Melanie Cole, MS (Host): Welcome to Bryan Health Podcast. I'm Melanie Cole. And today, we're delving into teen behaviors. Joining me is Andrea Ruiz. She's a mental health therapist at the Bryan Counseling Center.

Andrea, thank you so much for joining us today. This is such a great topic , have you seen an increase in anxiety disorders among our tweens and teens in the last couple of years?

Andrea Ruiz, MA: Thanks, Melanie. Yeah, I would say there have been quite a few increases. I've been doing this for almost 18 years. And the content of what we're worried about has shifted so much with the onset of social media and online resources and activities. COVID six years ago was definitely a game-changer. So, definitely more and definitely a more diverse set of issues than when I started.

Melanie Cole, MS: And I'd like to get into some of those red flags and concerning behaviors. Before we do, what kinds of issues have you been seeing? Because I know you just mentioned social media and there's anxiety and stress disorders and eating disorders and, you know, there's so many ones now today that weren't really as prevalent as you say many years ago. What are you seeing?

Andrea Ruiz, MA: Yes, definitely the technology and social media shift, even from when I was growing up, that's such a huge difference. But I would say that probably anxiety at school has increased. You know, many kids took a year or more off of school during COVID especially. And I say, I think in the last several years, we've just seen more truancy, more difficulty with making friends and connecting with people at school, being involved in extracurriculars and grade decline.

lots of different issues that parents deal with, And I like to work with parents on trying to find ways to address those without being overly critical And a lot of that goes with doing things like that are kind of in that middle area. finding that middle ground with your teens is very important Certainly true. So, what are some typical and concerning teen behaviors that we should be looking out for?

Well, I'll just kind of run down some of the typical things we see and I have kids come in with their parents for. And often I'm having to differentiate, is this normal or i is this something we need to pay attention to? So yeah, I'd like to go over some of the typical things. And I'll go into detail on a few of them, but increased moodiness is normal, greater self-consciousness, procrastination, distractibility, parenting conflict, experimentation with drugs or alcohol, invincibility and risk-taking behaviors, kids being more opinionated and argumentative, the dating and sexuality issues that come up, increased need for privacy, messiness, sleep issues. Most of these really can test parents' patience. but they're often a sign that teens are developing independence, identity, and decision-making skills.

Melanie Cole, MS: Wow, that was quite a list. So, what are some ways to increase positive behaviors and decrease some of the negative behaviors? What are we looking to do here?

Andrea Ruiz, MA: Sure. I think the first thing is awareness, right? Paying attention to those issues with moodiness, things that are more persistent, severe, or interfering with daily life need more attention than the typical blow up and recovery real quick. Often that's more normal to have adolescents just get very emotional, and then they can kind of go back to baseline. If it's persistent and they can't go back to baseline, they might need extra help.

Moving on to, let's see, parent-teen conflict, for example. That's really hard to communicate through, right? But teenagers are always striving for independence and because of this, disagreements increase often. Questioning rules, wanting more autonomy. These are healthy developmental milestones. But when it escalates into maybe verbal abuse, physical aggression, destruction of property, or running away, this is when more intervention is needed.

Melanie Cole, MS: So, you mentioned communication before, and I think that one of the most important thing parents can do is recognize that and learn how to communicate with their teens. So, tell us how that plays a role in interactions. But importantly, how do we start those conversations with our teen? How do we keep those lines of communication open?

Andrea Ruiz, MA: Yeah, it is absolutely one of the strongest predictors of a healthy parent-child-teen relationship. I would say one of the most important skills in good communication is actually validation. And, you know, validation, does not mean agreeing with your teen. It means acknowledging that their emotions make sense from their perspective.

So, for example, instead of saying, "You're overreacting," which is dismissive, you know, judgy, maybe say, "I can see this feels really important to you." So, when you validate, they're more apt to be willing to problem solve. Parents can also improve communication by doing things like listening before they give advice, asking open-ended questions, staying curious rather than making assumptions, avoiding lectures, choosing calm moments for those difficult conversations, and really avoiding extremes. So, we don't want to be overly strict or overly permissive. We want to find that balance in between.

Melanie Cole, MS: Yeah, that balance is really so important. So, what kind of resources are available if we sense our teen is struggling?

Andrea Ruiz, MA: I always recommend that you start with your pediatrician. Oftentimes this person has been involved with the family for a long, long time. They know the history of the people. And they can also determine whether these emotional or behavioral changes are typical or might need to be referred to a therapist or a psychiatrist.

School resources are great. They have counselors, psychologists, social workers. Even teachers, they can provide support if there are school issues coming up. Then, of course, mental health professionals like licensed counselors, psychologists, marriage and family therapists, and psychiatrists. And then, that family therapy that I just mentioned, that's really helpful in improving communication. Often, like, they're a first line for that.

There are also skills groups like dialectical behavior therapy skills groups. These are very focused on learning skills to manage your emotions and handle distressing situations. And then, we have resources, here at Bryan.

We also have online supports like NAMI, which is the National Alliance for Mental Illness. They have a lot of good resources for parents in figuring out how to communicate, set boundaries, expectations and consequences. And then, I always point to the National Mental Health Hotline, which is 988. So if you're in a crisis, that is often a first response place. They have licensed people who can talk through the crisis situation and access resources if they're necessary.

Melanie Cole, MS: Well, thank you for really going over all of those resources. And tell us a little bit about some of the therapies that you use, that you've found that work. And when you're working with teens, Andrea, what do you do? Because parents want to start that discussion and say to their teens, "I recognize that you're struggling." Help us to start that discussion. What do you say?

Andrea Ruiz, MA: I often try to get them on the same page, try to find more of the commonalities and the positives, things that are working well so that we can build from them. That really reflects that walking the middle path idea But truly, you know, I've been doing this for so long, I have several different approaches, that I kind of use as an eclectic approach. So, cognitive behavior therapy, for example, is great to help people learn how to change their thinking and maybe then changing how they feel about a certain situation and giving them space to make a better choice on how they're going to react. Like I said, the dialectical behavior therapy. But just even finding that, like I said, common ground, finding things they're interested in together so they can start building or rebuilding connection.

Melanie Cole, MS: Do you have any other advice for our listeners as we wrap up?

Andrea Ruiz, MA: I would like parents to remember that adolescence is temporary. It can be easy to feel discouraged during these teenage years, especially when that relationship changes. Try to remember that adolescence is a stage of development, not a permanent personality. That teen who rolls their eyes today might still be willing to listen to everything you say, even if they're not showing it. Make sure you're focusing on the relationship and not just the behavior. While it's absolutely important to address inappropriate behavior, don't lose sight of the relationship. Research actually shows that teenagers are more likely to accept guidance from adults they trust and feel connected to. So, that's a good thing to have.

If you feel like you need more help, you can contact us here at the Bryan Counseling Center. We have a lot of resources on our website, including an online screening tool that can help parents kind of assess where their kiddos are at, and then get the proper referrals going for therapists or maybe higher levels of care if necessary. We also have the emergency resources here at our mental health emergency department and our inpatient units.

Melanie Cole, MS: Thank you so much, Andrea, for joining us today. And I'd like to thank our Bryan Foundation partner, Holmes Murphy. To listen to more podcasts from our experts, please visit bryanhealth.org/podcasts. And that concludes this episode of Bryan Health Podcast. Please remember to subscribe, rate, and review Bryan Health Podcast on Apple Podcasts, Spotify, iHeart, and Pandora.