The Portable Therapist for Your Teen

Teens can be notoriously monosyllabic in response to questions at dinner like: “How was your day? How are you doing?” and as they are developmentally practicing their independence of mind and spirt from and away from parents, they can also be notoriously oppositional. It can be a tough time for parents to figure out how their teen or young adult who has just gone off to college is doing. Anxiety and depression are not infrequent occurrences for our kids and it can be really tough for parents to know when their kid needs help, and even getting them to go for help can be tricky. However, for any parent out there who has ever worried that their child is depressed, there is some really good news.

Jacob Towery, MD, is an adolescent and adult psychiatrist who runs a practice in Palo Alto and where he also is on the Adjunct Faculty at Stanford University. Lucky for all of us, he has written a book for which there is an Audible version: "The Anti-Depressant Book, A Practical Guide for Teens and Young Adults to Overcome Depression and Stay Healthy". For our kids who are glued to their headphones and smartphones, it truly can be a lifesaver.

He uses a holistic approach to treating depression that includes attention to sleep, exercise, and mindfulness along with cognitive methods to decrease depression. Dr. Towery breaks down, step-by-step, good reasons a teen may not want to move forward and do the things they need to do in order to help themselves get over their depression. He is respectful, and at the same time, unwavering in his understanding that if one imagines that they will become less depressed while utterly sleep deprived, then perhaps it makes sense to close the book at this moment and return to it when they are able and wish to address getting more sleep in the ways suggested. At times in fact, getting more sleep for our teens so radically improves their mood, that their depression is better without doing anything else. Or adding in the 30 minutes of vigorous exercise 6 times a week, that Dr. Towery knows is vital to the mental health and treatment of depression. If the individual isn’t feeling better while having attending to these steps, (chapter by chapter,) they are able to move forward and add in other changes to habits along with cognitive approaches that can radically improve their mood.

The key ingredient I think however, (the ‘special sauce’ as it were!), is Dr. Towery’s tone of respect and lack of condescension. He speaks directly to teens and young adults, and particularly speaks to the understandable and perhaps even good reasons and things that their depression says about them. This approach, which has been developed by David Burns MD, one of the foremost founders of Cognitive Behavioral Therapy and further expanded to a method called TEAM CBT, and with whom Dr. Towery trained with, carefully helps bring to consciousness, the part of the individual that may hold on to feelings of depression or anxiety. For example, feeling depressed when failing in school, or getting worse grades than one hopes for, speaks to the high standards that this individual has for themselves, and possibly how much they care about their parents and worry that they may disappoint them if they don’t do well. In fact, in this book, Dr. Towery pushes the individual to think of a few good good reasons and great things these negative thoughts say about the person, before moving forward to change the thought. By approaching this ‘resistance’ head on, which is unique in this approach, the work not only respects the individuals’ rights and self-determination, but also decreases the resistance so that it doesn’t pop up a few months down the road, and block all the work that has been done in improving the teens’ mood, leading to even more hopelessness and a belief that even this therapy didn’t work, and how defeated and hopeless the individual may feel.

Aside from this being an invaluable tool for therapists to learn and practice with any patient, particularly for teens, this respect and help in them appreciating and valuing the parts of themselves that are holding onto some symptoms of depression, can literally ‘melt away the resistance’ (as David Burns, MD puts it!) and radically reduces power struggles, putting the teen and therapist on the same team, working toward the same goal. (Full disclosure, I have personally consulted with Dr. Towery as a colleague in TEAM CBT.)

There is nothing worse than the helplessness a parent can feel when their teen is struggling with depression. Even worse, teens can ‘cover up’ and function well enough so that we may not even know the struggles and pain they are experiencing. The recent article written by a parent as she learned about the two types of suicide, ‘impulsive suicide’ and the more thought through planned version, was heartbreaking as she described her son’s communication to her while he was in his last days at college and how many of our young adults do ‘cover up’ their feelings which can leave them at more risk.

We know depression is a killer. Roughly 1 in 11 adolescents has a major depressive episode each year. A recent Washington Post article that interviewed Dr. Towery reported this: “Roughly 1 in 11 adolescents has a major depressive episode each year. According to the 2015 Youth Risk Behavior Survey, 8.6 percent of youth in grades nine through 12 reported they had made at least one suicide attempt in the past 12 months. In Palo Alto, Calif., where the author, 38, works as a child and adolescent psychiatrist and an adjunct clinical faculty member at Stanford University School of Medicine, young people struggling with depression is not a remote statistic. Two suicide clusters in recent years prompted a Centers for Disease Control and Prevention investigation, and many, including Towery, wondered what they could do to help more young people. Nationwide, a shortage of child and adolescent psychiatrists — 8,300 clinicians for the 15 million children and teens who need them — long waiting lists, high costs, and a lingering stigma associated with mental illness make finding care difficult. Towery wrote a book to walk readers through the same concepts he uses with patients in private practice. Recently, he released an audio version to reach those who find reading “torture,” he said. Towery says that he hopes teens will follow along in the paperback while they listen to the audiobook. It is a good combination even for those who enjoy reading. Towery offers an honest and accessible narration, and there is something exciting about turning a cellphone into an ally in the fight for mental well-being. Having the Stanford psychiatrist’s book on your phone is akin to having a private, portable therapist in your pocket.”

Need I say more? When there is a relatively inexpensive book that can appeal to your teen and young adult, I get excited and want to spread the word. There is hope for helping our teens and young adults. There is something we parents can do in accessing help that truly speaks to our kids.