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Supporting the Mental Well-being of Teenagers

There have been welcome signs over the past few years of the beginnings of a shift in societal attitudes towards the subject of mental health. This has been largely a taboo area, but more recently there has been some evidence of an increasing willingness to talk about this hitherto hidden subject. An additional nudge in this direction has resulted from the national lockdowns instituted in response to the Covid-19 pandemic. The normal busyness of life was brought to a stop, networks and patterns of relationships were interrupted, and liberties were curtailed. The suddenness of such enormous changes prompted many to confront, perhaps for the first time, the robustness of their own mental health. The impact for teenagers was heightened by the need to limit social activity since this forms part of the exploration and striving for independence from parents that is associated with adolescence.

What is Mental Health?

It is widely recognised that one of the barriers to discussion in the area of mental health is its confusion with mental illness. In trying to understand these terms, I find it helpful to draw a parallel with physical health and physical illness. We all have mental health and need to look after it, just as we all have physical health and should protect it. At times, we may experience a mental health issue, just as we might experience a physical health issue, which may be easily resolved or something we have to learn to live with, but it is not necessarily an illness or evidence of one. However, if we develop an illness, be it mental or physical, it will impact our (mental or physical) health and will often require some form of treatment or intervention Huffington Post. It should also be noted that whilst they are treated separately above for the sake of drawing the extended comparison, our mental and physical health influence and affect each other. In general, our mental health refers to our ability to cope with life, to process our emotions and feelings, and to manage stress.

Teenagers and Mental Health

It is important to remember that the teenage years are a significant developmental stage in the life of a person. As they seek to develop independence from their parents, teenagers are developing the strategies and tools that will enable them to cope with the stresses of independent adult life. This applies as much to a person’s mental health as to any other area of their life, and it is complicated by the intensely personal nature of our individual mental health profile. Some teenagers by their make-up are, for example, more prone to worry about things than others; some might handle stressful situations with ease whilst some of their friends cannot. This means that any definition of what constitutes “normal” mental health must leave room for personal variation. Ultimately, I prefer to think of a good level of mental health as being a state of mind that enables the individual to enjoy life whilst managing its stresses.

However good one’s level of mental health might be, there will still be difficult experiences in life and teenagers need to learn to distinguish between serious challenges to mental well-being and just having a bad day or a difficult time. Robust mental health enables us to face and deal with difficulties and challenges and to become stronger as a result. In July, an article carried by Heidi News in Switzerland, stated that “The Covid-19 lockdown has affected the mental health of some 40% of teenagers, stressed by being cut off from friends and schools, fears of falling ill and a future that is out of their control.”. However, I would argue that fears of falling ill during a pandemic are a natural human response, and for the vast majority, their mental health will enable them to face and manage those fears. Those most at risk from the experience of lockdown in terms of mental health are those who already have underlying mental health issues, whether they have been previously diagnosed or not. Such underlying issues make it more difficult for them to respond appropriately to the new situation.

A month later, it was revealed that a study conducted in the UK amongst 13-14 year olds had indicated that for some teenagers, mental health had improved during the lockdown. As the NIHR School for Public Health Research suggests, the mental health improvement “may be due to the removal of stress factors often found in school environments such as pressure of academic work and challenging peer relationships.” With regards to the present discussion, the findings serve to underline the individual nature of mental health.

Teenagers, Mental Health Issues and Mental Illness

Given that different people and organisations draw the line between mental health issues and mental illness at different places, I find the comments of the Mental Health at Work Group helpful: “When a mental health issue begins to seriously take over a person’s life – impacting work, relationships, education, or social lives – MHAW considers it to be a mental illness.”

The World Health Organisation (WHO) suggests that 10-20% of adolescents globally experience mental health conditions. Anxiety and depression head the majority of listings of the most common mental health conditions experienced by teenagers, often followed by loneliness and stress. Such listings often go on to include eating disorders, self-harm, drug-taking, and a variety of learning, behavioural or personality disorders. The WHO points out also that suicide is the third leading cause of death in 15-19-year-olds.

What can parents do?

Parents are both the best placed and the worst placed to be able to help their teenagers in the area of mental health and well-being. Proximity within the family enables observation of behavioural changes that might be important signs of a developing mental health issue. At the same time, however, some teenagers are extremely reluctant to talk about personal issues with their parents. Often, the ability to help relies on a strong pre-existing relationship, which all parents can seek to build with their teenager.

I would summarise what parents can do, as follows:

  • Model and seek an adult relationship with your teenager.
  • Make time to listen to your teenager.
  • Take what your teenager says seriously.
  • Don’t pretend you know all the answers.
  • Seek out quality information about mental health amongst teenagers, including the signs to look out for.
  • Be on the lookout for marked behavioural changes – not the same as being faced by teenage stroppiness.
  • Don’t be afraid to suggest medical help if you think it is required, or to insist if you think the condition is becoming worse.

Parents need support too

Parenting can be hard work and extremely stressful. When faced with possible issues with the mental health of their teenager, parents can also feel incredibly alone. Wise parents will recognise the need to find support for themselves. Whether that support is professional or informal, having someone to whom they can talk about their fears, and who can help them find a way forward, is an invaluable aid to becoming better equipped to help and support their teenager.

This article was published in the Spring edition of International School Parent magazine, 2021.

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Teenagers and Anxiety

Considerable concern has been expressed of late about an apparent rise in teenage anxiety. The number of teenagers receiving medical treatment for severe anxiety is on the rise and a variety of theories are being advanced as to why this might be the case.

It should be clear from the outset that a certain level of anxiety (for example: when faced with new challenges) is both a natural response of the human body and a good thing. Anxiety in the face of changed circumstances or new experiences is part of the body’s “fight or flight“ response. It sharpens our focus, heightens our concentration, provides a surge of energy to face and deal with whatever challenge has come our way – an invaluable asset for exams, public performances, college and job interviews, and the like. It is also useful for prompting teenagers to reflect on unsafe situations in which they might find themselves. Given the amount of change that occurs during the teenage years, it should come as no surprise that teenagers experience varying levels of anxiety. Indeed, learning how to control and use anxiety could be seen as one of the many tasks of the teenage years.

Most of the time, and for most teenagers, anxiety is a temporary phenomenon that resolves itself as the situation that prompted its arrival is faced and resolved. There are times, however, when anxiety can become a problem, times when

  • feelings of anxiety become very intense so that they begin to envelop more and more of the teenager’s life, or
  • their anxious state does not recede but persists over weeks or months, or
  • anxiety begins to eat away at the teenager’s ability to manage and enjoy daily life.

In circumstances such as these, anxiety loses its usefulness as a tool to help manage and enhance life and may develop into an anxiety disorder for which medical or psychological support may be necessary.

The causes of such a change in the nature of anxiety from a life-enhancing tool to a potentially destructive force are varied. Genetic, personality, environmental and physical factors have all been suggested among the list of possible causes, and for many it seems likely to be a combination of a variety of factors. Whilst identifying the causes can help those managing treatment and care to find an appropriate path towards a solution, many of the causal factors cannot be eliminated or avoided. We shall therefore concentrate below on steps that parents and teachers can take to help teenagers learn to manage “normal” anxiety in such a way that it retains its power as a tool to help them shape life positively.

Advice for parents

Be well informed. As with so many areas of raising teenagers, parents are required to walk something of a tightrope. On the one hand, seeking to shield teenagers from all situations that might provoke anxiety will leave them ill-equipped to face the stresses of the adult world. On the other, seeking to over-expose them to anxiety-producing situations as a form of “innoculation” against future anxiety may well undermine their confidence and leave them more prone to anxiety than they might otherwise have been. Rather, careful observation of how your teenager handles stress, knowing the classic signs of “anxiety”, recognizing the signs your teenager gives out when they are becoming over-anxious about a situation, learning when to encourage them to face their fears and when to avoid situations are all aspects of becoming a well-informed parent on this particular subject.

Maintain a healthy relationship with open channels of communication. Certainly, there will be times when teenagers reject the advice and guidance of their parents, but maintaining a relationship within which teenagers know they can share their concerns when they feel the need to do so, is an invaluable means of support that can give teenagers confidence through the years of adolescence. If parents are able, when appropriate, to talk about their own experiences of managing anxiety, including times they may have struggled with it, this can help teenagers see that it is not a subject and experience to be avoided at all costs and may well dispose them to be more open about their own experiences.

Watch out for the warning signs and don’t be afraid to act if necessary. Becoming aware of the classic signs both of anxiety and of over-anxiety is something of an academic exercise, but knowing how to act on those signs in the best interests of your teenager is highly personal. It requires the kind of detailed knowledge of your teenager that only parents, and perhaps a few others, can acquire. Of course, parents should avoid any inclination to jump in and take over their teenagers’ lives, but when the danger signs are there, parents should not be afraid to act. If anxiety gets out of control, a teenager’s longer term mental health could be affected so early intervention in terms of seeking professional support is strongly advised. School counsellors, therapists, family doctors are all possible starting points for finding professional help for those who need it.

Advice for Teachers and Schools

Inform students about anxiety, its symptoms and how to find help. The ready availability in schools of age-appropriate resources is as important in equipping teenagers to manage anxiety as in many other areas. Funding the provision of resources covering a wide range of mental health and social issues might be beyond the budgetary capabilities of many schools. However, if it were possible, it could be developed into a major contribution to student health and well-being. Schools are starting to include more aspects of well-being within their social and health education curricula, which is to be encouraged, and certainly the management of anxiety should find a place within such schemes. Anxiety carries something of a stigma of fragility and an inability to cope with life. Handled wisely, this need not be the outcome for anxious students, although it represents a danger for those whose anxiety spirals out of control. Such stigma is often best addressed by openly addressing the subject, whether it be in a classroom setting or in private conversation.

Communicate concerns. Teachers will expect to see a certain level of anxiety amongst their students from time to time, especially during the exam season, for example. However, teachers will often be the first to notice when individual students begin to show signs of becoming overly anxious. When teachers are concerned about individuals in this respect, it is important that they communicate their concerns promptly. Whether that communication happens with the student or their parent, or with someone who has pastoral responsibility in school will depend on a whole host of factors, including the age and personality of the student, the procedures in place within the school, the relationship that the teacher has with the particular student, and so on. Whatever its most appropriate form, the important thing is that the communication happens and that difficulties are not allowed to push that communication aside.

Don’t underestimate the value of encouragement. We all need encouragement from time to time, and encouragement can be a particularly effective means of support for those who are anxious. In some cases it may take the form of encouragement to face a challenge head-on despite the anxiety, but in others it will be about helping a student to find another way of achieving a goal. The approach will vary according to the individuals and circumstances involved. However, the value of the encouragement offered by a concerned teacher should never be under-estimated when offered in the context of student anxiety.

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Supporting Teenagers through the Exam Season

At this time of year in the northern hemisphere, many teenagers are becoming aware that the exam season is moving inexorably closer. For some this will mean an assessment of progress made during the current school year; for others it will mean a series of exams that could play a large role in determining their future: which university they will be able to attend, if any, and ultimately the career upon which they might embark.

The exam system has its detractors, who argue that it is possible to learn how to be good at exams, without necessarily being good at anything else; or who see exams as a poor basis for taking decisions that may have such a long-term effect on a person’s future. However, universities and employers seem generally to be agreed that, whilst the exam system may not be perfect, it remains the best tool we currently have as a means of assessing academic potential. Many use other additional factors or measures alongside exam performance, but even so, exam results still carry enormous weight.

Of course, there are some students who look forward to exams, knowing they are likely to perform better than they do ordinarily. For others, however, exams begin to loom on the horizon like some kind of mythical beast that needs to be fought and conquered. It is not just the importance of the outcome that contributes to the stress surrounding the exam period. Fear of failure, exaggerated parental expectations, realization that time during a course of study has not been used wisely, knowing that their hopes for the future might be dashed by the outcome – all these factors, and more, can combine to make the exam season a time of extraordinary stress and anxiety. So what can we do, as parents and teachers, to support teenagers through this stressful time of year?

Advice for parents

Practical help. I have lost count of the number of parents who have said to me over the years something along the lines of, “I decided the most valuable thing I could do was feed them!” Practical measures that enable the student to focus on revision and preparation for exams represent one way that parents can show support. The nature of the support will depend on the teenager and the family. Other approaches I have encountered include: suspending certain household chores until the exams are over, funding one night out a week during the exam season to ensure the student takes some time off from revision, and making adjustments to the pattern of life in the household to try to minimize disruption for the student.

Encouragement. Parents will want to encourage their teenagers to keep going in the face of pressure and when they feel like giving up. But there are other forms of encouragement that may be required too. Students work best when their revision programme is balanced. Encourage your teenager to draft a revision plan. It does not need to account for every minute over a three-month period, but it does need to include all the subjects! Also, encourage them to include time off, exercise and sleep so that their overall approach is balanced, as that will enable them to work much more effectively. Ultimately, encourage them to accept that your love for them is not determined by the level of their exam achievements, and if the results turn out to be disappointing, reinforce that message when they find out. In the meantime, encourage them to work hard through the time that remains to them before the exams and to do their best.

Place responsibility with the student. Ultimate responsibility for your teenager’s exam results rests with them. Teachers, tutors, peers and parents can all offer support, expertise and help as appropriate, but that will achieve little if the student does not put in the work. None of the above, nor exam boards, are there to act as scapegoats if the results do not turn out to your teenager’s liking. It is important that your teenager understands that this is what reality looks like when it comes to exams.

If your teenager is among the small minority of students who, despite being made aware of their responsibility, persist in doing next to no work, there is little a parent can do other than reinforce the message about responsibility. Difficult though it may be for parents to watch, some teenagers will only learn the hard way. If the worst happens and the results are disappointing, I can only say that I have worked with a number of parents over the years whose teenagers have not been admitted into their chosen university at the first attempt, or who have needed to take a year out and re-sit a number of exams. Often the teenager has succeeded the second time around, or they have decided on a different direction for their future, and both the teenager and the parents have found eventually that the initial poor results were not the end of the world, even if it felt like it at the time. For a significant proportion of those who found themselves in that position, the experience turned out eventually to be a valuable learning experience.

Advice for Teachers and Schools

Advice about revision. I would encourage schools to offer some form of programme to help prepare students for revision and exams. Such a programme should explore a variety of approaches to revision that will appeal to a range of learning styles. Also, they should help students develop the skills they need to make revision plans and to know how to use those plans helpfully. It is also helpful for teenagers to understand the value of sleep, of a healthy work-life balance, and of good examination technique, so all these might helpfully be included in a programme of preparation.

Active revision. Over the years I have had numerous conversations with teenagers about their preparation for exams. Many of them have told me that their teachers have stressed the need for active revision, but when I have followed up with a question about what that means, a surprisingly large proportion of them seemed not to know. Good advice is soon wasted if it contains educational jargon that the students do not understand! The term active revision is trying to get the message across that there is far more to a good revision programme than the student just reading through their notes, which a surprisingly large number seem to think is sufficient. That may be part of it, but there should also be working through examples from scratch, checking notes against textbooks, asking teachers or peers for clarification where needed, trying out past exam questions. I have seen a number of instances where students have formed their own revision groups for certain subjects, where they teach, help and support each other through the exam season.

Encouragement. There may have been times throughout a course of study when a teacher felt the need, either with groups of students or individuals, to highlight their misuse of time and bemoan lost learning opportunities. However, as the exam period moves closer, such an approach can have a marked negative effect and might even lead some students to feel that there is no point even trying to prepare as it is already too late. In the exam season, encouragement needs to be the order of the day, and I have seen a number of instances over the years where students have achieved beyond all expectation due to the optimistic encouragement of their teachers.

Consider gender differences. It is generally accepted that girls mature earlier than boys, which can give them an edge in exam situations where students sitting an examination are pretty much the same age. Self-doubt can affect many teenagers, often girls especially; whereas lack of organization can be an affliction that is more common in boys due to their comparative immaturity. Whilst students do not always follow their gender stereotypes, there is nevertheless sufficient truth within a stereotype to give teachers an understanding of things for which they need to be looking. Whatever the cause, such characteristics can be a disadvantage during the pressured exam season, but they are also issues that can be addressed and managed with help.

Place responsibility with the student. Teachers, as well as parents, need to remember that ultimately students are responsible for their own exam results. Teachers offer instruction, insight, clarification, additional help and encouragement, but students are responsible for their own performance. In very unusual circumstances, such as teaching the wrong syllabus, teachers and schools might be held responsible for the outcome, but such situations are very unusual. Generally, the majority of students will perform in line with teacher expectations, whilst a few will over- or under-perform. That is the nature of the exam system and within that system students carry responsibility for their level of performance.

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