By

Daniela Owen, Ph.D.

Partner, San Francisco Bay Area Center for Cognitive Therapy

In the December 2015 issue of the The Atlantic, Hanna Rosin wrote a thoughtful and haunting piece entitled “The Silicon Valley Suicides: Why are so many kids with bright prospects killing themselves in Palo Alto?” With Palo Alto just a bit south of our group in Oakland, the article really hit home. Teenagers growing up in communities all over the country where education is valued highly and “success” in adulthood is often defined by the prestige of one’s job, cost of homes and cars, and academic pedigree, are being routed into a very narrow mindset. If they do achieve at this expected level, they believe, they have not achieved at all. This perfectionistic “black and white” thinking pervades high schools where taking several Advanced Placement classes is considered the “norm.” And it is very dangerous. Rosin highlights the danger in this type of thinking and the perpetuation of this type of thinking by parents, educators, and peers. But oftentimes, it becomes the culture of the school and adolescents can’t help but get swept up into it. In these communities, the children who commit and attempt suicide are not necessarily the picture of a depressed adolescent. They are often the star athlete, the straight A student, the prodigy musician. These kids can easily slip through the cracks and we need to be watching for signs that these kids are struggling. Some signs and symptoms to watch for are: lack of engagement in any activities that are “just for fun” (i.e., won’t show up anywhere on a college application), lack of sleep ( I often work with families in which perfectionistic teens work themselves into desperate states characterized by fear and self-doubt. Parents can often be heard saying “It’s not a big deal.” “Stop working so hard.” “It’s just high school.” But those kinds of statements are invalidating and fall on deaf ears. Teens just shrug and say (or think) “They don’t understand.” And they are correct. Those statements are a complete mismatch for the culture of a community that measures success based on achievement in school. From the time they are young, kids hear “You have to get into a good college to be able to get a good job and have a bright future.” No variation and grey scale is used to explain how many different possible paths they can actually find themselves on. As a result, these teens work extremely hard to get and stay on the path that they think they are supposed to take, and that is exhausting. Literally. Many sleepless nights, feeling upset when peers get higher grades and then feeling guilty for being upset, and limited time for relaxation all comprise what it takes for teenagers to perform at this level.

So what can we do?
One thing that is so frequently overlooked is lack of sleep. When I first meet with adolescents and children, one of the first things I explore with them is how much sleep they get per night. When do they go to sleep? What time do they wake up? Do they feel tired? (Can I see dark rings under their eyes?). There is strong evidence to support the idea that sleep is essential for physical and emotional health. These findings are strongest for teens who require more sleep than adults, yet their biological and school clocks are at odds. Changes in the circadian functions of teens leads to teens becoming sleepy later in the evening yet their school schedules mandate that they wake up for the average 8am first period. The evidence shows that teens need 8-9 hours of sleep for optimal emotional and physical health. With extracurricular activities, sports and homework, this is nearly impossible. So they stay up late or wake up early. And parents let them. Parents support this concept that getting work done is more important than getting at least 8 hours of sleep per night. That needs to change. Parents often tell me that they do not know when their teenager is going to sleep because they go to sleep before their teenager.

Talking to children at an early age about the importance of sleep and continuing that conversation into adolescence is important. Not getting adequate sleep is dangerous! Rosin noted that the one thing notable about Cameron Lee, a teenager who committed suicide this year, is that he never seemed to sleep. Peers noted that he was always awake when they contacted him in the middle of the night. Insomnia in teens is not something to take lightly. Insomnia can lead to depression, anxiety, and a whole host of other problems. Sleep is one of our body’s most essential resources. When exhausted everything feels harder and less manageable. For teenagers whose brains are still forming and for whom the “big picture” is much smaller due to their fewer years on earth, the effect of lack of sleep can be disastrous. If life feels hard for a well-rested teenager, life for a teenager who does not get adequate sleep feels nearly impossible. Managing emotions, tasks, and activities can be overwhelming. Finding time for fun amongst the myriad obligations may not feel possible. As a community, getting parents to insist that their teenagers get more sleep and work with their teenagers (and possibly school and coaches) on ways to do this, may be essential. Just telling your child “that’s it, lights out!” won’t (usually) work. Because for parents of adolescents who are competing in high school against a class of peers who can stay up all night working, that is a punishment. Parents need to partner with their adolescents to figure out how to prioritize sleep. Parents can limit the classes their children take so that the workload is manageable. Parents can work with coaches to allow for missed practices if there are too many academic obligations on the night of a sport. Parents can talk to schools about test awareness so that teachers do not all give tests on the same day. Parents can help their adolescents break down a big project into manageable pieces so that their child is not working through the night each time a project is due. While one parent speaking up may be very difficult and only make a small difference, a group of parents working together with schools on their children’s behalf may have a greater impact. Parents in such communities can take their concerns to the school board, as Ken Dauber did to help get Gunn High school drop their early morning zero period as explained in Rosin’s article.

Another important thing that parents can do to help their teenagers get more sleep is to limit distractors that prevent adolescents from doing their work in a timely fashion, which leads some teens to be up late at night. Parents can set “electronics free” hours in the home, during which their children can only use electronics for schoolwork, if necessary. They can institute open-door policies to help teenagers manage their homework and not get distracted by watching videos on YouTube, knowing a parent might walk past any minute. More distractible teenagers, can work at more public – though quiet – space in the house, such as a dining room table or in a home office with a parent, to help support homework completion before entertainment time. Reducing procrastination can help adolescents complete necessary schoolwork and have time to relax before going to sleep, which will likely help them fall asleep more easily. For children and adolescents who have problems with insomnia, parents should seek professional help from a psychologist. CBTi (Cognitive Behavior Therapy for Insomnia) is a brief and effective treatment for children, adolescents and adults to improve sleep.

Parents often dismiss their teens’ concerns about achievement with responses like “it’s just high school.” I suggest trying a different approach, by validating your teen’s experience and demonstrating that you recognize how hard it is and reassuring the teen: “This is extremely stressful for you. I am concerned that this stress is bad for your health and well-being. No grade or acceptance is worth hurting yourself over because I love you no matter what.” Creating a balanced lifestyle where adolescents are more than just a student can help teenagers manage stress. Helping your child or teenager to find and cultivate passions can help develop values and a strong and healthy sense of self. This can be a protective factor for youth who grow up in communities who emphasize achievement above other values. Having activities outside of academics that are not highly competitive and allow youth to be themselves can help foster a sense of a balanced life in which everything has a place and a value. Being able to talk to themselves in a way that is compassionate rather than critical can also help in developing and maintaining a strong sense of self. When parents hear their adolescents lambasting themselves for doing worse on a test than a classmate, they can ask, “Did you put in effort for this test?” When the adolescent likely responds that they did, the parent can say, “Well, you worked hard and sometimes that pays off and other times the test is just hard. That grade does not have any bearing on how smart you are or how conscientious of a student you are. There will be hard tests and easy tests. I’m proud of you for trying, and you should be proud too.” Even if the adolescent rolls her eyes, she heard her parent. The more teenagers hear messages like that, the more they will start to internalize those messages.

Demonstration self-compassion rather than self-criticism by role models is also important. Focusing on accomplishments (one’s own and one’s children’s) teaches youth that worth is based on what we accomplish. Even if adults do not directly say you are what you score, asking a teenager if he won his baseball game rather than if he had fun at his baseball game places the emphasis on accomplishment rather than participation. Adults who talk about their children’s teammates as lazy or their classmates as not as motivated in an attempt to boost their child, are often having the opposite effect. They are sending the message that teenagers are not good enough if they do not perform or participate at a certain level. Hearing ones’ parent talk disparagingly about their own performance at work or some other activity again sends the message that worth is determined by accomplishment and that being critical towards oneself is motivational. Oftentimes adults can push themselves extremely hard and handle it. Once we reach our thirties our brains are pretty much developed, and we have a better sense of our limitations and abilities. This is NOT SO for adolescents. Reading in Rosin’s article that teenagers are actually considering “suicide to be one of the options” is frightening and understandable. If an adolescent thinks that not being able to handle the pressure means that s/he will never be able to handle the pressures of life… that is a pretty scary thought. Couple that with not enough sleep and we have a dangerous situation on our hands.
We should encourage our adolescents to define themselves by more than their academic accomplishments and emphasize the importance of individual interests, inside jokes, and personal values. Parents can model this by doing these things themselves. While having dinner together as a family is a terrific thing, having fun as a family means insisting that kids put their books down to watch a silly movie together, laugh or engage in a friendly game night of “heads up”. Parents can lead by example by following the same rules they are setting: turn of devices during family time, leave work activities for after family time, try a technology-free weekend or vacation. Parents can model physical activity for fun, not just achievement (e.g., a fun run rather than a triathlon). Parents can emphasize the importance of personal pursuits by spending time with their own friends or engaging in their own passions. Just as competitiveness at school is contagious, so is living a joyful life. If parents can model balance and acceptance of a wide variety of interests, choices, and futures, their children will have some protection from the belief that if they are not perfect, life is not worth living.

http://www.theatlantic.com/magazine/archive/2015/12/the-silicon-valley-suicides/413140/

For more information on research on sleep and health, check out these links:

http://www.cbsnews.com/videos/science-of-sleep-part-1/

http://www.cbsnews.com/videos/science-of-sleep-part-2/
http://www.apa.org/topics/sleep/why.aspx
http://www.health.harvard.edu/press_releases/importance_of_sleep_and_health
http://uk.businessinsider.com/health-brain-body-smartphone-before-bed-2015-4?r=US&IR=T

http://www.nytimes.com/2014/01/12/opinion/sunday/goodnight-sleep-clean.html?_r=1.