Inside the Adolescent Mind

Inside the Adolescent Mind: Belonging, Identity & Emotional Survival | Who We Are EP40

Estimated read time: 1:20

Summary

In this episode of "Who We Are with Rachel Lim," the conversation delves into the complexities of adolescent mental health and the challenges teens face today. Featuring insights from Dr. Cheryl Low, a seasoned psychiatrist, the discussion highlights the importance of understanding adolescent identity, emotional survival, and belonging in a world heavily influenced by social media and digital interactions. The conversation emphasizes the role of parents and educators in providing a supportive environment, fostering open communication, and helping teens develop a strong sense of self amidst the pressures of modern life.

Highlights

Teens turn to digital spaces when they feel unseen at home or school 📱
Dr. Cheryl Low emphasizes the need for spaces where teens feel understood 🕊️
Parenting requires being involved and offering emotional support, even on tough days 🤗
Adolescents are constantly changing, requiring flexible approaches from adults 🔄
The internet offers a less demanding social space for teens but lacks personal connection 🌍

Key Takeaways

Teens often feel misunderstood and unseen, leading them to digital spaces for validation 🌐
Building strong relationships with teens requires patience and open communication 💬
Parents should strive to be the 'better alternative' to the internet 🌟
Adolescents are in a crucial stage of developing identity and need support 🛠️
Despite challenges, most adolescents navigate through with potential for positive change 🌱

Overview

Adolescents today navigate a complex world filled with challenges that stretch beyond traditional concerns, diving into the digital and social realms where validation and identity are constantly tested. Dr. Cheryl Low joins Rachel Lim to explore how these young minds are influenced by their environments, both physical and virtual, and what adults can do to guide them.

Dr. Cheryl explains how teens are essentially navigating life much like everyone else but with the added intricacy of forming identities in an age of digital saturation. Parents and educators play key roles in this formative period by providing stable environments and meaningful dialogues without dismissing the digital world.

The episode sheds light on how essential it is for adults to engage genuinely with adolescents, understanding their evolving identities without jumping to conclusions. The discussion underscores the importance of offline relationships that offer more than what digital interactions can provide, emphasizing growth, understanding, and support in a practical and heartfelt manner.

Chapters

00:00 - 01:00: Introduction The host introduces the episode, discussing the impact of the Netflix series 'Adolescence'. The series has left them with many questions and pervasive concerns, particularly as a parent. While social media is often seen as a threat, the host hints at a deeper underlying issue that will be discussed in this episode.
01:00 - 10:30: Adolescent Mental Health The chapter discusses the challenges faced by adolescents in terms of mental health, emphasizing how they often feel misunderstood, dismissed, and unseen in crucial environments like school and home. It introduces Dr. Cheryl Low, a psychiatrist and mother, who has significant experience in supporting adolescents through their vulnerable moments. Dr. Low helps young people understand their identities, emotions, and the often inexpressible pain they experience.
10:30 - 21:00: Parenting and Professional Insights In this chapter titled 'Parenting and Professional Insights', Dr. Cheryl discusses the challenges faced by today's teenagers and young adults, emphasizing the hidden emotional burdens they carry. The conversation highlights the reasons why teens often seek empowerment and expression through the digital world. Dr. Cheryl offers insights into how parents, educators, and concerned adults can become more supportive figures by serving as mirrors and anchors, and by honing their listening skills to better connect with the younger generation.
21:00 - 30:00: Influence of Internet and Social Media This chapter introduces the speaker, a psychiatrist who completed medical school in Singapore and specialized in psychiatry. The speaker finished training in 2008 and began working as a psychiatrist, notably at Chinese General Hospital, where they deal with a variety of patients, including adults and older individuals.
30:00 - 40:00: Building Strong Relationships In this chapter, the focus is on establishing a service within the adolescent mental health field as a sub-specialty of the broader department. The initiative was spearheaded by someone who had recently qualified as a psychiatrist, around the year 2012. The discussion reflects on the early stages of building the service, transitioning it from the traditional scope, which typically involved children and adolescents, to focus more specifically on adolescent mental health. The chapter underscores the importance of developing specialty areas to provide better, more targeted care for young people.
40:00 - 55:00: Risk Factors and Environment This chapter discusses the challenges of categorizing teenagers distinctly from children and adults. The speaker reflects on their training and realization that teenagers require unique attention and care, different from what is suitable for children or adults. The traditional approach of lumping them together with children did not adequately address their specific needs. The speaker shares a personal journey towards recognizing and advocating for this unique treatment approach for teenagers.
55:00 - 67:00: Role of Schools and Social Media The chapter titled 'Role of Schools and Social Media' discusses how children, teenagers, and adults are perceived and treated regarding mental health issues. It highlights that children often face developmental and learning challenges, while adults are more prone to major mental illnesses. Teenagers, in particular, are seen to deal with adjustment problems due to life stresses. The role schools and social media play in shaping these perceptions and providing support is implied.
67:00 - 78:00: Challenges and Hope in Parenting The chapter 'Challenges and Hope in Parenting' explores the initial episodes of mental illness in adolescents. It emphasizes the importance of understanding and treating young individuals during their first contact with such challenges, highlighting the rarity and difficulty for teenagers to comprehend falling ill. The focus is on guiding and helping them understand the nature of the illness, which is typically unexpected at a young age.
78:00 - 90:30: Final Thoughts The chapter titled "Final Thoughts" emphasizes the importance of understanding and managing adolescent mental health as a distinct category from general depression or anxiety. It highlights the need for young people to continue on their natural developmental trajectory and distinguishes the unique attributes of adolescent mental health issues. It also notes the international definition of adolescence as the age group from 10 to 19 years old.

Inside the Adolescent Mind: Belonging, Identity & Emotional Survival | Who We Are EP40 Transcription

00:00 - 00:30 Hi everyone, welcome back to another episode of Who We Are. Today's episode is one that I feel deeply about, especially as a parent. Like many of you, I recently watched Adolescence on Netflix, a series that left me deeply unsettled and also very reflective, and I had so many questions on my mind. And I think what stayed with me wasn't just the story line, it was the question beneath it. How did we get here? And we often talk about social media as the threat. But perhaps the deeper threat is
00:30 - 01:00 that our young people, our adolescence, our teens feel misunderstood, dismissed, and unseen at school, at home, or even in the spaces where they most need to feel safe and valued. That's why today I knew I had to speak to Dr. Cheryl Low. She's a psychiatrist who has spent years walking alongside adolescents in their most vulnerable moments, helping them make sense of their identity, their emotions, and the pain they often can't articulate. She's also a mother to one
01:00 - 01:30 teenager and one young adult uh and brings both a professional lens and a deeply personal one to this conversation. In today's episode, we're going to explore what today's teens are really carrying beneath the surface, why they turn to the digital world to feel powerful or heard, and what we as parents, educators, or simply as adults who care can do to be better mirrors, better anchors, and better listeners. Welcome to the show, Dr. Cheryl. Hi. So, for those of us who may not be as
01:30 - 02:00 familiar with you and your work, could you share a little bit about yourself? Oh, sure. So, of course, psychi I'm a psychiatrist. Um and I finished medical school first. I came to medical school in Singapore and then I did my training in psychiatry as a specialty. Um and I finished my training in 2008 and I've been a psychiatrist ever since. Wow. I I worked in Chinese General Hospital and um over there of course we do the whole range adults older people and then I
02:00 - 02:30 started the adolescent mental health service there as a subsp specialty of the department as a whole. And which year was this that you started it? Whoa. About that time that I I qualified as a psychiatrist. So maybe about 2012 I would say if you want to put a year to it. But it's it's a service we we sort of started it we build it up you know and at first it it always is traditionally a child and adolescent and and so we would see the young uh the
02:30 - 03:00 teenagers together with children from from like seven years old onwards and I think in my training years that's the way it it was. I I think along the way I started to realize that they were a special group within a group within a group. Yeah. That I particularly enjoyed and I began to feel that they they needed something slightly different. They were not children. uh they were not adults either and and putting them sort of mashing them together with the rest uh didn't give them a space where they could be treated um as they as I felt
03:00 - 03:30 they they would be better treated or better listened to or better seen as as having uh a particular set of problems and and truly children have more say conduct developmental uh learning kind of problems. Adults of course have the the kind of major mental illnesses of of adulthood and teenagers very much were were presenting with things like adjustment problems relating to stresses in their lives as well as the first
03:30 - 04:00 episode of what would later be a major mental illness of adulthood. But this would be their their first time presenting with such a thing. And I began to feel and I think very much the ethos of adolescent mental health is that their first contact with this they should be uh understood and treated. They should be helped to understand something which um not a lot of teenagers will have to deal with. Right? Falling sick is just not a not a thing for young people. But to fall sick to understand what the the illness is and
04:00 - 04:30 to be able to feel that it can be managed, it can be understood and they can get better. they can continue on that developmental trajectory that young people should naturally have. I think these these are the the things that make adolescent mental health uh stand out versus just um sort of treating it like another depression or another anxiety. And just to frame the conversation for today, adolescence we define them between 10 to 19. Uh so internationally
04:30 - 05:00 of course adolescence uh varies a lot but I think in in Singapore we were and and when we did it we were very practical. So we we just started secondary school as long as as long as you you finished your your primary six then we started at secondary school. Okay. So 13 that that's the way was at Changi General Hospital where where I start started this thing up. Um and then we would go all the way to 19 and around around 181 19 we we weren't too strict
05:00 - 05:30 about it because the the girls of course would go university the the boys would be in NS. Yeah. Uh but since it was a a complete department then of course they would just naturally transition into adults but we didn't have to sort of separate them because the same doctor would just continue seeing them all the way. And at that age, the adolescent stage, they are also most malleable, right? Yes. A lot of things are are changing for them. Physically, of course, they are growing, they're changing. How they look affects a lot of
05:30 - 06:00 how they feel about themselves, right? Um not just for girls, I mean for boys too. Uh being a short boy or a skinny boy is is a stress in itself. And then they are also changing in how they they see things, right? We understand that that both kids and uh teenagers are are learning things all the time and they have a great capacity to learn but really in adolescence they are learning to do more adult type thinking. So they
06:00 - 06:30 are being able to not just think or learn facts but they are being able to reflect on what they are thinking report on thinking about thinking as it were right and not just uh pick up facts which which we we can do and that's a easier form of thinking and and so um it's a positive right it makes it allows them to reflect on themselves and all that and then sometimes it can be a little bit tricky and they might need a little bit more guidance because then they they think about thinking about and then they're like, "Okay, where am I?
06:30 - 07:00 What am I doing?" And if they have no sort of uh reflective space for that, no sounding board, then it gets into a little bit of a echo chamber or they ask other teenagers and they're all grappling with the same sort of thing, right? And and teenagers do need some adult supervision, some adult presence in their life or influence. Yeah. M um which they might not want to say it and and maybe not a lot of adults might see that they need it. They're so smart what
07:00 - 07:30 they can learn so many things. They know so many things that I don't even know. But actually it's it's not about the the things that they know or the the ways they can do computer that we cannot or things like that right um but it's really this sort of of thing right this space for for them to talk about things for them to hear an adult sort of ideas about it and biologically besides of course you know uh the physical changes that they're going through what's happening at that stage for them in their minds and in their brains I think
07:30 - 08:00 um they are really developing ing uh what we'll think about as so not just cognitively intellectually right learning things and then like I said being able to think about things in that metacognition right thinking about thinking ways but also they are developing a a sense of self right a personality as we as we think about it right um they are developing an idea of who they are in that sense uh what they're good at or what they're not good
08:00 - 08:30 at and and it's both important right we cannot be good at everything and we must be able to accept the I'm good at this and I'm not good at that um they are also developing uh what I like and what I don't what I approve of and and what I don't and also a sense of um what I can do and and so this this whole thing becomes personality as it were right eventually as an adult this this kind of things become personality and and we
08:30 - 09:00 develop it partly from from bi biological processes, right? Being able to think abstractly. Um, but also say from experiences, from how they from the things they they realize they can do, right? Like interactions, interactions with other people, uh, successes in school tell them, hey, I I can do something. Um, interactions with their peers, right? Their friends says, hey, thanks for helping me. You know, uh, you know, you did this. It really helped me. Then they they they are learning from
09:00 - 09:30 from this. They're also learning from their interactions with with adults, right? Why do I get scolded all the time? Something's wrong with me. Of course, on the outside, they might say that women say silly, whatever. But but internalizing all of that, right? If it keeps happening to you and they they're thinking about it, right? Um is it is it me? Is it her? You know, I get scoded all the time. They are learning all these things from from their environment. And then of course like you
09:30 - 10:00 say nowadays the environment consists of uh the big wide web as it were. So, so I think it's a process that has been happening throughout you know human society but now we should think about the environment as including the internet which which then makes a lot lot bigger a lot bigger space and um it's controlled I mean people always say it's uncontrolled but I think it's controlled by very different things it
10:00 - 10:30 is controlled it's controlled by very different things from maybe what uh adults today were used to when they were when they younger and I cannot wait to dive deeper into that. But you know like what you shared earlier I think adolescence at this stage of their lives they're absorbing and internalizing so much signals from the world um the peers the parents the teachers the basically just influences around everything what is it Dr. Cheryl that most of us misunderstand about
10:30 - 11:00 adolescence and their mental health. You know, I think adolescent mental health is something that we we can all understand if we take time to to talk to them to be open to what they have and what they can tell us. Um, teenagers are very articulate. They are able to um to say what they are thinking. It does sometimes like I said this is a process they are learning. So sometimes it does take a little bit of asking questions of
11:00 - 11:30 being open of going through it again and again but unlike uh children very different from children uh they are able to to articulate to say and I think it's important to to come to them with with an open mind not the all teenagers are dot dot dot um just like not all adults are any one thing uh teenagers are not all one thing either Um, and I think they would they would benefit from that. Their mental health would benefit from
11:30 - 12:00 from just that openness to hear from each one of them. The other thing about teenagers maybe versus adults is that teenagers are still growing and changing. Um, and and so what they are one one year, the next year, one month, a few months later is is changing and they are not faking it. They're not, you know, lying or being hypocritical or something. Being inconsistent for the sake of they they are and they should be
12:00 - 12:30 growing and changing all the time. And and I think that's why maybe working with them requires that that flexibility, that openness, right? Because sometimes they do things which are, you know, downright paradoxical. I mean, you say you want to do well, but why are you spending so much time on on your phone, right? Um, but I I think we we should be able to to believe both of them. they that they want to do well and that they like spending time on their phone as well. contrast can be true at the same we should we should hold it together it doesn't always happen the
12:30 - 13:00 way it might uh with a with a adult in in their best days and then I think when we we talk about mental health problems and we understand that this is a a vulnerable time for them and then thankfully most of them get through it but this is a vulnerable time there are many changes which are natural changes and then along the way there are you know I think um there events which which unfortunately happen and and this is how it is and and they do affect uh young
13:00 - 13:30 people and at that point they they need help. They need more help than maybe an adult and they do need help to access help, right? That an adult might be more able to to get the help that they need. An adult might be in a better position just in terms of resources. a teenager especially in Singapore is still very much dependent on the family unit um for for the kind of day-to-day support as well as for support to get uh anything
13:30 - 14:00 anything more and and so teenagers are um uh in in that bit of a a corner where I feel for example when when children are are in trouble a lot of times the children don't know the parents know and then they see and then they bring to a doctor and that becomes quite a natural way of Yes. Uh when the teenager and they can, you know, they can do so many things on their own. They go school on their own. They can buy things. They can argue with you seemingly more independent. Yeah. So they sometimes
14:00 - 14:30 look they don't look like they need help. But actually mental healthwise you you can tell that it would be a very difficult thing for a teenager to find a therapist to articulate to articulate the and then to to do anything about their circumstances, right? If if there's a big problem in school or there's a big problem with their friends, who's the where do they get help from? As of now, your kids, they are you told me a teenager, 21 and yeah, turning 21 and turning 20, let me think,
14:30 - 15:00 19. I see I forgotten already. And for yourself, it's interesting because you have this like dual lens both as a parent yourself uh to I'm not sure it's a good thing. Yeah. How has that journey been like for you and also I'm so curious Dr. Cheryl, were there moments even with your years of training that parenting them especially during the adolescent years
15:00 - 15:30 still caught you offg guard emotionally? M I think it's something that that no you know you never really become an expert at and I I kind of use this to encourage a lot of the parents that I see because they I mean they are at a low point they are bringing their kid to see a psychiatrist for many parents that becomes the the mark that I failed I I I messed up that's why I'm sitting in this clinic with this strange woman asking me
15:30 - 16:00 about my kid and you uh there are questions I can't answer and you know why is my kid sad it must be me I think you know it becomes like that but I always uh tell parents you know you're always a first time parent a lot of them are very successful people at work with their friends they you know involved in society but then I said but you cut yourself some slack and give yourself some credit you are always parenting your 15year-old for the first
16:00 - 16:30 time next year you will be parenting being a 16year-old for the first time and then following year be 17 year old for the first time. Don't expect yourself to be some sort of completely in charge expert. Um and then also understanding that not everything's your fault. I I think you know it it is true family does uh influence uh child mental health a lot but not everything is is the parents right. uh not everything is some some wrong mothering that you did.
16:30 - 17:00 And I I feel that this kind of of um judgment right leads to that that kind of very anxious parenting where where you have to do it right where from the time they are born you have to like read about I don't know everything breastfeeding playing with your baby also got correct wrong school you know everything because if you do it wrong you know consequences you'll mess up you know look at all those kids And uh that it's
17:00 - 17:30 unnecessarily yeah uh anxietyprovoking. Um parents we we do need parents to be calm, happy, involved themselves. They do need to be able to to relate to their kid, you know, and not leave it to the experts. Yeah. No experts, I think. And you know, Dr. Cheryl, would you say it's been almost like 20 years in this? It has. It has. All right. So, it's 2008 till now.
17:30 - 18:00 Right. So, oh amazing. And from what you're observing, especially today, how are adolescents navigating identity, selfworth, and belonging? Nowadays, we really should think about what's closest to them uh including the the internet, including people. Yeah. Their devices which are the portal, right? That's where the internet comes to them from. And and so these are then maybe slightly different because these are not people who know the kid, right?
18:00 - 18:30 The kid knows these people very well but these are are not say people who directly know the kid and so the things that the kid or care in that individual way right so so they they are saying whatever they are saying for their own reasons and it influences our children and teenagers very much and it becomes part of their world. Um but in that way that say the family and friends and
18:30 - 19:00 school right um how they they treat the kid very much comes from a personal knowledge and relationship and a certain responsibility but I suppose then people on the internet right in general they don't know the kid um whether I I think a lot of times the intent of of things that are available or there is not malicious in that way and you're talking about um role models or influences, right? Influencers or even just your your stars, right? Your actors, singers,
19:00 - 19:30 your models, your celebrities, uh even people who air their views. I don't think we should think about them as intently malicious to your kid, but they don't know your kid. Your kid is just one of millions of people listening to to them. So, they have no responsibility to to the kid like that. and they cannot see the effect they have on your kid. Uh they're happy to have a listener but they they they cannot see that. And so
19:30 - 20:00 there's no back and forth. There's no relationship. But then maybe in that way it is a little bit lopsided because last time the person who has the most relationship has the most influence. But now you can have influence without a relationship. I think a lot of teenagers have to deal with how they present themselves to other people which if you think about it teenagers always had to but they were you know in in earlier days long ago it was people in real life
20:00 - 20:30 and people that you know and in that way it is limited because that's only that many people you can you can meet and be in front of and now you can be in front of so many people at the same time and you don't even know who you're watching in front of. I think that increases your level of self-consciousness. Uh it increases your exposure to judgment. It increases your exposure to um you know just like or the need for
20:30 - 21:00 validation. Validation where does it come from? Right? If you have 10 people in your life and you know nine of them validate you and make you then you you is good enough. But if you have a million people in your life and nine of them validate you, you know, it's not the same. You you feel you feel lousy. And of course, the million people who don't even know you exist, maybe they they don't have that opportunity to to validate you. And and how you going to get validation from somebody who's so important to your life, but basically
21:00 - 21:30 doesn't know you exist. Wow. Um I I think it it warps, right? I would say walk because I'm used to the old way but it changes the demands on them how they behave what they should do how they should maintain it the effort they need to put in it's harder to relax I feel it's harder to relax so it's almost like they constantly have to perform I I don't know they have performative performative I think they have to constantly double think you know
21:30 - 22:00 you can't on top of all the changes they are really navigating right now you have to think about and that also means you know besides having to perform for more people that also means these people have more influence on their lives and shapes them their identity their values. Yeah, I I would think so, right? Because you just have to you have to keep it Yeah. in in in mind all the time. And I think
22:00 - 22:30 versus adults, of course, we can see adults on the internet too. We have to think like what's my what's my staff, you know, saying about me? But I guess adults have um a greater sense of themselves. We more developed. Yeah. Where we are fixed, right? We can just say I don't care more more easily. Um then teenagers are still trying to figure out who matters. Who should I care about? Oh, who am I? Right. And so then there's this they are still figuring it out and
22:30 - 23:00 to have to figure it out in this environment. I think it it demands a lot more from them. M and on this also maybe are there any emotional wounds that you see that are becoming more common that perhaps are maybe unnoticed or misread by adults in adolescence lives sometimes because they spend so much time on the internet and there's so much on the internet that their parents don't so-called relate to right and then the parents can kind of see them enjoying
23:00 - 23:30 the internet so then parents sometimes I think this is a time not to step back, but actually to get involved to to offer your teenager a relationship with a real person who really cares about them to be important in their lives. Right? So instead of trying to get rid of the internet to present I think to always be uh an alternative and a better and a closer relationship to them not to see
23:30 - 24:00 that the internet excludes you and therefore you have to fight the internet right the devil or treat it like the enemy. Yeah. Like the enemy. Okay. No switch off your phone. Get off it. The problem with you is that you spend too much time on your phone. Actually parents and adults need to to step in right to to start building that relationship in real life that they will never get from the internet. We need to present a viable alternative. And I would say that that teenagers are not
24:00 - 24:30 averse to it. They what they are averse to is adults who constantly criticize them and tell them the internet is is bad. But actually we have a lot more to offer our teenagers. And we we should do it. We should we should talk to them in real life. we should show up with them. It's amazing, Dr. Cheryl, that you are the the way you're you're explaining it. It's like, you know, we as parents to be the better alternative. So, the internet, it seems like what you're trying to tell us is it's here to stay.
24:30 - 25:00 We have to accept it and not try to just get rid of it. Imagine if we got rid of it, what would be left? You would still need still need you still need Yeah. And is it also the way you said it like to be the better alternative as parents? Is it because at this stage for adolescence our not grip but maybe maybe our influence on them becomes lesser as they also turn to they have so many
25:00 - 25:30 other activities and things which is natural. I think it's natural. It's healthy. It's healthy. Yeah. But don't don't say, "Oh, no. Actually, he's not interested in me." You know, actually, you know, they only want to be on the internet. Don't take it personally. Yeah. In that way, don't step back, right? So, don't step. Stay stay involved. Stay Yeah. Stay involved. Stay in your kids' life because you have you have something to offer your kid which they are not going to get from the How does that look like? It means staying in
25:30 - 26:00 conversation with them. I think just like I said at the beginning being sort of open to to sort of knowing what they have to say. They have things to say. What are they doing on the internet is they are expressing themselves and it's just that on the internet you know with a million people you can always get a few responses and immediately right immediately um but actually your kid does have things to say and and be there to to listen. So don't judge also, right? You're just being open. I think
26:00 - 26:30 it's not like kids you you cannot say anything. You cannot criticize your kid. I mean that's not right either. Your kids telling you because they they you know they want a response. Um and they're also testing what your response would be. Yeah. And I think we can we can say our opinion, we can give our perspective and even if we don't agree, it doesn't have to be critical, right? Um it is it is a thing that they are thinking or they have done right that
26:30 - 27:00 that uh you can you can have an opinion on you can hold your own perspective. You don't have to like, oh, wonderful, great, excellent, good job, everything is, you know, gloss gloss gloss. But you have something to offer the kid and it's not praise and it's not valid. You know, it's a relationship. It's care. It's personal. Don't don't shy away from it just because it looks like your kids having more fun on the internet than with you. Unfortunately, parents are maybe not the most fun, but that's not
27:00 - 27:30 what we have to offer our kids. We we offer them something different but also something that I I think they need that I think that that adults who care that parents family has a unique place uh in in a young person's life and what are some guiding principles that ground you especially you know through the different stages of parenting. I think the same as when I
27:30 - 28:00 have patients and of course patients like I said they come with problems and sometimes if you're a doctor then the the patients the problem becomes like such a big thing right and that's why they came and there's something you have to fix and it becomes that thing but but always with with uh young patients I I always find I always look for and I always find the positive the the strengths And they are amazing. They they have so
28:00 - 28:30 many talents. They are curious. They are creative much more than adult patients. Um they are fun. They are open. They are changing. Right. And actually that's a great thing about teenagers. Of course you try to make sure they don't change for the worst. You could go both ways. They could go both ways. then you you remember that actually then they they have so much capacity to to do good. Um so so I think with the kid as well then
28:30 - 29:00 you you look for the positives right when there's a bad day when they didn't do well in Chinese or they misbehave when they misbehave when they argue with you when they are being difficult then you you try to to remember the positives and to remember that they are both there at the same time right one of them is the sort of the bigger problem now but actually is is your Did your kid suddenly become uncreative and a completely different
29:00 - 29:30 kid just because right now we don't agree on you know some something? Uh no that actually they are both concurrently true and and and so when we relate to the kid and relate to the patient we relate to the the whole person. I think that that has helped me that has helped me. It helps me to to see beyond the current problems to realize that there is a great uh future trajectory that there is a ongoing relationship between
29:30 - 30:00 me and this other person. One is my kid, the other one is my patient, but there's an ongoing relationship between me and and this young personing and and we are working on that, right? We're working through our current problems towards towards that. So to remember that this is just like a chapter in this is a chapter of many chapters right and we're very lucky with teenagers we are at the beginning chapter and what we do has so much potential to make the influence
30:00 - 30:30 later much more positive you know very interestingly I wanted to ask you kids who just now you talked about social circle and influence we have parents we have teachers we have peers you also talked about um kids who are influenced by like churches and the groups, right? So, are there any data points that have been interesting just in general that a kids who actually perhaps have like organized religion uh groups versus
30:30 - 31:00 those that don't or kids that come from broken family or parents are going through something. Sure. So actually the risk factors for for mental illness as a glob are definitely genetics. So we understand that that there is a a higher heritability. Yes. So that's what we mean by by genetics. There's a big component of whether you get major depressive disorder, schizophrenia, uh anxiety disorders, there's a big
31:00 - 31:30 genetic component to that. It doesn't doom you, right? Your mother is depressed, you will be depressed. It it doesn't what it means is that it increases your risk. Yeah. It also doesn't mean that you will get exactly what your mother got. Your mother was uh mildly depressed. Doesn't mean you will be mild. You could be much more seriously depressed. Uh schizophrenia does also increases your risk of uh depression. So it doesn't uh breed true as it were. Yeah. But but we have to I
31:30 - 32:00 think understand that these things do uh run in families and and we always talk about gene environment interaction which means that the genetics is a risk factor. The environment is also a risk factor. Having both of them uh is more than the additive risk of each of them. M so it doubles it it doubles or it it increases the the more than the sum of its parts and you can easily see how how
32:00 - 32:30 that happens when you because from your parent you not only get the genes you get the environment you get the mom who is depressed not only you got her genes which makes increases your risk you also get the fact that she's less less attentive present less present nature and and nurture and then we understand that they they mix together to make things uh much worse. Um and then they of course they tend to not be able to
32:30 - 33:00 work so well. Therefore they tend to earn less money. Then then we come into a certain social uh deprivation uh section of things and then that becomes your neighborhood. And if you live in a less good neighborhood, then you're exposed to a lot more uh crime, violence, uh the way people uh deal with each other, addiction, then you you realize that it it one thing leads to another. So these things are not
33:00 - 33:30 separate uh risk factors. They each of them accumulate. So unfortunately, right, that that means that bad things happen in in groups. Yeah, I think that's maybe how how we see this. Certainly genetics is one thing. Social economic it doesn't mean uh so not that poor people are more likely to be depressed. Uh that is only true for extreme poverty. Um so that means at a point where you don't have enough to eat, we have inconsistent shelter. So not being uh sort of not rich in itself.
33:30 - 34:00 So extreme poverty certainly exposure to to violence. Yeah. And traumatic events. And by that we mean major traumatic events, violence, uh abuse when you are uh less than six years old. So the early childhood years we understand is a big is a big uh vulnerable age for for trauma. And then of course but not just like after that you can deal with anything certainly uh the whole of
34:00 - 34:30 childhood. So so those sort of things are are big things. um we don't actually have have information about uh organized religion or school but if you think about it they are not likely to be fact data points or factors in themselves. So children from more stable families from better neighborhoods who are less exposed to um violence and abuse are also um more likely to be in school and more likely to be in organized religion.
34:30 - 35:00 They they are associated they are not separate points. Dr. Sher this is so interesting because then I'm thinking you know like are all schools good schools and maybe also for the adolescence stage you know like there are so many forces of um that there are so many forces that shape their identity and basically shape them. You talk about parents, peers, schools, social media.
35:00 - 35:30 How do they compare in weight and impact in this time of their lives? I think we should remember that despite social media being like completely omniresent, right, that actually our children still spend a lot of their growing up and young person life in school in a physical environment. in a physical environment with a with a real person who is you know for many for for most
35:30 - 36:00 part stable, knowledgeable and caring. Yeah. Right. And so has that opportunity to do so much good to provide uh kids with a experience that they might not have from their families unfortunately and that's that's an opportunity. Um so I I think it it it is still a thing. It always was and we should we should see it as an opportunity how to make the most of the opportunities. I'm a big proponent that that children should have a stable
36:00 - 36:30 teacher in school. So for example versus you're talking about like a teacher that is with them throughout the year. Not not say true not even you know but maybe at least the whole year a teacher like the whole concept of a form teacher right who knows this certain bunch of kids and and we'll see them through a year sometimes two years and and I think that's how they they get that that support right I think sometimes in the
36:30 - 37:00 economies of scale thing there's a tendency maybe to group large numbers of teenagers lecture them all together and then you know leave them to project work by themselves. I think we can see that that would maybe be a more efficient way. I don't know I'm not an educator that might be a more efficient way you know it sort of is it makes economic sense but I think we we lose that when we we or we say oh uh but you know uh if we put them in a sort of a class
37:00 - 37:30 according to their needs that might be better for their learning academic needs. academic needs, but then you risk breaking students up. You know, you spend one period with this teacher, you don't have a consistent uh teacher and you lost that. You lost that. So, any school system that you know can can give the kid a teacher who you know at least for one period of every day uh sees that kid throughout
37:30 - 38:00 time. I I feel that that is is um is is something that that the kid gets from school that is beyond academics which yes I understand is not the most efficient use of of teacher manpower but we we lose something when when kids have nobody who is always looking out uh for theming in that nonacademic way and why do you think from your experience kids turn to social media the internet uh or
38:00 - 38:30 even gaming. What are some underlying or emotional needs that they're trying to meet? I think uh they they do get number one, they get entertainment, so they don't have to think about negative things all the time. Number two, they make friends uh uh online which they might not have in real life. M and sometimes when you are depressed and anxious and you don't go to school and you don't perform in school so well, it's harder to make friends in school or
38:30 - 39:00 you just feel lousy about yourself in school. Then you go online, you you game well or you just chat well or you know all the social rules of the online world and and people are you know people like you, they they keep in touch with you. It's you know why why wouldn't you? PE uh young people need friends and if it's easier online and a lot of times a lot of them will tell me it's just they they don't feel an they don't feel as anxious online if they don't have to turn on their camera they don't feel so
39:00 - 39:30 anxious and people are more accepting right they don't need to know everything about you and you can just show up on a good day and just you know be your best self and people respond to you and be accepted whereas if you're in school you have good days you have bad days. On a good day, people still remember your bad day and they're like, "What's up with you?" Right? And you don't want to explain that. So online, the demands are a lot less. They're a lot less. I think we should we should give that, you know,
39:30 - 40:00 the the internet has become a place where our kids can feel good because it's a lot less demanding in some ways. You can show up on a good day and everybody will just take you as you are. So how should we as parents also in this case I love what you said earlier about being that better alternative for our kids in this particular example. How can we step in to ensure that there our kids are not just you know fulfilling all the
40:00 - 40:30 emotional needs from other sources. Yeah. I I think unfortunately it then becomes that you are playing the long game. Parents are always playing the long game that on a good day we are there on a bad day we are also there but we are there on a bad day and we are allowed to be there on a bad day because we were there on a good day and and we are allowed to be there on a good day because we were there on the bad days. Um and so it it becomes a little bit of
40:30 - 41:00 a it is effortful. It definitely requires a lot of effort from from parents and sometimes it's demoralizing because you see that you know they don't really want to talk to me but being there sort of reminding them you don't have to sit down and have a heartto-he heart talk every day. I think that's also quite tiring but you you show up you say hi. You check in. You you show them that you you actually your demands are not great. You just want to make sure they're okay. You're okay. You're okay. Back off. Right. It's a good day.
41:00 - 41:30 they're okay, leave them alone. And and so when you talked about being there as parents on the good days and the bad days, how should we show up during the bad days? For example, what if really um our kids are testing waters to try and tell us something to to gauge our reaction? You know, how should we if you really hear something that you may not want to hear from your kid? How should we respond? I think it's it's still goes back to to the same
41:30 - 42:00 um that you get them to say as much as they want to say, not as much as you want to know or you want to hear, right? So, we we always uh ask questions, right? Don't jump in with the solutions. We always ask questions and then sometimes the question will be, do you want to tell me more? And if the answer is no, then you should I think we can take it as a not right
42:00 - 42:30 now or I don't want to talk about this. Do you want to talk about something else? Uh you know I think we we try we hang on to our anxiety. Of course we hang on to our anxiety. we don't try to interrogate the whole story out of them or we don't have to worry that if you don't tell me everything right now uh you know you're going to kill yourself going to the worst case scenario I think if we've built a relationship with our
42:30 - 43:00 kid over the years then it's always a continuing conversation we have never heard 100% of it and then we are okay we can sit with that we know that there's a problem and we are willing to continue the conversation at at a a certain time, a certain pace, and in a certain scope. And I think that that's an important kind of conversation uh to be able to have with your kid. And it starts when they are young. And we should keep it going. We should keep it
43:00 - 43:30 going. Yeah. And still sit with them even when they give one worded answers or don't want to. One's very good. Yeah. They're still sitting there. Yeah. The one to talk also can you're still there. I I find this um you know it's a privilege to be a parent for me to be a a psychiatrist. They they came right sometimes they don't want to talk. Uh sometimes um they don't want to
43:30 - 44:00 listen right. So so there's always this ongoing changing dynamic. Not every time is for talking. Not every time is for listening. Not every time is for doing anything. A lot of their problems I have I have no solutions. What can you tell a kid when their parents are are fighting and their whole family life is is going uh you know down the drain. I have no solutions. Maybe that's a time to to listen. Sometimes they don't want to talk. Maybe that's a time for for me to
44:00 - 44:30 say something, right? But there's that ongoing uh relationship and I think we should we should see it as as we are playing the long game and to allow them to be seen and be heard. Be heard. Yeah. Yeah. You know in in in the Netflix show adolescence you know at the very end the child what he committed was he stabbed his female classmate to death and parents were also wondering like how did he get here? You know I thought he was
44:30 - 45:00 safe. He's at home every day. Is it Give him everything. Yeah, give him everything. What are some of the unseen signs or signals that we miss as parents and that that that leads to this like emotional implosion? I think from from my experience I would say that a lot of times um maybe by the time we get there there are some things that parents have noticed throughout the years and then
45:00 - 45:30 maybe they just felt that they felt helpless to to change things. They felt that this was inevitable. This is how things are nowadays. So they for example for example you know that your kid does not talk to you that you don't know where your kid is right sometimes you you feel that maybe you know I should respect his independence or privacy but actually there are some of these quite old-fashioned ideas right it's not wrong
45:30 - 46:00 to ask your kid where are you going right um you know to ask how are you to you know to know what your your kid is up to and if you find that you you can't even get that um it doesn't mean that your kid is definitely having a problem but that speaks to the relationship again that you you don't know and you feel you can't know I I think then this is you know a time to think about whether there's a problem and parents of
46:00 - 46:30 course can start by just asking their friends or say older relatives or reading up about these things because really our we we're all nobody's an expert Right? Maybe maybe there's nothing happening to your kid, but it tells you something about the relationship. If this young person who's living in the house that you that you love and you are providing for and you care so much and you are able to help and support, but you don't know anything
46:30 - 47:00 about their lives. You can't talk to them. I mean really that that's not that's not uh really what we should accept as as okay. And we should start to to look into it to to build that relationship to make baby steps. Baby steps. Yeah. Do you find that you know um a strong parent child relationship can really cut through the noise and what does that look like in real life? It does in in so many ways. Um it allows
47:00 - 47:30 the kid to be heard, right? So the kid can say anything knowing that it will they don't have to worry that the parent will get upset I said this they don't have to worry that uh they will you know scull me or judge or used against me definitely they don't have to worry that they'll be misunderstood. Uh so the kid feels much more open to say it to to me and to say it in front of the parent. And then we find that parents when they have a good relationship with the kid,
47:30 - 48:00 they have noticed something themselves, right? They're more attuned. They have noticed things and some of the things the kid hasn't noticed, right? When sometimes when we are depressed or we're anxious, we're all caught up with our own symptoms. The parent has noticed something and that becomes very helpful uh for the intervention. Yeah. For the kid, for the doctor to understand, right, what's been happening at home. Yeah. I think then that also allows the parent to really okay to to acknowledge that the kid has a big problem and my
48:00 - 48:30 kid is struggling and then to to come and what can I do and very often if you're already on the background of a good relationship then you know what you can do and you have you have opportunities you have levers you have you have you know you know what what would help your kid or how to help your kid and and so on the background of a normal good relationship we are so much more able to intervene when when there is a mental illness when there is a much bigger problem. Yeah. Yeah. And I think
48:30 - 49:00 that really helps also like the the the child feels so supported in this journey. Yes. We cannot choose our illnesses unfortunately and we cannot choose like bad things happening. We we choose our responses and and there are so many opportunities in the life of a kid for the adults for the parent to make a a positive a positive choice. You know, Dr. Cheryl, how do we help teens build a strong internal compass and one that is not like easily shaken by
49:00 - 49:30 external validation or, you know, shame or what they're going through. Yeah. In their lives. I think that that very much speaks to how they how they built it up, right? The end product, the kind of compass you have, speaks to how it was built up. If it was built up consistently from an adult or a community that showed you care, that didn't just say, "Oh, you're great. You're wonderful." But also how they treated you, how they they behaved
49:30 - 50:00 towards you, how they taught you things, how they corrected you. Um then the the compass is real. It was built on a firmer foundation than something that you know is is more like rahrrah more like pep talk or more like things that you read about or even just things that you hope you are right that that kind of of compass which is very changing. So, so how you how kids turn out is really
50:00 - 50:30 how they were how they experience the world around them, how they learn about themselves is they learn it from from everything that happens to them around them while they are growing up. And and so that stability, right, that strong internal compass comes from it is not a one-off thing and is not a technique. is a everything everybody all the time you know it's a consistent thing that they have experienced in their formative years and teenagers are still in their
50:30 - 51:00 formative years and I love it because like you shared earlier also like actually teenagers are still a relatively early chapter in their book of life yeah where we can still you know influence them in the direction that we want them to go which would be good for them which would which would be a gift that we we give them. You know, for a parent who perhaps is listening to you and she feel he or she feels out of depth, what are some small shifts that
51:00 - 51:30 we can make to build, you know, to improve the connection and understanding with our child? I think um we have this concept in in psychiatry and and child psychology called good enough parenting. You don't have to be um perfect. you don't have to have the latest parenting techniques and to right know about kids and I think just now we talked about that when we talked about being an expert um that a lot of how we we people raise their kids
51:30 - 52:00 um is good enough and good enough really means good enough it means good for your kid don't don't stop don't doubt yourself don't withdraw and you know let let somebody who knows better or something that seems to be entertaining your kid or making your kid happier. Do do that job, right? It's it's quite irreplaceable. I do think there's a lot to be said for communities or parenting,
52:00 - 52:30 right? Your friends who are going through the same thing. Uh there's reading about things, but again, there's no need to feel like other people know your kid better than you. They they don't. They know about, you know, child development. Yeah. They they have textbooks. They read research. But there's your your one kid, your one job is your one kid, right? Or however many kids that you happen to have and you are the expert. You're the expert parent on it. And uh I think it it does a lot to
52:30 - 53:00 to get involved to keep engaging your kid because actually even for for myself I learn about uh teenage mental health from talking to teenagers. Not not from textbook. No. Right. Half from textbook. Right. And then the rest of it even be relevant to me. He's gone. My textbook was 10 years old by the time I read it, right? Yeah. And I learn about the the kid that is in front of me by talking to the kid. You've seen so much of what's
53:00 - 53:30 broken. But what are you hopeful about? I I'm hopeful because over the years then actually yes, most young people do get better. They work through their problems. Sometimes it takes, you know, one or two years. I see them as as incredibly energetic, full of potential, uh full of ability to change. I think that's something we we definitely want to message to them when we meet them and they are at a low point when they have problems and they they don't know,
53:30 - 54:00 right? And I don't want to promise them that it will turn out like this or like that. Yeah. But we understand that there's so much potential to change. What we have is the ability right now. you are in front of me. We have certain resources. We don't have everything that we want, but we have certain resources. We have certain opportunities. We have certain choices that we can make. And we can do it together. And you know, there there will be some bad days and some good days ahead of us, but we can do it
54:00 - 54:30 together. It is not hopeless. We can try. No. Look, you have your parents. They they did bring you here. Okay? Maybe you don't like them very much. Maybe yesterday they scoded you but but we have you know we we we have something together here. I think we want to to allow them that hope and in that way we are adults we have seen more of life and they are young people maybe we don't we don't need to expect them to to carry
54:30 - 55:00 that hope because it doesn't come from experience but we we have that experience we we should use that to give them give them hope and bring them along with us. M and you know if you could have a a a billboard message a message if you could have a message on a billboard that you know anyone in the world could see what would your message say? I think maybe it would say say hello to your kid today. Yeah. I think it's in the small
55:00 - 55:30 things. It's in is in keeping that relationship going every day. Good day, bad day, boring day. say hello to your kid today. Because yeah, we we we dismiss too easily these sort of small things. We want the the techniques, the strategies, we want the the upto-ate, we want to be cool parents, right? But you know, it it's all based on relationship. And what
55:30 - 56:00 kind of relationship do you have if some days go by and you just didn't didn't say hello, didn't touch base with somebody that you care about so much who lives in your house who needs your at a very basic level needs your food and money kind of thing, right? Encourage parents. I would encourage parents that this is something they can do every day and it's it's an important thing. It's an important thing and it'll be fun. It'll be nice. Yeah, it's not terrible.
56:00 - 56:30 And that is that small shift that can compound when when done daily. So, thank you Dr. Cheryl. Thank you. Thank you so much for this conversation. Yeah. [Music]