Purpose Over Peril: Roadmap for Teen Mental Wellness

In this gripping episode, Dr. Scott Kolbaba, a renowned physician, and author, takes us on a profound journey into the heart of teen mental health. With his work in an adolescent psych unit and personal experiences as a father of seven, Dr. Kolbaba exposes multifaceted challenges facing today's youth, from the relentless pressures of social media and bullying to overwhelming academic demands.

But amidst the darkness, a beacon of hope emerges as he shares the transformative power of finding purpose – a lifeline that can combat teen depression and ignite resilience. Prepare to be captivated by Dr. Kolbaba's poignant stories of teens in crisis, stories that have left an indelible mark on his soul and fueled his mission to create supportive environments where meaningful connections and mental wellness can thrive.

Join us as we uncover actionable strategies and life-changing insights that can guide our youth through the complexities of modern adolescence, empowering them to embrace their purpose and navigate their way to a brighter future. Don't miss this powerful episode – a must-listen for anyone committed to nurturing the well-being of our next generation.

Today's episode is brought to you by the Joan of Arc Scroll Medal, a beautiful brass alloy medal, designed by award-winning artist, Pat Benincasa. This uniquely shaped medal is ideal for holiday or as a special occasion gift!    Visit www.patbenincasa-art.com
For international listeners the medal is available on Etsy.

Please Note: The views expressed by our guests do not necessarily reflect the views of the podcaster.

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Chapters

• 0:06 Teen Mental Health Crisis and Solutions
• 10:58 Social Media Impact on Youth
• 17:37 Teen Mental Health and Purpose
• 29:18 Guiding Teens to Find Purpose
• 34:16 Supporting Youth Mental Health and Wellbeing
• 42:50 Inspiring Dedication to Teen Mental Health

Transcript

Pat
Fill To Capacity where heart, grit and irreverent humor collide. A podcast for people too stubborn to quit and too creative not to make a difference.

Pat
Hi, I'm Pat Benincasa, and welcome back to Fill To Capacity.  Today, episode number 75, “Purpose Over Peril: Roadmap for Teen Mental Wellness.”  My guest is Dr. Scott Kolbaba, a distinguished physician and bestselling author known for his insightful book, “Physician’s Untold Stories,” which by the way, I read and really enjoyed. And his most recent book, “Clara's Magic Garden,” which explores a young girl's battle with depression and her journey to find happiness and purpose. 

 Chicago Magazine has recognized Dr. Kolbaba as a top doctor. He brings a wealth of experience from his extensive work in the adolescent psychiatric unit at Northwestern Medicine in Illinois, where he also serves as an attending physician. 

Now, outside of his professional life, Kolbaba is a father of seven, including three kids adopted from diverse racial and cultural backgrounds. You know, this personal journey has given him firsthand experience in navigating the many challenges teenagers face today from social media and bullying to academic stress. 

Dr. Kolbaba is a passionate advocate for mental health, and he is especially committed to helping teens discover their purpose as a powerful antidote to depression. Well, welcome, Scott. I am so delighted to have you here.

Scott 
It's great to be here. I'm glad we discovered we're both artists. That's kind of interesting.

Pat 
That was interesting to know that you had supported yourself by selling your artwork, your beautiful ceramic pieces during college.

Scott 
I did the best I can. I'm now sad that I sold all of my nice stuff, but that's all right.

Pat 
Well, somebody else is enjoying it. 

So now, before we go any further, please know that we will be discussing suicide, suicide ideation, and self-harm. Okay. 

To start the conversation, I'd like to provide a context with data from the National Institute of Mental Health and from the Substance Abuse and Mental Health Services Administration in 2024: “The state of teen mental health in the US remains a critical concern. Recent findings indicate that the prevalence of major depressive episodes among adolescents has continued to rise now impacting around 17% of our youth population. Post covid, a mental health crisis has emerged with an alarming rate of teens contemplating suicide.” 

So, Scott, what are the symptoms of teen depression?

Scott 
A chemical depression in teens is characterized by a loss of interest in onset activities. Teens will go up to their bedroom, close the door, and stay there. Change in appetite, either increased or decreased. 

Whenever I get depressed, I eat more. But lots of the teens will just stop eating, looking unkempt, not combing their hair, not  doing the things that you normally would do to make yourself look good. 

Loss of interest in friends, staying away from friends, not wanting to do things, feeling down in the dumps.  When you talk to the teen, they are just kind of lethargic and just don't feel like doing much of anything and not making eye contact. That's a big one. I watch for that in the office when I see someone that looks at the of the floor and not making any eye contact.

Scott
That's a big one. And just expressing a kind of a, a blue attitude and not being fun anymore. And so those are the things to look out for. 

The real big things to look out for though, Pat would include things that would lead you to believe that they're suicidal. And those would be things like thinking about death and talking ruminating about death and people that are dying and things like that. 

And then, one of the things that we always are taught to ask  in the examination room. And, when we see the teens would be, “you're down. Have you thought about committing suicide? 

You've thought about ending your life?” That's a big one. And if you don't ask that, sometimes you don't know, because some of the teens will disguise that.

Scott 
They'll look like happy campers and all of a sudden doing something awful. And the next thing you ask is, do you have a plan? “What have you thought about doing? And if they say, “Well, I like trains. I'm gonna go to 59th Street and, go cross the tracks and jump in front of the train. Those are things, when they have specific ideas like that, those are things you, you jump on immediately.

 I had one kid in the office, you know, I was kind of surprised. He looked like he was doing pretty well, mild depression. And I said, well, have you thought about committing suicide? And he said, “Yes, I've thought about it. And I then I said, “Well, have you had a plan? He said, “Well, I went to my dad's study the other day and, and he has a gun in his, in his drawer. And I, I took the gun out and then, you know, he has some bullets locked in the other drawer, and I know where the key is. So, I unlocked the drawer and I got the bullets out and loaded the gun. And then, you know, I just decided not, this wasn't the right time.” 

That's a kid that goes right into this  right into the psych unit. That's a kid that is very serious. And so, when you hear those kinds of things, you have to act. I immediately,

Pat 
Scott, let me ask you a really basic question. How can parents gauge whether it's normal moody behavior or serious self-imploding feelings that could lead to self-harm? How do you know it's not just a moody teenager?

Scott
Well, most teenagers are moody at some point, you know? Yeah, 'cause we've had seven kids, and they all have been moody at times. Those tend to come and go. Those things will tend to pass. What we like to do, though, we like to talk with the kids, there are a couple circumstances that will allow  people to get into the kids' head a little bit. And one of those is dinnertime. We like to have dinner together. And I think that's, you know, we've lost that in, in many cases. People aren't having dinners together. And we've had circumstances where we're so busy. We have seven baseball games in one night. You know, it's crazy. We're empty nesters right now, but we've, we've gone, we've lived that life. Yeah. We've gone through them. And so dinnertime is a great time to talk with your kids and kind of feel 'em out.

Scott 
Now, frequently, and I've lived through this too. Your child comes home and you say, “Well, how was school today?” “Fine.” “What'd you do?” “Nothing.” “Anything going on?” “Nope.” How do you get beyond that? You know, that's universal. Every soul will say that. So, what we've done in our past, what's worked really well for us, we live on  a circular street, and it's about a half a mile. And we say, let's go for a walk. And, you know,  let's take the dog for a walk. And most of the kids will respond to that. You know, they like to walk the dog. So, as you're walking the dog, just things come up, simple conversations. You don't have to quiz a kid about where are you right now, who are your friends? All those kinds of things. Things just come up spontaneously.

Scott
And they'll kind of give you an idea of where they're at.  And, and the things that we've mentioned before, you know, the moodiness, the loss of interest, you know, unkempt hair and so forth are things to watch out for. But those walks have been incredibly valuable for finding out where the kids are. And, even when they've grown up, the kids will come home and they'll say, yeah, can we take a walk?  They're still into that.  

The other thing that my mom has observed, you know, moms are drivers. They drive to the baseball games, to the whatever the soccer matches and so forth. And when they have kids, that they take the neighbor kids or whatever, the kids don't think that the person driving the car, hears anything.

Scott 
They're deaf, and the kids talk about all the stuff that's going on. And my wife has said to me multiple times, that's the best way to find out really what's going on in the school, what's going on with these kids. So that's another way. 

But I think we've lost in many cases, the opportunity to talk with our kids at dinner time. Or these other circumstances. Everyone is getting busier and busier. And with the economy the way it is, people have to work hard. They're tired. And so we need to emphasize, getting together with your kid. And just sharing, sharing some things in a non-threatening environment.

Pat Well, now you're kind of leading into my next question. What do you think are the main drivers behind the increase in teen depression over this last 10 years? What have you observed?

Scott 
Well, we've had the pandemic of course. And with the pandemic, everyone was driven to communicating other than one-on-one.  When I was a kid, we didn't have those kinds of things, and we didn't have cell phones either. And we would, you know, if you wanted to talk with someone, you'd call 'em up on the phone and talk with 'em, or you'd meet with them. And those are things that have kind of gone by the wayside. I've even had circumstances where our kids in the same room will text me something, you know?  And they're sitting opposite from me and on the couch. 

So, what's happened, I think, is we've gotten into social media, and that was encouraged during the pandemic, because we didn't have much else. And so, social media  is good and bad. It allows us to communicate. On the other hand, it allows us to communicate in negative ways. Many times people can be bullied on social media where you wouldn't bully someone face to face. And it can be very destructive. The CDC tells us, the kids that are bullied have a, a likelihood of committing suicide. That's two to nine times more likely than a person that's not been bullied. That's a huge, a huge number.

Pat 
Yeah, it is.

Scott
The other thing that happens on social media is that everyone is perfect. Everyone that talks about their vacation, it's a perfect vacation. They have perfect clothes after Christmas. They got perfect clothes. They have a perfect life. And no one has a perfect life. Everyone has issues. But when you go on social media, if you're impressionable, you see what someone else is doing, and you think that they are so much better than you because they have a perfect life.

Pat 
That's not the case. Well, even as adults, it's like the families that they're always smiling, always happy on vacation or around the house. No one ever puts the B side of the record on. That's to show that they're in a crappy mood. They don't wanna talk. And they need to get work done that should have been handed in three days ago. And they're grumpy. We don't see that. 

Scott
We don't, and that's not on social media. And that's not the problem. No. People think that everyone is better than they are.  And so when you have that mindset, and there are people that, you know, write about their experience with social media, and when they ultimately, come down to it, they finally realize that no one is perfect, and that someone's success doesn't take away from your success. And that people have little mini successes all the time. And you have failures. Look at the author of, “Harry Potter.” She had so many failures that it was unbelievable. And she talks about that, JK Rowling. And finally, I take care of her publicist and in the office here, and they were telling me that she toured the country going to little, tiny meetings with three or four people discussing her book for about a year before she hit it big. So, everyone faces little challenges, and they have to realize that everyone does that. And there are some people that are better than they are and then they're worse.

Pat 
There's also the aspect of FOMO, F.O.M.O, fear of missing out. During the pandemic, kids were constantly holding their cell phones or on computers. Post-COVID, I've taught art for over 30 years, college and high school. I retired just before COVID hit, but I went back a year ago, March to teach a quarter in an 11th and 12th grade arts high school. And when I walked in, every student had their phone in their hand. Every student. And asking them to put them away, well, they could for maybe 10 minutes- out they came again because that was their lifeline. But now, back in reality, physical time, they're still hanging onto these devices, constantly checking to see they're afraid of missing out on something, or they just wanna connect.

Scott
That's very true. And that's, that's so destructive when you lose your real life to the phone and Yeah. And to not missing out. That's very true. And that's one of the problems that also has happened.

Pat
There was a BBC article just like three days ago, that people are wanting dumb phones. They want the phones that are not computers in your pocket. They wanna call text and maybe have an alarm. The reporter said, “The always-on feeling eroded my sense of wellbeing”. Whoa. They're always performing for social media. 

Scott
Yeah. You have to be on social media, otherwise you'll miss out and you won't be included. You won't be respected. It's terrible.

Pat 
So, what kind of strategies, I know teachers are struggling with this.  Many school districts are now banning phones in the classroom. What strategies might help mitigate these social media effects on teens?

Scott 
I think we have to talk as parents, we have to talk to our teens and tell them that no one's perfect. Realize that these things that you see on social media, these are people that are trying to make you believe that they're perfect and they're not. And you're not either. But you need to realize you have great talents. Pump 'em up a little bit. This is why you're valuable. This is why you're good. So that's one of the things that, that we can do. 

The other thing is, many parents are now limiting the number of hours that kids can be on the phone. That sounds draconian, but I think that makes sense, especially for the younger kids. You know, they can't handle this as much as some of the older kids. And in schools, they're doing the same thing, you know, put the phones in the basket as you enter the classroom, otherwise they're on the phone hidden somewhere and still texting and, and whatever. So there's not an easy solution for this.

 Pat
No, there's not. I read in your material that you had sent me, that you've had some personal experiences in your family with bullying. Could you share a story?

Scott 
Sure. I think all of our kids have had some bullying. But the one that stands out, we adopted a girl that's half black and half white. And so, you know, some of the kids would make fun of her. And there was one particular boy on her bus that would really get to her, and she didn't wanna go to school. It was really a pretty sad situation. Now, in our family, we have seven kids, as I mentioned, the older ones look after the younger ones and spoke to the boys. And Nathan is my big football player. He played division one football. So, in high school, he noticed that Jordan, the little girl was being bullied. So, he got dressed in his football gear, went on the bus with her, and he said, Jordan, who is the kid that's giving you a hard time? Here's this big husky football player, walks up to this little boy. He said to the boy, my sister is Jordan. If you give her a hard time again, you are gonna answer to me. The bullying stopped.

Pat
Hmm. Really?

Scott
It was just amazing. And I love to tell that story because, you know, he's such a big, strong guy that I can see him talking to one of the little kid. And I'm sure he intimidated the little boy. Considerably so, the bullying ended and that was all there was to it. You'd have to take these things immediately. You have to go after the, the bullying immediately and do something. And that's what we've observed, and that's what we do. You know, if she didn't have a big brother that did that, we'd do it ourselves. Not in the same way, of course. But we'd, we'd contact the parents probably. 

Pat 
Yeah. I wanna switch gears and zero in on the gender difference in mental health challenges. Why are girls more affected than boys?

Scott
There's a couple things that happen, and one is, girls are much more sensitive, I think, to anything. They're more sensitive to the hairstyles. They're a little overweight. And those things are things that they look at. And when they go online, they see people that are perfect, they're thin. Their hair is always perfect. And, and we've got some kids that actually remove some of the pictures that they posted earlier because their hair isn't perfect, or things like that. So they think the girls are much more sensitive than the boys. And what we've seen in the psych unit, we see lots of kids that have tried to commit suicide or tried to do things that would get someone's attention because they're asking for help. They're asking for attention.

Scott 
And one of the common things we see is cutting. And girls will take a knife or a razor or something and make linear cuts very nice. And, and even like rows  on the farm corn field, on their forearms. Now, if you wanna commit suicide by cutting, you cut into your radial artery and you bleed to death. That's what they're trying to say, that that's the next thing I would do. 

And then when we see overdoses with girls, they'll frequently take a handful of pills and then call someone, call their friend or text someone That's very, very common before they actually die. 

 Now, the boys are a little bit different. The boys, if they are really seriously wanting to commit suicide, they are much more likely to accomplish that. Boys have four times the suicide rate of girls and girls are twice as likely to be depressed than boys. So that's a huge difference. And the mechanism of the means of suicide is not cutting their forearms, it's guns. They shoot, they'll kill themselves by shooting their head. Hanging is another one that is pretty big for boys. And then there's sort of the drug overdose also. 

So, girls are more sensitive, boys are less sensitive. But when boys get in trouble, they are in big trouble. 

Pat 
It seems like the girls internalize more. They take it in more but won't possibly talk about it.

Scott 
Yeah. And they ruminate over  a comment. You know, just one simple comment. There was a lady that worked in Ohio. Alyssa Lum Young was her name. She worked at Lee Health in Ohio. And she was in charge of social media for the hospital. She would post good stories about people that were healed and things like that. And she was getting comments like, I hate you, or you should die, or, I don't believe in the pandemic, or those kinds of things. And she found that she was internalizing that stuff, and it would last for many, many days. She'd be thinking about that particular comment, and she couldn't get it out of her head. You talk about sticks and stones break your bones, the comments are, I think, more deleterious than physical abuse. And so she finally realized what was going on, and then transformed herself, and finally came up to the conclusion that I'm getting rid of a lot of the social media stuff that I'm doing. I recognize that I'm okay. I don't have to keep up with everyone. And that someone else's success doesn't take away from my success.

Pat
You know, it's human nature. If you get 10 compliments on something and the 11th person says something negative, immediately, you just start ruminating over the negative comment. I mean, that's just normal.

Scott 
It is. It happens universally Yeah. Universally to everyone. 

Pat 
Yeah. One of the things I loved about teaching high school is that that's an age where kids are at a crossroad. They are forming who they're going to be. And it's a privilege and an honor to work with these kids. And you can kind of see glimpses of who they're gonna become. But it's also a fragile time where something hurtful or a comment can really knock the wind emotionally out of a young person. It's so fragile.

Scott 
Yeah. And that's what happens with social media. Those fragile kids get exposed to some negative comments. And that's especially girls that are very sensitive to this. And then they become depressed, and then that could lead to more serious things.

Pat 
So, what would you say are the specific barriers or challenges to treatment for teen mental health problems?

Scott
Well, first of all, there's not enough mental health workers out there. When I try to get someone to see, uh, I'm an internist, so I, I work in the adolescent psych unit. But when someone's really bad in my office, I'll try to get one of the psychiatrists to see them. The waits are three months. It's hard to get people into a psychiatrist. And the same is true now for counselors, social workers, psychologists. It's very difficult. And, and the, the government estimates the CDC estimates that about 11 million people in this country will not have access to mental health. Now, mental health treatments are expensive. And if you don't have insurance and your insurance doesn't cover it. So that's one of the things that we're running into that, that it's, it's, uh, very difficult to get someone to, to be seen.

Scott 
The other thing that we run into is, you know, people don't want to do any counseling. They want to just gimme the pill. You know how that's the American way. I don't want to watch my diet, just gimme the diet pill, or, I don't wanna get into counseling. Just gimme the Prozac or whatever, you know, whatever the appropriate, uh, SSRI or whatever. 

So that's another thing that we're seeing. There are other barriers, making the right diagnosis. I saw a lady the other day that had been on a number of medications and was bipolar, and none of the medications worked, but she didn't have the right diagnosis. Bipolar is treated much differently than just a unipolar depression. There's that issue. 

And then getting kids to realize that they have a problem and recognize the problem, and then agree to get some help, it can be embarrassing. And there's still a stigma. Whatever we say, there's still a stigma. It's becoming less and less to mental health. If I'm depressed and see someone for mental health, that goes on my record that follows me around. And there's  still a stigma for that. It's less and less, thank goodness. But that's the other issue.

Pat 
So tell us about the relationship between purpose and depression, and what exactly do you mean by purpose?

Scott 
Good question. The American Psychiatric Association defines purpose as a person's passion, and then using that passion to develop what they think they wanna be doing in their life, and using that to help someone else, or to help a cause. 

What we have found is that when I interview the kids in the psych unit, I  won't say, what's your passion? I'll say, you know, what do you like to do? And invariably, every kid that I've interviewed likes something they like to draw. They like, animals, they like to write about their condition. And I'll frequently say to them, do your parents know about your interest? And universally they say, no. I don't know if they hide it or what. To develop a purpose, which we think is critical to maintain your overall sense of wellbeing and your health, you need to pursue a passion. We need to discover what the passion that the kids have. Is it writing, is it working with animals? Is it football? You know, what's your passion? And then you develop that into a purpose. And then that purpose can be used to help others. When I was a kid, for example, my parents were really good. I was an only child and an only grandchild, but I'm not spoiled at all. 

Pat
Of Course.

Scott 
And I had all kinds of crazy interest. Then I collected rocks for a while. I got so many rocks at the drawers, and my desk fell, fell through because there were too many rocks in the drawers. Then I got into hot air balloons. I then made an oil barrel that I washed out really well, so it wouldn't catch on fire. Put hot coals in there, got the vacuum cleaner. Reversed the vacuum cleaner. So it blew into the barrel and the hot air came off the other end and I hooked it up to a hot air balloon. And the hot air kind of caused it to rise a little bit, but not very much. And it was kind of an unsuccessful thing. And my parents would take me around to hot air balloon festivals in the Midwest. And so they really helped me pursue that passion of hot air ballooning.

Scott
To this day, I still realize from that experience that I can pursue things and get them accomplished. 'Cause that gave me a sense of accomplishment. And writing a book, for example, that's a pain in the neck to write a book. But my experience as a kid and having my parents help me pursue my passions led me to believe that I can do these kinds of things as an adult. And so, what parents or guardians, or uncles or neighbors need to do with kids is if a kid seems like he or she's in trouble, to ask them what their passion is, find out what their passion is. And then help them develop that passion by getting a mentor to work with them on football or going to a animal shelter. You like animals. You can shovel the poop in the animal shelter and take care of the dogs.

Scott 
Lots of things that they can pursue. And sometimes it doesn't require very much. Lemme tell you a story about my two grandkids in Phoenix. I go to Phoenix a lot. 'cause I have 13 grandkids there now. It's a crazy mob. But two of the grandkids, a number of years ago, I wanted to do something. So we decided to go fishing. And how many fishing holes do you think there are in Phoenix? There aren't very many. But we bought some fishing poles. We went out and we went to a fishing hole in the middle of town. There were no fish, I'm sure. And we casted for about two hours and no one hooked their ear or anything else. We hooked a bunch of trees. But that was about the extent of it. And we didn't catch anything.

Scott 
And I was kind of disillusioned. And I felt terrible by bringing the kids out there and having nothing happen. But two years later, one of the little kids came up to me and said, Grampy, you know, this still gets to me. You know, that day we went out fishing and didn't catch anything. And I said, yeah, that was the best day of my life. Ever since then, he's loved fishing and they do fishing. And that's not their purpose in life, but that is a passion that they have pursued. So, it doesn't always require a lot of time. It can be just a little thing like that. We'll get a kid turned on. And when kids are turned on and they have a purpose, they wake up in the morning  with a purpose in mind.

Scott 
My son Nathan, the football player, he was a terrible football player as a freshman in high school. The coach, he even told him not to go out for football the next year. But he wanted to pursue it. So we helped him. We got him lessons and all the kinds of things you do, where they work with a kid. And ultimately, he was the only kid in high school that graduated and ended up in a division one school playing football. So, so you can help the kids find their passion. And that changed his life when he realized he could really play football. That's what a purpose does. 

Jack Canfield, for example, in his writing, has come out and indicated that a person that has a purpose makes all the difference in the world in terms of depression and also physical health.

 Scott
And there are some big-time studies from the NIH and from other institutions and the government that find when they study this, that people that have a purpose are not depressed or it helps with the depression or prevents the depression. I'm on my soapbox saying that, find your purpose, and if you find your purpose, that will make a huge difference. And when parents start to talk about that, they need to have a purpose too, because the kids will emulate the parent. So, if the parent has a purpose, the kid will frequently develop a purpose too. 

Pat
You know, I was thinking a lot about your writing about purpose, and  I began to think about Viktor Frankl's book, “Man's Search for Meaning.” And that's a book about finding purpose and strength amidst brutality and despair in Nazi concentration camps. And the way he was able to survive. by finding meaning. And I was struck by the similarity to what Frankl was saying. And fast forward to today, what you are saying, that this concept of guiding teens to find their purpose is really guiding them to find meaning in their life. And perhaps it's something bigger than themselves. If they study art, if they play football, they're connected to a larger universe.

Scott 
That's so important for our teens, for everyone, there's a purpose and everyone needs a purpose. And that keeps you going, that keeps you healthy, that gives you a positive mental altitude. 

We have a huge problem with depression in this country. And if finding a purpose doesn't cost anything, it doesn't require taking a pill. It doesn't require a visit to a doctor. Now, if a person's very depressed, I'm still a conventional doc, and I think you need some help. You may need some medication or whatever. But before you get to that point, if we can prevent people from getting into a, a depression by giving them a, a purpose in life, giving them a reason to wake up in the morning and something they're passionate about, if you can develop that passion and find that passion, and that may be some work in itself, finding what, what the kid likes. You might wanna visit some animal shelters. You might wanna visit a, a nursing home. And maybe you take up a lessons on piano or whatever. Learn some art.  If you do that and, and expose a child to lots of different activities, they'll find a passion. And then you can pursue that and make that their purpose. Then have them help others by pursuing their purpose in the community.

Pat 
Well, let me ask you a question about the nature of depression. Sometimes people will say, well, just get over it, you know, buck up and come on. It's not that bad. It's not so much getting over depression as much as managing one's depression. Is that a fair thing to say?

Scott 
Well, there are lots of degrees of depression and some depression is just a temporary thing. The dog dies, your favorite uncle leaves the country, or has a serious problem or something, then people get depressed. And they can get over that in many cases. But a true chemical depression is hard to get over. There's certain things that  neurotransmitters in the brain that become deficient sometimes that requires either medication or counseling, and counseling can be in the family too. Counseling has been shown to be as effective as medication in many cases in treating a depression. If you can talk about it and get it out in the open, that may be very effective. But it's hard to say, suck it up. You'll be fine. Because, that kind of actually puts a person down a little bit, you know? Yes, you're not good enough. Or then the child will think, well, I knew I wasn't good enough in the first place, you know, and now I've got a confirmation that I'm not good enough and I need to suck it up and be better. So that doesn't always work.

Pat 
One of the things, again, teaching at an arts high school, during these studio classes, art students talk to the point where I say, excuse me, we do not wanna hear about your dating habits, or what happened Saturday night? This is an open studio. And then they would giggle 'cause they think I'm old fashioned. But I did try to guide whatever conversation, but I was amazed by the depth of their observations and feelings about what is going on in the world. 'Cause kids feel like, if you're asking them to express themselves, there has to be a level of trust in the room and respect.  So, they would talk about stuff, and it was interesting to me how much they pick up on external stressors, climate change, what's going on in the world. Political discourse, rude commentary, the economy. I've had kids living in their car with their families. I mean, it's pretty extreme. And these kids are seeing all that and they're living it. So now we have these external factors that weigh heavy on them. What do you say to that, Scott? Like, how do we help them cope with all that?

Scott 
Well, that's one of the things, that is one of the major causes of depression. That it's the home situation and the environment. And you know, today with the rising inflation that we're having, people are having to have two jobs. There are parents that are both working in the family. You know, one of the major causes of divorce in families is money and talking about money and not having enough money and so forth. And so kids are exposed to that. That is one of the major causes in addition to bullying and the stuff that we talked about, is home strife. And if there's some genetic influence too, that one of the parents has a history of depression, that could be a genetic influence too. So what do you do with those kids that are seeing what's happening with their parents and the strife and the family?

Scott 

And again, it goes back to certainly professional help is available for some, not everyone, medications are available. But again, the thing that seems to get people out of the doldrums and gets them away from that bad situation is what Viktor Frankl went through, you know, he went through the Nazis, in World War II, but now we have family strife. And that is a big stress. And, and if you can have a passion and a purpose that will see you through that strife in many cases. 

Pat 
The other aspect too, if we can come back to social media, this thing about doom scrolling that people look at the news. Well, news is usually pretty awful.

Scott 
Yes, it is. 

Pat 
I, for myself, have stopped doing that. I mean, I research newspapers all the time for stories for the podcast, but I'm very careful now about my intake that doom scrolling can really, really upset you. It just knocks your equilibrium to pieces. And we're adults.

Scott
Yeah. I've stopped watching as much news as I watched in the past. You simply can't do that. Because you think the world's gonna end any minute there. There are awful things happening in our country and in the world, the wars, the economy. And then the crime's a whole bunch of things that you almost can't watch it. And some of the leadership decisions that are being made, there's some crazy stuff happening out there. And so if you watch that with any regularity, you'll become depressed yourself. And I think keeping kids away from some of that is very reasonable, because need to stay away from some of that. And, you know, the news shows don't bring out the good stuff. What sells, time and what sells newspapers is the yellow press is the bad stuff that's happening out there. We need to limit the exposure to all that. Kids are aware of that. But if you can prevent them from seeing that 24 hours a day, they'll be a lot better off.

Pat 
Now, you wrote a book, “Clara's Magic Garden.” What inspired you to write the book? What is it about? 

Scott 
It's about a little girl. And what inspired me, I'll tell you the story of the, of the book. But what inspired me is I was called to the emergency room to see a 13-year-old girl who was in a deep coma from a drug overdose. Now, this is 13-year-old, you know what 13-year-olds look like. They're  little, they're little kids. These are just little precious kids. And so she's lying there on a gurney. Her mother's holding her, her icy hand, she's totally comatose. The mother's sobbing while, while she's holding her hand. And the fathers in the corner with his head down, and, and he's got tears in his eyes. And so we had to zipper off to the ICU to pump her stomach. We had to intubate her. And all the things that you do when a person is critically ill because they're near death from a drug overdose.

Scott 
And seeing that beautiful little girl was a huge influence in my life. You know, you talk about doctors trying to be aloof but you get into  the problems that people have, you can't help it. And she influenced me a great deal. And one of the things I decided to do is, is to see if I could influence others to prevent that from happening. So, I decided to write a book about a little girl. And, if you've had little girls, and we've had little girls, you know, that they all think that they're not pretty enough. They don't have enough friends, they're not smart enough, they're not enough, enough, enough. They don't have enough clothes and enough shoes and all those things. So this is a little girl that is that way, you know?

Scott
And, and so she has a little magic garden where she can talk to the plants, and she finds some seeds, plants them. And the seeds grow into a little, kind of a ugly little bush. Okay. So the bush, and she get along really well because the other plants in the garden, don't like the bush, it doesn't have any flowers and so forth. And so they kind of hit it off a little bit. They're both, you know, sad sack. And eventually at the end of the season in the fall, the bush turns into a burning bush. It's become beautiful. It's all red and crimson standing like a sentinel guarding the garden. And so she realizes, well, the bush, this happens to the bush. Well, maybe I'm special too. Maybe I have a purpose in life.

Scott
'Cause the bush has a purpose of helping little girl realize that she's something special. And so she becomes special and she and the bush get along. And so she grows up and becomes a functioning normal person with kids of her own. She comes back one fall to see the garden. And  there's the burning bush, and the kids love it. But at the end, Clara, the initial girl realized that she can't hear the bush anymore. She's old now and she can't hear the bush, but the daughter can. So the daughter hears the bush and writes about it. So, that's the book.

Pat 
What a beautiful story. And who illustrated the book?

Scott
We had a Swedish illustrator. You know, it's funny, you can get help from anywhere in the world these days when you write a book from illustrations, the editing and so forth. So we thought her art was, was spectacular. And she's done some very beautiful artwork in the book. We loved her work. And

Pat 
The illustrator is Dina Leuchovius.

Scott
Yeah. It worked out really well.

Pat
Well, also, it speaks to the artist side of you to creatively put that story together in such a creative, childlike way that that's wonderful. 

So Scott, what would be the one thing you would hope listeners would take away from our conversation?

Scott 
I think anyone listening to this has the opportunity may come in  strange ways and strange times to literally save a life. And people need to pay attention to, especially the youth in our country and our world, and in their neighborhood. And if someone is depressed with the symptoms that we just discussed before, they can sometimes make a huge difference by helping them find their purpose. If we can help a neighbor kid, or your own child know what their passions are, help them explore their passions, develop that into a purpose, and have them help somebody else or some other organization with their talents that they discovered and that they're, pursuing, that would make a huge difference. You all can potentially save a life by having someone discover their passion and their purpose.

Pat 
I know earlier we're talking about the disarray and the madness of the world, but then we come full circle. And your work and your strategies, your creativity in approaching teen mental health is really heartening. It, it's really inspiring. I wanna thank you so much for being here today and just letting our listeners know of the good work that, that you're doing.

Scott 
Everyone can do this. Everyone can find a child that needs their help. And you know, I think things spread so that if you help one child, that child will change and may help someone else. And pretty soon you've got three or four people that are being helped. And, and I think you can spread your influence throughout the whole world, potentially by helping one person,

Pat
You know, one person does make a difference. I do believe that. Yes.

Scott
Yeah, I do too.

Well, That's my goal.

Pat :
Thank you. And I just wanna say thank you to all of you out there who work with young people, big respect for you. Thank you listeners, for joining us today. Until next time. Bye.
LINKS
Clara's Magic Garden y Scott J. Kolbaba, MD and Florin Kolbaba

Physicians' Untold Stories: Miraculous experiences doctors are hesitant to share with their patients, or ANYONE! by Scott J. Kolbaba, MD