Ask the Expert: What’s Going on with My Teenager?

5 min read  |  October 05, 2023  | 
Disponible en Español |

It’s obvious that your child’s adolescent body and skin are changing. What might come as more of a surprise are the many cognitive, emotional, social, and habitual changes teenagers experience. You may find your teen’s new attitude, sleep schedule, likes and dislikes unrecognizable and concerning. Who is this independent, defiant young adult who used to look up to you for advice, approval and hugs? Is something wrong, or is their behavior “normal” at this stage?

“The shift from childhood — when parents are the most important influences in their child’s life — to adolescence when their peers take over that role, is profound and (to parents) often confusing and upsetting,” says Paige Kalika, D.O., a pediatric neurologist with the University of Miami Health System. 

Adolescents may not look that different than adults, but their brains are very different.

Dr. Kalika

To help parents understand and appreciate why their growing child suddenly thinks and acts differently, Dr. Kalika explains what’s happening, from a neurological perspective.

What is unique about the way adolescents make decisions? 

Dr. Kalika: The prefrontal cortex, a part of the brain responsible for emotional regulation, decision making and planning, continues to mature through early adulthood. Because of this, even smart, mature teenagers struggle with impulse control. In all cultures, adolescence is a time of risk taking, sensation seeking, and boundary pushing. While this may sound negative and dangerous, it’s a normal, healthy and very necessary part of development that helps adolescents mature into healthy, well-adjusted adults. 

Risky, defiant behaviors allow teenagers to develop their own identities and push out of their comfort zones, while helping their brains learn to regulate emotions and consider consequences.

Dr. Kalika

Why do their peers and popular culture have a stronghold on adolescent thinking? 

Dr. Kalika: Social acceptance and rejection become major drivers of adolescent behavior, and teenagers feel intense pressure to conform to their peer group. Separation from the family helps children grow into independent adults and develop a clear sense of self as they question who they are and how they fit into the world. This social development parallels physical changes in brain structure seen throughout adolescence. 

The network of brain areas that process executive function, social perception and cognition help young adults learn to better understand themselves and others.

Dr. Kalika

Why do teenagers stay up late and sleep in?

Dr. Kalika: Teenagers have a natural shift in their circadian rhythm that prompts them to stay up and wake up later. This, along with more autonomy in their schedule and an increased ability to ignore sleep cues, pushes back bedtimes every year from grades 6 through 12. 

Adolescents require more sleep than adults, but they tend to get less. Most teenagers need 8.5 to 9 hours of sleep per night, but two-thirds of them get seven hours or less and suffer from pathological sleepiness at the start of the school day, leaving them unprepared for academic and social challenges. When school start times are delayed, teenagers get more sleep. This correlates with increased school enrollment and attendance, less sleeping in class, improved mood and reduced rates of car crashes by teenage drivers.

 Healthy sleep is associated with improvement in learning and memory, and poor quality/insufficient sleep is associated with worsening of mood, difficulty regulating emotions, feelings of hopelessness and anxiety.

Dr. Kalika

While this is more pronounced in adolescents with pre-existing mental health concerns, otherwise healthy teenagers have increased risky behaviors with insufficient sleep. These include fighting, smoking, alcohol and marijuana use, sexual risk-taking and texting while driving.

How does exercise or lack of physical activity affect the adolescent brain? 

 Dr. Kalika: The World Health Organization recommends that adolescents engage in moderate-to-vigorous intensity physical activity for 60 minutes every day. Unfortunately, less than 3 out of 10 high school students participate in regular physical activity.

Aerobic exercise is linked to improvement in memory, learning and cognitive function. Because the adolescent brain is still developing, the positive effects of exercise are magnified and serve as a foundation for a healthy brain later in life.

Dr. Kalika

What’s the role of nutrition in the brain function of teenagers?

 Dr. Kalika: Adolescence is a time of growth, and growth is fueled by food. This is why healthy teenagers tend to be hungry teenagers. Their bodies and brains need that food to grow. Teenagers need a balanced diet with protein, carbohydrates, healthy fats and sufficient calories. 

Calorie-dense, high-sugar foods are gratifying, and teenagers frequently prefer them to less processed foods. While they are not the healthiest option, expecting teenagers who already struggle with self-regulation and impulse control to ignore these foods — especially in peer pressure — is unreasonable. 

Encourage the development of (mostly) healthy eating habits, physical activity, and adequate sleep to lay a foundation for a healthy lifestyle. 

Q&A compiled by Dana Kantrowitz, a contributing writer for UMiami Health News. 

Tags: brain development, cognitive control, decision making process, Dr. Paige Kalika

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