The Teen Brain and Dialectical Behavioral Therapy

The 2017 Children’s Mental Health Report takes a look at adolescence, and how brain development in this period is responsible for some normal teen behaviors (impulsivity, angst, independence) and some more serious challenges (social anxiety, depression, self-harm).

The interplay between developing brain regions in adolescence leads to the increased intensity of feelings (fear, aggression, excitement, sexual attraction) that many adults still remember. It also results in the decreased ability to “hit the brakes” in responding to these feelings, leading teens to lash out, make hasty choices and develop unhealthy habits. The teen brain also has a heightened sense of self-consciousness, making adolescents truly feel like everyone is watching them. These feelings peak around 15 years old.

A couple of years ago, we made the above video with Hannah, a Child Mind Institute patient who completed dialectical behavioral therapy (DBT) for her severe anxiety and emotional dysregulation. Hannah told us about the sort of severe reaction that was getting in the way of living her life:

I got into this fight with a boy. He was poking me in the back of my head in my math class and I got so upset about it. I had a crush on him. It was just a typical thing but I remember just crying, crying and crying about it. Thinking I was not worth anything and that everyone was always going to hate me.

Hannah says that the key to DBT is its focus on practicality and acceptance. “It teaches you not how to live a perfect life,” she says, “but how to cope with everyday problems in your life. To accept who you are as a person. Not try to change who you are.”

According to Hannah, the tools she learned in DBT — calming exercises, mindfulness, coping skills — have tipped the scale from despair to hopeful determination. “By learning to believe in myself and learning to appreciate what’s going on in my life, I’ve become a much happier person,” she says. “Everyone deals with hard things but a happy person will get through them and understand them.”

The 2017 Children’s Mental Health Report contains information about teen behavior, mental health disorders and treatments, and brain development facts that parents and teens can use to have a conversation together about making healthy choices. It all starts with communicating free from blame or shame, and accepting that “life is messy,” as Hannah says.