Melanie Cole, MS (Host): Welcome to Long Live Childhood, a pediatric health and wellness podcast presented by Children's Health of Orange County. I'm Melanie Cole, and joining me today is Dr. Shirin Mostofi. She's a Pediatric Psychologist with the Adolescent Intensive Outpatient Program with Children's Health of Orange County, and she's here to help us today with teen communications, tips for talking to your teen.

Dr. Mostofi, welcome. I'm so glad that you're here with us today. I'd like you to start by just kind of giving the listeners a little bit of your own background and your expertise in this topic.

Shirin Mostofi, PsyD: Sure. Good morning, Melanie. Thank you for having me. Well, I've had over 10 years of experience working with children and parents in different capacities, and mainly the main focus is around parent child interactions and connections. My main focus right now is working with teenagers in high school and how their families can better support them with their mental health journey.

So I'd like to say I've had a lot of experience working with families and helping them reconnect.

Host: Well, that's important for our conversation because we are talking about how to talk to your teens. Now, as we think about the mental health of our teens and Dr. Mostofi, I know there is an epidemic right now, a mental health crisis for our teens and our kids right now. Have you seen an increase in anxiety, eating disorders, mental health issues over the course of the last few years?

Shirin Mostofi, PsyD: Absolutely. I think with all the challenges that we as the world went through, collectively, there have been a lot of challenges at reintegrating back into society and life, such as school, family interactions, social interactions, and everything else. There's been a lot of challenges that's come with that for specifically teens in high school with that critical developmental age as well as they're trying to find their own identity and trying to connect and how social interactions are so important with them and they are finding a lot of challenges with that.

Host: Well I saw it with my kids too with COVID when they were doing school online and it took a mental health toll. And so that's why I think this is a really important episode we're discussing here today because you have to communicate. So red flags for us, Dr. Mostofi. What are some potential signs that one of our children are kind of disconnecting, that they're not communicating, some signs of anxiety, depression, things we might not know are really going on?

Shirin Mostofi, PsyD: I think it's important to know that naturally teenagers do start disconnecting a little bit from their caretakers and parents as they're trying to strengthen their connections with their friends and communities. Of course, there are some signs that maybe the struggles is just beyond their typical development.

Some things could look like limited to no interactions with their parents or caregivers, and the few ones that they do have are accompanied maybe with agitation or irritability. They might spend most of their time in their room, and even on the weekends, they don't want to come outside of that safe space that they have.

Maybe they're not making eye contact with you or giving you brief responses, kind of brushing you off, so to say, and realizing maybe that you as a parent and your child are not having as much fun together anymore. So kind of that sense of like you don't quite understand what's going on for your teen because you're not really part of it anymore.

Host: So there are those little red flags. So we're not feeling as much a part of it. And as you said, that's normal for teens anyway. And what we've learned about the teenage brain, is in itself a podcast episode. Yeah, it's like something that we really don't completely understand and we're learning more and more. But if we notice these signs, then what do we do?

Shirin Mostofi, PsyD: I think, other critical things to keep an eye out for is change in habits, too, that lasts more than just a few days or a few weeks. You know, those changes in hygiene, where they're not brushing their teeth, or showering could be hard, or they're wearing the same clothes time after time, or they're starting to recently have a hard time going to school and such things like that, there's changes in daily routines that become noticeable and they last for longer periods of time. And to answer your second question of what to do with that, I think it's important to check in with them. I think oftentimes parents and caregivers tiptoe around their children and don't want to push them over the edge or upset them.

I think it's very important to check in with them with how their day is going, maybe even more than just how was your day or did you have a good day? Maybe take it beyond and say things such as what are two, three things that you enjoy today? What are a few things you dislike today? What are some things that made you smile and some things that made you frown?

Host: Those are great tips. And what about some self care tips if we want to communicate with our kids? Are there things that we can do such as taking walks, exercise, yoga, meditation, really, before we would call in a professional? And we're going to talk about that part of it all too, but that can help facilitate some of that communication, things we can do together?

Shirin Mostofi, PsyD: Absolutely. What you said is critical. Doing things together. I think when sometimes we check in with our teens and ask them these questions, parents don't end up sharing their own experiences throughout the day. So it's important to give as much as you expect to receive from your child.

If you're asking about their day, share some things about your own day. If you want to have fun with them, then take the initiative to do fun things with them. And I think an important factor to consider is when you're trying to have fun with them, whether it's going on the walks or baking, cooking, going shopping, watching a movie, it's important to recognize that do I spend at least 10, 15 minutes a day with my child where I'm not being a parent per se, where I'm not keeping that parent hat on the whole time, where we can have casual conversations outside of those really stressful topics like school, chores, family responsibilities, and life events. Can we just relax and have fun?

Host: Well, I feel Dr. Mostofi, that starting that early basis of trust and communication is so important. When they're little, we want to start doing these things and getting them to talk to us. And one of the things I learned with my kids was to let them know that while they can tell me anything and there may be consequences, we certainly can work things out together.

One of the things that many parents wonder is how do we respond to our youth's problems when they share them with us? If it's something that makes us either uncomfortable, maybe it's of a sexual or drug nature, or maybe it's something that happened in school, bullying, in either direction, how do we best respond?

Shirin Mostofi, PsyD: I think this is probably something that parents struggle the most with, and it's naturally so because as parents and caregivers, we want to be there for our children. Of course, we want to solve their problems. We want them to be safe. We want them to be taken care of. We want them to stay protected.

And oftentimes when they share something, we notice that our own emotions kind of start boiling up as well, and we want to react and respond in a way just to make sure everyone's safe. So I think, my primary recommendation or my main recommendation is to take a step back and before jumping to punish, criticize, solve it or fix it, allow space for them to continue talking and sharing.

So rather than cutting it short with solutions or punishment or timeouts or scolding, what are some things that parents can say that would show their children that I understand the struggle you went through? I don't agree with your decisions maybe, and I understand how you came about making those decisions or how you ended up where you are right now and how you're feeling.

An example of that could be, you mentioned something about using drugs. So if someone, your child, your teen shares with you, I smoke pot or I smoke weed, or I use substances, at this event that I went to, I know initial reaction would be, well, this is not our value. You know that you're punished. How dare you? This is not okay. I would suggest taking a step back before saying those things. Just the first response to be something that understands as a teenager and me being your parent, I get the peer pressure that you probably went through to make you decide to do that.

Or I understand maybe the anxiety of saying no to your friends in that situation, how hard that must have been. Or, hey, I get it. Maybe you were just curious to see how this would feel like, and I'm glad that you came and shared it with me. So putting a pause and saying, I see you before I respond as me as a parent.

Host: That's great advice, because you can see in a child when they shut down, if you say the wrong thing, you say something that seems condescending or in another way judgmental, too judgmental. You can watch them, literally watch them shut down, and then they will be more hesitant to communicate with you in the future.

Now, what are some signs that we need to bring in some professional help? And is that first professional help our pediatrician, or do we look for a specialist?

Shirin Mostofi, PsyD: I think it can be either or. With those changes in routine that I mentioned, it could also accompany changes in mood, changes in the way they communicate, changes in weight, their eating habits, their sleep, their loss of interest in doing things. So it could be some shifts that you notice in your child. And of course, you can start with your primary care for a wellness check. You can get their lab works done and they can do a primary evaluation assessment of is there anything else that goes on? I think right now, primary care clinics are doing a fantastic job screening for a lot of mental health challenges as well.

So that's on their radar and some things do get flagged. So you can start with your primary care provider. Or if you are able to find a mental health provider for that initial assessment evaluation as well, fantastic! Either or would be a great place to start.

Host: And I'd like you to wrap up here with your best advice. You're in this field, all of us parents are seeing it. I mean, we've been seeing it since before COVID really, but that really exacerbated the situation and we saw our children in a much different situation than we'd ever seen them before. Cut off from their friends and the social situation took on a completely new way, really, even for us.

And we're under stress, we felt that stress, so we know our kids felt the same. I'd like you to give us your best advice for as a family, taking care of ourselves so that we can take care of our kids, because certainly as women we have to do that and take care of ourselves first. But we have to do it all together because we're all in the same situation, but our kids feel it a little more acutely.

Shirin Mostofi, PsyD: Oh, these are tough times. We went through a very big change and now we're trying to recover. My best advice would be to plan out your days and times together, kind of looking at your schedule and seeing as a parent, do I have enough time set aside to have fun with my children and have fun as a family, as a unit?

Do I have one on one attention with my children and do we have time as a unit to have fun together? And same, to encourage your children as well, are they swamped and wrapped up with all the duties and tasks that they're trying to catch up with life and everything that they fell behind from in the past few years?

And are they having enough time in their schedule for fun, relax,downtime, enjoyable moments and is there time for them to see if they also have time in their schedules and it must be a pretty busy one too, to enjoy life as well.

Host: I agree with you and what an informative episode this was. Thank you so much, Doctor, for joining us today. And for more mental health tips and information, please visit choc.org/mentalhealth. Thank you so much for joining us on Long Live Childhood, a pediatric health and wellness podcast presented by Children's Health of Orange County. Together, we can keep kids happy and healthy. And please remember to share on your social channels as we're all learning from the experts at CHOC together. I'm Melanie Cole.