Melanie Cole, MS (Host): There's no handbook for your child's health, but we do have a podcast featuring world-class clinical and research physicians covering everything from your child's allergies to zinc levels.

Welcome to Kids Health Cast by Weill Cornell Medicine. I'm Melanie Cole. And today, we're talking about science-based parenting strategies for repairing relationships and helping young people thrive. We're talking today about supporting your teen's mental health and what could be more important than that at this time. Joining me is Dr. Andrea Temkin-Yu. She's an attending psychologist and Assistant Professor of Psychology in Clinical Psychiatry at Weill Cornell Medicine.

Dr. Temkin-Yu, it's a pleasure to have you join us again. As so many parents right now, we're all feeling the same thing. You have little kids. I have older kids. We're worried so much about our children, and it seems to feel that there's a lot more anxiety, certainly than when I was growing up, and I'm way older than you are. Can you start with have you seen an increase in anxiety-related disorders in our children and teens over the course of the last few years? And if you have, what kinds of disorders are we seeing?

Dr. Andrea Temkin-Yu: Thank you so much for having me and talking about this. I think it's a really important topic that's definitely on parents' minds. And you're right, we're definitely seeing an increase in anxiety and beyond that. Anxiety, depression, more kids are being diagnosed with substance use difficulties, there seems to be a really genuine rise in these concerns for, I think, lots of different factors. Everyone's still feeling the implications from the pandemic, the social isolation, the academic gaps that were created. I think kids are very aware of things that are going on in the world these days, politics, climate, safety, which on the one hand is really good and, on the other hand, is really upping that anxiety level. So, any of those kids who maybe already were slightly anxious, now we're seeing more generalized anxiety or more separation anxiety or more obsessive-compulsive disorder. So, we're just seeing an uptick in mental health disorders sort of across the board these days.

Melanie Cole, MS: I truly think there's a mental health epidemic among our youth. And you and I will get into the lack of providers as well, because that's really a part of a disparity in the mental health situation that we're seeing. As we think of the pandemic, the stresses that the kids are under, and the factors as to why this is getting worse, can you share some of the impacts of the news, media on our kids? With so much happening, it can really be confusing. I mean, there's drones in the sky, and elections changing, and things going on, and our kids see it, Dr. Temkin-Yu, and we didn't see it because we didn't have this stuff.

Dr. Andrea Temkin-Yu: Yeah, you're absolutely right. And they're getting it from so many angles. I think kids are tuning in when it's on the radio and on TV at home. They're getting it from their own social media channels. They're hearing it from friends at school. And again, on the one hand, I think it's kind of amazing. I have all these kids who come into sessions and there's like this new generation of activists who are young and engaged, and that's really wonderful.

But on the flip side, teenagers have access to all this and they have much less control than adults do. So, they're just so much more limited in how they can respond to these concerns. And I think there's a couple of issues. One is, just like all of us, teenagers are having to sort through what information is correct, what information is false. One of the things we know is that social media really sort of makes money by making people outraged. So, kids are scrolling through their reels and their feeds and they're seeing headlines or posts that are specifically designed to make them more anxious or more angry, more upset because those give you more clicks and those clicks give people more money. It's so frustrating. And I think most adults aren't even so hyper-aware of that, and then how do we expect our 16 year olds to be aware of that?

So, I think parents really want to be thinking about how can we set our kids up to be good consumers. It'd be nice to just say, "Turn it all off." Don't expose them. But it's not realistic, right? They're going to get it from somewhere. So if they're going to get it, I'd really rather parents be talking with their kids about how can you figure out what sources are good sources. If you see news that you trust, but is still stressful, how do we interpret it? Who can you talk to? How do you cope with that? When you read information that's scary or frustrating or hard, how can you engage in a way that makes you feel empowered rather than helpless or terrified? So, I think there are steps that parents can take to help alleviate some of the stress, but we don't want to just pretend it's not happening. It's there. So, how can we get ahead of it with our kids?

Melanie Cole, MS: Okay. So first, red flags, things we should be looking at that would say, "You know what? Maybe we do need to get ahead of this because now maybe we're not so ahead." What are we looking for in our kids that would signal that this is something-- I mean, we need to pay attention to it, that's for sure. But can you give us some things you look for?

Dr. Andrea Temkin-Yu: Absolutely. So, one thing we're going to pay attention to is any major changes in our kids behavior and that could be in a couple of areas. So if their sleep is suddenly off, either they're sleeping way more or way less, or their appetite is drastically different. They went from eating pretty normal amounts at meals and now, all of a sudden, they're starving all the time or they're not touching their food at all, if their energy level seems totally out of whack. So, any of these sort of big changes, we want to pay attention to because it tells us that something's up.

Now, I'll note, a lot of these things do change in the teenage years. You know, kids' sleep change, their appetite changes. That's all normal. What parents want to pay attention to is if they're seeing multiple of these changes ongoing over time. It wasn't just one weird week of appetite, it's ongoing. And it's happening at the same time as the changes in sleep, and it's happening at the same time as the changes in energy.

The other thing parents want to look for is whether their kids are starting to pull back or avoid things that they didn't used to. So, maybe they've stopped responding to text messages from their friends, or they decide that they want to quit soccer after having played on the team for the last 10 years, or usually they're pretty good at getting their homework done and, all of a sudden, parents are getting notifications from the teachers that things are getting turned in. So if we're seeing signs that kids are sort of pulling back and withdrawing from their world, we really want to make note of that. If it's just A Change in interest? No problem. So if they quit soccer because they want to start dance, cool. Kids develop as they grow. But if they're starting to drop things they used to care about and they're not being replaced with anything, we really want to pay attention because that can definitely be a sign of increasing mood or anxiety difficulties.

Melanie Cole, MS: These are all such great tips. And because you're so great at tips, I would really love for you to tell us about your new workbook for parents, Supporting Your Teen's Mental health.

Dr. Andrea Temkin-Yu: Thank you. I'm so excited to talk about this workbook. So, this really stemmed from the fact that most people just don't have access to expert care. So many parents are worried about their teenagers. So many parents are worried about their kids of all ages,. But it's really difficult to find a psychologist or a mental health provider who can give you evidence-based strategy.

So, my goal with this workbook was to take some of the core skills that we have researched and know are effective at supporting teenagers and kids and putting them into a book that anyone can access. So, parents will learn a whole bunch of different tools to help build their kid's self-esteem, build their relationship with their child, decrease problem behaviors.

And what I really love is just like I would do if I was meeting with a parent face to face in session, is the book will sort of outline what each skill is, why it's important, and then give tons of practice. So if we're talking about how to validate your child, parents are going to read a whole bunch of examples of what that looks like, and then they get to try it on their own. So, there's lots of exercises and quizzes, things to make it interactive, and I'm hoping that parents find it a nice, sort of easy way to access skills without having to go through the whole burden of finding the right care team, making sure insurance covers it, and all that stuff that we know can make accessing care difficult.

Melanie Cole, MS: Wow, that's so cool that you were able to do that. And I think accessing care is one of the biggest issues today. Some kids might be willing to go or see a therapist. However, telehealth, since the pandemic has really changed the landscape of mental health. I mean, there's companies out there now you can go on and find a psychiatrist to help you manage your medications or to talk to a psychologist. What do you think of this telehealth and how it can help parents to access better care?

Dr. Andrea Temkin-Yu: Yeah, telehealth is an amazing resource. I actually exclusively use telehealth with my families that I work with. And I think for a lot of people it works really well. So, telehealth is great for parents, because you don't have to worry about commuting to the office during rush hour. You don't have to worry about child care, because you can hop on Zoom while your kiddos are finishing homework. It's really great. We have lots of research that shows us that telehealth can be as effective as in-person treatment.

I do think though there are still some families who can't even access that, either because their insurance doesn't cover it or they really need someone who can meet after the kids go to bed and only so many providers have 8:30 p.m. appointments. So, you still do run into access to care issues, but it does open up a whole new window for families who wouldn't have been able to get to an office in person. It's a great option if it works for you, and you can find someone who can offer it.

Melanie Cole, MS: Let's talk about some at-home tools that can help to support positive mental health in our teens because some of these are common sense, some of these are really science-based parenting strategies to help our kids thrive. Some of these things we've seen work over the years. Give us some of your best tips when you're talking to parents and you're like, "Okay, you know, we've talked things out. We've done this. We've looked at all the different aspects of treatments. But I also at home want you to be doing this. I want you to go to yoga together," whatever it is. Give us some of your best tips.

Dr. Andrea Temkin-Yu: Yeah. So actually, one of the tips that I start with most for parents is I want them to validate their child more. And by validate, I mean, helping your child understand that what they're experiencing, their feelings, we get it. We can see where they're coming from. And I think as a parent, when you see your kid and they feel anxious, or you see that their mood is lowering, we really want to jump in and problem solve. We want to say, "Let's go to yoga," or "Let's email your teacher together," or "Let's figure out a solution," and that can be really great.

But if you have a kid who's feeling so down or who's feeling really worried, the very first thing they need is just to feel understood. So, if parents can work on expressing, "Hey, I get it. Of course, you're anxious, you care a lot about school, and you've got that test coming up in two days. No wonder you're a little on edge." That really just helps bring the intensity of that emotion down, and that will make it easier for your child to then accept your solutions, right? So, if we can say, "I totally get it. Of course, you're really frustrated right now," and that kid feels really understood. Now, when I say, "How about we talk to your teacher together?" or "How about we take a break and go on that walk?" your kid's going to be much more likely to listen to what you have to say because they can see that you're on their side and you're understanding. So, my sort of number one catch-all trick is when you want a problem solved, start with that validation.

Melanie Cole, MS: That is such great advice. It really does make a difference. And I see it with my own kids. And if I don't do the validation thing, then they feel, you know, like not heard or not seen.

Dr. Andrea Temkin-Yu: That's exactly right. We get a lot of eye rolls. We get a lot of like, "You don't understand," or "You don't get it, you're not a teenager." So, we really want to start with that, help your kid feel understood, and then we can move from there. But that validation will go a long way.

Melanie Cole, MS: So as we get ready to wrap up, Dr. Temkin-Yu, so much great information you've given us today. With all of this in mind, everything that's going on in the world today and how global our children are now, what would you like parents to take away from this episode today in the mental health epidemic that we're seeing in our youth, ways that they can help, things that you can do for them at Weill Cornell Medicine?

Dr. Andrea Temkin-Yu: I think there's sort of two main things. The first piece is just to recognize that the love you have for your kid is your biggest strength. It's really scary and exhausting and nerve-wracking to be a parent. And with all the parenting advice online and social media, it's easy to feel lost. But most parents just adore their kids and if you use that as your North Star, they're already ahead of the game. So, don't lose sight of how important just your love and support is. And then beyond that, when you're feeling stuck or you're not sure what the right answer is, there is good help there. So whether it's the book, Supporting Your Teen's Mental Health, or talking to your child's pediatrician, or the guidance counselor, or looking into your own mental health care, there's really good treatment out there to help you feel confident and help give you the strategies to support your kid. Even if it takes a little while to find the right provider or the right type of help for you, it's out there and it can make a world of difference.

Melanie Cole, MS: It certainly can. That was so well said. And, listeners, go get the new workbook for parents, Supporting Your Teen's Mental Health by Dr. Andrea Temkin-Yu. She explained how this workbook can help us work with our kids and validate their feelings and sort through things. So, how important that is if you have teens, tweens, kids in that age group because, boy, we're sure seeing it. Thank you so much, Doctor, for joining us.

And Weill Cornell Medicine continues to see our patients in person as well as through video visits. And you can be confident of the safety of your appointments at Weill Cornell Medicine. That concludes today's episode of Kids Health Cast. We'd like to invite our audience to download, subscribe, rate, and review Kids Health Cast on Apple Podcasts, Spotify, iHeart, and Pandora. For more health tips, please visit weillcornell.org and search podcasts. And don't forget to check out Back to Health. We have so many great podcasts there as well. I'm Melanie Cole. Thanks so much for joining us today.

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