Ep. 73: Dr. Lisa Machoian - Learning the Language of Teenage Depression and Mental Health

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Dr. Lisa Machoian is a national expert on adolescent mental health, with a specialty in girls and the psychology of women. As a Harvard trained developmental psychologist, psychotherapist and former faculty member and director of the Harvard Graduate School of Education's Gender Studies; she is the author of the first and only definitive book on Girls Depression, The Disappearing Girl: Learning the Language of Teenage Depression. As a speaker and expert, her appearances include NBC News, CBS News, ABC News, National Public Radio, and in The New York Times Online Room for Debate. Since her time as an undergraduate, Dr. Machoian has retained an interest in the mental health causations and trends of young women. Her research includes the rising rates of technology, social media, and cultural shifts in the manifestation of depression and anxiety. Her work is inseparable from her passion for the subject, both of which are highlighted in this episode.  

More on Dr. Lisa Machoian

Website: https://lisamachoian.com/

Facebook: https://www.facebook.com/drlisamachoian/

LinkedIn: https://www.linkedin.com/in/lisa-machoian-ed-d-ed-m-00503037/

Twitter: https://twitter.com/lisamachoian?lang=en


Books Mentioned

The Disappearing Girl: https://www.amazon.com/Disappearing-Girl-Learning-Language-Depression/dp/0452287103

To Kill A Mockingbird: https://www.amazon.com/Kill-Mockingbird-Harper-Lee/dp/0446310786


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Show Notes

  • [00:17] Dr. Lisa Machoian is a national expert on Adolescent Mental Health with a specialty in Girls and the Psychology of Women. 

  • [00:26] A Harvard trained Developmental Psychologist, Psychotherapist and former faculty member and director of Harvard Graduate School of Education's Gender Studies, she is the author of the first and only definitive book on girls depression The Disappearing Girl: Learning the Language of Teenage Depression. 

  • [01:04] I had worked with children since my undergraduate work as a teacher, actually specializing in children with dyslexia. And as I was headed and waiting for an acceptance to graduate school, there was a family tragedy. And I had an extended family member, a cousin who killed herself after suffering with disordered eating for a number of years, and that really impacted my life. 

  • [02:23] Why do you think the depression rate is rising in teenage girls?

  • [02:27] Currently, it's risen quite a bit in the last 10 years. You know, their rates are just unfortunately going up. And what other research says and what I've gathered from listening to girls is I think there's increasing isolation and loneliness, despite the fact that in some ways people are more connected, girls may feel more connected via social media. However, there is less face to face and social connection. And there's a lot of research that says that if girls are on social media too much, then the time gets taken away from being with people live and in person. So that's an issue right there, because girls very much are very social and very relational.

  • [04:01] What are your thoughts on social media? Do you think that it should be banned completely or how do you think it should be managed?

  • [04:47] Belonging and approval is heightened as it is during the adolescent years. You know that transition from childhood to adulthood. So I think, you know, because of the developmental period, it profoundly impacts them. And it's a very difficult question because on one hand, you know, I've got, you know, 10 and 11 year old girls saying to me, my mom won't let me get a phone and won't let me on social media. And I understand why. And then, you have the girls feeling like, well, I'm left out. Everybody else has one. 

  • [06:11] Boys are relational too, but girls are very socialized to be relational. I think the social media also certainly impacts boys as well. It doesn't seem as though their popularity and their self-esteem is quite as impacted as girls through social media. 

  • [07:53] I think in coaching parents, it's also important for people to be happy, but we also want people to feel peaceful. And how do we help a child feel peaceful and also happy at times

  • [08:58] You talk about the role of the parents. Some parents are helicopter parents and some parents are non helicopter parents, maybe not involved enough in the child's life. How do you talk to parents about that and what do you recommend? 

  • [10:50] But there can be a lot of pressure because there are stresses in life and there are things that happen. And people and kids may not always feel happy. And the pressure to feel happy could become a stress in and of itself or to be happy. There was a young woman that I interviewed and she said the reason she couldn't tell her parents that she was depressed was that her nickname was "Sunshine". So she kept it from them because she felt like she was supposed to be happy and cheerful all the time, and also did a bit of linking it to gender that I'm a girl, I'm supposed to be happy and smiley, and cheerful. The reality is, is we are all not happy 24 hours a day, seven days a week. Sometimes kids feel pressure to be happy and may not communicate stressors, which then could end up snowballing for them if they're not feeling happy and they may not seek help if they need help because they're supposed to be happy and want to please their parents.

  • [13:00] What kind of behaviors are you seeing in depressed young women? 

  • [13:03] There can certainly be a lot of self-loathing. A continuation, I mean, this may sound cliche after all of these years, but there still remains huge issues with body image, and what they look like. Also, if somebody is very, very irritable too, if they are overwhelmed very easily. Right now, there is such an overlap. 

  • [14:25] Anxiety is more about worrying about the future. They may have regrets and worrying about the past, but anxiety, there's a lot of worrying, you know, worrying about school, worrying about their friends, wanting the approval of teachers, parents, their peers. You know, there's certainly different types of anxiety that we can see in children and young people. Certainly there can be a generalized anxiety where we see anxiety pretty much about a lot of things. There also can be anxiety where it's more socially based, which more and more young people are having now, social anxiety, separation anxiety, and what's a very pronounced anxiety disorder. There's been some debate in the field whether it is an anxiety disorder, where it should fall, but also, kids that have experienced trauma and have post-traumatic stress disorder.

  • [15:54] One young woman that I work with said that she really thought that her anxiety was fueling her depression, that she was getting so anxious, it was making her depressed. And there's also a lot of overlap between the two. And there are also, you know, things like physical complaints, stomach aches, headaches, muscle tension in a youth report that came out probably about four or five years ago now. That, you know, there's also a lot of physical complaints that can come with anxiety and also depression.

  • [17:14] One thing you always want to tell people is if you trust your gut and your instincts, always listen to that.

  • [19:21] What happens when a teenage girl is quiet or even silent? How do you get to the bottom of that?

  • [19:27] Oftentimes a girl is silent. If she feels like someone may not be listening or if she's not being listened to, or if there isn't a strong connection. Listening is very important to girls on the research on girls development.

  • [20:01] I think sometimes girls shut down if they feel they're not going to be heard, or if no one is listening or if they feel like what they have to say might be unspeakable. You know, if something, traumatic or very distressing has happened, that could be something, you know, that they might be afraid to tell.

  • [20:54] I was beginning my training. And what happened was I shifted, in a sense, the power dynamic, because she came in and I started to ask her some questions, and she just kind of shrugged and would say, I don't know. I don't know. I don't know. Which I knew from the research on girls is a bit of a red flag that often girls may know, but they may not actually say what they know. 

  • [23:05] That idea of just never giving up just really resonates, and I think what you're saying earlier, don't wait. That if your gut tells you there's something going on. Start reaching out, right. As a parent and pull your team together. 

  • [23:48] How do you see hormones factoring in? 

  • [24:45] However, there's a bit of a recent trend that there's more and more girls right now experiencing premenstrual dysmorphic disorder, basically meaning they have a very difficult time premenstrually and can get depressed right around then, and you know, I'm not sure if that has something to do with puberty coming on sooner, hormones in some of the foods that we eat, you know, and their speculations about that. But that is, often where we may see the hormones factoring in when girls have a very difficult time or a mood shift right around the time of their menstrual cycle. At least it's becoming more common. Whereas 15 years ago in my work you didn't hear or see much of that at all. 

  • [27:04] So if a girl or a boy is talking about suicide, if they are making suicidal gestures or comments, you need to certainly get them help right away. Other signals maybe are they becoming very, very withdrawn? And sometimes there could be a slight mood lift. And if they start giving things away, that's a sign to be very aware of. That's a really huge red flag. 

  • [29:06] I think technology has done wonderful things, but the pace has gotten much, much faster, and we need to be more present in the moment.

  • [29:36] The kids are very aware of that, and people are on social media so much, and on their phones that people being fully present is not as common as it used to be. And if girls equate listening with caring and being present with caring, that's often how they think, well they don't care because they're not listening or they're not fully present. And parents need support as well too.

  • [30:50] I often use the word healthy eating because that's important, because a lot of girls are concerned about their size and their weight, and disordered eating and eating disorders, are still a risk for many groups of girls. So framing it under self-care, and how do I take good care of myself? And one of those ways is eating healthy, and also, you know, not running on empty, which a lot of girls might do, you know, they'll skip breakfast. Girls tend to skip breakfast more so than boys because they're often spending time concerned about how they look for school. 

  • [33:33] There's one that resonates deeply with me. It's not a quote. It's a lyric from a song. "May you always see what your life is worth." That's a song lyric that I've loved since my own youth.

Thank you for joining us on HealthGig. We loved having you with us. We hope you'll tune in again next week. In the meantime, be sure to like and subscribe to this podcast, and follow us on healthgigpod.com.

“One thing you always want to tell people is if you trust your gut and your instincts, always listen to that.” - Dr. Lisa Machoian 

“I think technology has done wonderful things, but the pace has gotten much, much faster, and we need to be more present in the moment.” - Dr. Lisa Machoian 

“The pressure to feel happy could become a stress in and of itself.” - Dr. Lisa Machoian

Keywords

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