Talking To Teens About Unhealthy Behaviors

to practice this behavior safely,” Dr. Perry says. Some safe ways for kids to get an adrenaline rush include participating in sports; going to amusement parks; or performing music, comedy, or dance. “If they have that safe and structured outlet, they are less likely to seek risk elsewhere,” Dr. Perry says. The second important thing for parents to recognize is that teens are hypersensitive during this time. “Sometimes they are really upset about things that don’t seem significant to us as adults,” Dr. Perry says.

Around age 11, children experience a major growth of neurons, or brain cells, that shifts which parts of the brain dominate behavior and decisionmaking. At this time, the prefrontal cortex, which controls behavior and decision-making, is growing but not yet mature, while the limbic system, which controls fear and pleasure, is becoming the most active it will ever be. “That means that adolescent behavior is being driven by unfiltered fear or pleasure-seeking emotions. They don’t think before they act because their brains aren’t wired to do that,” says Martha Perry, MD, adolescent medicine specialist and the medical director of the UNC Children’s Primary Care Clinic. Back in the age of hunter-gatherers, teenagers needed to go out and make their own way. “They would need to have the courage to take risks and the hypervigilance to keep themselves safe until they had more experience,” Dr. Perry says. Today, these changes can lead teens to engage in risky behaviors that may affect their health and safety. PARENTING YOUR SENSITIVE RISK-SEEKER If time and experience are what help teenage brains develop, learn to navigate the world, and make decisions, how can parents help guide them? “The first (thing) is to recognize that they are riskseeking at this stage of development and give them opportunities It can be a confusing time – there are moments when teenagers can be rational and make appropriate decisions. But in other moments, they cannot explain why they made a certain choice or why they find something upsetting. “A common thing I hear from parents is that their child knows better,” Dr. Perry says. Teenagers may know the risks or the reasons not to do something, but remember, the limbic system dominates and drives their behavior. “Their brains are not wired to think through what is right or wrong in the moment. They just act because of what they needed to be doing hundreds of years ago,” she says. TEACHABLE MOMENTS Giving teenagers accurate, unbiased information is key to getting through to the prefrontal cortex. But having conversations with teenagers about vaping, drinking alcohol, having sex, or doing drugs can be difficult. One way to help teens navigate these decisions is to talk about these issues often. For example, if you’re out together and see someone engaging in a risky behavior, such as vaping, use it as a teachable moment. You might ask, “Have you heard of vaping, or have you seen people vaping?” Give accurate, age-appropriate information on the subject, such as that vaping can be dangerous to your lungs and addictive. Then you might follow up with another question: “Do you know what addiction is? Let’s talk about that.” “The earlier you have those conversations, the more awareness kids have and the more opportunities they have had to think about it on their own,” Dr. Perry says. “When the time comes that they are in a situation where everyone around them is smoking or vaping, they have more brainpower to make that choice.” But be careful about giving misinformation. “Saying, ‘If you vape once, you will get addicted’ or ‘If you have sex, you will get pregnant’ is not completely accurate. You don’t want your teenager to stop trusting what you are saying,” Dr. Perry says. So, be sure to obtain information from reliable sources. You can also acknowledge that you don’t have all the facts. Saying, “We can look it up together,” for example, can make learning a shared experience. WHEN YOUR TEEN IS UPSET Teenage brains are not wired to have a reasonable conversation during a moment of upset, and teens need to have their emotions validated. “Parents see an adultlike figure in front of them and TALKING TO TEENS ABOUT

UNHEALTHY BEHAVIORS

think that they can have a reasonable conversation, and they can’t. And when that doesn’t happen, they sometimes view their teenager’s behavior as disrespect,” Dr. Perry says. “It’s not that they are trying to disrespect their parents; it’s more that their brains are driving them to be irrational and hypersensitive.” So, hear them out. Why they are upset might not make sense to you, but when you listen and validate how they are feeling, it creates trust. Try responding with, “I can see you are very upset” or “I understand this is really hard.” These phrases might seem simple, but they can help your teen feel understood.

WHAT TO DO AFTER RISKY BEHAVIOR Plain and simple – keep the conversation going. If you find out that your child has engaged in a risky behavior, do not freak out. Keeping dialogue open is critical to helping him or her navigate a complicated situation. For instance, if teenagers feel judged or that they will be in trouble with their parents, they are not likely to share information. Do not dismiss the behavior, but instead thank them for sharing the information with you. Ask them to tell you more about what happened and how they feel about it. “Kids will be surprised to hear parents talking to them in that way, but that is how you are going to get more information and be able to help them sort out how they feel,” Dr. Perry says. Framing your response around your concern for their safety can also help minimize feelings of judgment. If you are upset with your teenager, take a break before talking with him or her. “As a parent, it is disappointing, and you feel angry when you hear your kid is doing something that you think they shouldn’t be doing. But if they are choosing to tell you, that also means that they trust you,” Dr. Perry says.

YOUR PHYSICIAN IS HERE TO HELP Signs that teens are experiencing challenges that warrant professional help include a drop in their grades, loss of appetite and weight loss, withdrawn or secretive behaviors, decreased interest in things they used to enjoy, and isolation from friends and family. “Any time that a parent notices a dramatic change like that, I think it’s important not to just chalk it up to them being a teenager, but to seek help at that point from their pediatrician, family physician, or other trusted health professional,” Dr. Perry says. Share with teenagers why a visit with a health provider is important, so they feel like they are being helped, not judged. Teenagers might see a trip to the pediatrician as a form of punishment, as if you are trying to get the doctor on your side. “We know that punishment isn’t an effective way of changing a behavior in the long term,” Dr. Perry says. “Letting them know that you are concerned for their safety and that you want to do things that support them so that they can stay safe would be a better direction to go.” 

If you have questions or concerns about your teenager’s health, talk to your child’s doctor or find one near you at findadoc.unchealthcare.org.