Adolescent problems

I)             introduction

Many adolescents today have problems and are getting into trouble. After all, there are a lot of pressures for kids to deal with among friends and family. For some youth, pressures include poverty, violence, parental problems, and gangs. Kids may also be concerned about significant issues such as religion, gender roles, values, or ethnicity. Some children are having difficulty dealing with past traumas they have experienced, like abuse. Parents and their teenagers are struggling between the youth's wanting independence while still needing parental guidance. Sometimes all these conflicts result in behavior problems. 

Any number of isolated behavior problems can represent adolescent problems and delinquency-shoplifting, truancy, a fight in school, drug or alcohol ingestion. Sometimes, kids can't easily explain why they act the way they do. They may be just as confused about it as the adults, or they simply see delinquent behaviors as appropriate ways to deal with what they experience. Parents and loved ones may feel scared, angry, frustrated, or hopeless. They may feel guilty and wonder where they went wrong. All these feelings are normal, but it is important to understand that there is help available to troubled kids and their families.

II)            School Problems in Adolescents

School constitutes a large part of an adolescent’s existence. Difficulties in almost any area of life often manifest as school problems.

Particular school problems include

Fear of going to school

Absenteeism without permission (truancy)

Dropping out

Academic underachievement

Between 1% and 5% of adolescents develop fear of going to school. This fear may be generalized or related to a particular person (a teacher or another student—see Bullying) or event at school (such as physical education class). The adolescent may develop physical symptoms, such as abdominal pain, or may simply refuse to go to school. School personnel and family members should identify the reason, if any, for the fear and encourage the adolescent to attend school.

Adolescents who are repeatedly truant or drop out of school have made a conscious decision to miss school. These adolescents generally have poor academic achievement and have had little success in or satisfaction from school-related activities. They often have engaged in high-risk behaviors, such as having unprotected sex, taking drugs, and engaging in violence.

Adolescents at risk of dropping out should be made aware of other educational options, such as vocational training, graduate equivalent degrees, and alternative programs.

III)             Behavioral Problems in Adolescents

adolescence is a time for developing independence. Typically, adolescents exercise their independence by questioning and sometimes breaking rules. Parents and doctors must distinguish occasional errors of judgment from a degree of misbehavior that requires professional intervention. The severity and frequency of infractions are guides. For example, regular drinking, frequent episodes of fighting, truancy, and theft are much more significant than isolated episodes of the same activities. Other warning signs include deterioration of performance at school and running away from home. Of particular concern are adolescents who cause serious injury or use a weapon in a fight.

Children occasionally engage in physical confrontation. During adolescence, the frequency and severity of violent interactions may increase. Although episodes of violence at school are highly publicized, adolescents are much more likely to be involved in violent episodes (or more often the threat of violence) at home and outside of school. Many factors contribute to an increased risk of violence for adolescents, including

Gang membership

Access to firearms

Substance use

Poverty

There is little evidence to suggest a relationship between violence and genetic defects or chromosomal abnormalities.

Because adolescents are much more independent and mobile than they were as children, they are often out of the direct physical control of adults. In these circumstances, adolescents' behavior is determined by their own moral and behavioral code. Parents guide rather than directly control the adolescents' actions. Adolescents who feel warmth and support from their parents are less likely to engage in risky behaviors. Also, adolescents whose parents convey clear expectations regarding their children’s behavior and show consistent limit setting and monitoring are less likely to engage in risky behaviors. Authoritative parenting is a parenting style in which children participate in establishing family expectations and rules. This parenting style, as opposed to harsh or permissive parenting, is most likely to promote mature behaviors.

Authoritative parenting typically uses a system of graduated privileges, in which adolescents initially are given small bits of responsibility and freedom (such as caring for a pet, doing household chores, picking out clothing, or decorating their room). If adolescents handle this responsibility well over a period of time, more responsibilities and more privileges (such as going out with friends without parents, and driving) are granted. By contrast, poor judgment or lack of responsibility leads to loss of privileges. Each new privilege requires close monitoring by parents to make sure adolescents comply with the agreed-upon rules.

Some parents and their adolescents clash over almost everything. In these situations, the core issue is really control. Adolescents want to feel in control of their life, and parents want adolescents to know the parents still make the rules. In these situations, everyone may benefit from the parents picking their battles and focusing their efforts on the adolescents’ actions (such as attending school and complying with household responsibilities) rather than on expressions (such as dress, hairstyle, and preferred entertainment).

Adolescents whose behavior is dangerous or otherwise unacceptable despite their parents' best efforts may need professional intervention. Substance use is a common trigger of behavioral problems, and substance use disorders require specific treatment. Behavioral problems also may be a symptom of learning disabilities, depression, or other mental health disorders. Such disorders typically require counseling and mental health disorders often also require treatment with drugs. If parents are not able to limit an adolescent’s dangerous behavior, they may request help from the court system and be assigned to a probation officer who can help enforce reasonable household rules.

IV)          Overview of Psychosocial Problems in Adolescents

Psychologic and social problems, particularly involving behavior and school issues, are more common during adolescence than at any other time during childhood. Adolescents are much more independent and mobile and are often out of the direct control of adults. When misbehavior becomes severe and frequent, adolescents should be evaluated for a psychosocial disorder by a mental health professional. In particular, depression, anxiety, and eating disorders are common during adolescence. Adolescents who have psychosocial problems, anxiety, or depression may have physical symptoms such as fatigue or chronic fatigue, dizziness, headache, and abdominal or chest pain.

Depression is common among adolescents, and doctors actively screen for it during examinations (see Depression in Children and Adolescents). Suicide (see Suicidal Behavior in Children and Adolescents) is rare, but thoughts about suicide (called suicidal ideation) are more common. Suicidal ideation may go unnoticed, but, once it is noticed, the adolescent should receive a mental health evaluation.

Anxiety often manifests during adolescence (see Overview of Anxiety Disorders in Children), as do mood disorders and disruptive behavioral disorders such as oppositional defiant disorder (see Oppositional Defiant Disorder) and conduct disorder (see Conduct Disorder). Thought disorders (called psychosis—see also Childhood Schizophrenia) most commonly begin during adolescence or early adulthood. The first episode of psychosis is called a psychotic break.

Eating disorders, especially in girls, are common (see Definition of Eating Disorders). Some adolescents go to extraordinary lengths to hide symptoms of an eating disorder.

V)                Adolescent Substance Abuse

Being a teenager and raising a teenager are individually, and collectively, enormous challenges. For many teens, illicit substance use and abuse become part of the landscape of their teenage years. Although most adolescents who use drugs do not progress to become drug abusers, or drug addicts in adulthood, drug use in adolescence is a very risky proposition. Even small degrees of substance abuse (for example, alcohol, marijuana, and inhalants) can have negative consequences. Typically, school and relationships, notably family relationships, are among the life areas that are most influenced by drug use and abuse. One of the most telling signs of a teen's increasing involvement with drugs is when drug use becomes part of the teen's daily life. Preoccupation with drugs can crowd out previously important activities, and the manner in which the teen views him or her self may change in unrealistic and inaccurate directions. Friendship groups may change, sometimes dramatically, and relationships with family members can become more distant or conflictual. Further bad signs include more frequent use or use of greater amounts of a certain drug, or use of more dangerous drugs, such as cocaine, amphetamines, or heroin. Persistent patterns of drug use in adolescence are a sign that problems in that teen's environment exist and need to be addressed immediately. 
What causes adolescent substance abuse? 

There is no single cause of adolescent drug problems. Drug abuse develops over time; it does not start as full-blown abuse or addiction. There are different pathways or routes to the development of a teen's drug problems.

Some of the factors that may place teens at risk for developing drug problems include:

insufficient parental supervision and monitoring

lack of communication and interaction between parents and kids

poorly defined and poorly communicated rules and expectations against drug use 

inconsistent and excessively severe discipline

family conflict

favorable parental attitudes toward adolescent alcohol and drug use, and parental alcoholism or drug use

It is also important to also pay attention to individual risk factors, including:

high sensation seeking

impulsiveness 

psychological distress

difficulty maintaining emotional stability

perceptions of extensive use by peers

IV) How can I help my teen avoid substance abuse?

Parents and guardians need to be aware of the power they have to influence the development of their kids throughout the teenage years. Adolescence brings a new and dramatic stage to family life. The changes that are required are not just the teen's to make; parents need to change their relationship with their teenager. It is best if parents are proactive about the challenges of this life cycle stage, particularly those that pertain to the possibility of experimenting with and using alcohol and drugs. Parents cannot be afraid to talk directly to their kids about drug use, even if they have had problems with drugs or alcohol themselves. An excellent resource on how to talk to kids about drugs is Parents - The Anti-Drug (www.theantidrug.com). Parents are encouraged to give clear, no-use messages about smoking, drugs, and alcohol. It is important for kids and teens to understand that the rules and expectations set by parents are based on parental love and concern for their well being. Parents should also be actively involved and demonstrate interest in their teen's friends and social activities. Spending quality time with teens and setting good examples are essential. Even if problems such as substance abuse already exist in the teen's life, parents and families can still have a positive influence on their teen's behavior.