Clinical Psychologist Nupur Dhakephalkar guides us through the minds of adolescents to understand what we can do to address the ever-growing cases of mental illness amongst the youth
Let’s start with a quick definition of ‘Mental Health’. The World Health Organisation defines mental health as a state of well-being in which every individual realises her or his own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to contribute to her or his community.
This year’s theme for World Mental Health Day was ‘Young people and mental health in a changing world’. ‘Young People’ covers the age range of 10-24 years while ‘adolescents’ are individuals in the 10-19 years age group. Since the term young people covers a vast population, for the sake of this article, I will be focusing on adolescents.
Before we begin, it is important to state that all adolescents too are not the same. They come from different circumstances and have unique needs. The aim of this article is to understand adolescence and the mental health challenges and opportunities that come with it. Statistics show that nearly two thirds of mental disorders and premature deaths occurring in adulthood are caused because of the problematic conditions and behaviours that developed in one’s youth. They may express their distress by internalising behaviours like fearfulness, social withdrawal, and physical complaints. Some may display externalising behaviours like bullying and vandalism. In such cases, one needs awareness, acknowledgement, and acceptance of the problems, along with the realisation that we can do something about it.
The transition from childhood to adulthood involves dramatic physical, sexual, psychological and socio-developmental changes, all taking place at the same time. In addition to opportunities for development, these changes pose risks to their health and well-being. Let’s start by understanding the developmental aspect.
As the child becomes an adolescent, different areas of the brain gradually start communicating a lot more with each other during the teenage years. However, he or she is not mature enough to deal with situations requiring self-control, planning, and thinking about the future. Adding to these changes are the changes in the brain’s emotional/social network. The adolescents end up reacting more strongly to stressful events and experience pleasurable stimuli more intensely, but find it difficult to manage their powerful impact. This imbalance contributes to their unchecked drive for novel experiences, including drug taking, reckless driving, unprotected sex, and antisocial activity, especially among those who are highly stressed and need to deal with continued emotional pain.
In case of psycho-social development, in the ages of 5 to 13, children discover the joys of creation. They learn new skills and take pride in the things they make. If they are not ready for this stage of psychosocial development, they may develop a sense of inferiority and/or inadequacy. Teachers and other role models become very important in circumventing this sense of inferiority and achieving competence by encouraging creativity, discovery and play.
Age 13 onwards, puberty comes knocking. While experiencing its numerous social and physiological changes, adolescents are also trying to discover and realise their own identity. They reflect upon how they appear versus how they feel. Knowing who you are and how you fit into society brings along a sense of identity and belonging. Sometimes, lawbreaking, difficulties with gender identity, etc.can result from such confusion.
Adolescents may also need help in developing their emotional intelligence. They need to be enabled to manage their own emotions and interact competently with others; to be able to perceive emotions on people’s faces correctly; reason about emotions in social situations; match emotions to thoughts and activities; and be able to regulate their thoughts and emotions. The emotions that are felt and perceived at that age provide learning lessons for life if they have a safe space to share, explore and understand them.
Being in the middle of childhood and adulthood is not easy. The adolescent feels that she or he is not a child anymore but is not yet an adult. Many mental illnesses begin by the age of 14 but most go undetected and untreated. Depression is the third leading cause of distress among youth, and suicide is the second leading cause of death among young people. World Health Organization statistics have estimated that each year about one million individuals end their life. As per official reports of the Indian census board, nearly 1,36,000 deaths were caused due to suicidal acts in the year 2011 among those between the ages of 15 to 29. Another study revealed that more than 40% of recorded suicides occurring in India are committed by individuals falling below 30 years of age.
We at the Centre for Mental Health, Pune, conducted an informal survey in a Pune women’s Facebook forum to gauge what they wanted to know about and for the mental health of their children. Some of the most common concerns that came up were: Attention and concentration; the cognitive, social, and physical development; excessive use and negative impact of technology; failure and coping; sexual development and sex education; dealing with academic stress; fitting in and standing out; bullying; peer pressure; body image issues; depression; and effect of differences in the family.
My very close friend, who is a psychologist and works primarily with adolescents in a school setting, disclosed that many times when there is distress/rebellion/withdrawal or even a clinically diagnosed mental health condition, parents’ perceptions of the problem are very different from the experience of the child.
Look out for behavioural indicators like increased secrecy about daily experiences, social withdrawal, locking oneself in the room, cut marks/self-harm marks on the body, increased mood swings, anger and irritability, missing/running away from school, sadness, talk about dying or self-harm and other calls for help. To be able to understand them better, you must break barriers of communication with your child; take an interest in your child’s life (without being nosy and accept the information they readily share with you). It’s crucial to show what you admire about your child along with giving constructive feedback. Parents who refrain from labelling their teenager, refrain from being judgemental, argumentative or preachy, but communicate openly and make an effort to understand the individual, are more likely to raise healthier adolescents. The striving for autonomy and pushing boundaries to explore more, needs to be dealt with parental patience, oversight, discipline, and guidance all at the same time. Encouraging independence and allowing them to make mistakes and learn from them helps adolescents discover their uniqueness. This also builds trust. It helps them become more confident in their own abilities to cope with situations. Providing experiences that fulfil their social and emotional needs can improve their adjustment. These can help with the transition from adolescence to adulthood in a healthy way.
Parents, teachers, and mentors of the youth can help start a healthy conversation towards mental wellness. Positive coping skills and healthier methods of dealing with negative emotions and thought scan be taught. The most functional and effective coping styles depend upon individual personality aspects and needs. These tools permit the individual in acknowledging, understanding, and expressing his/her emotions. Building life skills in children and adolescents and providing them with psychosocial support in schools and other community settings can help promote good mental health. Programs to help strengthen the ties between adolescents and their families are also important. If problems arise, they should be detected and managed by competent and caring health workers.
A few healthy coping strategies that can prove to be beneficial for dealing with stress or sadness are
- meditation paired with conscious inhalation exercises,
- positive affirmations and visualisations,
- drawing inspiration from musings and expressing them by relying on a creative outlet such as music, sketching, poetry or painting,
- physical activity which includes sports, dance, and exercise,
- going out in the nature and exploring in the open,
- planning ahead and having a precise and a well-structured schedule.
Lastly, it is important to reduce the taboo and stigma towards seeking professional help and making it available to the young adults.They must be spoken to about the normalcy of such ebbs in life and that these do not warrant secrecy or shame of any degree.Resilience is built by experiencing adversity when the safety belt of support is on!
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