How to Help a Teen with Depression

Parents of teens with depression often have a difficult challenge. You may notice that your child is especially irritable or sad, has a lack of energy, and is no longer interested in things they used to enjoy. Maybe they are struggling with procrastination or they’re isolating themselves and seem lonely. Often, a teen with depression falls behind in school and their grades start slipping. These things can be very alarming to parents! You may be used to stepping in to help when your child is in trouble. However, a depressed teen may push back, strongly, when parents try to help. A dilemma I see in my office often is a parent who has a distant and high-conflict relationship with a depressed teen that has developed because of a loving desire on the part of the parent to help their child feel better. Often, the teenager is angry, hurt, and in need of support from their parents. Parents sometimes ask me “What am I supposed to do? I can’t just leave my child alone, they are clearly suffering! But when I try to help and offer suggestions they become so angry and we get into a fight that just makes things worse.”

A parent in this situation is often suffering, too. They love their child and want to be there for them. They may be struggling with their own fears or sadness about what their child is going through. When parents come to me for therapy regarding these problems, I spend time listening and empathizing with their experience. I want to try and see this problem through their eyes and imagine what it is like for them to not only see their child suffering, but to have their child get angry and shut their parents out when parents try to help. When the parents can confirm that I understand their problems and I have given them the support and understanding they need, I explore any good reasons they may have for continuing to do things the way they have been and to not use the kind of help I have to offer.

The truth is, the help I have to offer a person in this situation is inherently unfair. That’s because I would only be able to help them change how they are handling the problem, rather than focusing on what can be done to get their child to behave differently. Often, parents are dismayed by the behavior of their teen who has depression. They have a lengthy list of behaviors they see that are making the problem worse and worse. I would agree that the teen really has a lot of things they could be doing differently to change things. But the parent is the person who is coming to me for help, not their child. Therefore, I can only focus on what the parent could do differently. To work with me, a parent would need to be willing to only look at how they are contributing to the problem in the relationship with their child. In fact, they will have to take a sometimes painful look at how they are actually causing their child to treat them in the ways they don’t like. This requires a death of the ego that can be extremely difficult. For the parent who is willing to experience this ego death, the benefits available are beautiful. They can transform the painful, frustrating, sad and lonely relationship with their loved one into a relationship of joy and love.

Let’s say a parent decides they want to work with me on this problem, even though it will be unfair and challenging for them. The first step will probably be to complete what’s called a Blame Cost-Benefit Analysis. This is a simple and powerful tool created by Dr. David Burns to bring to light all the good reasons for continuing to blame the other person for the problems in a relationship, and all of the disadvantages of doing this. You can see an example of a complete Blame Cost-Benefit Analysis at this link to Dr. Burns’ website. You can also listen to an excellent episode of Dr. Burns’ Feeling Good Podcast on the topic of addressing resistance to changing one’s own behavior in a relationship at this link. If after a parent completes the Blame Cost-Benefit Analysis they discover that the disadvantages of blaming their teen outweigh the advantages, I will offer them the tools of the Interpersonal Model of TEAM Therapy. A great place to start is learning the Five Secrets of Effective Communication. You can listen to an excellent Feeling Good Podcast episode that introduces the Five Secrets at this link.

Why do we focus on effective communication when a parent is asking how to help a teen with depression? We do this because of a paradox of relationships: The urge to solve problems is the cause of most relationship problems. The refusal to solve problems is usually the solution. At first, this sounds like confusing nonsense. “My child is in trouble! They need help! How can refusing to help them solve their problem be the answer? They need to get out of their room and do something!” Well, hear me out and see what you think.

If you want to have a closer, more satisfying relationship with your teenager, the biggest change you can make is to stop problem-solving and start communicating effectively. In the book “Feeling Good Together,” Dr. Burns teaches that if you want to communicate better, learn to talk with your EAR. In other words, do more listening than talking! Specifically, talking with your EAR means using three things: Empathy, Assertiveness and Respect.

In future blog posts, I will explore the E-A-R model and the Five Secrets of Effective Communication in more detail. If you are interested in learning more about the Five Secrets, check out Dr. Burns’ book “Feeling Good Together.” You can also get fantastic information on how to use the Five Secrets for free by listening to The Feeling Good Podcast. Try starting with episodes 65-70, which focus on the Five Secrets of Effective Communication and then explore the rest of the episodes to find other topics that are relevant to you.

To learn more about ways to help a teenager who is suffering from depression, check out the book “The Antidepressant Book” by Dr. Jacob Towery.

If your teenager is interested in therapy, you are welcome to schedule a free 15-minute consultation with me. This is an opportunity for me to get to know what your child would like help with in therapy and for me to show them the type of help I have to offer. If we agree that therapy with me could be a good fit for their problems, we can move forward with assessment, goal-setting and treatment.

Dealing with Anger in Relationships

How to Deal With Anger in Relationships | Psychology Today

In this article, the author makes excellent points about the ways we often damage our relationships with unhelpful ways of dealing with our anger. "A perceived lack of care or love leads to hurt…and hurt leads to sorrow…and being stuck in a place of hurt and sorrow leads to frustration, a desire to retaliate, anger, and aggression. And on it goes…but it never gets you what you want." In TEAM-CBT, we look at our responsibility for creating the relationship problems that are bothering us. It can be especially helpful to look at how our "should statements" about others can be questioned, which can be a way of cooling our anger. I work with individuals and couples who are interested in learning how they can change their own communication style in order to create the loving, satisfying relationships they want. Are you interested in learning more? Book a free consultation now.

What is TEAM-CBT?

TEAM-CBT is a structure for what makes psychotherapy effective, created and developed by Dr. David Burns. TEAM has two meanings: 1) We are a team, working together to help you achieve your goals in therapy. 2) It is an acronym for what we we are doing in your therapy sessions— T = Testing, E = Empathy, A = Assessment of Resistance and M = Methods.

T = TESTING

I use testing before and after every therapy session. The Brief Mood Survey I use checks to see how you are feeling by assessing your levels of Depression, Suicidal Urges, Anxiety, Anger, Positive Feelings and Relationship Satisfaction. You take the Brief Mood Survey before your session to help us both understand how you are feeling. We will discuss the scores on your survey and you will be able to tell me some details about how you are feeling. You will take the same survey after your session, so we can see how things went in the session. Did you feel better after the session? Are you getting better over the course of several sessions? This information is essential for us to adjust your treatment to make it personalized and as effective as possible for you. After your session, you will also provide an Evaluation of the Therapy Session. You’ll rate the truth of statements like “My therapist was warm, supportive and concerned,” “My therapist understood how I felt inside,” “The techniques we used were helpful,” and “I learned some new ways to deal with my problems.” You’ll also answer open ended questions like “What did you like least about the session,” and “What did you like best about the session?” The Evaluation of Therapy Session survey helps me understand what is and is not working in your treatment so I can adjust your treatment accordingly.

E = EMPATHY

The relationship you have with your therapist is a powerful part of psychotherapy treatment. It is important that I am trustworthy, understanding and supportive. I will take time in your session to understand as best I can the problems you are seeking help with in your therapy. Empathy is an essential element of therapy— without it, your treatment can feel cold, calculated and unsatisfying. This is why we put a big emphasis on creating a great relationship of understanding and trust.

A = ASSESSMENT OF RESISTANCE

Most therapy patients come to treatment because they are seeking big changes in their lives. You may want to feel happier or less afraid. Why would anyone resist feeling better? Yet, resistance is something that is present in almost all therapy sessions. in TEAM therapy, we take a unique approach to resistance that is powerful and effective. Our way of assessing and addressing resistance is what really sets TEAM apart from other kinds of therapy and makes it so powerful and effective. We ask, what if your negative feelings and the thoughts that cause them are not a sign of things that are wrong with you, but an important representation of things that are right with you? How are your feelings and thoughts helping you and what do they show about you and your values that is truly positive and even beautiful? We bring all of these things to conscious awareness and I take the side of resistance, putting you in the position of convincing me that you would want to feel better. The tools of Assessment of Resistance help you become aware of how your symptoms are helping you. When you can make a strong argument for changing anyway, then the Methods of therapy we use will have the chance be very successful very quickly.

M = Methods

I have over 100 Methods of TEAM-CBT available to help you change the way you feel by changing the way you think and behave. TEAM-CBT is an evidence-based practice, meaning that I only use therapy tools that have scientific evidence that shows the tools work. You can read details about most of the tools I use in therapy in Dr. Burns’ books, such as his latest book “Feeling Great: The Revolutionary New Treatment for Depression and Anxiety.” You can also get great information about the tools of TEAM-CBT on “The Feeling Good Podcast” with Dr. David Burns and Dr. Rhonda Barovsky.

What is Cognitive Therapy?

The therapy I practice, TEAM-CBT, was created by Dr. David Burns, a psychiatrist who is well-known for his New York Times Bestselling book “Feeling Good: The New Mood Therapy.” Dr. Burns beautifully describes the causes of depression and anxiety and how to recover from these problems in his excellent Ted Talk, which you can see at this link. To summarize, Dr. Burns wonders “Why do we get depressed? What can we do to get better?” Some people have theorized that these problems are caused by a chemical imbalance in the brain. Dr. Burns was working with patients and prescribing medications because the chemical imbalance model was considered the best treatment. However, his research showed that depression is not caused by a chemical imbalance in the brain, and that medications that supposedly changed brain chemistry did not help patients feel better. He learned of a new kind of treatment, Cognitive Therapy, developed by Dr. Aaron Beck, and began attending Dr. Beck’s weekly seminar. He learned that Cognitive Therapy has three main components: 1) Thoughts cause all of our moods, not events; 2) The negative thoughts that lead to depression and anxiety are deeply flawed and distorted; 3) People can change they way they think and they will immediately change the way they feel. You can watch Dr. Burns’ Ted Talk to see how these ideas were proved to be true in his work with the first patient he treated using Cognitive Therapy. He also tells a powerful personal story that illustrated the power of Cognitive Therapy from an experience in his own life.