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Harvard Commentaries
35320
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Minding Your Mind Minding Your Mind
 

The Angry Adolescent


October 23, 2013

By Michael Craig Miller M.D.

Harvard Medical School

Some years ago, a friend talked to me about his son, who was about to turn 20. As a teenager, the boy always had a quick temper. Dad assumed that his short fuse was related to the stage of life. But now, on the brink of adulthood, the young man seemed to be getting worse. He'd been less able to deal with criticism, minor upsets, jokes or any comment that disagreed with his point of view.

The young man's father had these questions:

    • Is he depressed or is this still part of a developmental stage? 
    • How do I approach him, since any time I reach out, his response is hostile? 
    • What, if anything, can I do? 

I recommended that he talk to his son. Here are some ideas I gave Dad to think about first.

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Remembering What 19 Feels Like

Several years ago a close friend and colleague (also a psychiatrist) told me about his then-15-year-old son. He said, "In training, they taught me about the terrible 2s, but they forgot to warn me about the terrible 15s." He was referring to the testiness that greets parents when they try to interact with their adolescent children. Between ages 15 and 19, some adolescents do get more comfortable in their own skin. But 19 is not an easy age either, so hostility is not so unusual.

Let's remember what 19 feels like. Still inexperienced, there are big challenges ahead: graduating from high school, entering the work force (in a tough economy) or starting college, living away from home for the first time. These are stressful transitions for everyone.

But when a teen gets angrier as time goes by — or more rigid and defensive — it is a cause for concern. At the very least, this is not a very adaptive response to life's challenges and it can make every day tougher than it needs to be. In fact, whether it's "depression" or "just anger" probably is less important than the fact that his son is suffering and could use some help — if he'll accept it.

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Understanding Where the Anger Comes From

Feelings, including anger, have origins that vary from person to person. To help the father understand the son's anger better, I asked the following questions. I could have asked the same questions about a daughter.

    • Irritability aside, is your son showing any other symptoms of depression? Is he having trouble enjoying his life? Is he sleeping too little or too much? Does he show a marked increase or decrease in appetite? Is he gaining or losing a great deal of weight? Does he have low energy or poor concentration?
       
    • Is there any sign that your son might be using a substance? Irritability or changes in mood can be the result of substance use (for example, alcohol or stimulants). You are understandably reluctant to ask him about his mood. You may be even more reticent to ask him questions about drug use. Indeed it is a large topic in its own right. ( The National Institute on Drug Abuse has information about substances, and advice about how to introduce this topic to your children.)
    • Is your son irritable with everyone or just with you? That sounds harsh, I know. But it is very common for children of any age to be intolerant of parents' input, whether it is constructive criticism, helpful advice or being playful. If this is so, perhaps there is an uncle or aunt, a family friend, a teacher or coach, a mentor or member of the clergy who can talk to him about how he's getting on. (Avoid teasing. You may feel like you're trying to lighten the situation with humor, but this kind of humor stings — especially when your child feels vulnerable.)
    • Is your son going through a crisis, a challenge or a developmental transition? Maybe there is a specific problem at the root of his testy behavior that needs attention — relationship trouble, low self-esteem, concerns about his identity, not feeling up to the pressures of school or work.
       
    • Is your son anxious about his ability to "make it" in the grown-up world? It is normal for late adolescents and young adults to worry about giving up the privileges of childhood and taking on adult responsibilities. Some become more anxious than average about their ability to develop the skills, gain the self-esteem, and build the confidence they need to make their way.

 There is no guarantee that your son will talk to you about these subjects, but having these ideas in mind may help you empathize with his point of view.

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No Longer a Child -- Not Yet an Adult

That brings me to what may be the toughest part for parents: A 19-year-old is no longer a child in the formal sense, but he's not a fully-fledged adult either.

The in-between state, which may be more apparent in wealthy countries than elsewhere, appears to extend well into the twenties. Some human development researchers have begun to call it "emerging adulthood." In theory, it is a time of life when a person takes life's possibilities more seriously. The emerging adult knows that responsible choices matter. But they are still young enough that they aren't ready to make lasting commitments.

People are reaching the usual adult milestones — financial independence or getting married and having children — later and later. It's not clear if the trends are a natural part of human development or a product of the social and economic changes in our communities.

So, whether we call it very late adolescence or emerging adulthood, the twenties remains a time when many children feel entitled to call on their parents to help them grow up.

My friend's job as a parent was to convey the idea to his son that he was old enough to take responsibility for solving his problems. That didn't mean he should go it alone, but he was in charge. The son should decide how much help he wanted or was willing to accept from his parents or anyone else. And his parents could make their own decision about how much help it was reasonable to give.

Taking a step back does not mean abandoning your child. By the time a child hits young adulthood, the goal is to replace direct help with encouragement about (and belief in) your child's ability to manage these responsibilities on his own. And that can spur the process of maturing.

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Some Practical Advice

I wanted my friend to get the following message across, calmly: He was taking his son's problems seriously. And his son owed it to himself to take the problems seriously, too. I wanted my friend to remind his son in a loving way that he was now responsible for his own life, that he respected his son, and trusted his son's ability to manage whatever problems came up.

Here's what you might say if you find yourself in the same situation:

    • "You are your own man (or woman). I only get to see how you interact with me. Perhaps you are quite happy when I'm not around, but from my perspective you seem very unhappy."
       
    • "I know it's up to you to deal with it, but let me know if you want to talk. Maybe I can help you."
       
    • "You don't have to talk to me about it. If you're managing things on your own, I respect that. But if you are unhappy and you don't want to talk to me about it, there are plenty of other people you could talk to."
    • "You may not be interested in help right now, but I'll always be willing to help you, or help you find someone other than me to help you, if and when you want it."

 If your child is interested, you can then point him or her to resources. A primary care physician is a good place to start. Or, if your child is college age, there's the school counseling service. You may already be acquainted with resources in your area, through your own workplace or your religious community.

Your child may respond to you with anger. When you're working hard to be helpful, and you're met with hostility, it's tempting to strike back. Resist that impulse.

Here is one more hard part for parents. Your child may take the advice to heart and get help, but there is no guarantee he or she will report back. Or say thanks.

At least not right away. Sometimes, if the growing up process takes hold, my friend's son might remember having gotten the kind of support that helped him move his life forward. It could take years, but some day my friend might hear from his son, something like, "Hey, Dad. Remember a few years ago when I was being such a pain? Thanks for putting up with me."

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Michael Craig Miller, M.D. is editor-in-chief of the Harvard Mental Health Letter and an assistant professor of psychiatry at Harvard Medical School. Dr. Miller has an active clinical practice and has been on staff at Beth Israel Deaconess Medical Center for more than 25 years.

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