The Website of Dr. Mark Goulston

It’s midnight. Do you know what your child is doing?
by Mark Goulston

Mother: Do you think she’ll cut on herself?

Let’s hope she doesn’t hit an artery.

And so begins another evening of pillow talk between the parents of an angry, non-communicative teenager.

Would it surprise you to know that an inordinately high number of families of high-achieving parents with three or more children, have at least one child who is not making it? There are many reasons for it, but one is that a problem solving approach does not appear to make it through the gates of hell where such children spend too much time.

If your child is angry, negative, brooding and avoids people and you’re thinking depression, think again.

More and more research shows that in a majority of cases where adults or adolescents have a mixture of anxiety and depression, the anxiety comes first and in most cases causes the depression. That anxiety causes such people to withdraw socially, self-medicate with alcohol or pot, and eventually to have it cross over to poor school or work performance. It’s these disastrous effects that intolerable anxiety has on their lives that causes them to feel depressed, it’s not the depression itself.

This is important to keep in mind, because while many anti-depressant medications are effective on anxiety, anxiety is different than depression and requires a different approach both pharmacologically and psychotherapeutically.

If you treat the depression, miss the underlying anxiety that’s causing it and if you treat your kids from the outside in, without relieving their pain from their inside out, they will not do as well.

Unfortunately one of the worst combinations that teenagers and young adults sometimes have is what I refer to as the “Triple A - Lethal Cocktail of Adolescence”

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