute-onset neuropsychiatric syndrome to further include not just the sudden onset of tics and OCD symptoms following exposure to a previous infection, but the sudden onset in children regardless of a previous infection or not.

What if I Think My Child Has PANDAS and is There a Cure?

Your family doctor or psychiatrist will be able to access and diagnosis whether your child has PANDAS or not. Treatment for PANDAS right now are the same as the treatment for Tourettes and OCD which include cognitive behavioral therapy and medications such as selective serotonin reuptake inhibitors (SSRIs). As research grows and the PANDAS hypothesis is either further confirmed or denied, other therapies and medication options will become available, but as of right now, there is no cure other than to try to reduce and control the disturbing and undesirable symptoms of PANDAS.

There seems to be a link between previous childhood exposure to infections such as strep throat, to the development of PANDAS, but there isn’t a 100% certain link and you shouldn’t worry too much that exposure to infection in childhood will lead to life long, neuropsychiatric problems. However, there seems to be growing evidence that in some children, this is the case and like with every child, if you notice sudden changes in your child, such as decrease in previous learned motor skills, increased irritability, tics (vocal and/or physical), difficulty sleeping, difficulty eating or any other unusual behaviors, it is very important to have your child seen by a doctor or specialist to not only rule out PANDAS, but also other diseases and pervasive developmental disorders such as Autism, Aspergers and childhood disintergrative disorder.

For more information on PANDAS visit http://intramural.nimh.nih.gov/pdn/web.htm