Explanation of the Series 

This 10-part series, “10 Important Conversations to Have with Your Kids,” provides parents with guidance on crucial topics to discuss with their middle schoolers. Written by family physician, Dr. Robin Dickinson, MD, each article offers background information, preparation tips, conversation dos and don’ts, and journaling prompts for both parent and child. These prompts can be used for journaling, writing assignments, or further discussion. Below is the list of topics Dr. Robin will cover.

1. Nutrition & Healthy Eating
2. Physical Activity & Exercise
3. Sleep & Healthy Habits
4. Online Safety & Digital Citizenship
5. Body Image & Self-Esteem
6. Puberty & Physical Changes
7. Healthy Relationships
8. Substance Use & Addiction
9. Mental Health & Well-being
10. Goal Setting & Personal Growth

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Middle school can be a turbulent time, marked by significant physical, emotional, and social changes. It’s also a time when mental health challenges can emerge or become more pronounced. This conversation isn’t just about “feeling down” or “having a bad day.” It’s about recognizing the importance of mental health, understanding common challenges, and equipping your child with the tools they need to nurture their well-being. It’s about creating a safe space for them to talk about their feelings and seek help when they need it.

The Foundation: Understanding Mental Health Challenges

Mental health is an integral part of overall health and well-being. It affects how we think, feel, and act. Middle schoolers can experience a range of mental health challenges, including anxiety, depression, and stress. It’s important to understand that these are common experiences, and seeking help is a sign of strength, not weakness.

I know many parents who regret former attitudes or comments they made in the past when they discover that their own child has a mental health challenge and is refusing help because of inaccurate beliefs or stigma. You can set yourself up for success in the future by making it a normal topic and demonstrating that you are knowledgeable and compassionate towards others.

Some parents worry that they will cause their children to have the same mental health hurdles as they’ve struggled with themselves. There are two ways this happens. One is genetic. People are born with different levels of inborn anxiety, optimism, etc. But the other you do have a great deal of control over. Even if you struggle, how do you talk about it with your child? Do you try to act like your mental state is healthy when it’s not? Instead, demonstrate getting help and talk openly about what you’re doing to take care of your mental health. While you don’t want to burden your child, pretending your struggles don’t exist isn’t helping anyone.

Common Mental Health Concerns in Adolescents

Anxiety is a natural response to stress. However, when anxiety is excessive, persistent, and interferes with daily life, it becomes a problem. This can manifest as excessive worry, fear, or dread, even when there’s no real danger. Helping your child understand the biological basis of anxiety can help enormously, as can care with a mental health professional.

Depression is more than just feeling sad. It’s a persistent feeling of sadness, hopelessness, or loss of interest in activities that were once enjoyable. It’s a mood disorder that affects how a person feels, thinks, and handles daily activities. In teens and men, it is common for it to appear to be normal irritability that has become persistent. 

Eating disorders are complex mental health conditions characterized by unhealthy eating patterns, distorted body image, and an intense preoccupation with weight and shape. These disorders are not simply about food; they often stem from underlying emotional issues. The sooner you get help, the easier it will be to address the issue. Too often, I’ve seen teens start showing early signs and parents refusing to address it because they don’t think it’s an issue yet. But why wait until it’s a bigger problem? 

Self-harm, also known as non-suicidal self-injury (NSSI), is a behavior where individuals intentionally injure themselves, typically by cutting, burning, or scratching. It is often a way to cope with overwhelming emotions, such as anger, sadness, or anxiety. It’s important to understand that self-harm is not typically a suicide attempt, but it indicates significant emotional distress that a person lacks the skills to cope with. Getting a teen into therapy quickly to learn the skills they need to cope with big feelings can make a real difference.

Stress is a natural physiological response to demands or pressures. In middle school, these can come from academic expectations, social dynamics, and developmental changes. While short-term stress can be motivating, chronic stress, or prolonged exposure to stressors, can have detrimental effects on both physical and mental health. Middle schoolers are particularly vulnerable because they are going through many changes, and may not have developed healthy coping skills. Stress can be the first step towards other problems ranging from burnout to depression to substance abuse. Get help early and avoid these more severe repercussions.

The Importance of Emotional Regulation and Coping Skills

Emotional regulation is the ability to manage and calm one’s emotions. Coping skills are strategies that people use to deal with stress and difficult situations. Developing healthy coping skills is essential for maintaining mental well-being. Many parents never learned healthy strategies themselves, which makes this doubly challenging as you may have to learn this alongside your middle schooler. 

Each time your child experiences challenging feelings is an opportunity to practice emotional regulation. It can help to keep a “menu” of options available that your child can choose from when they are struggling. These can include mindfulness activities (deep breathing techniques, 5-4-3-2-1 technique, stretching), cognitive strategies (challenging the cognitive distortions, distraction with a mentally stimulating activity), creative expression (journaling, drawing, playing an instrument or singing), physical strategies (exercising, splashing face with cold water), social strategies (spending time with family or friends, talking with a trusted person, or even just chatting with a stranger in line next to us).

Looking Inside Yourself

We’re all works in progress, and just like our children, we sometimes struggle with big feelings. Taking a moment to consider our own responses to stress, frustration, or disappointment can offer valuable insights. Are there patterns we notice? Are there moments we wish we’d handled differently? This isn’t about self-criticism, but rather a gentle invitation to grow alongside our children, learning and practicing healthy emotional regulation together. 

Do you find yourself losing your temper or yelling, threatening, stuffing your emotions and pretending everything is okay, avoiding conflict, behaving passive aggressively, blaming or shaming, using substances or food to handle feelings, or otherwise struggling with your own emotional regulation? This is a wonderful opportunity to be a role model for your children! If you’re always perfect, you aren’t showing them what to do when they aren’t perfect and are setting them up to think they have to always be perfect. I’ve made sure my kids have always known that humans are messy and mess up and that’s okay…and I have provided plenty of demonstrations of it myself!

If you do behave in a way you regret, apologize! I have apologized to my children a multitude of times. I use a seven part apology, though I may skip parts if that seems excessive for what I’ve done. Because of this, my kids are both extremely competent at apologizing and not afraid to take responsibility for their mistakes. (In case you’re wondering, the seven parts are acknowledging what I did, expressing remorse, accepting responsibility, acknowledging harm, making restitution, planning to change, and respectfully requesting forgiveness. But this needs an entire article of its own!)

Recognizing When Professional Help is Needed

It’s important to recognize when your child may need professional help. If you notice significant changes in their mood, behavior, eating, or sleep patterns, or if they are expressing thoughts of self-harm or suicide, it’s crucial to seek professional help. Don’t hesitate to reach out to a mental health professional, such as a therapist, counselor, or psychiatrist.

Parent Preparation: Being Informed and Supportive

Before talking to your child, take some time to learn about common mental health concerns in adolescents. Understanding the signs and symptoms of different mental health challenges will help you recognize when your child may need support. It’s also important to identify your own mental health challenges and strategies. Taking care of your own mental well-being will make you better equipped to support your child.

Conversation Tips: Open Communication and Empathy

Use open-ended questions to encourage your child to share their feelings. Instead of asking “Are you okay?” try asking “How are you really doing?” or “What’s been on your mind lately?” Normalize feelings like sadness, anger, and frustration. Let your child know that it’s okay to feel these emotions and that everyone experiences them from time to time.

Help your child develop healthy coping mechanisms. Encourage them to engage in activities they enjoy, such as exercise, spending time in nature, playing an instrument, or pursuing creative hobbies. 

Creating a Safe and Supportive Environment

Create a safe and supportive environment where your child feels comfortable expressing themselves. Let them know that you are there for them and that you will listen without judgment. Reassure them that seeking help is a sign of strength, not weakness.

Avoiding Pitfalls: What to Avoid

Don’t dismiss or minimize your child’s feelings. Even if you don’t understand what they’re going through, it’s important to validate their emotions. Avoid saying things like “You’re fine” or “Just get over it” or “It’s not that bad.” These comments can make your child feel invalidated and less likely to open up to you in the future.

I will never forget when my kids were little and we went to a playground we hadn’t been to before. There was a very long fast slide that went down a hillside and my toddler son came down fast and landed with a bump. He looked up at me with a mixture of shock and about-to-cry. “That was a surprise!” I said. “You didn’t expect to land that way. You didn’t like it. Are you okay?” My friend we’d met for a playdate was stunned. “It never occurred to me to do that,” she said.  “I always just told him he was okay and thought I was helping.”  

Just then we saw another toddler from our group land with a bump and start crying. “You’re okay!” his mom told him brightly. He sobbed more as she continued to tell him that he was okay. She walked to us carrying him so I leaned over to him and screwed up my face into a worried scowl that matched his response and repeated more or less what I’d said to my son. “That was a yucky surprise! You didn’t like that! It was scary! Are you okay?” He stopped crying and stared at me. “You didn’t like that!” I repeated. “Yeah,” he said and then got down and climbed back up the hill to go again. Before long all the little ones were successfully playing on the slide and laughing over the occasional bumpy landing. 

Journaling Prompts: Exploring Inner Landscapes

Here are some journaling prompts for both you and your child to further explore these topics:

For your child:

• What are some things that make you feel stressed or anxious?
• What are some healthy ways you can cope with difficult emotions?
• Who are some trusted adults you can talk to about your feelings?
• What are some things you can do to take care of your mental health?

For you:

• What are my own experiences with mental health and well-being?
• How can I create a more supportive environment for my child’s mental health?
• What are some ways I can model healthy coping strategies?
• What resources do I have to help with my mental health or to reach out to if I have concerns about my child?

By having open and ongoing conversations about mental health and well-being, you can empower your middle schooler to prioritize their mental health and develop the resilience they need to navigate the challenges of adolescence.

Check in next week when we’ll be focusing on the important topic of goal setting and personal growth!