Protecting Our Teens (Even When They Push Us Away)

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Thanks for joining us this week for Family Policy Matters. NC State University reported last semester that four NC State students died due to suicide. And UNC Chapel Hill has reported a recent rise in student suicides as well.

It's a sad statistic to hear that suicide is the second leading cause of death for college students nationwide. Well, Erica Commissar is a clinical social worker, psychoanalyst, and parent guidance expert who's been in private practice in New York City for over 30 years. She joins us today to provide insights on this tragic situation and help us all to know what we can do to spot potential issues and provide help before it's too late. Erica Commissar, welcome to Family Policy Matters.

Thank you for having me today. Well, how critical is the mental health crisis among college-age people, and what does that look like exactly? It's pretty darn critical. We have one in five kids coming out of childhood with some form of mental disorder. Many of those are addressed in childhood, but that's a very high figure, one in five.

And the suicide rates have increased by at least 30 percent. And a lot of that has to do with COVID as well, but with happening before COVID. And there's a number of reasons why that's happening.

All right. So talk about that. What are some of the primary causes and factors that you're seeing? Well, adolescence is what we call the second critical period of brain development when the brain is most susceptible to environmental stress, but is also susceptible to things like drugs and alcohol. So you'd say it's a perfect storm of vulnerability with an incredible increase in environmental stress in the form of increased emphasis on achievement in school and competition. There's also all of the social media issues, meaning being exposed to too much in terms of technology. You know, there's a lot of evidence to show that the creation of the smartphone has increased the vulnerability of our adolescents and add to that the intensity of the drugs and the availability of the drugs. The marijuana of today is not the marijuana of one or two generations ago. It's much more intense and it's leading to a lot of breakdowns in a lot of children. Wow. OK, so several things that I would like to ask questions on there.

Let's start with the last one. I think a lot of people feel like, you know, marijuana is just what's the big deal? Let's legalize it. We're even seeing some of that talk in our state legislature.

But you're saying that this is a bad idea. Oh, I am vehemently against legalizing marijuana. I think legalizing marijuana is an economic issue for many states.

It's a tax benefit for them as opposed to it being done illegally. But in terms of the mental health of our kids, no, we don't want to make marijuana more available. Marijuana within that critical period of development between nine to twenty five is very impactful on the brain. And as I said, the marijuana today is not the marijuana of my adolescence.

I'm almost 60 and the marijuana today is tenfold more intense. And kids are breaking down because it causes something called depersonalization and hallucinations. We don't think of marijuana as a hallucinogen, but it is. It's not a sedative.

It's a hallucinogen. And so what it's doing is for a lot of kids breaking down the very fragile membrane between reality and fantasy. And it's actually increasing the incidence of mental breakdown in our kids.

I know North Carolina Family Policy Council has some really good articles on some of the issues surrounding the latest versions of marijuana. And so those kind of resources are certainly out there. Can we talk about when adolescence ends? Because I wonder if part of the problem is when we send our kids off to college, we're like, well, you know, I did my job. So there you go. Does adolescence continue into college age and do we need to continue to think of them as adolescents at that age?

Absolutely. So adolescence technically doesn't end till twenty five. And it ends at twenty five because the part of the brain that we call the emotional regulation part of the brain, the prefrontal cortex, doesn't finish its development till twenty five. And we didn't know that before we had the neuroscience research to prove it. But that means that their brains are still very, very susceptible. And also they don't have the capacity to regulate their emotions. And what we say is that anxiety and depression are disorders of emotional regulation.

And so we're using all these medications, antidepressants, anti-anxiety, basically to upregulate and downregulate the nervous system because the brain is fluctuating and isn't able to regulate itself. So when we know that adolescence does not end until twenty five, how should this change the conversation and perhaps even our behavior toward our children and grandchildren that are of college age? It means that our physical and emotional presence in their lives is more critical than we think. So we think because they seem more independent than they seem not to want you and need you around, that they're adults and they're not adults. Their brains are very different than that of an adult. There's all kinds of research to show that the adult brain functions very differently in response to stimulation, in response to stress, very differently than the adolescent brain.

And that goes straight through to twenty five. And so we still need to be available to them emotionally and physically as much as possible to help to be their filters, to help to be their emotional regulators. Think of yourself as a parent, as the emotional digestive system for your children, at least until they're twenty five. And that's a different way of thinking. But are you suggesting that parents are maybe misguided and sending their kids far away to college, or do you think they're prepared at least for that?

I do think they're misguided. For some kids it works out, but I think for many kids, I mean, we have an ethos in this country that separation means they have to go very far away from us geographically. And that has to do with this ethos of independence and self-sufficiency. And what we know is that kids are more fragile in these years than they have ever been.

And that has to do with environmental things. It has to do with the way we raise them, essentially. You know, in other countries, Italy, France, you look at other Western countries, kids actually stay closer to home in the college years until they're through this period of critical brain development and then they move away. But the idea is they stay pretty close to home. So they have at least the option of what Margaret Mahler, a very famous psychoanalyst, called emotional refueling. Coming home to get comfort, then going back out to explore.

And so we think it's such a good thing to send them three thousand miles away. And for most kids, it really isn't. That's really interesting. OK, so talk about the tension between the present and future as it relates to the mental health status of adolescents and young adults. That's a very interesting question, because adolescents are very present oriented in a negative way. So what happens is, particularly in middle adolescence, like 14 to 18, when they're depressed, when they're overwhelmed, when they're under stress, when they're anxious, they cannot imagine not being that way. They are stuck very much in their feelings and they cannot be a way out. And so as adults, we have to remind them that these feelings are temporary because for them, they aren't temporary, which is why kids kill themselves. I mean, they kill themselves for a variety of reasons. But one of the reasons is that whatever they're feeling in that moment feels so intense, 10 times more intense than an adult would feel it.

And we can see that on brain scans. They feel things more intensely and they feel things without being able to see the relief in the future that it could get better. You mentioned already the positive relationship that parents can have with their children related to mental health issues. Are there other relationships that are key as well? You know, all the adult relationships around them are critical. Coaches, teachers, school principals, other parents that they're close to, all of those adults in their lives play a role, grandparents, aunts and uncles. It's why, in effect, extended family is so important to have around when you're raising children. And I think that's something we also get wrong in this country. And because you have choices, if you don't want to go to your parents because you don't feel they understand you or you're trying to separate from them and individuate from them.

So you're trying to create distance. You have other choices of adults who you can lean into. So, yes, it takes a community to really raise healthy children. And that could be ministers or rabbis or priests too.

I mean, it could be religious figures as well. Right. And I'm assuming from that that it's important that, as parents, we would monitor those relationships, make sure that those kinds of relationships are positive, good relationships. Yeah, absolutely.

And we shouldn't assume that. Again, going back to that talking with your kids thing that you were mentioning. So talk a little more about parents and grandparents and what they can be doing early in a child's life to help reduce some of this risk of mental health problems later on. Well, I mean, the first thing you can do is don't be a Victorian grandparent. And what I mean by that is the Victorian had their children and grandchildren brought in for tea and then brought out for the rest of the day. They saw their grandchildren between three and four in the afternoon, gave them a quick hug and watched them play and then off they went. Be helped.

And that's an interesting term. Be an active participant in your grandchildren's lives. If you live nearby, ask your children if you can spend a day a week helping to raise your grandchildren or pick them up from their piano lessons and bring them back to your house and give them dinner once a week or have a family dinner once a week. But there's no replacement. So this idea that we can move to Florida or move to Arizona, the idea that we can move away and see our grandchildren every once in a while. First of all, that doesn't create closeness or intimacy. They're not going to love you in the same way.

And that may be a shock to people, but it's just true. You have to earn love. You don't deserve love just because you're biologically connected to that grandchild.

You have to earn it by having a relationship. And that means being present for them. So when they're sad, you're there to help process their feelings when their parents aren't there or there to help process their feelings when they don't want to turn to their parents.

So I would say more is more. The more physically and emotionally you're involved in your grandchildren's lives, the more the chance that they have another adult in their lives who they know love them and can help to understand them and process their emotions. Can we as a culture address this? Are there public policy ideas or at least just some cultural remedies for reducing some of the stressors that our young people are feeling? Public policy.

There are a few recommendations. One is that which we didn't get to talk about today is that kids don't get enough sleep. That also creates depression and anxiety if they're not sleeping enough. And we can't force them to go to sleep early in the evening because they have something called sleep wake phase delay, which means they don't produce melatonin until after midnight. And so parents are always on their kids like you've got to go to sleep, but they can't go to sleep because they don't feel sleep pressure. So we could, as a policy, start schools later in the morning so they can follow their natural rhythms as adolescents, because that's the way it works. As you get older, you start producing melatonin earlier in the evening. When we get old, that's why we do the early bird special and go to bed at nine o'clock.

So that's one thing. The other thing is really educate kids about marijuana and drugs and the intensity of it. And we don't show them what depersonalization and a psychotic breakdown looks like. So a lot of kids are ending up in emergency rooms because of marijuana. I don't mean to overemphasize this, but this is a very common thing we're not thinking about, we're not talking about, and we are not actually showing kids what a psychotic event looks like for marijuana.

How would we do that? How would we show kids what that looks like? We actually show them films of kids decompensating from marijuana use or from trying psilocybin mushrooms. You know, psilocybin is completely available to our kids now in a way that it was only available to a handful of people in the 60s and 70s.

Like you had to work really hard to find it. Now it's as available as marijuana. And again, when you do hallucinogens, you are breaking down the barrier between reality and non-reality and it creates a portal in that kid's brain that can't always be closed or can't be closed for many months. And this is a very common theme on college campuses and is one of the things that's leading to all of these suicidal attempts. As people who are around college-age students, are there some things that we can do then if we're seeing signs that are startling us that this young person may be suicidal? Don't hesitate to get help.

Don't wait. Don't, as a parent, say, oh, all adolescents go through this and this is just a phase and they'll be fine. And yes, it is normal for moods to shift in adolescence. But if you see extreme shift, meaning and I have a book that I wrote called Chicken Little, The Sky Isn't Falling, there's a whole list of things to look for around depression and anxiety and suicidal thought. And there are actual signs to look for.

And when you see more than two or three of those signs together, you should not hesitate. Work through your own denial to say, we're going to get my child help and get them help immediately. Erica Komisar, where can our listeners go if they want to read more of the things that you've written and studied and just learn more about this topic? So you can go to my website, which is www.komisar.com, and on there are both of my books and also a list of articles and blogs I've written and ways to contact me.

All right. Erica Komisar, thank you so much for all of your good work and for being with us today on Family Policy Matters. You've been listening to Family Policy Matters. We hope you enjoyed the program and plan to tune in again next week. To listen to the show online and to learn more about NC Families work to inform, encourage and inspire families across North Carolina, go to our website at ncfamily.org. That's ncfamily.org. Thanks again for listening and may God bless you and your family.