Growing Up Is Hard to Do

Those close to adolescents should be aware of “at-risk signs” and intervene.

Posted Mar 23, 2020

All stages of life include biological, cognitive, emotional, and social development. Many researchers, however, identify adolescence as a particularly robust period full of changes requiring multiple and complex transitions. Adolescents are bombarded with multiple issues, including:

  • Developmental changes (physical and psychological)
  • The phenomenon of individuating into their own person and becoming independent
  • The need to become adaptive in situations that are novel or intimidating
  • The tenuous and fickle nature of social interactions and bonds, including friendships and being in love with someone
  • The pressures and expectations placed on adolescents from family, peers, and even themselves
  • The concern about broad social, environmental, and financial matters affecting local, national, and global settings

As young people progress to middle school, they experience a variety of changes and new demands (Ryan et al., 2013). These include the need to adjust to large classrooms and rigid time schedules, as well as increasing academic expectations. They also begin to focus on issues related to themselves, such as self-worth and self-esteem, their sexuality, identity, future plans, as well as the effect their relationships with peers and family members have on them (Rew et al., 2012).

As the adolescent grows older, typical concerns include career plans, educational pursuits, and the development of more intimate personal relationships. The importance of focusing on life skills, such as employment, vocational preparation and training, money management, residential needs, and the development of life coping strategies, often occur among post-high school adolescents. There is also the inclination to assume more independent managerial functioning. Problems in doing so are not uncommon, given that the older adolescent may not have the requisite abilities to perform effectively across most spheres.

Generally, adolescence can be a formidable time, even for those who are resourceful and supported. It’s not uncommon for them to experience symptoms of anxiety stemming from the stressors produced by expected developmental transitions. They may worry about being able to meet expectations or if their plans for the future will come to fruition.

Because they are in the process of developing a sense of self, adolescents can be particularly sensitive to negativity or even ambiguity. In addition, given the psychological benefits of belongingness (where one feels accepted, supported, and respected), their mental health may be adversely affected by rejection from peers (Vaz et al., 2015) or someone to whom they are romantically attracted.

For some adolescents, these challenging issues may be too great for them to handle. This difficulty may be even more pronounced if other external stressors are present (such as family problems or dysfunction, financial insecurity, frequent changes in residence or schools, and important losses). If the adolescent places high or unrealistic expectations on their ability to cope or simply does not have the knowledge or abilities to do so, serious mental or behavioral problems may result.

Adolescence is the stage when mental illness may first appear. Anxiety and depression can manifest during mid-adolescence. Unfortunately, the rates of depression are increasing for adolescents. Suicidal ideation also occurs during this period, and if left untreated, suicide can result.

Suicide in the United States among adolescents aged 13-19 was the second leading cause of death in 2018. The number of suicides for males was 2,149, with a rate of 14.31 per 100,00 population; the number for females was 675 with a rate of 4.69 (Centers for Disease Control and Prevention, 2020). Social issues such as bullying, discrimination, and marginalization contribute to increased rates of depression and suicide (Cleary et al., 2011). The use of alcohol and drugs is another mental health risk factor that further impairs the adolescent.

As the adolescent grows older, these illnesses become more psychologically and behaviorally impairing because of having untreated symptoms for a long period and not having adequately developed the skills and confidence they need to navigate the tasks they now encounter. Therefore, when the adolescent first experiences symptoms of depression or anxiety, this is “the optimum time to introduce prevention intervention programs” (Woods & Pooley, 2015, p. 98). Other troubling or dysfunctional symptoms (e.g., stress, sleep disturbance, withdrawal, difficulty concentrating, anger, poor hygiene) should also be addressed.

School personnel, mental health professionals, and parents should all be involved in supporting the adolescent. Communication among them can be quite effective in gaining a better understanding of the adolescent’s difficulties, needs, and intervention progress. For many adolescents, focusing on the following issues can be helpful:

  • Life skills training
  • Self-efficacy
  • Communication and problem solving
  • Adaptability
  • Social connections

Other recommended interventions include

  • Universal mental health screening for those entering a new school (Moore et al., 2019)
  • For older-aged youth who are experiencing more serious difficulties, mentorship with people who have had similar life experiences, because they can offer empathy, trust, support and guidance in helping the adolescent make better decisions (Gilmer et al., 2012)
  • Group therapy focusing on specific issues, such as violence and sexual abuse (Gilmer et al., 2012)  
  • Family therapy to assist members in gaining a better understanding of the adolescent’s difficulties and what interventions could be applied

It is important that adolescents, parents, and school personnel are educated about problematic issues that occur during adolescence and aware of programs for mental health interventions so that help can be obtained. For those adolescents who have psychiatric disorders or functional impairment, early and comprehensive mental health treatment is warranted to prevent further decompensation as well as assist the adolescent in successfully making developmental transitions.

Many people are either afraid or unwilling to seek mental health treatment. The reasons are many; nevertheless, their difficulties continue and can possibly grow worse. The struggles that often accompany the adolescent developmental period may be too great for some to handle. Therefore, for those of us who have or know adolescents, we should be aware of “at-risk signs,” so that we may be able to help the troubled youth. Growing up is hard to do. Not helping someone in need is even worse.

References

Arango, C., Díaz-Caneja, C. M., McGorry, P. D., Rapoport, J., Sommer, I. E., Vorstman, J. A.,McDaid, D., Marin, O., Drozdowskyj, E. S., Freedman, R., & Carpenter, W. (2018). Preventive strategies for mental health. Lancet Psychiatry, 5, 591-604. https://doi.org/10.1016/ S2215-0366(18)30057-9

Centers for Disease Control and Prevention. (2020). Injury prevention and control. Fatal injury data. Retrieved March 14, 2020 from, https://www.cdc.gov/injury/wisqars/fatal.html

Cleary, M., Walter, G., & Jacksn, D. (2011). “Not always smooth sailing”: Mental health issues associated with the transition from high school to college. Issues in Mental Health Nursing, 32(4), 250–254. doi: 10.3109/01612840.2010.548906.

Gilmer, T. P., Ojeda, V. D., Leich, J., Heller, R., Garcia, P. & Palinkas, L. A. (2012). Assessing needs for mental health and other services among transition-age youths, parents, and providers. Psychiatric Services, 63(4), 338-42. doi: 10.1176/appi.ps.201000545.

Moore, S. A., Dowdy, E., Nylund-Gibson, K., & Furlong, M. J. (2019). A latent transition analysis of the longitudinal stability of dual-factor mental health in adolescence. Journal of School Psychology, 73, 56-73. https://doi.org/10.1016/j.jsp.2019.03.003

Rew, L., Tyler, D. Fredland, N., & Hannah, D. (2012). Adolescents’ concerns as they transition through high school. Advances in Nursing Science, 35:3, 205–221. doi: 10.1097/ANS.0b013e318261a7d7

Ryan, A. M., Shim, S. S., & Makara, K. A. (2013). Changes in academic adjustment and relational self-worth across the transition to middle school. Journal of Youth and Adolescence, 42, 1372–1384.  DOI 10.1007/s10964-013-9984-7

Vaz, S., Falkmer, M., Ciccarelli, M., Passmore, A., Parsons, R., Black, M., Cuomo, B., Tan, T., & Falkmer, T. (2015). Belongingness in early secondary school: Key factors that primary and secondary schools need to consider. PLoS One. 2015 Sep 15;10(9):e0136053. doi: 10.1371/journal.pone.0136053. eCollection 2015.

Woods, R., & Pooley, J. A. (2015). A review of intervention programs that assist the transition for adolescence into high school and the prevention of mental health problems. International Journal of Child and Adolescent Health, 8(2), 97-108.