There’s a mental health crisis in America, and it’s not limited to the 20 percent of U.S adults that experience anxiety, depression and other mental illnesses in a given year; it’s also impacting our children.

According to the CDC, 7.1 percent of children aged three to 17 (approximately 4.4 million) have diagnosed anxiety, while 3.2 percent of children aged three to 17 (approximately 1.9 million) have diagnosed depression. The National Alliance on Mental Illness (NAMI) reports that one in five teenagers between 13 and 18 will experience at least one “severe mental disorder” during their life, as will roughly 13 percent of kids aged between five and 15 years.  For parents, paying attention to our children’s mental health is paramount.

Whether you see signs of depression in your child or just want to be proactive about their mental health, use these strategies to engage your kid in conversation.

1.      Start the conversation early

“It’s hard to talk to kids about their worst stuff if you’re not having regular conversations,” says Ashley Miller, a psychiatrist with the Mood and Anxiety Disorder Clinic at BC Children’s Hospital in Vancouver. Make sure you are creating frequent opportunities for discussions to happen. “Sometimes it’s having neutral time together, where there’s no pressure—going for a drive, going for a walk or doing something the kid likes to do,” says Miller. Ask open-ended questions, like, “Did you talk to any friends today?” and have free-flowing conversations when you can.

2.      Validate their feelings

When your child is upset, your instinct is likely to reassure them that things aren’t so bad. “But that can minimize their suffering,” says Miller. Let them know you really hear them, and that their experience sounds difficult, by saying something like, “That sounds terrible.”

3.      Confront the scary stuff

When your child is talking about an emotional problem, read between the lines. Kids don’t like to be interrogated. So sometimes it’s better to trust your gut and make an educated guess, such as, “It sounds like you’re thinking of hurting yourself to get through this numbness.” If they’re showing signs of depression or self-harm, ask about suicidal thoughts. “When your kid is depressed, you want to let them know you can handle it,” says Miller. 

4.      Don’t take it personally

Sometimes depression comes out as anger. “Even if they say, ‘I hate you. You’re the worst mother ever,’ if you get too lost in taking it personally, you can’t see what’s going on with them,” says Miller. Sarah Cannon, whose daughter has depression, has found it’s important to take breaks—she calls on her parents for help when she needs to step away from the hurtful outbursts.

5.      Seek help

Talk to your family doctor about getting a referral to a mental health program. Accessing these resources early can help your child build the tools they’ll need to deal with the illness. If your child is suicidal, seek assistance as soon as possible. During a suicidal crisis, that often means heading immediately to the emergency room.

It is very normal for adolescents to experience stress and anxiety, sometimes even on a daily basis. However, the level of severity of their symptoms can interfere with their everyday functioning and therefore have a profound impact on their quality of life. It is important to be able to identify signs of anxiety or stress in your child so you can properly address their level of need.

The “power of positive thinking” is a popular concept, and sometimes it can feel a little cliché. But the physical and mental benefits of positive thinking have been demonstrated by multiple scientific studies. A positive mindset can give you more confidence, improve your mood, and even reduce the likelihood of developing conditions such as hypertension, depression and other stress-related disorders.

All this sounds great, but what does the “power of positive thinking” really mean?

You can define positive thinking as positive imagery, positive self-talk or general optimism, but these are all still general, ambiguous concepts. If you want to be effective in thinking and being more positive, you’ll need concrete examples to help you through the process.

Here are seven:

1. Start the day with a positive affirmation.

How you start the morning sets the tone for the rest of the day. Have you ever woken up late, panicked, and then felt like nothing good happened the rest of the day? This is likely because you started out the day with a negative emotion and a pessimistic view that carried into every other event you experienced. Instead of letting this dominate you, start your day with positive affirmations. Talk to yourself in the mirror, even if you feel silly, with statements like, “Today will be a good day” or “I’m going to be awesome today.” You’ll be amazed how much your day improves.

2. Focus on the good things, however small.

Almost invariably, you’re going to encounter obstacles throughout the day—there’s no such thing as a perfect day. When you encounter such a challenge, focus on the benefits, no matter how slight or unimportant they seem. For example, if you get stuck in traffic, think about how you now have time to listen to the rest of your favorite podcast. If the store is out of the food you want to prepare, think about the thrill of trying something new.

3. Find humor in bad situations.

Allow yourself to experience humor in even the darkest or most trying situations. Remind yourself that this situation will probably make for a good story later and try to crack a joke about it. Say you’re laid off; imagine the most absurd way you could spend your last day, or the most ridiculous job you could pursue next—like kangaroo handler or bubblegum sculptor.

4. Turn failures into lessons.

You aren’t perfect. You’re going to make mistakes and experience failure in multiple contexts, at multiple jobs and with multiple people. Instead of focusing on how you failed, think about what you’re going to do next time—turn your failure into a lesson. Conceptualize this in concrete rules. For example, you could come up with three new rules for managing projects as a result.

5. Transform negative self-talk into positive self-talk.

Negative self-talk can creep up easily and is often hard to notice. You might think I’m so bad at this or I shouldn’t have tried that. But these thoughts turn into internalized feelings and might cement your conceptions of yourself. When you catch yourself doing this, stop and replace those negative messages with positive ones. For example, I’m so bad at this becomes Once I get more practice, I’ll be way better at this. I shouldn’t have tried becomes That didn’t work out as planned—maybe next time.

6. Focus on the present.

I’m talking about the present—not today, not this hour, only this exact moment. You might be getting chewed out by your boss, but what in this exact moment is happening that’s so bad? Forget the comment he made five minutes ago. Forget what he might say five minutes from now. Focus on this one, individual moment. In most situations, you’ll find it’s not as bad as you imagine it to be. Most sources of negativity stem from a memory of a recent event or the exaggerated imagination of a potential future event. Stay in the present moment.

7. Find positive friends, mentors and co-workers.

When you surround yourself with positive people, you’ll hear positive outlooks, positive stories and positive affirmations. Their positive words will sink in and affect your own line of thinking, which then affects your words and similarly contributes to the group. Finding positive people to fill up your life can be difficult, but you need to eliminate the negativity in your life before it consumes you. Do what you can to improve the positivity of others, and let their positivity affect you the same way.

Almost anybody in any situation can apply these lessons to their own lives and increase their positive attitude. As you might imagine, positive thinking offers compounding returns, so the more often you practice it, the greater benefits you’ll realize.

We expect emotional outbursts from very young children, but by the time they are in their tweens and teens we expect them to be controlled and self-managing. It is a big ask…and unrealistic. Emotional maturity takes a long time. The brain only reaches an adult state in a person’s early twenties.

EMOTIONAL REGULATION IN TEENS

There are times in this development where the experience of emotion is multiplied by the impact of hormones. When these chemicals first flood the brain at around age two and then again during puberty, all hell can break loose.

We tend to underestimate how often a child has to self-regulate over the course of a day. We don’t notice because we are so good at it and we forget what it was like to not have those skills down pat.

WHAT ARE THE SKILLS OF EMOTIONAL REGULATION?

According to Alice Boyes PhD, there are ten skills of emotional self-regulation that we need to master by the time we are adults.

1. Identifying which specific emotions you’re feeling.

2. Identifying which specific emotions someone else is feeling.

3. The ability to start and persist in pursuing goals even when you feel anxious.

4. The ability to tolerate awkwardness.

5. The ability to have intimate conversations rather than stonewall, avoid, or flee.

6. The ability not to crumble when someone is pressuring you.

7. The ability to soothe your own emotions.

8. The ability to soothe other people’s emotions.

9. The ability to not go over the top with positive emotion.

10. The ability to delay gratification.

Some would argue that an understanding of the additional factors that negatively impact our emotional regulation is also very important. Factors such as lack of sleep, lack of exercise, hunger, drug use and alcohol use.

WHAT CAN ADULTS DO TO HELP CHILDREN DEVELOP THEIR EMOTIONAL REGULATION SKILLS?

1. Create emotionally expressive environments at home and school. These are spaces and places for kids where they feel free to say how they feel without fear of being ‘shut down’. There is a limit on behaviour but there is not a limit on emotion.

2. Develop your empathy response and use it with children. Kids need to feel heard. You don’t have to fix anything, just listen to understand.

3. Create a strong sense of belonging. Ritual and routine can help here. This sense of belonging makes it safe to express emotion and learn how to regulate safely.

4. Model your own emotional regulation. Talk about emotions you are experiencing and the strategies you are using to regulate those emotions.

5. Overtly teach strategies for self-regulation:

• Self-talk

• Meditation

• Take a break

• Exercise

• Talk with a good listener

• Breathe

6. Talk to kids about emotional regulation and strategies when they are calm, not in the middle of a meltdown. Mindfulness is essential.

7. Teach kids that positive emotions need to be regulated, not just negative ones. When kids talk over others or act ‘over the top’ and silly because they are excited they put people off.

8. Try not to be dictated to by our culture’s gender bias. Unfortunately, males and females get quite different feedback to emotions. Boys are expected to suppress their emotions much more than girls. Equally as damaging is the perception that female expressions of emotion are melodramatic and not to be taken too seriously. Let’s avoid the dismissive, ‘that’s just girls’. 

FINALLY…

Remind children that crying is a valid form of emotional regulation. Remember that it’s not necessary to stop someone crying. It won’t make them feel better. Just be with it. Tears are not a sign of weakness or of lack of competence. Crying releases emotional tension and can flag distress. Just because someone is emotional does not mean that what they are saying or thinking is not rational.

The teenage years have a lot in common with the terrible twos. During both stages our kids are doing exciting new things, but they’re also pushing boundaries (and buttons) and throwing tantrums. The major developmental task facing both age groups is also the same: kids must pull away from parents and begin to assert their own independence. No wonder they sometimes act as if they think they’re the center of the universe.

This makes for complicated parenting, especially because teens are beginning to make decisions about things that that have real consequence, like school and friends and driving, not to speak of substance use and sex. But they aren’t good at regulating their emotions yet, so teens are prone to taking risks and making impulsive decisions.

This means that having a healthy and trusting parent-child relationship during the teenage years is more important than ever. Staying close isn’t easy, though. Teens often aren’t very gracious when they are rejecting what they perceive to be parental interference. While they’re an open book to their friends, who they talk to constantly via text messages and social media, they might become mute when asked by mom how their day went. A request that seemed reasonable to dad may be received as a grievous outrage.

If this sounds familiar, take a deep breath and remind yourself that your child is going through his terrible teens. It is a phase that will pass, and your job as parent is still vitally important, only the role may have changed slightly. Here are some tips for navigating the new terrain:

1. Listen. If you are curious about what’s going on in your teen’s life, asking direct questions might not be as effective as simply sitting back and listening. Kids are more likely to be open with their parents if they don’t feel pressured to share information. Remember even an offhand comment about something that happened during the day is her way of reaching out, and you’re likely to hear more if you stay open and interested — but not prying.

2. Validate their feelings. It is often our tendency to try to solve problems for our kids, or downplay their disappointments. But saying something like “She wasn’t right for you anyway” after a romantic disappointment can feel dismissive. Instead, show kids that you understand and empathize by reflecting the comment back: “Wow, that does sound difficult.”

3. Show trust. Teens want to be taken seriously, especially by their parents. Look for ways to show that you trust your teen. Asking him for a favor shows that you rely on him. Volunteering a privilege shows that you think he can handle it. Letting your kid know you have faith in him will boost his confidence and make him more likely to rise to the occasion.

4. Don’t be a dictator. You still get to set the rules, but be ready to explain them. While pushing the boundaries is natural for teenagers, hearing your thoughtful explanation about why parties on school nights aren’t allowed will make the rule seem more reasonable.

5. Give praise. Parents tend to praise children more when they are younger, but adolescents need the self-esteem boost just as much. Teenagers might act like they’re too cool to care about what their parents think, but the truth is they still want your approval. Also looking for opportunities to be positive and encouraging is good for the relationship, especially when it is feeling strained.

6. Control your emotions. It’s easy for your temper to flare when your teen is being rude, but don’t respond in kind. Remember that you’re the adult and he is less able to control his emotions or think logically when he’s upset. Count to ten or take some deep breaths before responding. If you’re both too upset to talk, hit pause until you’ve had a chance to calm down.

7. Do things together. Talking isn’t the only way to communicate, and during these years it’s great if you can spend time doing things you both enjoy, whether it’s cooking or hiking or going to the movies, without talking about anything personal. It’s important for kids to know that they can be in proximity to you, and share positive experiences, without having to worry that you will pop intrusive questions or call them on the carpet for something.

8. Share regular meals. Sitting down to eat a meal together as a family is another great way to stay close. Dinner conversations give every member of the family a chance to check in and talk casually about sports or television or politics. Kids who feel comfortable talking to parents about everyday things are likely to be more open when harder things come up, too. One rule: no phones allowed.

9. Be observant. It’s normal for kids to go through some changes as they mature, but pay attention if you notice changes to her mood, behavior, energy level, or appetite. Likewise, take note if he stops wanting to do things that used to make him happy, or if you notice him isolating himself. If you see a change in your teen’s daily ability to function, ask her about it and be supportive (without being judgmental). She may need your help and it could be a sign she needs to talk to a mental health professional.