RESEARCH points out that habits adopted in adolescence are what individuals bring into adulthood, but inculcating good practices in teenagers isn’t easy given that the life phase is filled with physical and emotional changes.
The onset of puberty, peer pressure and the need for autonomy could mean that this group is somewhat left to their own devices, despite needing guidance so they become healthy, wholesome adults.
Consultant paediatrician and adolescent medicine specialist Dr N. Thiyagar admits that dealing with teenagers can be challenging.
“The period between 10 and 24 years old is when an adolescent undergoes drastic physical and psychosocial development. And as challenging as it is for adolescents, it is also challenging for families and healthcare providers.
“But this is a critical time in life when individuals develop independence and social skills, and learn behaviours that will last until adulthood,” he says.
Positive Parenting chairman and consultant paediatrician Datuk Dr Zulkifli Ismail says although it is well-known that adolescence is the transition between being a child and an adult, teens are neglected because there are limited subspecialists in this field even though almost all paediatricians have been taught to deal with the basic complexities of the phase.
“This period is challenging to adolescents and they need support from their peers as well as from adults and professionals who are knowledgeable,” he adds.
Adolescents also perceive they are healthy, says Dr Thiyagar, so they tend to take health issues lightly. But parents, he says, should engage with their teenagers early to discuss various aspects of health including reproductive health, mental health, personal hygiene, sleep hygiene, healthy diet and exercise. “By providing them with relevant information, teenagers can identify any health issues and seek help promptly,” he adds.
Dr Zulkifli says health-seeking behaviour should also be inculcated in teenagers. The same applies to early diagnosis and treatment for any condition.
“This includes prevention like vaccination, balanced nutrition, healthy activities and avoidance of unhealthy ones. If there is good rapport between the teen and his or her parents, they can discuss health-seeking issues easily.”
In October, the Malaysian Paediatric Association (MPA) launched its Positive Teens programme with its first workshop to equip Malaysian teenagers with tools, knowledge and coping mechanisms to navigate the complex challenges that they may face.
The expert-teen initiative is led by a panel of experts who specialise in paediatrics, adolescent medicine, clinical psychology and nutrition, among others, to help teenagers and parents navigate this phase better.
“We hope to cultivate healthy lifestyle habits and foster positive behaviours which will help build the character of our youth and leave a lasting and positive impression on their lives,” Dr Zulkifli says.
Dr Zulkifli (left) and MPA President Dr. Selva Kumar Sivapunniam (right) with Youth and Sports minister Hannah Yoeh, who launched the event.
Walk the talk
When it comes to getting teenagers to adopt healthy habits, adults (especially parents), have to walk the talk.
Role modelling is very important, Dr Thiyagar says. “Parents should practise healthy lifestyle daily, because both good and bad habits that a child is exposed to early in life, tend to carry on into adulthood,”
Dr Zulkifli agrees. “Habits are inculcated by watching adult examples and discussing issues with adults with whom the adolescent can relate to. However, most adolescents cannot open up or interact with their parents, so there is a need for engagement with a third party or experts,” he adds. Dr Thiyagar says parents should raise their children in a supportive and loving environment, and teach them basic life skills including house chores like cooking, ironing and cleaning up around the house.
“They should also encourage children to walk for better physical health, teach basic social etiquette and use decent language at home and in front of children. Set rules on screen time and praise them when they accomplish a given task,” he adds. Parents should also instil resilience when teenagers face difficulties and guide them to be kind to others.
Dr Zulkifli says other good habits include waking up early, respecting people and being punctual. “Teenagers need to be a part of the family unit even though they may be beginning to distance themselves in an effort to be independent,” he says.
Mental health and teenagers
It is a known fact that adolescents gain information primarily from social media. Although there is currently more mental health content posted online, these advice are not necessarily accurate or updated. They may also be posted by non-experts which can lead to the danger of misdiagnosis or erroneous self-diagnosis.
To handle this, behavioural psychologist Alexius Cheang advises that teenagers share their mental health symptoms and concerns with their family doctor or general practitioner (GP), especially when they go in for other physical issues.
“The medical doctor is usually the first point of contact who can do a quick assessment and refer the teenager to get appropriate mental health assistance from a counsellor, clinical psychologist or even psychiatrist from the local government hospital,” he adds.
“Starting from a place of deficit, particularly since they are developing their own identity, teenagers need to be in a place of love and support. Even if negative events happen in their lives, having a stable base of support where they know they are loved and accepted unconditionally, allows them to be brave to try out new experiences which they can grow from, developing self-esteem and confidence to nurture themselves,” he adds.
Cheang says over the years, he has seen a dramatic increase in stress, anxiety and depression among teenagers.
“Stress is a natural response that prompts individuals to deal with challenges. It can even be motivating, like getting us to study for an exam. However, high levels of stress can happen when we don’t know how to manage a situation or are overwhelmed because we lack the resources to deal with it.
“A time-based component such as a deadline can transform this stress into anxiety – we can see the deadline looming but we still haven’t figured out how to manage it. If we don’t learn how to manage the situation, constantly being in an anxious state can then lead to being depressed and essentially learning to give in and give up, with very little in life to look forward to,” he explains.
Unfortunately, Cheang says, young people are not taught life skills like self-regulation and adaptive coping methods. “The emphasis is on academics which, while important, does not translate into everyday life skills since they are mostly theoretical and hypothetical, and are not very practical. Over time, being in a depressed state of mind can lead to various other mental disorders, which are also on the rise among teenagers,” he says.
Sarah and her mum Raihan. She says it’s essential for teenagers to have a safe space at home to talk about anything. — SARAH ARIESYA KHAIRUL ANUAR
Value of safe space
Sarah Ariesya Khairul Anuar, 14, says she feels lucky to be heard and listened to, thanks to her “very supportive friends and family members who hear me out whenever I vent about my problems.”
Sarah says a safe space at home to discuss everything is important to her, and to everyone. “After a long and tiring day, surely some people would have bottled up troubles and thoughts. Where else could you talk about your problems if not at home?”
She says she doesn’t have a problem communicating with her parents. “I have a decent relationship with them. And although they are constantly occupied with work, they somehow manage to squeeze in some time to spend with me,” she says.
Her mother, cybersecurity manager Raihan Ismail, 46, says as Sarah is her only child, she and her husband include her in their daily conversations since she was very young.
“From a very early age, she is used to being able to express herself and having her own opinions. Whatever we need to correct, we will talk to her and explain our reasoning. We also involve her in more physical and fun activities such as jogging, walking and hiking, and we do it together as a family,” she says.
Sarah says she enjoys art. “Whenever I don’t feel like talking about my problems, I’ll spend some time working on a canvas, or maybe even hop on a video game for a bit,” she says.
She says she knows how to manage her stress. “Unhealthy coping mechanisms can lead to long-term consequences and may take a toll on mental health. Whereas healthy coping mechanism, like art, for me, can help manage stress beneficially,” she adds.
When it comes to parent-child relationship, Raihan says most of the time, they are like friends. “But this has limitations, because we are still her parents with a certain degree of authority,”
“I guess I am more of a friend and my husband is the more authoritative one when the need arises,” she says. “While we do notice changes in her, maybe due to external influences such as peers and social media, we try to address it one by one by talking to her.”
Cheang says the number one mistake parents make when it comes to their children’s mental health is downplaying or ignoring their child’s issues because they are usually not equipped to deal with them.
“Parents also find it hard to accept that their child is suffering as they take it as a reflection of their parenting and family environment, which they may deem shameful. Telling a child to ‘toughen up’ or to ‘deal with it’ is not only not helpful, but makes the child feels even worse. The response indicates that the issue is within the child.”
“The reality is that the family functions as a unit and every member contributes to the environmental support (or lack thereof),” he says, adding that parents can improve their response by actively listening to whatever their child has to share and to hold off on giving solutions.
“They can help provide the social support their child needs by creating a safe space or ‘no-judgement zone’ to encourage their child to open up and share issues and concerns. Instead of friends or the internet, parents should be teenagers’ go-to for help and support,” he adds.
“Parents can also learn new knowledge and get answers from a qualified family counsellor or therapist who can assist the family to understand and build the family support system not only for the children, but also for themselves,” he adds.Dr Zulkifli says it’s important for parents to be present for their children in times of conflict or distress.
“What seems small and insignificant to an adult may be a big thing to an adolescent, so parents should always listen to the teens and not look down on issues that they bring up. Parents should be parents, guiding the adolescent, and yet be a friend too,” he says. Dr Thiyagar says parents should nurture children holistically. “They should build a strong foundation with loving care, to enable teens to develop important emotional skills. They should always strive to be good role model for teenagers.
“Assist the teenager to develop good communication skills and provide guidance on exercise and appropriate diet to achieve optimum physical health,” he adds.