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Podcast: Help! My Teen Is Struggling with Anxiety and Depression (David Murray)

This article is part of the The Crossway Podcast series.

How Parents Can Help

In this episode, David Murray, author of Why Is My Teenager Feeling Like This?: A Guide to Helping Teens through Anxiety and Depression, discusses how parents can help teens who struggle with anxiety and depression. He reflects on the dramatic rise in teen anxiety and depression in the US over the last few years, offers guidance for thinking through the different potential causes of depression and anxiety, and speaks to the parent wrestling with two questions: Did I do something to cause this? and What do I do now?

Why Is My Teenager Feeling Like This?

David Murray

Adults play a vital role in helping teenagers through anxiety and depression, and this book gives spiritual encouragement and practical direction for parents and other adults who want to help but don’t know what to do. A companion volume to Murray’s Why Am I Feeling Like This?, written for teenagers.

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Parental Guilt over Teen Anxiety

02:15

Matt Tully
I don't have teens myself yet. I have three kids, but they're all younger. I'd imagine that one of the first questions that parents might have when they first start to suspect that their teenager—they're young kid of some some age or another—might be struggling with anxiety or depression is, Why is this happening? And then maybe quickly thereafter, What did I do wrong? Did I do something that led to this happening in the life of my child? What would you say to that?

David Murray
What is going wrong here is certainly very important for parents to pick up on signals that their kids are sending, noticing anything unusual and being able to begin to get them help. So I think it's very important for parents to be kept in tune with their kids through the teen years and look for things like withdrawal, changing sleep patterns, changing eating patterns, and just be prepared to ask that question because a lot of parents will actually just try and ignore it and deny it and minimize it. I'm busy enough. I don't need another problem.

Matt Tully
Did you feel that? You have five kids, is that right?

David Murray
Yes, five.

Fighting the Urge to Minimize Teen Anxiety and Depression

03:36

Matt Tully
Did you feel that pressure, or that temptation, to not ask those questions and not push in?

David Murray
I think it applies to every area of parenting, doesn't it? You want things to go as smoothly as it can, so you might say, I don't want to see that, I don't want to hear that, I don't want to notice that because that involves time and stress. But actually, in the long run it saves you time, it saves you stress, and it saves your kid as well. I think we need a sensitivity and a willingness to stop, sacrifice time, sacrifice comfort, and press in on these issues.

Parents ask, What did I do wrong? We've given the kids everything, and here we are with a wreckage. I think the first thing I would say is don't give up. Every kid goes through blips and slumps, and this is just a normal part of abnormality in an abnormal world. I think you need to expect these things rather than view them as unusual or weird or that they actually condemn my parenting. You can be the best people in the world and your kid still runs into these issues. So I think that's the first thing.

I think the second thing is also to realize there are things you just don't have any control over. The culture that we're a part of is a large part of the causes of teen anxiety and depression. Parents can try and protect your kids, of course, but there's a lot you can't take them from. So you have to accept that there are things out of your control that you are not to blame for. And of course there can be a genetic component as well.

I think the third thing is to recognize it may have been factors out of my control, but let me examine myself. Let me have a good look at myself and ask myself, Have I contributed to this? Oftentimes I would say the most common area that parents maybe are a bit to blame is excessive expectation—demanding extremely high performance of the kids in every area of life, all through the year, year after year. That can eventually have a crushing effect that just causes them to collapse. If you have gone wrong, if you are partly responsible, confess it. Go to your kid and say, Look, I'm sorry. I've played a part in this. I ask your forgiveness. Let's ask God's forgiveness. Now let's get to work and try and work on cures.

Can Parents Push Too Hard?

06:17

Matt Tully
How do parents know if they are pushing too hard? As Christians, we want our kids to grow up and to love God and to trust God. Also, even before they are Christians, to not do things that are going to forever change their life in negative ways, and so we push them, we encourage them, we have high standards. We hear a lot about the importance of consistency and discipline and structure. How do we know the line between all those good things and then pushing them too hard and contributing to these kinds of things?

David Murray
I think there are two pressures in our society that actually end up in the same place. One is excessive expectation—performance-itis—where eventually the child just breaks under it. But the other extreme is the snowflake problem where kids are not pushed at all, they're in control, they set the agenda, they set the boundaries—and there usually aren't any, and that's not good for them mentally and emotionally either. Both extremes end up at the same place, which is often broken kids, broken minds, broken hearts. I think the cures are very similar as well, and maybe we can talk about that down the road. But I think the next thing to say is that every kid is different. You may have your first kid, they're a real high achiever, high performer, they are driven, they've got great capacity. The next kid comes along and they just don't have that, and you're trying to make them like the first kid.

Matt Tully
That's so easy to assume that they're going to be just like the first kid.

David Murray
Right. So I think that's the first thing to be sensitive to—the nature of your child, the abilities of your child. Recognize every child is unique. The parent has to look at the basics of life. Is this child sleeping seven to nine hours a night? Is the child socializing well—not overdoing it, not overdoing it? Is the child getting exercise, time for leisure? If these things are going wrong then the balance is wrong.

Matt Tully
So there's some basic, common sense things that we don't want to neglect in all of this.

David Murray
Yeah.

Comparing and Contrasting Depression and Anxiety

08:54

Matt Tully
You've already mentioned a couple of times now anxiety and depression. It seems like in conversations about mental health for teens, but also for adults, those two topics—anxiety and depression—are often discussed together. Why is that? Those seem like, maybe to someone who hasn't struggled with those things, they seem like very different issues.

David Murray
So there is overlap, but there are also differences. Basically, about fifty percent of people who have depression also have anxiety. So you can see there's some overlap, but not all the time. Some of the symptoms, therefore, are different, and some of them are similar. With depression you will see low mood, loss of interest, guilt, feeling you want to die. Anxiety is at the other end of the scale though: there's worry, there's a restlessness, the person is sort of keyed up and tense and worried about the future. Areas where they overlap are usually sleep—either excessive sleep or very little sleep—and concentration—usually very tired. I think in order to try to understand why there is such an overlap we go to things like the genetics of a person. The same area of our genes that is broken manifests itself in these two areas so that both problems are traceable to this one area.

The Genetic Component

10:34

Matt Tully
Is there a lot of research these days that seems to point to a genetic component?

David Murray
There is, and even in the way that certain brain mechanisms work it's evident in people with depression that the same kind of thing is going on in the brain of somebody with anxiety. I think another reason why they often come together is that one often leads to the other. So if you've got someone who's very anxious and they're kind of hyper and tense and stressed and keyed up, that eventually exhausts somebody and they eventually have nothing left in the tank and they slump. And it also goes the other way: if someone's really depressed, cast down, hopeless, then they get a lot of fears about themselves and their world and their future. So it's a bit of a vicious circle, often, that one leads to the other and multiplies the other, and it just keeps going round.

The Importance of Parental Empathy

11:33

Matt Tully
Have you ever heard someone describe what it's like? I'm thinking of those parents who are listening who maybe don't struggle with anxiety or depression and would love to better understand what it is their teen is is actually feeling. How would you describe what that might be like?

David Murray
If you've ever been in a car accident, or you've come very close to a disaster—falling off a ladder or something like that—your fight or flight system kicks in. As you see a car spinning towards you, or a tree coming towards you, you've got that adrenaline cortisol rush. It's just the most horrifying feeling. Or when somebody jumps up from behind and scares you.

Well, imagine that all the time. Not just you have a bad accident and twenty minutes later you're beginning to calm down, or a few seconds later after the scare from your sister or your brother. But this just keeps going and you're living in that state. Or if you think of the saddest time ever in your life—whether it's a bereavement or a great loss of some kind—and again, just think of living like that. Hopefully these images can begin to help people understand and sympathize.

Why the Recent Rise in Rates?

12:58

Matt Tully
So I think probably many people listening right now have heard some of the statistics related to teen anxiety and depression and how that is on the rise, almost to crazy levels—levels that we have never seen before in the US, in the West. What's behind that? What's going on on a broader level that would be contributing to that?

David Murray
Yeah, the stats are awful. Something like a third of all teens will have an anxiety disorder, and about twenty percent of teens will have depression. One in five—that's awful, isn't it? Think of every fifth teen you know. And we're not talking about the odd bad day or week. This is life altering, it's incapacitating. I remember reading of one woman counselor who said that when she started counseling—twenty-four years ago—one in twenty of the kids who came to see her were there for anxiety problems. Now it's sixteen out of twenty.

Matt Tully
Wow.

David Murray
It's horrific.

Matt Tully
One of the common responses to that would be, Well, we're just diagnosing it more now. We're just labeling it differently now. It's not actually necessarily increasing. Do you think there's any truth to that?

David Murray
I think there is more diagnosis, and I think there can be an element of copycat as well among teens. So there's probably some element of exaggeration there, but I think we also have to face the fact that there are real increases and there are real reasons for those. They're not coming out of nowhere.

I think the first cause is pressure, the level of performance required of teens today. When I was growing up, I think we had two periods of exams in the whole year, lasting a couple of weeks each time. There was very little in the way of testing, assignments, and grading in between those exam periods. So you had a good life apart from a few weeks a year. But I'm raising teens and every single day there are tests and quizzes and papers that have life impact, that are taken into account in their grades. And then it's not enough to do well academically, you've got to do well in sports. And it's not just getting on the team, you've got to get a sports scholarship. And then you're supposed to be multiplying friendships and conducting all of these friendships. And then you've got church. And then you've got to do volunteer work as well and shadow people at work. You need all this to get into college. So the pressure is a huge element. And then, obviously, teens are putting themselves under a lot of pressure as well.

I think a second area is instability. We're recording this in the midst of the coronavirus—who knows where that's going—but that upsets teens. Maybe those of us who are older can be a bit more sober and serious—

Matt Tully
It's destabilizing.

David Murray
Yes, it's very destabilizing. I think it comes at the end of a couple of decades of instability. Since 9/11 it's a very different world. It feels very insecure compared to us—at least myself—growing up. You've got school shootings, you've got family breakdown, all the institutions of our society seem to be cracking—the political system, legal system. So there's an awful lot of instability. There's the sexual instability—gender issues and confusion. It used to be that you were a guy or you were a girl.

Matt Tully
Kids and teenagers are facing so much of that pressure directly in a public school context where maybe a lot of us adult Christians, it's just not quite the same experience for us.

David Murray
So that's a ton of instability. Technology is a third area—the information overload, hyper-stimulation, the social media pressure—the comparison that's going on there all the time—these are things that past generations just didn't have to deal with.

The Role of Social Media

17:31

Matt Tully
What do you think about social media? It seems like a lot of people point to that as the primary culprit in this kind of stuff. Do you think that's true? Do you think that's a really big factor here, or is that overplayed?

David Murray
The stats seem to show it's a huge factor. If you look at the rates of anxiety, depression, and suicidal ideation, it begins to rapidly increase about 2007. Then it spikes 2011-2012, and it's increased ever since. 2007 was the introduction of the iPhone, 2012 was the year most people attribute to mass adoption of the iPhone among teens. If you look at Jean Twenge's book, iGen, all her stats point to these two moments in time as massively influential because it coincides with all the other bad stats. So I think it is a big factor.

Matt Tully
How is it having that impact? What is it about social media and our ever-present smartphones that is hurting kids in this way?

David Murray
I think the most basic thing is our brains were never built to receive so much information every day. If you actually look at the gigabytes, or terabytes, that are absorbed every day compared to the past, it's gazillions more. Our brains have not gotten bigger and better, right? So I think that's one thing. The hyperstimulation is the other—the brain does well when it works really hard and then gets a good break. Total downtime. There's no downtime today. We can't sit a red light, we can't even go to the bathroom without—

Matt Tully
I'm sure many of the adults listening right now feel that same thing—you can't walk down the hall without pulling out your phone.

David Murray
No, it fries your brain, it really does—all the buzzes and beep. And then, of course, there is the comparison element via social media, the bullying as well.

The Effects of Bullying

19:39

Matt Tully
How big is that? I think that's another topic that, it seems like in recent years, has become more prominent. We used to think of bullying as someone getting shoved against a locker or punched after school, but really it's not that anymore. It seems like it's much more digital.

David Murray
I think the thing is it's constant. You can't get away from it now; you bring bullying home with you. It's not confined to the yard, it's not confined to the corridor; it's in your bedroom now. And it's through the night even. Some of the messages I've seen are just . . . it's terrible. What can you say? And then you got to go and face these people each day.

Matt Tully
And we've all seen even again, among adults, the propensity for people on social media at this distance to say terrible things to one another—things that I don't think they would say face to face. There's this lack of a filter that comes with technology.

David Murray
It's very impersonal and inhuman. One other area—the pressure, the instability, the technology—I think also the spiritual element to this. There's a lot less true Christianity around; therefore, there's a lot more guilt around, a lot more shame around. Sin itself is multiplying, especially the sin of immorality, pornography. I've seen that especially with young guys, but it's not just young guys. It's girls too. It's devastating to their mental health.

Again, going back even fifteen, twenty years, the barriers to pornography were so much higher. But now it's accessible, it's available, and it's free. It's extremely hard for teen guys to resist it, and teen girls. Something about that sin is incredibly guilt-generating and shame-generating and God-distancing. So there's a big spiritual element, and I think there's substance abuse too—addictions are increasing. Without the gospel, people just don't know how to get free and so they're in this bondage at very young ages. For cannabis now, the access age is something like 9 or 10? So what are the chances?

Matt Tully
I'm just struck in all this that all of these struggles, these sin issues, are not brand new. They are things that humans have struggled with for a long time, but there seems to be something about the technology that we now have that heightens them to a level that we've never maybe seen before.

David Murray
I think if you were to truly label our smartphones, if they were marketed truthfully, it would be something like Get the latest mental health destroyer! And yet, we're giving them to our kids without any instruction, mentoring, boundaries.

Matt Tully
It seems like there's a little bit of a wake up happening about the threat posed to our kid's mental health by smartphones. App developers and manufacturers of phones are starting to think about this, but it's slow.

David Murray
It's slow, yeah. You're up against money because there's a lot of money being generated by the addictive element of it. It's not just Christians who are ringing the bells here it's non-Christians too. They're seeing not just the spiritual impact, they're seeing their kids just disintegrate and looking for help.

The Spiritual Component of Mental Illness

23:52

Matt Tully
You mentioned the spiritual side of this that isn't part of the conversation for non-Christians. That's one thing that parents might wrestle with or not fully know where they stand on the issue of how do we integrate our understanding of these mental health issues with what the Bible says about us and the reality of sin and our faith and the call to believe the gospel and how that impacts how we view ourselves and view others. It seems like sometimes those can be placed at odds with one another, or not fit together well. What would you say to that?

David Murray
You've got your two extremes: you've got the all-spiritual approach to this where there's no recognition of any physical, social, mental element. And then you've got the all-physical approach where they say, They just need meds and they'll be fine. I think we have to recognize there are spiritual causes, there are relational causes, that are mental causes, there are physical causes, and take a holistic approach to it.

But I think that's where the Christian message here has such power because even if the primary causes are physical, mental, relational, all of these have a spiritual element to it. It's not so easy to separate. But a lot of the anxiety and depression is related to sin in people's lives, also a wrong view of God. So if you talk to kids with depression and anxiety, a lot of them have been raised in very legalistic backgrounds and their view of God is really horrible. They kind of project what they've seen onto God, so it's just this demanding, condemning, never satisfied, ever-multiplying of rules and regulations. They know they will never satisfy that God, and there's no remedy for their guilt. Even if they get some temporary relief, it's back again.

So one of our tasks, I think, is to communicate the true God of the Bible—the God of forgiveness, the God who delights in his people, the God who wants his people to have joy in him and in his world, and just seeing God in a whole new light through Jesus Christ, and bringing the gospel of forgiveness. My wife worked in a psychiatric ward—she's a doctor. There was a consultant there who had worked with mental health patients all his life. He was not a Christian. He told my wife that fifty percent of the patients in these wards—some of them were locked wards, but they were inpatients—fifty percent of them were there with unresolved guilt.

Matt Tully
For things that they had done?

David Murray
Yes. Some of that was false guilt, but a lot of it true guilt. What pill can you get for that? You can't. He was despairing. In fact, here's the sad thing, he took his own life. But in a sense, who wouldn't when you see such misery and despair there's nothing you can do?

Matt Tully
Yeah, when there's no solution.

David Murray
And here we have it: full, free, forever forgiveness. That's not just for eternity, that's life-changing. But we've gotta get that out to young people, and also a purpose to life. Why am I here? What is there to live for? You talk to young people today who have no God, no wonder suicide rates are going up—there is nothing worth living for. They're just looking ahead to debt for decades and just getting on the rat race and just miserable lives. They see so many broken relationships and they don't want that.

Again, we can come and we can say, Look, there's a reason to live and there's a purpose to life. It doesn't matter what job you do, you can serve the Lord in it and you can have the Lord's help in it. The Lord can give you good families. There's just so many blessings. Even that whole area of discontent that drives a lot of depression, the gospel comes along and says, Seek first the kingdom of God and his righteousness and all these things will be added to you. (Matt. 6:33) The devil loves this. We don't believe, like some, that all mental illness is satanic; but every mental illness is an opportunity for the devil. And he takes it.

Guiding an Unbelieving Teen with Biblical Wisdom

28:57

Matt Tully
So then how does all that then inform the truth of the physical side of these things? How does a parent know, when they're dealing with their kid, maybe a kid who's not reading the Bible and this parent knows that their kid isn't praying very often and doesn't want to be at church or with other Christians. How do they disentangle or make decisions about what to push on, what to suggest, what to say?

David Murray
I think it's easy for parents to say, Well, if you won't deal with the gospel, you won't deal with your soul, then I'm done with you.

Matt Tully
You've got to start there.

David Murray
Yeah. But Jesus healed ten lepers and only one came back to give him glory. It would appear only one was truly touched spiritually, but he didn't take his healing back of the other nine. So that's where I would start. If you can't make contact spiritually, I think just out of compassion for people and care and love, say, I think the ultimate issue here is spiritual, but I think I can help you in a few areas. We could be in touch with a doctor or a counselor, but just know that this is not going to fully resolve, or resolve this for long, until you get this piece right in your life. I'm always here to help you with that.

When to Get Professional Help

30:18

Matt Tully
How do parents know when to get a mental health professional involved? That can probably feel like a very big step, a radical step, a step that might not be very popular with their child and that might lead to a lot of conflict. It might just even personally feel scary like, Wow. This is to that level that I need to get some professional help for my kid. How do parents know when it's time to do that?

David Murray
I think, first of all, don't overreact or too quickly react. Some may have heard of over-diagnosis. We've got to accept our kids are going to have some down weeks and they're going to have some anxious weeks. That's not a reason to bring in the experts. We walk alongside and we say, This is part of life; let's push through. Let's not overreact and try and be calm. In many, many cases—maybe most—they will get through this. So I think that's just the first thing, to try—not deny—but just try and take a reasonable, objective approach to it.

I think the second thing I say in my book, Why Am I Feeling Like This?, there's a range of symptoms and so you must look not just at does he/she have all these symptoms, but the severity of them and how long they've been going on. Ultimately you really want to get to the doctor. I've found family doctors are extremely good at knowing if this is something that will pass or—

Matt Tully
So not necessarily a mental health counselor, just your doctor.

David Murray
No, just your family doctor. They see this a dozen times a day and they know what to look for, they know what not to be alarmed about, they will often make a few suggestions and say, Come back and see me in a couple of weeks. And again, have a sort of minimalist approach, but if in a couple of weeks there is still no change, or things have gotten worse, then he'll have some other suggestions.

I've found that, as a pastor, working together with a family practitioner—consulting together with permission from the patients—that usually can be the best way for a parent to approach this. So you're not taking all the responsibility on yourself. But I have to add, obviously, if your child is suicidal—talking about taking their own life—or you're very worried about that, don't wait. You have to act.

Interfering in Severe Situations

33:03

Matt Tully
Explain why, especially in those kinds of severe situations, why parents need to act. A parent might feel, I know my child. I know what he or she needs. I can talk to them. I understand them better than any random doctor could. Explain why it's important to not delay in getting help.

David Murray
Most of us don't know our children fully, and I think that's something that surprised me going through the teen years now with four kids—what you thought you knew, well that was a shocker! So there's always things we don't know. We look back on our own teen years—my mom and dad didn't know half of it. So don't assume you know. There are always things going on you don't know about. So look out for signs. Don't dismiss them. Play safe. What's the point in taking a risk, especially when there's help out there. Yes, you may get off with it; but you may not. And you don't get another chance.

That happened to me once with a member in my congregation. I'd been a pastor for about six years and, without going into all the details, somebody was accused of certain things and it looked like a really bleak prospect. It was from their pre-Christian past, and he took his own life. I should have seen it. I should have heeded the warning signs, but I kind of thought, Well, he's a Christian and he's a great guy. He's not going to do that. But he did, and I should have known. That lives with me, and obviously you don't want that. You don’t want it especially if it's a child. So again, we're trying to avoid two extremes of under reacting and overreacting and just getting help, incremental help, as you see things incrementally worsen.

The Role of Pastors

35:23

Matt Tully
So what role should pastors play in all this? I think sometimes people have a default reaction on that front, but what would you say would be the ideal way a pastor could be involved with parents and children and maybe also with a mental health professional?

David Murray
Lifeway did some research on this a few years ago and they found that the pastor was actually the one who was usually first contacted, which actually was surprising.

Matt Tully
Before parents?

David Murray
No, sorry. Parents usually contacted the pastor first for their loved one. The pastor was actually involved at quite an early stage in the process, especially if that pastor had shown any sympathy and care for those with mental health issues. People can tell if a pastor is going to be unhelpful, let's just put it that way. But pastors also said that though they were first contacted, they did not know what to do and they didn't know what the next step was and that they usually just referred them on or stumbled around unhelpfully.

So what I say to pastors is try and build up a team in your area—in your district, your city—of a doctor, a psychiatrist, a psychologist, a counselor, a biblical counselor. Get to know them. Build relationships with them. They don't all need to be Christians. Obviously ideally you want that, but as long as you have Christians involved, especially focused on the spiritual, and as long as the non-Christians are not going to undermine your emphasis and work and aim, that can work well together, especially if there's long term, trusting relationships. So you put together a team and you say well, they need a doctor and a biblical counselor; or they need a doctor and a psychiatrist and a counselor. Just over time you build a team, you build a sensitivity, and you're always involved. You're not just handing it over, but you're still involved, you're still caring, you're still meeting with the person, you're still checking in on them. And it doesn't happen quickly without stumbles, but over time. That way you're caring directly but also through other professionals as well.

Common Pastoral Pitfalls

37:58

Matt Tully
What are some of the biggest pitfalls that pastors, church leaders, youth pastors would want to avoid in this? Maybe someone doesn't have a lot of experience with this, or just wants to do better—what should they be aware of?

David Murray
I think one danger is trying to do too much, trying to do it all. You want to be that guy, or woman. You want to be the one with all the answers, but you usually don't have all the answers. You have a degree, a level, an area of expertise. Try and recognize your limits. Use what God has given you. Learn and educate yourself, but always be conscious of Okay, abuse or PTSD or something like that, that's beyond me. But hey, I know someone you can go to. So I think that's the first thing. Don't try to do too much. Don't be scared is the other. A lot of pastors will just not want to talk about this.

Matt Tully
It feels overwhelming.

David Murray
Yeah. And they either just delegate and walk away, or just push people away. You don't want people to just go to the Internet and type in “counselor.” You just don't know what they're going to get.

Matt Tully
Well David, thank you so much for taking the time to speak to us, speak to parents, and offer them both practical and spiritual, biblical wisdom about helping their teens as they struggle with this.

David Murray
Thank you. I hope it's helpful and that parents are helped to minister to their kids. You know, this relationship actually can be really strengthened through this for life.


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