Dubai: Augmented social expectations, peer pressure, hectic schedules that try to balance school and extracurricular activities leading to high stress are some of the reasons that are causing children in the age group of 13-20 to suffer from a host of mental issues ranging from depression and anxiety disorders to aggression and disconnect with reality, among other issues.
In the UAE, a 2013 study by Dubai Health Authority (DHA) has revealed that about one in five teenage students in Dubai showed symptoms of depression. Out of 1,289 students between the ages of 14 and 18 surveyed, in 16 private and four public schools, nearly 17.5 per cent were diagnosed with advanced symptoms. There have also been a spate of teen suicides with about 10 students having committed suicide since 2014 in the UAE.
How has the pendulum of mental health issues swung so dramatically towards the younger age group?
Mary John, Dubai–based clinical psychologist, said teen mental health issues are on the rise and believes a host of factors are at play when determining why a teenager is maladjusted. The two big issues, however, are family dynamics and school performance. In the former, the nuclear family status, Dr John said, is a significant causative.
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The nuclear family syndrome can incubate many disadvantages for the teenager, she said. If for instance, there is marital discord among the parents, it can have a negative impact on the child as the differences between the spouses tend to become implosive due to lack of extended family support and the dilution of stress thereof. “When parents quarrel, when marital tensions exist and when, in some cases, each parent seems to get disconnected from the other, it can lead to a very stressful situation for the teenager.”
If parents fail to create a normal environment at home, by knitting close family ties, it can take its toll on a child’s mind, said John.
The disconnect the teenager witnesses between parents can often become the teenager’s own point of view.
The obverse aspect to family life in every child’s life is the academic one. School, scholastic performance and the intense competitive nature of modern education places immense pressure on the young child who is exhorted to always be one step ahead of their peers. “The extraordinary expectations parents have of their child’s performance at school [is also is a pressure point],” says John.
Compounding these twin forces of family and studies is the tyranny of social media — a new, inevitable presence in every child’s life today. “Teenagers lead a very stressful life in terms of being constantly judged on social media on what they wear, where they are seen, how many friends they have... they feel the pressure of having to look good at all times that leads to issues of negative body image and triggers eating disorders. Teenagers are often up all night chatting on social media which alters their sleep patterns, resulting in arriving at school tired and distracted which, in turn, results in poor performance,” said John.
This is a vicious cycle, she said, which causes more anxiety disorders and the fear of failure.
Also, many teenagers are victims of bullying at school, she added.
Dr Mohammad Tahir, a qualified teen, adolescent and adult psychiatrist based in Dubai Health Care City (DHCC), said the issue of teen mental health is complex and multilayered. Teenagers in the UAE have to deal with multi-ethnic challenges. “Demographic factors play a role here. In Dubai, where 80 per cent of the population is expatriate and there is a melting pot culture, people develop a sort of competitiveness, of new learning and information sharing. Expectations of high-achieving parents and the need-to-have-it-all culture creates a stressful environment at home with less available quality family time. As we all know, mental health is not affected by just one factor. In addition to genetic predisposition, multiple psycho-social stressors are a big risk factor.”
What are the top mental issues among teens?
Dr Tahir said: “Many mental health issues are gender-specific. Depression is more common in females. Likewise, anxiety is also more frequently seen in females except for OCD. (Obsessive Compulsive Disorder, usually equally prevalent in males and females).
He provides a general list of mental health issues in children and teenagers.
Anxiety disorders: Disturbances in brain mechanisms designed to protect you from harm
Mood disorders: Disturbances in usual mood states
Psychotic disorders: Disturbance of thinking perception and behaviour
Personality disorders: Maladaptive personal characteristics
Eating disorders: Disturbances of weight and feeding behaviour
Developmental disorders: Early disturbances in usual brain development
Behavioural disorders: Persistent disturbances in expected behaviours
Addictions: Disorders of craving and substance abuse
Obsessive-Compulsive and related disorders
Why mental health needs more attention in the UAE
Social stigma, said Dr Tahir, is one of the main reasons why parents in the UAE are reluctant to seek help for their teenager’s mental health issues. Compounding this issue is the failure of parents, and society in general, to recognise the troubling symptoms in their teenager early enough to adopt interventionist methods.
“Parents, in as much as they feel proud when their child excels in class and gets a distinction in a subject, also have a hard time accepting the fact that their child has a mental health issue and that it is interfering with their social, academic and professional development. They [either] feel defeated [by the problem] or take it as an ego-bruiser that there is something wrong with their child’s outlook or attitude.”
“In other words,” said Dr Tahir, “they get into denial mode.”
What needs to be done?
Both specialists, John and Dr Tahir, agree that once parents have recognised there is a need to seek help from a clinical psychologist and/or psychiatrist, they must adopt the following actions:
1. Allow their child to communicate whenever he/she is ready [about what is bothering them]
2. Do not interrupt him/her when they are speaking
3. The child might blame you; do not get defensive. Remember, this is not about you. It is about your child
4. You must let your child know that you understand them perfectly, and that there can be a solution if you and he/she can work together
5. Do not play the blame game as parents; particularly if there are differences between the mother and father on the child’s problem and its cause
6. Your child should feel safe with both of you
7. Negative thoughts can lead to negative emotions, hence try and help your child convert the negative thought to a neutral positive thought. This will help in seeing hope even when feeling depressed
8. Do not criticise and hold your child responsible for any form of abuse or bullying they must be experiencing. On the contrary, trust them and believe what they are saying without putting forth buts and ifs
9. If your child has self-harming tendencies or you suspect him or her to be nursing suicidal tendencies, consult a psychologist or a psychiatrist. Medicines given in the right dose at the right time will help lift mood and feel positive
10. Rewarding appropriate behaviour (openness, expressing emotions) and ignoring inappropriate behaviour (anger, secretive behaviour) should be eschewed. Instead, develop an attitude of making your child feel loved unconditionally. This will help in developing a good rapport with your child.
What specialists look into
Dr Tahir feels when tackling mental health issues in teenagers, it is important for the specialist to take into account both the parents’ and the youth’s point of view to understand the causes and treatment options. He lists the following bare essentials that people need to keep in mind while going in for treatment:
Each youth needs individualised evaluation and treatment plan which best suits him or her
A full evaluation of home and family environment is required to develop a treatment plan
Individual therapy
Family therapy
Medication
Hospitalisation (if needed)
