Commentary

Without knowing the specifics of your situation, I can’t determine what your family needs, but I can help you think about it.

We have all been programmed to believe that counseling is a magic bullet. BetterHelp, a mental health website, advertises that psychotherapy has a “unique expansiveness.” Of course, they would say that; what a great business model for a handy, easy-to-use therapy page. They are creating their own demand.

However, it didn’t used to be this way. In the past, if a person really struggled with mental health issues, they felt real shame around it. It was difficult to get people to recognize and admit that they needed professional help. Mental health issues and behavioral issues shouldn’t be shamed, but they shouldn’t be encouraged, glorified, or celebrated either.

Back in 2008–2011, when I worked at a partial hospitalization program with young people struggling with severe mental illness, I spent a lot of time helping my patients accept that something was seriously wrong (we didn’t normalize it) so they could begin their road to recovery. At that time, therapists and doctors perceived much of mental illness as something inherently wrong in the brain, while simultaneously believing that the individual has agency and can make better choices and recover. They also didn’t believe that mental illness was common, and diagnoses were given out sparingly.

However, nowadays, too many people are seeking labels, and professionals make diagnoses and prescribe medications with little discretion. Our culture has shifted so much that having a diagnosis went from something undesirable to something glorified. In the effort to reduce stigma, the pendulum has swung too far. Do more people suffer now from mental health issues, or have more people simply adopted the labels? I would argue—both.

I have watched a similar pattern happen in schools regarding learning disabilities. Having a learning disability used to be something shameful, not something people pronounced casually, whether it’s true or not. These types of struggles shouldn’t be shamed, but they shouldn’t be rewarded either.

Schools are struggling to field special education evaluation requests. Perhaps it’s because learning disabilities are on the rise, but also perhaps it’s because having a learning disability is incentivized for both schools and students. Being labeled with a learning disorder or a mental health disorder becomes a solid excuse for not working as hard, and it commonly becomes adopted and recognized as an important identity. We know certain celebrities and influencers who wear these labels proudly, and some create entire channels around it. It’s tempting for young people to do the same.

Schools get more funding for special education students, and social-emotional learning (SEL) programs are a big enterprise. SEL programs are designed to help students be more “emotionally intelligent”; however, there is little evidence that they succeed. (I would argue that they do the opposite and will have to discuss that topic further in a different essay. See CourageIsAHabit.org for more on the many ways that SEL programs are problematic.)

With schools adopting widespread SEL programs that are incentivized to create students with emotional or learning issues and provide benefits to students, it makes sense that more young people would adopt these labels.

In addition, teachers, doctors, and coaches are being trained to believe that they are mental health experts. The words depression, anxiety, and trauma are being thrown around so easily, it’s difficult to decipher who really struggles with these problems and to what extent. How many kids are told that they “have anxiety” when, in reality, they are nervous about something they should be nervous about? How many kids are told that they “have trauma” when they are experiencing a typical life challenge?

Darby Saxbe, a clinical psychologist and University of Southern California professor, pointed out in her recent New York Times op-ed piece titled “This is Not the Way to Help Depressed Teenagers” that framing struggles like this is a perfect way to undermine resilience. Several school districts have implemented a trauma-informed model for teachers to follow. It is unclear what constitutes trauma in these programs and how it is measured and treated. When you are trained to be a hammer, everything becomes a nail, so many kids could be labeled as traumatized as they are going through normal life.

In addition, in many cases, the environment is expected to cater to real or perceived triggers, rather than create an environment of resiliency.

When does a problem require a professional? Hard to say, but I do believe that people are seeking professional help too quickly. It seems that our problem-solving skills are too quickly outsourced to “experts.” When did we lose so much confidence in ourselves that every problem requires a professional? When did we become so addicted to parenting advice experts? The real question is: When did the grown-ups stop believing in themselves?

If parents were more confident in themselves, and less in experts, that would ground the children. You don’t have all the answers as a parent, but why would you expect a random therapist or teacher to have the answers? Who is a better expert on parenting your own child than you?

Back to my original question: Does your teen really need therapy? I can’t answer, but here are some practical questions to think about first:

• How serious is the problem, how long has it persisted, and what have you already tried?
• Have you thought about simple environmental and behavioral changes? Nutrition, sleep, less electronics, more social time, more family time, better school environment, stronger connection to community, etc., can have a tremendous impact on mental health.
• Does the problem need to be solved by a therapist? Perhaps your teen needs less time focusing on herself, not more. Perhaps someone else, such as a religious leader, relative, or family friend, can help?
• How much is the problem about family dynamics? This is a tough question, but it’s important to be honest with yourself about that.

In a nutshell, I am well aware that there are circumstances that require professional help, especially when behaviors are dangerous. However, I have noticed there is a current trend for parents to run to “experts” without trying things within the family first. We have been conditioned to believe that professionals will fix all problems. Unfortunately, in most cases, that simply isn’t true. If parents believe in themselves, trust their own instincts, and remain more present, children will feel secure and need less therapy.