Remember being a teenager? You couldn’t pay me enough to go back. Now imagine spending those years moving from country to country, going to school in a foreign language or being torn between your immigrant parents’ culture and that of your peers. Maybe you don’t have to imagine; you’re a Borderline reader, after all.
Dr Anisha Abraham is a pediatrician and a global citizen herself. While taking her own family from the US to Hong Kong to Amsterdam back to the US, she’s made a specialty of helping cross-cultural kids navigate the challenges of adolescence. She talked to me about what happens inside the teenage brain, why they can be so baffling and how to be present for them – without going insane. Below are extremely condensed excerpts of our chat. Listen to the podcast or read the transcript for the full conversation.
Before we talk about global teens, let’s talk about teens, period. Who are they?
Anisha Abraham: Teenagers are about ages 12 through 21, although we're now seeing young people as early as 10 or 11 going through pubertal changes. Adolescence is a universal concept. Whether that's recognized can very much vary. For example, in the Netherlands, this is a very important time where kids are developing autonomy, whereas in other cultures, for example in Hong Kong, kids remain living with their parents and communicating about decisions until later on in their life.
It's an important time because so much of what we see in terms of morbidity and mortality as an adult has a lot of links to what's occurring during the teen years – for example, alcohol use, mental health issues... Spending time making sure that young people do well during their adolescence has such an incredible benefit in terms of what happens during their adulthood.
How does a teenage brain differ from an adult brain?
First, with the developing brain, it takes some time before all of the synapses are fully connected. If there is an immature brain, young people who are exposed to anything high-risk, such as alcohol or drugs, are more likely to have little changes in their brain that are irreversible, compared to someone whose brain is fully developed. A lot of my work with young people and families is trying to prevent behaviors like smoking cigarettes or using alcohol at early ages, knowing that young people are more likely to stay addicted. The same thing goes for being exposed to chronic stress or restricting their eating.
The other concept that is really important is the prefrontal cortex versus the limbic system. The prefrontal cortex is the area right in the front of the brain. It's the command center of the brain. It helps people think about consequences of actions: if I do this, then something is going to happen. And again, that is not developed until later in adolescence.
But what's really strong during the adolescent period is the limbic system, which is trying and testing things out, pleasure and reward. So a really normal part of adolescence is actually experimenting. I tell kids all the time that they can blame their brain as a work in progress when they sometimes are doing things that are a little bit impulsive. But a lot of what we need to be doing is helping kids make good decisions and protect the brain that they have.
Sometimes young people just want us to be like a houseplant. Just to be there, not saying anything.
So given that reality, what impact does it have on a teenager to be moving frequently or having a foot in different cultures or communicating in a foreign language, all these things that are part of a global childhood?
A very important part of adolescence is discovering your physical identity and being over time comfortable with your body as it is. Another important part of adolescence is becoming accustomed to what your gender and sexual identity is. But if you throw on top of that your cultural identity, there's a lot that you need to develop and to think about. The challenges can include the fact that you're not quite sure where you belong. Who is your tribe? What is your true identity? And there can also be issues related to grief and loss every time you move from one place to the other.
How can you help them through it?
The pandemic has really affected young people – not being able to travel, not being able to have their normal routines, a loss of milestones, not being able to do many of the activities that they usually will do. It's increased the number of young people that I'm seeing in my daily practice that are feeling anxious or depressed, and in some cases even suicidal. Having regular conversations, checking in with young people about how they're feeling, what's going on in their lives, and what they're doing that's protective, is very, very important.
And we all know how easy that is, engaging a teen…
So a couple of tips. The first is if you are with a young person, try to do activities in parallel. For example, walking with them, driving a car with them, biking with them, so you're not looking directly in their eyes. It is a wonderful opportunity to check in. Ask first about what their peer group is doing. Because sometimes they don't want to talk about themselves, but it's easier to talk about what their friends are experiencing. So I will ask, are your friends feeling down or stressed or not feeling good about what's happening? Are your friends sometimes vaping or smoking or using alcohol? Or are you feeling pressure to sometimes use these things? And that then can be a very nice segue into what might be happening in their own lives.
And the final point is keeping things short. Again, thinking about teen brain development, sometimes they're not able to think about all of what we're saying when we have these very long, philosophical discussions. So sticking to what I call the 50% rule and saying half of what we intend to say may actually be a good rule of thumb.
Hormones really can make young people feel angry one moment and happy the next day. At the end of the day, many young people just want us to be like a houseplant. Just to be there, sometimes not saying anything, to provide love and support. That's an important message for many parents, just to realize that our kids want us there. They want our unconditional love and support. It can go a long way.
One of the biggest predictors of success for young people is not having perfect grades. It's being able to get up on your feet after you've experienced a challenge or disappointment.
What kind of adults do global teens become?
The upsides are being empathetic, being tolerant, being aware, being open to change. These are such wonderful qualities that we need right now in a time where there is so much polarization. There's some incredible strengths that come with this experience. It's so important for parents to expose kids to more than one culture if they can.
One of the biggest predictors of success for young people is not having perfect grades or doing every last activity or even getting into the top university or having a perfect job. It's this ability to have what I call balance – being able to get up on your feet after you've experienced a challenge or disappointment. And I do think being cross-cultural gives young people a tremendous ability to build on resilience and to build on this concept of balance. That's a wonderful gift that we can give young people.