Category: Mindfulness

Teen Mental Health: What Dialectical Behavior Therapy (DBT) Can Offer

By Thanos Nioplias, MA

Anxiety and depression are clearly on the rise among teenagers. And it’s not only psychologists and educators who are concerned. Everyday conversations among teens focus on how stressed and anxious they feel, and the press has recently written extensively about mental health struggles that young people face. Time magazine, citing compelling clinical research and personal accounts, recently described the modern teenager as “fragile, less resilient and overwhelmed”.

What is wrong with our teens?

The modern teenager has been impacted by technological advances unlike any previous generations. At any given time, our teenagers are glued to their screens. As a result, they are exposed to plenty of negative information, some of which is genuinely terrifying and even horrifying. They are also constantly comparing themselves to others on social media where they are exposed to images of idealized bodies and lifestyles, which leave them feeling excluded, lonely, and dissatisfied with their own abilities and accomplishments. But perhaps the most insidious negative impact of screen-time is that teens are less focused and less present-minded than ever. As a result, they are less likely to naturally recognize and regulate their basic needs and emotions. All the bright lights and limitless scrolling are so distracting that many have no clue what they need themselves to maintain emotional wellness. The worst part about the above is that it has become completely normal for kids to use technology for hours on end each day.

As a result, we have a serious crisis. It is almost expected that teens today are moody, lacking in confidence, insecure about their appearance, filled with worry and concern about their future, and that they have been exposed one way or another to alcohol and illicit substances when interacting with peers. It is also very common for teenagers today to experience significant depressive symptoms including pervasive sadness, apathy, complaining about life being “hard and overwhelming” and even thoughts about suicide. Equally common are bouts of anger, which are frequently followed by apathy and seclusion, as well as failure to complete academic work and/or maintaining meaningful hobbies and interests (aside from scrolling on their phones). Also common are possession and frequent use of alcohol and drugs, and frequenting places where these substances can pose a threat to wellbeing. Worse, a staggering number of teenagers engage in self-injury and have significant, active suicidal ideation. The majority of the above symptoms – while common – are clear red flags that warrant professional intervention and care.

Can therapy help our teenagers become more resilient?

Dialectical behavior therapy (DBT) is a comprehensive, evidence-based psychotherapy originally developed to treat self-injury, suicidality and other high-risk behaviors among individuals with Borderline Personality Disorder. More recently, DBT skills groups have been modified to help troubled teenagers reduce depression, irritability, anger, impulsivity, self esteem issues and overall social adjustment, in addition to self harm and suicidal ideation. A DBT skills group is like a classroom. Teenagers (or adults) come to a 90-minute session each week for approximately six months to learn and practice skills in four core areas.

First, DBT participants learn how to practice Mindfulness, which helps them to slow down, be present in the moment, and simply identify and be aware of their thoughts, emotions, and urges.

Second, they focus on Emotion Regulation, which involves learning how to change their feelings such as anxiety, depression, anger, etc.

Third, they learn Distress Tolerance skills to manage impulsive and other problematic behaviors that can be damaging to themselves and others.

And finally, they learn strategies to build and maintain Interpersonal Effectiveness in order to improve and enhance social relationships through assertiveness and reducing hostility.

For teens, a fifth component of treatment focuses on Middle Path skills to let go of “black-and-white” thinking and embrace a balanced perspective in their relationships and in their life.

Among other therapies that have been showed to effectively improve teenagers’ mental health, DBT is especially promising in keeping teenagers safe and helping them build a life worth living. Even in our fast-paced and uncertain times, we have evidence to believe that our troubled teenagers can learn life skills, get better, and thrive in their lives.

Holiday Self-Care

By Laura Vraney, PsyD

While the Spring holiday season ushers in nicer weather and rays of optimism, there is no question that it also brings about anxiety. At times, we may become so distracted by the to-do list, both leading up to and during the holiday time that we forget to appreciate and enjoy the festivities. Additionally, other stressors often surface preventing us from enjoying the holidays; for instance, many celebrate the holiday with family members who are hypercritical; others are reminded of loved ones who have passed away, and some are navigating transitions that do not allow for certain family members to be present. Well, you are in luck! Whether the holidays are usually a joyous time or a stressful one (or both!), here are three self-care strategies you can utilize to ensure a more cheerful and relaxing holiday.

  1. First and foremost, acknowledge and validate your feelings with minimal self-judgment. You may have anxiety or stress or sadness or anger or other feelings. If you pretend to be “fine,” especially to yourself, then either you will repress your feelings only to “explode” at a later time OR your feelings may manifest in disguised ways, for instance, a loss of appetite or passive-aggressive behavior. Neither of those routes is productive. While it may feel selfish, you need to be kind to yourself. Rule of thumb – support your own emotions just how you would support a friend or loved one when they are feeling anxiety and/or stress.
  2. In order to feel a greater sense of control, here are some basic behavioral strategies you can implement. Write a list of everything that needs to get done in the days to come – spend as much time as you need getting everything organized. Prioritize in a daily planner your responsibilities based on the day, required preparation time, and deadlines. If you are someone who struggles with other aspects of the holidays (e.g., family gatherings), know your warning signs when feeling overwhelmed. These may include a shift in your mood, increased heart rate, or loss of appetite. Whether the former and/or later, give yourself permission to take 10-15 minutes alone to refresh. Find things that are self-soothing, such as journaling, listening to music, or stepping outside for a short walk. Also, please make sure you are eating well-balanced meals and getting adequate sleep both during the holidays and in general. We are more vulnerable to stress and anxiety when we are “emotionally eating,” skipping meals, and/or sleep deprived.
  3. Let us not forget why holidays are so special! Research has found that taking the time for gratitude can facilitate neurobiological changes that protect us from stress, anxiety, and depression. Especially when one is preoccupied with planning or overwhelmed by other holiday activities, it is not abnormal to be disconnected from the meaning of the holidays. So, give yourself the freedom and space to appreciate the good in your life over the holidays. A way to do this is by slowing yourself down to acknowledge three wonderful things in your life and contemplating them for a full 60-seconds each. Whether in a state of distress or not, there is no better time to appreciate and adopt an attitude of gratitude!

Think Before you Post: Managing Anxiety in the Era of Social Media

By Rebecca Holczer, MA

As a member of many Facebook groups (perhaps too many?) I see almost every day how group conversations over social media can easily get out of hand. All group discussions start with an original post, however, it seems more common than not for discussions to go in all sorts of directions that are rarely relevant to the initial post. There are many reasons for this phenomenon, but the most compelling is that social media posting tends to be so fast and impulsive, that it is often more emotional than rational. In other words: Social media communications tend to be less about what we truly want to say, and more about what we want to convey in the moment. The problem with this (aside from miscommunications) is that the more people just give into our emotions, the more they tend to be prone to anxiety. Here are six tips we can use to manage anxiety when participating in group discussions in the era of social media:

  • Consider not responding at all: Yes, this is an option as well that we sometimes forget is available! But it’s often the best one. Of course, it’s fine to contribute to a group discussion if you want to share or to make an original post and initiate a discussion. But you don’t need to contribute or respond to everything.
  • Mindfully pay attention to your feelings: Before you post, think about how you are feeling and try to name that emotion. Some posts will make you feel angry, some may elicit feelings of sadness, and others will bring on anxiety. Being aware of your emotions and mindfully paying attention to them is a key strategy to making sure your feelings don’t get out of hand or take over. Consider it a challenge: Can you notice and name your gut reaction without giving in right away.
  • Adopt perspective-taking: Try to put yourself in the shoes of others who are posting messages for a few moments. Think about what their intentions were when they wrote their comments. Are you sure you’re understanding what they are trying to convey? Also, is their message written clearly (often it is not!) and do you need to clarify what they meant before responding?
  • Re-read before you reply: Relatedly, if you would like to make respond to a comment, take the time to read the comment you are responding to a second time. Group discussions can proceed at a rapid pace, and often people make errors when reading through comments. Don’t you just hate it when you post a response to a participant, only to realize seconds later that you misread their comments?
  • Role play in your mind: Before firing off a post, take 20 seconds to imagine how an in-person conversation might go with others in the group. What would you say if you were facing the group members in person? Research suggests that people feel much more free to express themselves in extreme ways when they are removed from a situation, or anonymous. But if you would not say something to someone’s face, do you really want to post it on the Internet?
  • Consider a direct message: When joining into an online conversation, we sometimes neglect the possibility of writing individual direct messages, instead of contributing to a group chat. Even if you ultimately do wish to post en masse, this alternative can be a good starting point to clarify ideas (yours and others) and help create more intentional and meaningful exchanges with others.

Social media has the potential to achieve what previous generations were unable to accomplish—we can now connect to others around the world with the mere touch of our fingertips. For that very reason, let’s make sure we actually connect with others without miscommunicating or getting stymied by our emotions in the process.