OMA Spotlight on Health

Children and Adolescent Mental Health with Dr. Javeed Sukhera

January 22, 2021 Ontario Medical Association Season 2 Episode 1
OMA Spotlight on Health
Children and Adolescent Mental Health with Dr. Javeed Sukhera
Show Notes Transcript

Did you know that 1 in 4 younger people struggle with clinically significant anxiety?  Listen as Dr. Javeed Sukhera, a Psychiatrist specializing in Child and Adolescent Mental Health offers advice to families on how to cope and protect their mental health. 

Spotlight on Health - Season 2, Episode 1 – Children and Adolescent Mental Health with Dr. Javeed Sukhera

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Voice-over: In this podcast the Ontario Medical Association looks at current health issues that are on everyone’s mind. Spotlight on Health gives you the straight talk. We’re Ontario’s doctors and your health matters to us.

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Anne Marie Flanagan: I’m Anne Marie Flanagan, and I’m the Director of Media Relations and Social Media at the Ontario Medical Association.

Dr. Javeed Sukhera: Hi, I'm Javeed Sukhera. I'm a child and adolescent psychiatrist in London, Ontario, I'm an associate professor of psychiatry and pediatrics at Western University, and I have a clinical practice at London Health Sciences Centre.

Flanagan: And we're here today to talk about mental health.

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Flanagan: How common are mental health issues, particularly, in children and youth?

Dr. Sukhera: They're actually quite common. Approximately one in four young people struggle with clinically significant anxiety. We know that, particularly, adolescence and young adulthood is a time where there's a great number of first presentation of mental health concerns. So, the period when someone's between the ages of about 12 and 25 is a uniquely vulnerable period for mental health difficulties. 

With decreasing stigma over time, that means more people are seeking assistance and help. There have been lots of people who have suffered in silence for very long. There are times where young people are struggling with things that actually their parents also struggled with, but when I meet with families, parents reflect that when they were younger there just wasn't the kind of space and time created for them to be able to get help. 

Being young right now is a uniquely different experience than a generation ago. Young people have to deal with a wealth of information; they are tapped into the stresses of life in ways that perhaps previous generations were more sheltered or isolated from. Some of the ways in which we shifted as a society, I think, also reflects that there may be a harder time coping with certain types of distress. 

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Flanagan: Is social media something you see having a significant impact?

Dr. Sukhera: So, I definitely think that social media can have an impact on the mental health of young people, but at the same time I think it can also have a positive impact. I, myself, do some work and research and inquiry into conversations that we have on social media and how social media is used. 

We live in an era where this is just the paradigm. This is the ways in which people interact with one another, socialize with one another. And there is something about social media that brings young people together, that fosters connection in ways that perhaps weren't possible before.

While acknowledging before the era of social media a teen would be comparing themselves to their peers—if a young person before had to compare themselves to 20, 50, or 100 people, now they're comparing themselves with millions of people. 

And the ways in which certain aspects of social media are designed to feed the need for validation—through clicks and likes and shares—is actually designed to keep people's brains hooked into the use of some of these platforms. That can be problematic for a young person who's simply building their sense of who they are, and where they fit, and where they belong. It is something that can have negative connotations and, again, speaks to the need for finding a balance—not necessarily completely digitally dependent, but also not necessarily completely cut off either.

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Flanagan: What kinds of things should parents be watching for? What would tip them off that maybe there's a problem and that they should see their doctor?

Dr. Sukhera: So, that can be among the most challenging things for parents sometimes because it's hard to see. What I would say is for parents to take a step back before being too concerned about early warning signs. 

I think it's important for all of us as parents to really, again, carve space and time for genuine presence with the young people in our lives on a regular basis, whether it's before tucking them in at night or on the drive home from school. Checking in—not just about what they did, but really how their day was and better understanding what's going on in their world and life—and making sure that we create spaces where we know that, if they share they're struggling or they're vulnerable, they know that that's okay.  

When we're looking for warning signs, couple of things to tune into, the first is really just anything that makes a person, the young person, seem like not their usual self, need changes. So, not a change for the moment, but a change that's more marked and persistent. 

The other thing is withdrawing from others. It's a very important warning sign that I think needs to be addressed. Of course, teens start withdrawing—want to spend less time with us—but it's really important if something's off or something has changed. 

The other thing we sometimes see is emotions that are suppressed and carried can be heavy, but they spill over on things that don't really seem to matter. So, if your young person’s really upset about something that seems totally out of proportion to what's going on, take a step back and ask yourself and them, are they really upset about this one little thing, or is this something bigger? Is this about something else going on? Is this about something going on overall? And try to have that conversation with them. 

Right now, during the pandemic, young people are faced with an unprecedented kind of stressor. And so, it's going to affect them in lots of different ways. And I think we just need to be able to be tuned into that. And rather than seek the urge to fix them, or alleviate their suffering—which is a natural instinct—and create space for them to explore and process and carry those heavy emotions as much as we can.

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Flanagan: How important is it to have those moments of connection where there aren't other distractions—people aren't on their devices or kids aren't watching TV?

Dr. Sukhera: I think it's even more important now. That idea of genuine presence together is so, so crucial. 

And I think it's also important to remember we can put ourselves under the pressure about the quantity of that time, and I think it's really not about the quantity, it's about the quality. Even five minutes of genuine connection and presence can mean the world to relationships. 

And I think that it's important for parents and adults to recognize that we're role models. So, no matter what we say, what we do is going to be what our kids internalize. 

So, when it comes to distraction and devices, if we can show some discipline and try to disconnect as much as possible in their presence, that helps set that tone. 

One of the most important pieces of advice I give parents is to help young people recognize their own limits rather than setting strict limits that can be unmet. So, what do I mean by that? Yeah, you can set strict limits and say, "This is how much you can use, and this is how much I can enforce," but what's more important is actually educating them about how much they're using. And we can do that by going through screen time data together, by having conversations and educating ourselves about how we can become addicted to devices, and by reminding young people and each other about how different it is when people in the family are on their devices versus when everyone's more genuinely connected to one another. 

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Flanagan: Do you think the pandemic has the potential to make the increase of suicidal ideation and serious psychological distress worse?

Dr. Sukhera: I do. I think that the pandemic is an example of a significant persistent stressor. And the ways in which we react to and cope with stressors are not too different, it's just that the pandemic, for a young person, particularly older teens, is harder to cope with because older teens don't have the same life experience to be able to imagine an end to things. Whereas adults have more life experience, so we can still imagine that this thing will come around and there'll be a turn back to something that resembles normal. For a young person though, their whole world is in that moment. And so, if they're missing things, if they're missing opportunity, it's a much bigger deal for them because their frame of reference is different. 

There's a lot of uncertainty—whether it's economic uncertainty, uncertainty related to the stress that their family's experiencing—but then if we add on top of it, for a young person, having to deal with issues related to health—physical health, fears of catching the virus, fears of spreading the virus—that only gets magnified by a chronic stressor being experienced, like the pandemic right now.

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Flanagan: What's the best way to support them and help guide them through this difficult time?

Dr. Sukhera: I would say there's three core things that I remind adult caregivers to remember. The first is we have to take care of ourselves too.

This is, in many ways, the most significant stress that many people have experienced in a generation. And so, before we can even think of supporting anyone, we have to remember to be kind to ourselves.

Being calm is something that's contagious. And at a time like this with so much uncertainty, what we really want to emphasize is a sense of control, predictability, and moderation. 

Structure and sleep are also really important because it's really hard to have some of that structure at a time like this, and it's often that we fall into extremes of either too much or too little structure. 

And the third piece relates to our impulse to fix things. There are things about this moment we simply can't and will not be able to fix. So, the strategies that people use to regulate to cope, that focus on fixing, aren't going to work. If we fall back into the sort of go-go-go mentality and ignore those heavy emotions, their burden will only grow. 

And so, it's important for us to create space and time to sit with those complex emotions with young people. Resist the impulse to fix every feeling. Sometimes we might just be inspired by the resilience and optimism of young people.

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Voice-over: This podcast is brought to you by the Ontario Medical Association. It is produced and edited by Jodi Crawford Productions. This podcast is not intended to provide medical advice for specific situations and is for general educational purposes only. Please consult your doctor if you have symptoms or questions about your health.

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