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If you are a parent searching for answers — or a teenager yearning for tools to understand yourself better — look no further!
Dr. Lisa Damour is a New York Times bestselling author, podcast host, clinical psychologist, mother, and all-around brilliant human. Her new book, The Emotional Lives of Teenagers: Raising Connected, Capable, and Compassionate Adolescents, is an essential guide for parents and teens looking to make sense of their emotional distress, complicated feelings, and current climate of fear and anxiety.
Lisa sits down with Dr. McBride to discuss the recent CDC data on teen mental health and common misconceptions about anxiety, distress tolerance, and how parents can help their teens cope with the ups and downs of adolescence.
Join Dr. McBride every Monday for a new episode of Beyond the Prescription. You can subscribe on Apple Podcasts, Spotify, or at lucymcbride.com/podcast or at https://lucymcbride.Substack.com/listen.
Get full access to her free weekly Are You Okay? newsletter at https://lucymcbride.substack.com/welcome
Please be sure to like, rate, review — and enjoy — the show!
The full transcript of the show is here!
Dr. McBride: Hello, and welcome to my office. I'm Dr. Lucy McBride, and this is Beyond the Prescription, the show where I talk with my guests like I do my patients, pulling the curtain back on what it means to be healthy, redefining health as more than the absence of disease. As a primary care doctor for over 20 years, I've realized that patients are much more than their cholesterol and their weight. We are the integrated sum of complex parts.
[00:00:32] Our stories live in our bodies. I'm here to help people tell their story, to find out if are they okay, and for you to imagine and potentially get healthier from the inside out. You can subscribe to my weekly newsletter at lucymcbride.com and to the show on Apple Podcasts, Spotify, or wherever you get your podcasts.
[00:00:56] So let's get into it and go beyond the prescription.
[00:01:03] Today on the podcast, I am thrilled to welcome Dr. Lisa Damour. Lisa is a New York Times bestselling author, Podcast host, clinical psychologist, and Mother. Lisa's latest book was published earlier this year. It's titled The Emotional Lives of Teenagers: raising, connected, capable, and Compassionate Adolescents. This book is an invaluable guide for parents and teens to help them make sense of their complicated feelings and how to navigate emotional distress.
[00:01:35] Lisa is a wonderful resource in this current climate of anxiety, fear, and uncertainty, and I'm thrilled for her to join me today. Lisa, thank you so much for joining me on the podcast.
Lisa: Thank you so much for having me. I'm delighted to be here.
Dr. McBride: There's so much I wanna talk to you about. I wanna start with the word anxiety.
[00:01:55] It is a word that is thrown around a lot. It's a word that we need to have in the vocabulary of our lives because. As I say to patients all the time, anxiety is part of the human condition. If you didn't have anxiety, you would walk into traffic. You wouldn't turn your term paper in on time. You would not run from danger.
[00:02:18] But anxiety is such a commonly used word that I think it almost gets watered down, if you will, or it's such a commonly used word. It gets misunderstood. And what I love about your work, Lisa, is that you’re helping shed more light on what the word means. You're helping people normalize anxiety, not to be afraid of it.
[00:02:38] And so I'd love to ask you first. Tell me about the anatomy of anxiety and talk to me about what it actually means.
Lisa: So this is a tricky one because there's not a lot of places where the vernacular term for an emotion is also the same one we use for the diagnosis. And I think anxiety gets hard in that way, right?
[00:02:55] For depression, we have sadness and depression, and we can make those distinctions more cleanly, even though of course people do use the term depression in a fairly elastic way. We do actually talk about healthy anxiety using the same term that we could use to talk about unhealthy anxiety. But even there, that's where you see that psychologists make the distinction that both are real, both healthy and unhealthy anxiety.
[00:03:18] So in the simplest terms, what we think about with healthy anxiety is that it is exactly as you described it in A Gift from Evolution. It is our internal threat system. It alerts us when something's not right. In my second commercial book I—which was called Under Pressure: confronting the Epidemic of Stress and Anxiety In Girls—a huge amount of that book is about helping make these distinctions and helping parents and their daughters understand how this works.
[00:03:45] But healthy anxiety is a huge part of being a safe person in the world. We only consider anxiety to become unhealthy or to warrant a diagnosis under two conditions. One is if the anxiety is present and nothing's wrong, that to the degree that it's a threat alert system, it should only be alerting us when there are actual threats.
[00:04:07] So we become concerned if a person is feeling an ongoing sense of anxiety, but there's nothing for them to be frightened of. The other time that anxiety arrives or kind of crosses the threshold into a diagnostic category is if the anxiety is way out of proportion to what's wrong. So, if a kid has a term paper that's due and is late on it, they should feel some anxiety that is actually valuable to them, that will motivate them to turn the paper in or get it done.
[00:04:36] If they're having a panic attack over that, that's too big, it won't be productive to them. It won't be useful. And so some of our work in caring for people who suffer from anxiety is not actually trying to rid them of the anxiety. It's actually trying to get the anxiety to arrive in proportion to the threat.
Dr. McBride: [00:04:55] It's such a good way of describing it. What I've learned over time and what I try to convey to my patients is that it's really about, as you said, trying to calibrate your level of vigilance to the moment, and that is, that's really lifelong work for most people. They don't always recognize it. I think that like what I see in my office is the physical manifestations of anxiety, particularly on the heels of the three year collective trauma we've been through; the cognitive distortions that arise when people are experiencing anxiety; and then the natural human instinct to try to numb this uncomfortable feeling. And so where I can be most useful and, I would imagine this is the case for you in your clinic, is sort of normalizing for people the anxiety.
[00:05:47] If you did not have an emotional experience of anxiety, vigilance, fear during the pandemic, for example, I'd kind of wonder what was wrong with you. Like if you were just kinda like- oh, this would be unusual, a virus, whatever. It's a virus. People are dying unexpectedly, and we're closing schools and rearranging our entire lives.
[00:06:12] And so I think as you so elegantly say, and describing your book, Lisa, the mere normalization of anxiety is helpful and, one of the reasons I think is because people get so anxious that they're anxious. Again, as a recovering, anxious person myself, I've learned that anxiety can be a signal, oh, there's something going on and maybe I need to recalibrate this feeling versus letting it take over my thoughts, feelings, behaviors, and then all of a sudden I am in the backseat of the car riding the speed bump.
Lisa: [00:06:48] Yeah, I mean I think one of the things that we're up against right now in the culture is there's some confusion about what actually constitutes mental health. And that's part of why I wrote this book. So often being mentally healthy is equated with being calm or relaxed or at ease or happy.
[00:07:08] And you know what we know as psychologists is that that doesn't really enter into our assessment of mental health. Like we want people to feel those things. Like we're not against those things, but in assessing mental health, what we're assessing is whether the emotions people are having map onto the circumstances they're in.
[00:07:24] So we would fully expect to see a lot of stress and anxiety in the context of a global pandemic. We would expect to see deep sadness if the family pet dies. We would expect to see, you know, real anger if someone is badly treated. And I think, so much of my work right now is trying to actually bring psychological distress back into the fold to help across a wide range of emotions.
[00:07:46] Parents and adults and kids understand that it's usually a sign of mental health, not the opposite, but what we're confronting right now, and especially as my work centers on adolescents, are a lot of headlines that are rolling up psychological distress with mental health concern and that. At minimum they are inaccurate and in terms of impact, pretty alarming for people because, especially with my focus on teenagers, distress is part of most teenagers most days.
[00:08:20] And, and most of the time it's actually evidence that they work perfectly, not grounds for concern.
Dr. McBride: I think you're so right. I worry too about these headlines, like the recent CDC study showing. The enormity of distress among adolescents, particularly among adolescent girls, and I know that's a particular focus for you.
[00:08:38] The headlines alone generate anxiety, and I think we have conflated normal distress with mental health on the fritz. When they're related, but they're distinct. And I think this is gonna be my favorite question of the week to anybody, because I'm asking Lisa Damour to define what is mental health?
Lisa: [00:09:02] I will define it and then we're gonna come back to that CDC study because there were a lot of challenges and how that was reported. So mental health is two things. The first is having feelings that fit the circumstance. Even if those feelings are painful, unwanted, distressing, they are often evidence of mental health.
[00:09:18] The second, and this is for us, you know, a psychologist, where the rubber really hits the road, is managing those feelings effectively. So picture, you know, an adult who gets the news that they are about to be laid off, we would expect to see significant distress. That would be very strange if they cared about their job We would expect to see significant distress and the absence of it would be very odd. Now, where the rubber hits the road is, what do they do with that feeling? Do they reach out to people who love them and talk about it? Do they start looking for a job? Do they take extra good care of themselves and do comforting things when they get home?
[00:09:51] Do they take their mind off of it a little bit by watching their favorite show? All of that is the picture of mental health, even as the person is feeling distressed and working their way through the distress. Or, do they come home and start drinking heavily? Do they come home and go after the people in the house, kind of if I'm miserable, we're all gonna be miserable, or do they turn their frustration against themselves? I'm so lousy. I'm so inadequate. What's wrong with me that I was on the list to be laid off and then find themselves moving into a really dark place. That's the divide, right? The presence or absence of distress on its own tells us almost nothing.
[00:10:28] What really is informative is the capacity and the strategy that the person who's experiencing the distress brings to the table for managing it.
Dr. McBride: You said it. I want to make a t-shirt or a billboard because as someone who considers, like you do, mental health, the most sacred element of our health, it is ground zero for our health and humanity.
[00:10:57] I think it's really important for people to understand that A) we all have mental health. It's not a feature of the human condition that you can opt out of like a feature on your alarm system. You have it, which means that you will experience joy. You'll experience pleasure, you'll experience pain, you'll suffer.
[00:11:14] You will have uncomfortable feelings and emotions, and there's a rainbow of emotions that we experience. The goal of health in my mind isn't to be happy all the time, isn't to be calm all the time. Wouldn't that be nice? Those are great goals, but rather, the goal is to tolerate the inevitable distress that is part of the human condition and to give yourself permission to have those feelings.
[00:11:38] And to reflect on how they live in your body and how they manifest out in the world. And if we can tolerate distress because life is distressing, being human is distressing, that's really the ticket to health. Everything else is just gravy.
Lisa: It's true, and, and it's interesting. I've been thinking a lot about the term distress tolerance because certainly I'm, you know, out and about with this book and talking about this book, really trying to encourage people who are around teenagers to have a pretty high tolerance for adolescent distress, to help teenagers build a tolerance for their own distress.
[00:12:18] As I unpack it more and more, what I think about is, okay, well why, why do we need distress tolerance, right? And, and what do we mean when we say it? So in the, why do we need category, here's why we need distress tolerance—First, feelings are fundamentally informational. Our emotions tell us all sorts of things about how our life is going.
[00:12:34] They are our navigational system. So I actually, I wouldn't want to be calm all the time because what it means is that I'm missing a lot of data. The things that make me anxious, the things that make me frustrated—those are telling me information that I need to be acquiring. Second, distress is often growth giving.
[00:12:52] It's in the things that are painful or hard that we find our depths, we expand our capacity for what we can be empathic towards. We deepen our knowledge of ourselves. And then, fundamentally, distress is often how we connect with one another. That we can have very profound interactions with people when we're happy.
[00:13:13] But I think some of the most close and intimate interactions that happen between people is when someone is suffering and someone is there for them. So it becomes a huge part of the fabric of being in community with people. So this is like if we have to make a case for why we tolerate distress, I think part of how we make that case is to truly articulate the value, within limits of unwanted or unpleasant emotions. But then the thing about the term distress tolerance—I feel like we should have like a one-two. Tolerance and processing. Like we want the distress tolerance and processing, because sometimes I wonder when I'm out on the stomp saying like, we have to help kids tolerate distress and I'm making the case for it.
[00:13:57] I wonder if part of what is heard is. Your kid's gonna sit there in pain and you just gotta watch. And no one wants that. I don't want that for my kids. You don't want that for your kids. So I think that so much of what we then need to pivot towards once we've made the case that first we're gonna welcome distress in, right?
[00:14:12] We're gonna welcome it in. It's important to our lives. Then we have to make the case for how we live with it if we have to or help it find its way out again. So that's where emotion regulation, a very boring term, but a very important idea comes in. And the last two of the five chapters of my book is entirely about emotion regulation.
[00:14:32] That's where we get into the category of how do you manage that distress effectively and and what are the strategies on board to do that. So I've been thinking in my own work, maybe trying to always pair what we're going for here is distress tolerance and management or distress tolerance and regulation.
[00:14:51] And really putting the two together. Because I don't think, I don't mean to suggest, and I worry, it sometimes sounds like I'm saying, yep, you're just gonna suffer. I don't think, we don't want that for anyone.
Dr. McBride: I think it's such a good point, Lisa, because distress tolerance is a buzzword, in our world.
[00:15:06] And it can come across as sounding like, look, your kid's gonna suffer. Just watch it - it's a benefit to him or her. And you're like, what? Really?
Lisa: No, no, I don't wanna see that. I think what you're saying is that having a sense of agency over our own internal world is really the birthplace of calm that we're seeking.
Dr. McBride: [00:15:32] As a parent myself, who has experienced my own children go through distress and hard times. It's extremely difficult. I don't need to tell you that. I also know intellectually that letting them feel the feelings and navigate that space on their own is healthier than me trying to fix it or micromanage it.
[00:15:51] It's not comfortable though, and I think you're right that parents and teenagers, but parents need tools to help understand the benefit, the utility of that space between their child and them, and then having some. having an arsenal of coping tools because, because it's not easy. It's hard enough to manage our own stress.
Lisa: Absolutely. You know, we hate to see our kids in pain. I mean, that's just the nature of being a parent. It's like one of the most powerful instincts we have. Let's come back to that CDC study. In terms of just contextualizing it, one thing that got lost in the reporting on that study is that those data were collected in the fall of 2021 and they were asking about mood over the previous year.
[00:16:40] and they were asking about low mood for a period of two weeks. And so you were tracking what was unfolding in the pandemic very closely. I was writing about it. I went and pulled some writing I did in the fall of 2021 just to really ground myself in what was happening for teenagers in that moment.
[00:16:56] Because in some ways, the whole pandemic can feel like a blur. And so what was happening for teenagers in that moment, much less in the previous year leading up to that moment, was that they were headed back into their third school that was going to be shaped by the pandemic. Some kids weren't going back at all.
[00:17:12] Some kids were going back in masks and pretty freaked out about it. Some kids were going out without masks and pretty freaked out about it. And what I was hearing from teenagers everywhere was, even if they were happy with how things were starting to normalize, what they were saying to me is, “They're gonna take it all away. We're gonna get there. We're gonna get settled again, and it's gonna be ripped from us.” And why wouldn't they have that worry. So, those numbers, which are horrible, map very well onto what we were seeing clinically in the fall of 2021. Now, I'm not sure what the new numbers will say. I hope they're better and certainly anecdotally, kids I am finding who are back in more normalized situations are in much better moods.
[00:18:01] Things feel like they've in many, many ways returned to typical development for young people, but there's other forces at play that may keep those numbers looking pretty worrisome. But I think that's a place where I just, I want parents to just have more context on those numbers because they were reported very heavily as though they were brand new. And I think that historical context or locating them in time really matters. And I think what is really important is like, what does this mean for your kid today? Because some kids are still suffering and some kids are still not, you know, where they should be.
[00:18:39] And so I think that our work as clinicians who care for people who are trying to sort through these headlines is to say, here's what you want to be looking for right this minute. You know, does your teenager's mood go to a concerning place and stay there? Is your teenager's mood running the show? Is your teenager looking to unhealthy forms of coping as a way to manage?
[00:18:58] That's what we want to focus on while we await new numbers.
Dr. McBride: I think that's right. As you know, one of the features of anxiety is catastrophizing. And so I think a lot of parents looked at those headlines and said, oh my gosh, there's a mental health crisis among teenage girls. I've got a teenage girl who's behind her bedroom door.
[00:19:16] I don't know what's going on in her mind. Maybe she's mentally ill.
And that's catastrophic thinking right there. And it's not about labeling it mental illness or whatever. It's about what is going on with your child, what is going on with you as you think through this scary headline. And then what tools do we have to navigate this moment?
[00:19:41] And I think the fear-based headlines are causing fear, and I think there's a lot of fear around us and there's a lot of anxiety and it's appropriate in many ways. But I worry about the reporting on a mental health situation in a mentally unhealthy way.
Lisa: I do. And, and I think what's so hard is, I wanna be so mindful to not diminish in any way, the level of suffering and also the ongoing suffering that we see.
[00:20:08] But I'll tell you as we have a handy tool of psychologists for addressing catastrophic thinking, and when we think about catastrophic thinking, a psychologist, we see it as sort of one of the steps along the way to irrational anxiety. It's a sign that irrational anxiety has taken hold.
[00:20:24] And definitionally, when we think about irrational anxiety, it's a two-part definition for us. It’s an overestimation of the risk and an underestimation of the ability to manage the risk or the threat. And so as you're caring for people who are worried about their kids, as I'm caring for people who are worried about their kids, we hit it from both sides.
[00:20:45] So if the parent comes in and says, “my daughter's having meltdowns, is she experiencing a significant mental health concern? I'm seeing all these headlines.” We can work on the question of whether or not there's an overestimation of the situation. And then we do our good clinical work where we ask a lot of questions.
[00:20:59] We put that distress in context, we see how she's managing it, and hopefully we can actually bring down to size the parent's level of concern and reduce their assessment of the threat. And then there's the other side of catastrophic thinking: underestimating the ability to manage the threat. And one of the things that is actually like a silver lining in all of this is that psychologists know more about how to treat anxiety than pretty much anything else.
[00:21:24] And we're better at it than pretty much treating anything else. And we have known what to do. We've known actually for decades and the work, this is not cutting edge work in the field. This is highly established principles that we know work extremely well. Therapy works, medications can support that when necessary.
[00:21:41] There's all sorts of therapies that we know to be highly effective. A lot of them can be DIY at home, and so in terms of the situations, even when there really may be A concern or an anxiety disorder that's taken hold, for psychologists, that doesn't really change our heart rate. We're like, okay, we can treat anxiety.
[00:22:01] We know how to treat it effectively. We're really good at it. We've known for a long time, and what we have works. So I think as you and I are operating in that space between the people we care for in the headlines they're reading, you know, having, for lack of a better word, the confidence that even if it's depression, even if it's anxiety, We've been treating those a long time and we're solid on on those treatments.
Dr. McBride: [00:22:23] We're solid. You're right. Amen. We know how to treat anxiety and as you said, a lot of it is DIY. As you talked about in your recent TED Talk and I talk about in my office, the sympathetic nervous system has been around since the beginning of time. It's that fight or flight access and the parasympathetic nervous system has been woven into our DNA since the beginning of time, and we can actually use breathing exercise.
[00:22:48] To tell the sympathetic nervous system that's gone on the fritz, “it's okay. It's all right. There's no actual threat right now.” And when you take those deep breaths in through your nose, hold at the top of your lungs and then out through your mouth, it's incredible what that does. I like you sort of raise one eyebrow if I could at some of this wellness speak. I'm like, oh, that's so woowoo. But guess what? Our bodies are meant to be our friend. Evolution has our back. Evolution has allowed us to have inside our own bodies the ability to calm that sympathetic nervous system. So I wonder how you counsel patients or parents about, in the moment, bringing that anxiety down.
Lisa: [00:23:37] So what I do is it's actually a lot of teaching because we do have such a good handle on anxiety as psychologists and do understand the mechanisms by which it unfolds. So I say a lot of what you say about like, look, when the anxiety response is triggered, it is, you know, an ancient system handed down by evolution that alerts us to threats.
[00:23:57] Now, the problem with this ancient system is that it's ancient and it’s idea of how best to respond to threats is either you're gonna run or you're gonna attack. We have this leftover response that in modern life doesn't often make sense. You know, a kid is anxious about a test. You can't run from the test.
[00:24:13] You can't attack the test. But it's a very primitive part of the brain that’s in charge at this moment. And so what I describe to adults and also to teenagers is what the threat response is doing is that it is telling the heart to accelerate. It is telling the lungs to breathe in ways that are quick and shallow.
[00:24:31] So is to send a whole lot of heavily oxygenated blood out to the large muscle groups. And that's because you're about to run or attack as far as your cave person brain is concerned. That explanation alone, which is just the beginning, reduces so much anxiety that it gives a logic to what can feel like a very out of control bodily response.
[00:24:52] And then I say, you know, and just as the brain can communicate to their heart and lungs, the lungs actually what our theory is that they have a pathway to the brain, that they have nerves that are stretched receptor nerves that are on the surface of the lungs. They are monitoring how we're breathing.
[00:25:09] Those nerves are there so that we don't suffocate in our sleep. Those nerves also can communicate from the lungs to the brain a shift in how we're breathing. So when we override that process and we breathe deeply and slowly, we override the signal to speed everything up. What we think is happening is that functionally the lungs are sending the brain a message that we are now safe.
[00:25:31] We only breathe deeply and slowly when we're safe. And that that does shut down this sympathetic response. And especially for teenagers, I have found who can be like—and this is why I love them—appropriately cynical of anything that seems woowoo, walking through the biology of why deep breathing helps to downregulate anxiety, we'll then convince them or make them much more open to using it as a strategy. That's just step one of anxiety, which is the physiological response. Then there comes the interpretation of it, which is really what is happening is that we're activated, right? That's what anxiety is. It's activation, and we can call that activation lots of things.
[00:26:09] We can call it anxiety, we can call it excitement. We can call it preparation, and so I always use as an option offering people that they can think about what they really wanna call it and, and maybe it's not even anxiety—it’s just an activated state, state, but if they're like, no, it's anxiety, I am terrified, and that would be the right term for fear, then we go to the third step of not catastrophizing, not overestimating the threat, not underestimating the ability to deal with that threat.
[00:26:36] T hat's what I mean by DIY. I mean, this is step 1, 2, 3. We have interventions at every level and truly what we would do in our office, a lot of people can do for themselves or their kids at home.
Dr. McBride: I think it's reassuring to know that it's in your coping kit that you were born with. That you have agency.
[00:26:53] You just have to tap into it. It's great. Let me shift gears for one second. I wanna talk about boys. for a few minutes. I have two sons. I have a daughter and it's so clear to me, not just because I have sons, but just because I have my eyes open to the world that boys are struggling. We tend to focus on girls, I think right now because for obvious reasons, including the CDC data.
[00:27:23] But boys are socialized to be tough, to man up. Just like girls need to be able to express feeling, Boys do too.
[00:27:35] My son who's 21, just lost one of his closest friends in college. Horrific experience, and I was heartened by the fact that he, he's, he's calling us to talk about the feelings intermittently. I'm doing my darnedest. I think you would be proud of me not to text him, call him every day and ask how he's doing because he doesn't actually really need me, he needs his group of friends, and I've been heartened also by the fact that he and his friends up at school have really bonded over this experience and they take time to talk about it. I don't know why that is, why he and his friends are doing that, and I don't, and it may not be enough. And it may be that there are kids in his social group who are not able to talk about it.
[00:28:25] And I just want boys, like their female counterparts, to be given more permission to be able to talk about their feelings. That being strong, as you said, is not about being invulnerable. It's okay to feel, to cry, to let down, and, and if we could do that for boys, I think it would be a gift to their health.
Lisa: [00:28:45] it would, and, and what you're saying is supported by the research that we, by and large, socialized girls to feel that they can express a wide range of emotions, including feelings of fear or sadness. You know what we just sort of categorize as vulnerable emotions and boys as a group are largely socialized that those are not acceptable and not considered masculine and one of the challenges that we run into is that, especially for boys who are focusing on developing a masculine identity, they can sometimes consolidate that around a sense of, you know, talking about feelings is a girl thing to do, and then if those boys are in heterosexual households, it's not altogether uncommon for the person who's initiating the conversations about feelings to be their mom.
[00:29:32] This well-meaning effort on the part of the mother may actually underscore the boys' belief that, yeah, mom is bringing 'em up, dad is not. So, see what I mean? This is a girl thing to do. And so one of the recommendations I make in my new book is that if we want boys to feel that talking about vulnerable emotions is available to them and falls under whatever definition of masculinity they are working with, it's the men in their lives who need to be starting those conversations, asking boys about their feelings, talking with boys about their own emotions, their own vulnerable emotions, and, that can be dads or coaches or teachers or mentors or bosses. I didn't expect to come to that conclusion in working through my chapter on gender in this book. But that's what the data made pretty clear and it's changed how I guide families in terms of helping their boys express more, you know, tender emotions.
Dr. McBride: One of the cultural forces, I think is at play, and I'd love your take on this, is that, and I hear this from patients, I hear it from dads, I hear it from moms, this misunderstanding about talking to your children about vulnerability and fears and feelings is somehow making them anxious or making them think about things they wouldn't otherwise, and we’re actually making a mountain out of a molehill or enabling a narrative that kids are mentally ill. I wonder how you counsel parents who are reticent to talk about things they may not have explored in their own life, and then fear that we're opening Pandora's box.
Lisa: [00:31:19] You know, it's interesting what you're describing is something I've heard rumblings of in my own clinical work and my conversations actually, especially with teenagers. I actually suspect, and this is just a theory, that the very harrowing headlines have actually given rise to polarized responses to those.
[00:31:37] So one is parents who are terrified and checking in on their kids constantly and asking about their feelings constantly, which I completely understand where that would be coming from. And I also ache both for that parent and for that kid in that situation. And then the other, which I've heard from teenagers is the, you're fine, the feeling—exactly what you're describing. We don't need to go there. We're making it worse than it is. There’s harm to be done in mucking around in those feelings all the time. As it were. And so I think what we want to actually try to accomplish is something, not surprisingly, this kind of in the middle, which is—
[00:32:13] Of course kids are going to be upset. They are teenagers. They are growing and changing. That is the nature of being an adolescent. The change equals stress. It has always equaled stress. Adolescence equals change, right? I mean, there's just gonna be distress in the picture, and no one needs to get unduly anxious about the mere presence of distress.
[00:32:32] Again, what we're always going to focus on, Then what happens? Does the kid act out? Does the kid shut down? Or do they go about some very healthy coping to manage the distress? And then in terms of the parents' own experience of distress, which parents will experience distress? They are human.
[00:32:49] This is going to happen. . What we want is to use those moments to model good coping, right? My favorite line about parenting, I actually found on the inside of a dove chocolate wrapper, which is: don't talk about it, be about it. So if the parent has the worst day ever at work, they should come home and say, “I had the worst day ever.
[00:33:09] I need to go for a walk. If anyone wants to come with me, that's fine. I just need to be out in nature. I'm gonna go do that.” That's a great way to show both I'm having a painful feeling and I am managing it well, whereas a parent could come home and handle it in a way that isn't so positive and doesn't actually model the kind of coping that we would want teenagers or our kids to adopt for themselves.
Dr. McBride: [00:33:34] I think that's right. And then also I would just add. Apologizing for the stupid crap that we do. My daughter is like on me, like she's in the process of applying to college and it's this game and it's this, you know, college industrial complex and you know, naturally it's agitating to parents even though it's the third time we've done it.
[00:33:53] And I said to her some stupid comment about, well, have you done, you know, she's like, mom, I mean really? Like, do you think I haven't paid attention? And I'm like, sorry, noted. Just so I apologize. I'm like, sorry, I'm. This is mom doing the reflexive, naggy thing that we do. Don't mind me. And I mean, it's, we're learning alongside them and I'm just taking notes from my kids at this point.
[00:34:20] I mean, not that they are God's gift to mental health, not that they are fully formed, not that they don't experience distress, but I'm trying to, they're, they're teenagers and young adults and I'm trying to kind of learn from them because they have a lot to teach us. In fact, I do think their resilience in many ways, Is broader than their parents sometimes.
Lisa: [00:34:41] I think it's true. It's interesting. One of the things we might say accounts for that is I've always observed that time works differently for teenagers than it does for adults. I've always said teenage years are like dog years. You know, one year for them is like seven years for us. And so that means that things like the pandemic are especially torturous for them because it just goes on for such a long stretch of their time on this earth.
[00:35:03] But I also think they do move on from things faster. You know, something we can be nursing a grudge about an interaction that happened at breakfast. You know, it's evening, they don't even remember it. I mean like that is like so far away that is actually not that important to them. And I tell in my book a story about being on the verge of texting my daughter when she was applying to colleges, when she was at work, she was at, you know, at her retail job. And I had anxiety about her application and I wrote the whole text and I don't know why, but I managed not to send it. And I really try to use that as a way of thinking about how our moods do shape the environment at home.
[00:35:41] How we want to be mindful of both, not unduly creating anxiety provoking situations for our kids and not unwittingly modeling to them less than helpful ways to manage anxiety. And so I think that every parent feels that. Like if you're really, you know, if you're doing your job, you really are heavily invested in your kid.
[00:35:59] Even if it's not about where they go to college. It's about wanting them to have what they want, you know? And. Becomes very loaded in family life.
Dr. McBride Absolutely. All right, let's wrap up by asking. I wanna ask you about you. You have this incredible podcast. You're writing for the New York Times. You're on the book tour.
[00:36:19] Your books are really, really, really rich, deep texts to give parents and adolescents A sense of agency over their everyday life. It's very important work. And you look calm. You have this lovely voice that I would want to listen to when I was feeling at my most activated, but you're also human and I imagine you have moments.
[00:36:45] And so I wonder what that looks like. I'd love to know what your top coping strategies are because if you're anything like me, anything like anybody on the planet, you've got to stress yourself.
Lisa: Absolutely. Absolutely. So I think about it in a couple ways. I really come to appreciate that coping needs to be built into the day.
[00:37:05] Like you can't actually wait till you feel lousy to then decide how you're gonna cope. And so for me, coping is really trying to protect sleep. We could have hours and hours of conversation about the sheer value of sleep. It's so important. It is going to govern pretty much how the rest of everything else goes, and I'm pretty diligent about it.
[00:37:26] It's hard when I'm traveling a lot and then I do feel myself get run down and so I really try to come home and, and stock up again on sleep. I love to exercise. For me, it's a real pleasure and I do it every day. And the other thing that started in the pandemic that I've stayed really religious about is that I walk twice a week for exercise with a very dear friend.
[00:37:48] And we have a place, a route that we take. It is always the same route. We don't have to think about it, we don't have to figure it out. And she's someone with whom I can process everything. The range of our conversation truly goes from what we're cooking to deep philosophical professional and personal concerns. And so for me, I don't wait till I feel overwhelmed to find out when she can walk. It is just built in and if I'm in a great place, it's a lovely, lovely experience just to be with her. And if I'm in a lousy place, I'm in a better place by the time we're done.
[00:38:22] So I've become much more aware in my own life and then in my care of people that those systems and strategies that actually help us maintain a sense of emotional equilibrium is how I think about it. Not happiness, not feeling calm all the time, but that we're gonna have things that knock us off balance and things that help us regain emotional equilibrium. Those should actually be built into the routines of our weeks because we will need them and when we're knocked off balance is not a great time to try to figure out what those are.
Dr. McBride: [00:38:54] I think you're right, and I think you're talking about prevention I mean, it's like we floss our teeth to prevent the cavity, or at least we should floss our teeth. We take our vitamins, we go to the doctor for their checkup. We need to treat our emotional wellbeing like we do any other organ system.
[00:39:11] And you're right, building it in is a good way to prevent the excess fear, anxiety, distress that we might otherwise experience. I think you talked about this friend before the pandemic. I remember hearing you on a talk, talk about the same friend. She must be like one of those golden people in your life.
Lisa: [00:39:30] She is.. She is. I mean, I have so many good friends who I turn to, but you know, she's in town. We're on this. We got a routine. It's the glue that holds me together a lot at the time.
Dr. McBride: I think it's amazing. The glue to me is being in nature, deep relationships. Movement and sleep. Sleep being the gasoline in the tank in the car .
[00:39:51] Absolutely. Lisa, I'm gonna let you go. I know you have a very busy schedule ahead of you. I am so grateful that you joined me today and thank you for all of your work. You're really making an impact on families at a crucial moment in their lives.
Lisa: That is really kind and I mean back at ya. Thank you for all you're doing. I think it's so important that people have informed guidance on how to take good care of themselves, so I'm so grateful for what you do.
Dr. McBride: Thank you, Lisa. Thank you all for listening to Beyond the Prescription. Please don't forget to subscribe, like, download and share the show on Apple Podcasts, Spotify, or wherever you catch your podcasts.
[00:40:30] I'd be thrilled if you like this episode to rate and review it. And if you have a comment or question, please drop us a line at info@lucymcbride.com. The views expressed on this show are entirely my own and do not constitute medical advice for individuals that should be obtained from your personal physician beyond.
[00:40:50] Beyond The Prescription is produced at Podville Media in Washington, DC.
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