May is Mental Health Awareness Month, and for parents with teens, awareness is key. According to Parents Lead, a North Dakota prevention program that works to promote healthy behavioral health in children, 29% of North Dakota high school students have felt sad or hopeless every day for more than two weeks in the past year. Of those high school students who felt sad and hopeless, 75% reported that they would not talk to their parents or adult family members about their feelings. One in six high school students have considered suicide in the past year, and perhaps most concerning of all, North Dakota experienced the largest suicide rate increase among all ages (58%) in the United States between 1999 and 2016.  
There are various theories as to why teen depression and anxiety has been on the rise, including less family support or structure, the widespread use of smart phones and other devices – which decreases face-to-face time – increased pressures at school and home, and alcohol and drug use, but regardless of the reasons, we should be concerned for our teens. So what can parents do?
First, spend some quality time with your kids. This isn’t a nicety, but a necessity. Talk to them about anything and everything while you’re in the car, at the dinner table, or doing family activities. If you’re not used to doing this and it doesn’t come naturally at first, start small; e.g., “How did your math test go?” or “Do you want to cook dinner together?” But it’s crucial that your teen feels like they can talk to you, especially when they’re feeling sad or anxious.
Second, if they do open up to you that they are struggling, listen to them. Do not get mad or brush it off. When I have students in my office at school who confess to feeling sad or anxious, I always ask if they have shared this with their parents, and if so, have their parents sought help for them? Often the answer to one or both questions is no. But why? Answer vary, but common ones include: “They just think it’s in my head and I can fix it myself.” “They don’t have time to listen to me.” “They get mad at me.” Or “I think they know, but they’re not doing anything.”
Third, do not assume that your child will never struggle, as depression and anxiety are very common. I had a wonderful upbringing with very supportive parents, but I still went through a couple of bouts of anxiety due to high stress and life changes. It was not fun. Often, the kids that seem successful on the outside could be struggling underneath; and it can be harder for them to seek help if they believe they’re not “supposed” to feel this way.
Finally, know that mental health issues are treatable and not permanent. Sometimes, life changes can help. Is your child active? Do they spend more than two hours per day on their phone? (Limit their time if so; more than two hours per day shows a spike in mental health concerns.) Do they spend much face-to-face time with you, other family members, or friends? If not, you might consider helping them get a job or join a school activity. Finally, are you available for them?
For moderate to severe depression or anxiety, please seek professional treatment through counseling, which is generally more successful with multiple sessions (National Institute for Health and Clinical Excellence recommends 6-8 sessions for mild to moderate depression) and/or medication, which might be a short- or long-term solution. Both types of treatment can come with a stigma; i.e., “I don’ t want therapy/ medication because I don’t want people to think I’m ‘crazy.’” Here’s what I say to that: If we are sick, we go the doctor and no one blinks twice. If we’re struggling with our mental health, we need to seek treatment too, simple as that. (Side note: Parents, if you are struggling, you also need to get help.)
Many health insurance plans will help cover the cost of both therapy and medication. If your family does not have health insurance and can’t afford it, check out the Healthy Steps program for children under 18 by visiting https://www.nd.gov/dhs/services/medicalserv/chip.
- North Dakota Department of Human Services: https://www.nd.gov/dhs/
- Crisis Text Line: https://www.crisistextline.org/
- Healthy Children by the American Academy of Pediatrics: https://www.crisistextline.org/
- Stuff That Sucks: A Teen’s Guide to Accepting What You Can’t Change and Committing to What You Can by Ben Sedley
- Depression: A Teen’s Guide to Survive and Thrive by Jacqueline B. Toner
- A.R.E.: The New Way to End Anxiety and Stop Panic Attacks by Barry McDonagh
If you or your teen is in a mental health crisis, call the Toll Free Crisis Line at 1-800-231-7724.
 ND Youth Risk Behavioral Survey, 2017
 Center for Disease Control and Prevention, 2018