Is My Teenager Just Moody or Is This a Mental Health Crisis?

It is a known fact that adolescents are moody. Sometimes parents find themselves walking on eggshells not knowing what mood will show up. Sometimes an adolescent's moods will dictate the state of the household. This can be very normal and you may hear things from your family and friends like “sounds pretty much like my household” or “this too shall pass.” Yet there are times when there is need for concern. 

Adolescence is a unique developmental phase. An adolescent experiences significant physical, emotional and social changes more than any other developmental timeframe. If they are exposed to poverty, abuse or violence they are at even greater risk of developing mental health issues. Yet even, well adjusted adolescents experience life from a unique lense, often confused or emotionally challenged from what is happening around them. Adolescents often feel like they are outsiders even if they have a lot of friends. This can lead to feeling lonely and isolated. 

According to the World Health Organization, one in seven 10-19 year olds experience a mental disorder, accounting for 15% of all mental health disorders globally. Depression, anxiety and behavioral disorders are some of the leading causes of illness and disability among teens. Suicide is the third leading cause of death among those aged 15-29 years old. 

50% of all people who will have a mental health disorder in their lifetime, start to experience symptoms by age 14. The median age of onset for anxiety disorders is 6 years old. 

Adolescents with mental health issues are more vulnerable to social exclusion and conflict, discrimination, mental health stigma affecting readiness to seek help, education struggles, and risk- taking behaviors. 

Some factors to look for that may be red flags in your adolescent are:

• Sleeping excessively or not being able to sleep. This may include difficulty falling asleep and or staying asleep

• Feeling sad, empty, hopeless or worthless

• Irritability accompanied by restlessness

• Onset of new behaviors or rituals that are repeated

• Difficulty concentrating or thinking

• Auditory or visual hallucinations, including ringing sounds or seeing lights

• Delusions including feeling superhuman. Teens can be higher risk-takers, but if they are putting themselves in danger due to feeling invincible, there may be a bigger issue

• Self-harm

• Suicidal ideation or a suicide attempt

• Psychosis or detachment from reality

• Significant weight loss due to disordered eating which can include restriction or vomiting after eating

If you believe your child is experiencing any of the above, it is important that they seek mental health services. If you are uncertain whether an emergency exists, call 988 for guidance from the Suicide and Crisis Hotline. 

As a therapist who has worked with adolescents for 35 years, I have learned the importance of family in assisting their adolescent in their mental health recovery process. It is never a straight line. The family can be extremely helpful in providing compassionate emotional support, staying alert to warning signs of mental health crises, and making sure their adolescent receives mental health care by trained professionals such as social workers, counselors, psychologists and psychiatrists. 

Even though adolescence is marked by individuation from parents and becoming independent, adolescents need guidance and support from their parents, now more than ever. If you feel that this period is more challenging than most so far, you are absolutely correct. It is important to stay vigilant and make sure that your adolescent is thriving and not just “surviving”. Parents can and should be the best resource and recognizing if their teenager is struggling with their mental health and seeking outside support to prevent a crisis. 

Finding light in the Holiday Season

For many of us, holidays are nostalgic and bring up many happy memories and traditions. Yet, for many others it is a time of mixed emotions where we think about those loved ones who have died or family conflicts or traumas that have arisen in the past years or in past holiday seasons. Maybe the blending of families is difficult to navigate, and you are not seeing eye to eye with even your closest support people. Or it could be the idea of coming together to eat a large meal that is particularly overwhelming if you have experience with an eating disorder. Holidays are often focused on eating. There is baking cookies, breads, and pies, preparing the Thanksgiving meal or even the brunch on Christmas morning. The packed social calendar of holiday parties, work events and family get-togethers can feel very hectic and obligatory or can excite or energize. It is an important time to think about balancing all the people and events in your life.

A 2023 survey by the American Psychological Association found that 89% of U.S. adults feel stressed during the holiday season, with 41 % reporting higher stress levels than other times of the year. This stress may cause depression, anxiety, or substance misuse.  

Some signs that you are struggling during the holiday season include, but are not limited to:

1. Not feeling like you are in the “holiday spirit”. Being surrounded by “cheer” and holiday decorations but not feeling very social. 

2. Feeling overwhelmed by grief and loss . 

3. Feeling the financial and emotional stress about giving and receiving gifts. 

4. Feeling pressure to participate in social activities and at the same time, you don’t want to. 

5. You are alone and isolating. 

Due to the hustle and bustle of the holiday season, many people muscle their way through the activities, but it does not have to be such a negative experience. There are several things you can do to take care of yourself and not feel burned out. 

It’s o.k. to say NO to events. People try to go to every holiday party they are invited to, which can be 2-3 in one day or evening. Pick the event which is most meaningful to you and where you are most comfortable. Surround yourself with the people who fuel you, not those who deplete you.  People that are hosting holiday parties understand that there are conflicts during this time. Prioritize the people and activities that bring you joy. 

If you are in a situation where one member of the group turns a conversation into a family feud or work argument, take a break. There is no shame in stepping away from stressful situations and either going into another room or stepping outside. 

Stay in your routine. Prioritize self-care. Focus on getting enough sleep, exercise and eating balanced meals. 

Get some fresh air and sunlight. Even if you are someone who does not like the cold, getting outside can help relax you and lift your mood. Walking outside in the sunlight has proven to be an excellent calming tool. Spending time in nature can help with concentration, improved mental energy and lower levels of inflammation in your joints. 

As mentioned earlier, grieving the loss of a loved one can feel very intense during the holiday season. This can be especially true for someone experiencing their first holiday without that loved one. It is important to honor and celebrate them with getting together with family and friends who share your traditions and know their life stories. 

Financial stress can be overwhelming even when it is not the holiday season. Make sure you stay within your budget so that over-spending does not leave you stressed as you get into the new year. Consider Secret Santa instead of buying gifts for everyone. Also consider homemade gifts or handmade items that may carry more meaning to the people receiving them. 

If you currently are in therapy, make time to have regularly scheduled appointments during the holiday season. Make this a priority. If you normally do in person appointments, ask your therapist if you can meet virtually to save a little travel time. 

The holidays do not have to be negative or stressful. Take time to understand what causes you stress during the holidays and make some adjustments to have the best holiday season ever. Happy Holidays!!

Mental Health Matters

Seasonal Affective Disorder (S.A.D.)

As we transition into fall, many people are excited  for the cooler temperatures,  Halloween decorations , flannel and pumpkin lattes. Yet, between 5-10% of the population experiences seasonal affective disorder (SAD) . In 2022 a poll found that nearly 38 % or 4 in 10 Americans reported declining mood in winter, though this may not always meet a clinical diagnosis of SAD. This is more common in women, young adults and individuals living farther north due to less sunlight. 

Thinking about the symptoms of seasonal affective disorder, they are similar to depression including: feelings of sadness, low energy, fatigue, and loss of interest in activities, change in appetite and increase sleep and daytime drowsiness, social withdrawal, grouchiness and anxiety, decrease sex drive, decrease ability to focus, and trouble thinking clearly.

SAD is a form of depression that is connected to seasonal changes and usually starts and ends around the same time each year. Most people who experience SAD have symptoms that begin in fall and continue through the winter months. When the days get shorter, there is less sunlight which leads to less Vitamin D intake, leading to a decrease in serotonin (the chemical that regulates happiness/joy).

The treatment for seasonal affective disorder includes:

• Exposure to sunlight. Spending time outside or near a window can ease the symptoms

• Light therapy. If increasing sunlight is not an option or impossible , exposure to a light therapy box (there are many different ones specific for SAD) for 30 minutes a day has proven to be helpful and can alleviate symptoms of SAD. The light box should provide an exposure to 10,000 lux of light and produce as little UV light as possible. Typical recommendations include using the light box: within the first hour of waking in the morning, for 20-30 minutes. Sit about 16 to 24 inches from the light with your eyes open but not looking directly into the light.

• Psychotherapy: Many types of therapy including cognitive behavior therapy and interpersonal therapy can help change some of the catastrophic thinking or distorted views you may have of yourself or your environment.

• Anti-depressants: Some individuals benefit from anti-depressants during the height of their symptoms.

Prevention for Seasonal Affective Disorder

• Exercise: helps you feel better because it increases dopamine which is the neurotransmitter that promotes feelings of pleasure and excitement.

• Go outside: Being outside in nature is helpful because of the absorption of oxygen.Try to be out in sunlight at least 10 minutes a day.

• Reach out to friends: Friends and family are a powerful source of support.

• Eat a balanced diet: Incorporate a variety of foods in your diet that build brain power allowing you to improve your mood.

• Drink more water: If you get enough water, it helps you sleep better.

• Limit alcohol use: 3-5 alcoholic beverages a week should be maximum for physical and mental health.

Recognizing the signs of Seasonal Affective Disorder (SAD) is an empowering first step toward feeling better. The great news is that there are effective treatments available that can help you regain energy, lift your mood, and thrive through the seasons. If you notice that symptoms continue even after the darker months pass, it may be an opportunity to explore deeper support for your mental health, such as treatment for major depressive disorder. Taking action can lead to greater clarity, joy, and a life filled with possibility.