An overview of teen development and parenting today's adolescence. Brain and social development, as well as depression and general mental health issues.

1. Teens 101:
Ways to Improve Mental Health
Michael Torres, PsyD
Clinical Psychologist

2. •Myths
• Hormones drive all behavior
• Reckless, impulsive and immature
• They’re just crazy
• They’re lazy
• Just get through it

3. Self-Fulfilling Prophecy
• What happens when we as a society
and culture buy into these Myths?
• Left side versus Right side of the
room
• Rosenthal, R., &. Jacobson, L. (1963). Teachers'
expectancies: Determinants of pupils' IQ
gains. Psychological Reports, 19, 115-118

4. Adolescence
• Most courageous and heroic periods of
the entire lifespan
• Incredible potential and possibility
• Awakening our true selves
• Bursts of energy and ambitions
• Great sensitivity and social connection

5. Brainstorm by Daniel Siegel, MD

6. Myths about Teens (Daniel Siegel, MD)
• 1) Raging hormones make teens act out of control: Recent
brain studies reveal that actual changes in the structure and
function of the brain are primarily responsible for the important
changes in thinking, feeling, and behavior of young people
during this time.
• 2) Adolescence is a period of immaturity: It is actually more
accurate to say it is a time of necessary transformation when the
brain is remodeling itself.
• 3) Teens do dangerous things because they are just impulsive
or reckless: Another story can be told; one that shows how
changes in the dopamine reward system of the brain and the
limbic area’s evaluative functions create what is called “hyper-
rational” thinking in which an emphasis is placed on the risky,
thrilling aspects of a choice with minimal concern for the
dangers.

7. “Brainstorm” – Dan Siegel, MD
• 4) Teens need to become totally independent from
Adults: Research shows that teens need to push away
from their parents to prepare to leave home, and
actually need trust-worthy non-parental adults in their
lives.
• 5) Adolescence is simply a time to get through as fast
as you can: Instead we can see that there is an essence
to adolescence with upsides and downsides. We
actually can hold on to the upsides of the emotional
spark (i.e., the social engagement, the novelty-
seeking, and the creative explorations) to make the
most of not only adolescence, but our adulthood as
well.

8. ESSENCE of Adolescence
• ES = Emotional Spark
• SE = Social Engagement
• N = Novelty
• CE = Creative Expression

9. Major Brain Changes
• Prefrontal Cortex (front of your head)

10. Prefrontal Cortex Governs
1. Balance emotions
2. Body regulation
3. Attuned communication with self/others
4. Response flexibility
5. Soothe Fear
6. Insight into Self (past, present, future)
7. Empathy
8. Morality, ethics and values
9. Intuition (informed by signals from body)

11. Child versus Adolescent Brain
• Child Brain =

12. Adolescent Brain
• They become Specialist through
Pruning
• More focused interests
• Use it or Lose It
• Neuronal loss
• Myelination

13. Myelination
• Allows neurons to work 3000x
faster than childhood neurons

14. Developing pathway integration
between…

15. Re: Preventable Accidents
(3x more likely to get injured/die)
• Reward Circuitry
• Dopamine secretion
motivates behavioral
choices.
• Restless with
familiar, more
dopamine for new
experiences
• More dopamine
available during
adolescence
• Evolutionary function
• Appraisal Systems
• Should I, or should I not?
• Tendency of this system
to overemphasize “yes”
versus “no I shouldn’t”
• Evolutionary function =
To get a teen out of the
cave/out of the home

16. Some methods to develop the brain
1. www.lumosity.com – games to develop Memory,
Attention, Problem-Solving, Flexibility, and Speed
2. Games: Chess, Puzzles, Sudoku
3. Dan Siegel’s Wheel of Awareness Guided Meditation
(http://drdansiegel.com/resources/wheel_of_awareness/)
4. Musical Instruments
5. Reading (short stories, graphic novels, poetry)
6. Art: Painting, Sculpture, Drawing, Collage, etc…
7. Learning a Foreign Language

17. The Body Changes
• Height/Weight
• Secondary sex characteristics
• Circadian rhythms
• Hormones
• Sexuality

18. Some Stats
• 6.2% of U.S. teens report being sexually active
before age 13 (2006).
• 7% of U.S. 9th
-12th
graders reported having
sexual intercourse before age 13 (2007).
• 65% had sexual intercourse by 12th
grade
(2007).

19. Findings re: LGBT Young People
Ryan Family Acceptance Project, 2009
• LGBT teens who were highly rejected by their
parents and caregivers were high risk in several
domains when surveyed at ages 21-25.
• More than 8x as likely to have attempted suicide
• Nearly 6x as likely to report high levels of depression
• More than 3x as likely to use illegal drugs
• More than 3x as likely to be at high risk for HIV and
STDs

20. Social World Changes
• Social World
• Affiliation
• Push away from parents and Pull Towards Peers
• Evo fxn – life/death depends on staying inside the herd

21. Resilience: An Engineer’s Term
Resilience is:
1. The property of a material to absorb energy when
it is deformed elastically and then, upon
unloading to have this energy recovered.
2. The property of a material that enables it to resume
its original shape or position after being bent,
stretched, or compressed; elasticity.

22. Tips To Improve Resilience
• Get Connected
• Use Humor and Laughter
• Learn From Your Experiences
• Remain Hopeful and Optimistic
• Take Care of Yourself
• Accept and Anticipate Change
• Work Towards Goal
• Take Action
• Learn New Things About Yourself
• Think Better of Yourself
• Maintain Perspective

23. How To Prepare For A
Difficult Conversation
• Manage Your Own Anger (Respond vs React)
• Timing (not at 11 pm, nor 7:45 am driving to school)
• Develop a Plan/Outline (as if preparing for a work mtg)
• Get on the Same Page as Your Partner
• Choose a Neutral Location (not their bedroom)
• Minimize Outside Interruptions (cell phone, TV)
• Avoid Giving-In to Power Struggles
• Prepare for the Worst

24. “The Conversation”
• I/We Love You.
• I/We see ______ (behavior: drugs;
depression; poor grades) happening.
• I/We feel ___ about your behavior.
• Listen to their response.
• Calmly state the house rules.
• I/We will take the following action.

25. Choose Your Battles
Divide rules into 4 categories:
1. Major Rules
Homework, no alcohol or drugs, school
attendance…
1. Negotiable Rules
Chores, allowance, curfew, dating, free time…
1. Parental Pet Peeves
Dishes in the sink, socks in the living room,
room clean, inappropriate clothing…
1. Ignore It Rules
Eye rolling, Attitude, Slamming doors, “I hate
you”, mismatched clothing, fidgeting…

26. Active Supervision
• You have the Right to Know (* as best as possible)
• Who they are with?
• What they are doing?
• Where they are?
• When they will be home?
• Where they are going?
• Why are you letting them out?
– Availability of Spot Checks and Random Drop-Ins

27. Ways To Communicate Effectively With
Your Teenager
1. Non-Judgmental Tone
2. Allow Your Teen to Be The Expert
3. Be Authentic – Don’t Be Afraid to Reveal
Your Self
4. Avoid Power Struggles
5. Tell them you love them (affection)
6. Examine Your Own Anger Reactions & Avoid
Using Sarcasm

28. LOVE & LIMITS
•Respect Who They Are
•You Are Their #1 Role Model
•Recognize That You Cannot Control
Them, but You Can Control many
Things Around Them
•Limits & Consequences

29. Teen Depression
Essential Stats
• About 20% of adolescents will experience depression
before they reach adulthood.
• About 5% of adolescents are suffering from major
depression at any given time.
• As many as 8.3% of teens suffer from depression for at
least a year, compared to about 5.3% of the general
population.
• Thirty percent of Teens with depression also develop a
substance abuse problem.

30. Essential Stats
• Untreated depression is the #1 cause of Teen
suicide.
• Second leading cause of death in Teens is suicide.
• Less than 33% of depressed adolescents seek help,
and 80% of those treated report improvement.
• Homosexual and bisexual teens comprise up to
30% of all Teen suicides.
• Females attempt suicide twice as frequently as
males.
• Males complete suicide five times higher than girls.

31. More Depression Stats:
• Fourteen% of h.s. students seriously
consider suicide/year
• Within past year (2011), 3.6% of teens
had suicidal thoughts
• Eleven% have suicide plan.
• Six% attempt suicide/year

32. Signs & Symptoms
• Irritability
• Poor attention/focus
• Self harming behaviors
• Morbid thoughts
• Negativity
• Low self-esteem
• Changes in appetite/sleep
• Increased physical complaints
• Low energy and mood
• Lack of interest in formerly enjoyed activities
• Isolation/Withdrawal

33. Causes & Contributors
• Biology
• Neurotransmitter(s)
• Heredity/Genetics
• Substance abuse
• Medical condition
• Environment
• Abuse
• Trauma
• High stress
• Violence
• Life
• Losses/Death of Loved One (pet)
• Divorce
• Adjustments to stress
• Romantic Break-Up

34. Treatment Approaches
Psychotherapy (#2) Lifestyle (#1) Medication
Individual
Family
Group
•Exercise
•Diet
•Education
•Behavioral Mgmt
•Treatment
compliance
•Extra-curriculars
Antidepressants
• Prozac
• Wellbutrin
• Celexa
• Zoloft

35. Twenty Two Habits of Happy People
1. Don’t hold grudges.
2. Treat everyone with kindness.
3. See problems as challenges.
4. Express gratitude for what they already have.
5. Dream big.
6. Don’t sweat the small stuff.
7. Speak well of others.
8. Never make excuses.
9. Get absorbed into the present.
10. Wake up at the same time every morning.
11. Avoid social comparison.

36. Habits of Happy People (cont’d)
12. Choose friends wisely.
13. Never seek approval from others.
14. Take the time to listen.
15. Nurture social relationships.
16. Meditate.
17. Eat well.
18. Exercise.
19. Live minimally.
20. Tell the truth.
21. Establish personal control.
22. Accept what cannot be changed.

37. Ways To Support A Depressed Teen
• Recognize that depression is real.
• Take any talk of suicide seriously and notify your Teen’s
physician or mental health provider immediately.
• Acknowledge that your Teen is suffering.
• Don’t criticize, pick-on, or blame your Teen for her/his
depression.
• Express affection, offer kind words, and let your Teen know you
care.
• Recognize the efforts your Teen makes to overcome depression,
no matter how small.
• Don’t expect your Teen to just “snap out of it.”
• Participate and support your Teen’s treatment.
• Encourage healthy friendships and social activities for your Teen.
• Get support for yourself. This isn’t easy for a parent.

38. LIFESTYLE PRACTICES TO REDUCE
ACCUMULATION OF ANGER
1) Ask For Help When You Need It (often related to school1) Ask For Help When You Need It (often related to school
and/or peer-related anger – e.g., bullying).and/or peer-related anger – e.g., bullying).
2)2) Know Your Triggers (what sets-off your Anger)Know Your Triggers (what sets-off your Anger)..
3) Practice Active Listening – so that you are truly hearing3) Practice Active Listening – so that you are truly hearing
what the other person is saying vs. a distortedwhat the other person is saying vs. a distorted
interpretationinterpretation
4) Practice Assertiveness (vs. Aggression and Passivity).4) Practice Assertiveness (vs. Aggression and Passivity).
5) Healthy Eating and Sleeping Practices to regulate mood.5) Healthy Eating and Sleeping Practices to regulate mood.
6)6) Cultivate a method for personal expressionCultivate a method for personal expression (journaling,(journaling,
poetry, making music, dance, sports, exercise, painting).poetry, making music, dance, sports, exercise, painting).
7)7) Gratitude JournalGratitude Journal (written word) or Happiness Notebook(written word) or Happiness Notebook
(drawings).(drawings).

39. Consequences of Poor Eating
1. Increased rates of Obesity
2. Increased rates of Type 2 Diabetes
3. Increased rates of Cardiovascular Disease
4. Iron-deficiency Anemia (vegetarians/athletes)
5. Calcium deficiencies (decreased milk
consumption + phosphorous in soda)
6. Eating Disorders
- Anorexia, Bulimia,
Food Addiction/Overeating

40. BREAKFAST:
The Most Important Meal of the Day
Most Teens Skip Breakfast for Three
Main Reasons:
1) I’m not hungry
2) I don’t have time
3) Trying to lose weight

41. Breakfast Skipping
• 75% of older and overweight adolescents
skip breakfast
• More likely to consume unhealthy
foods/bevs (soft drinks, high sugar
snacks, empty calories)
• Tend to overeat throughout the day
(which contributes to the development of
lifelong eating habit patterns)

42. One of these and a bottled water in the
morning on the way to school…I am Not
affiliated with Detour Bar in any way.

43. • No Affiliation to Muscle Milk

44. • Test anxiety is when a student excessively
worries about doing well on a test. This can
become a major hindrance on test
performance and cause extreme nervousness
and memory lapses among other symptoms.
The following are tips on reducing test taking
anxiety.
Ways to Reduce Test Taking
Anxiety

45. Test Taking Tips
• Being well prepared for the test is the best way to reduce test taking
anxiety.
• Space out your studying over a few days or weeks and continually
review class material.
• Don't try to learn everything the night before.
• Try to maintain a positive attitude while preparing for the test and
during the test.
• Exercising for a few days before the test will help reduce stress.
• Get a good night's sleep before the test.
• Show up to class early so you won't have to worry about being late.
• Chew gum (if allowed) during the test to help relieve test anxiety.
• Stay relaxed, if you begin to get nervous take a few deep breaths
slowly to relax yourself and then get back to work.

46. • Read the directions slowly and carefully.
• If you don't understand the directions on the test, ask the
teacher to explain it to you.
• Skim through the test so that you have a good idea how to pace
yourself.
• Write down important formulas, facts, definitions and/or
keywords in the margin first so you won't worry about
forgetting them.
• Do the simple questions first to help build up your confidence
for the harder questions.
Test Taking Tips

47. Test Taking Tips
• Don't worry about how fast other people finish their
test; just concentrate on your own test.
• If you don't know an answer to a question skip it for
the time being (come back to it later if you have
time), and remember that you don't have to always
get every question right to do.
• Focus on the question at hand. Don't let your mind
wander on other things.
• If you're still experiencing extreme test anxiety after
following these tips, seek help from your school
counselor.

48. Parent Test Taking Tips (#1)
• Make sure that your child does all their homework and
reading assignments, this will help make sure your child
is prepared for the test.
• Encourage your child to space out their studying and
homework assignments so that they won't be forced to
cram on the night before the test.
• If you are anxious about your child's test, it's ok but try
to keep cool around your child, you don't want them to
get anxious about their tests too.
• Encourage your child to do well but don't pressure
him/her. You may stress him/her out.
• It is important for your child to stay relaxed for the test.

49. Parent Test Taking Tips (#2)
• Keep a positive attitude about tests.
• Provide a quiet, well lighted area with little distractions to help your
child study efficiently.
• Mark down test days on your calendar so you and your child are both
aware of testing dates.
• Make sure that your child gets enough sleep on the night before the test.
• Ensure that your child eats a healthy breakfast and avoid heavy foods
that may make him/her groggy and avoid high sugar foods that may
make him/her hyper.
• Make sure that your child gets up early enough so that he/she will be on
time to school.
• Let your child relax for a few hours before bedtime, it can be stressful
for a child to study all night.
• Talking about the test with your child can relieve stress about test
taking.

50. Parent Test Taking Tips (#3)
• If your child is struggling on their tests, talk to them
about it and meet with their teacher to find out the
best way to help your child.
• Praise/reward your child when they do well on a test
or for their hard work preparing for a test.
• Encourage them to do better if they don't do well.
• Review the test with your child after they have taken
it and go over any mistakes they have made and
make sure that they understand what they did wrong
and how and they can improve on the next test.

51. Volunteering and Mental Health
• Mental health benefits of volunteerism include:
• Reduction in depressive symptoms (Musick &
Wilson, 2003)
• Happiness and well-being (Krueger, Hicks, &
McGue, 2001)
• Schwartz et al. (2003) focused on 2,016
members of the Presbyterian Church located
across the US.
• Both receiving help and giving help were
associated with reducing anxiety and
depression. Giving help was more sign
associated with better mental health than
was receiving help.

52. Volunteering and Mental Health
• Current consensus indicates that helping behavior
contributes to diminished depression rates in
Adolescents (Commission on Children at Risk,
2003).
• Midlarsky (1991) volunteering generates positive
cognition and affect and thereby counters negative
moods like depression and anxiety.
• Improves well-being because it increases self-esteem
(Wuthnow, 1991) and low self-esteem is a powerful
predictor of sub-clinical depression (Turner et al.,
1999)

53. Effects of Volunteering on Risk
Factors for Cardiovascular Disease in
Adolescents
• Schreir et al., (April 2013) assigned adolescents to
volunteer with elem school-aged children as a means of
improving teens’ cardiovascular risk profiles.
• Urban public high school in western Canada; N = 106
10th
grade students free of chronic illnesses.
• Weekly volunteering for 2 months vs control group.
• Results showed lower - cholesterol, BMI and
interleukin levels compared to controls.
• Those who increased the most in empathy and altruistic
bxs, and who decreased the most in neg mood, also
showed the greatest decreases in cardiovascular risk
over time.

54. 10 Reasons Why It’s
Good to Volunteer…
1. Can reduce depression
2. Can raise self-esteem
3. Can reduce anger
4. Can improve your physical health
5. Can feel a sense of connection
6. Can feel like you make a difference
7. Can help someone
8. Can help your community
9. Can learn new skills
10.Can make new friends

55. Local Resources
Local Volunteer Organizations
http://www.volunteerinfo.org/category/east-bay
http://www.redcross.org/ca/san-francisco/volunteer/youth-volunteer-services
http://www.volunteereastbay.org/volunteers-opportunities/student-volunteering/
http://www.handsonbayarea.org/For_Volunteers
http://www.dosomething.org/
http://thevolunteercenter.net/?Volunteer
http://www.volunteermatch.org/
http://www.pointsoflight.org/
http://www.oaklandzoo.org/Teen_Assistants.php

56. National Resources
National Programs
www.nationalservice.gov
- US National Service Corporation offering Americorp, Senior Corp, and FEMA
www.allforgood.org
- The community service search engine offers a mobile app to link volunteers to local
nonprofits and grassroots organizations.
www.servenet.org
- Dedicated to promoting service among children and teens, the site grants $1 million
each year to youth-led projects.
www.volunteermatch.org
- More than 93,000 nonprofits recruit millions of volunteers though this outfit
www.catchafire.org
- Matches professionals’ skills with what volunteer organizations need most.

57. Computer/Online Gaming:
Impact on Brain Function
• Chinese researchers (2013) claim that decreased cortical
thickness in the left orbito-frontal cortex (reward function and
decision-making) and insula (decision-making). Adolescents
with online gaming addiction exhibited impaired ability in
impulse control and decision-making (neg consequences for
addictive behavior).
• Increased cortical thickness on the left precuneus was associated
with gaming-urge, craving and severity of online gaming.
• Increased cortical thickness in pre-central and middle temporal
cortices may be associated with executing finger movements,
and increasing player skills to advanced status.

58. In simpler terms…
Much of this literature stems from evidence from
Asian countries and centers on young males. The
studies suggest that when these individuals are
engrossed in Internet games, certain pathways in
their brains are triggered in the same direct and
intense way that a drug addict’s brain is affected
by a particular substance. The gaming prompts a
neurological response that influences feelings of
pleasure and reward (dopamine), and the result,
in the extreme, is manifested as addictive
behavior.

59. Mindfulness and Meditation
• Multi-tasking leads to
lower overall
productivity.
• Students and workers
who constantly and
rapidly switch between
tasks have less ability
to filter out irrelevant
information, and they
make more mistakes

60. The Monk Study and Others…
 One thing that meditation does for
those who practice it a lot is that it
cultivates attentional skills.
 Those harnessed skills can help lead to
a more tranquil and happier way of
being
 The neural networks in experienced
practitioners change as they lower the
psychological wall between themselves
and their environments
 Researchers believe the ability to move
between the internal and external brain
networks concurrently may lead the
monks to experience a harmonious
feeling of oneness with their
environment - Zoran Josipovic at NYU
 Circulation: Cardiovascular
Quality and Outcomes in
November 2012, actually
tested this. For the study, 201
people with coronary heart
disease were asked to either
(a) take a health education
class promoting better diet
and exercise or (b) take a
class on transcendental
meditation. Researchers
followed up with participants
for the next five years and
found that those who took the
meditation class had a 48%
reduction in their overall risk
of heart attack, stroke and
death.

61.  People who meditate show more
left-brain hemisphere dominance,
according to meditation studies
done at the Center for Investigating
Healthy Minds at the University of
Wisconsin-Madison.
"Essentially when you spend a lot of
time meditating, the brain shows a
pattern of feeling safe in the world
and more comfortable in
approaching people and situations,
and less vigilant and afraid, which
is more associated with the right
hemisphere” - Emiliana Simon-
Thomas, science director for
the Greater Good Science Center at
UC Berkeley
 At UC Davis Center for Mind
and Brain: When researchers
compared blood samples
between 3 month meditation
retreatants and a control
group, they found the retreat
population had 30 percent
more telomerase - the enzyme
in cells that repairs the
shortening of chromosomes
that occurs throughout life.
This could have implications for
the tiny protective caps on the
ends of DNA known as
telomeres, which have been
linked to longevity.

62. ESSENCE of Adolescence
• ES = Emotional Spark
• SE – Social Engagement
• N = Novelty
• CE = Creative Expression

63. Questions/Answers
• Michael Torres, PsyD
• www.drmichaeltorres.net
• Facebook:
drmichaeltorres
• Twitter:
@drmichaeltorres
• 1516 Oak Street #313
Alameda
• 510-910-2640
• E-mail:
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