Related to
Adolescents
Whānau

By Keryn O’Neill, MA, PGCertEdPsych, Knowledge Manager

“Adolescence is a developmental window ripe with opportunity and creativity.”1

Adolescence is a time of incredible development for our rangatahi; with many new skills and opportunities. There are often also some challenges. Undergoing this development through a pandemic has created additional challenges for many.

The good news is that there are a number things that can support rangatahi well-being.

Adolescent Development

Adolescence is tricky to define, but it begins at the start of puberty and ends in the early to mid-twenties. So it includes more than ‘the teen years;’ sometimes lasting for 15 or more years.2 It’s a time of huge changes and growth: physically, socially, emotionally and also in terms of brain development.

This stage of development is important in its own right, but also because what happens during this time affects the health, development and well-being of rangatahi into adulthood too.

While some aspects of adolescence are biologically determined, their experiences and relationships both influence rangatahi development and affect their well-being.

Risk & protective factors

Many things influence the way rangatahi develop. Some things put rangatahi at ‘higher risk’ of poor outcomes (risk factors). Other things increase the chance of positive outcomes (protective factors).

Risk & protective factors can be biological, psychological and social, with development being influenced by a range of factors. The more protective factors rangatahi have, and the fewer risks they face, the more likely they are to enjoy positive outcomes throughout life.

It’s not only what’s happening for rangatahi during this stage of development that influences them, but also the experiences they had earlier in life; these contribute to large differences in individual rangatahi brain development and outcomes over this time.3

There are some influences on well-being that we can do little about (e.g. genes), however others can be changed to support better well-being for rangatahi.

Not everyone is affected in the same way, but some things tend to help development, while others tend to get in the way of healthy development. Let’s have a look at some of the things that we know can help support healthy development of rangatahi.

Relationships with adults

Despite typically spending more time with their peers in adolescence, parents and whānau continue to play an important role in rangatahi social and emotional development.4 These connections with the adults in their lives provide the foundations for rangatahi health and wellbeing.5 Whānau often have more influence on rangatahi development than their peer group, including on their brain development.6

All rangatahi need ongoing, positive relationships with caring, capable adults who can support their development of life skills and encourage rangatahi as they navigate these changes.7

Grandparents can be an important positive support for their mokopuna.8

It can be challenging, but when parents stay connected and involved with their rangatahi, young people are likely to have better outcomes.9 For example, one study found that rangatahi who felt more connected to their parents experienced fewer symptoms of depression, suicidal thinking, self-harm and behaviour problems.10 In this instance connectedness included feeling loved and cared for by their parents, as well as a sense of being valued and respected.11

Many studies show the importance of young people being connected to competent and caring adults in their whānau and community.12 Some rangatahi have parents who are unable to provide the support they need, for a variety of reasons. For these young people it’s particularly important that they have other adults in their lives who provide this support.13

While all rangatahi need the acceptance and support of whānau and other important adults in their lives, this is particularly important for those who identify with one or more marginalised groups. Rangatahi who identify as a sexual or gender minority are at increased risk of mental health challenges, including higher rates of suicide. Feeling that their gender and sexual identity is accepted and supported by their parents lessens this risk.14

Back to basics

Some of the basic things we need, at any age, are particularly important during the huge development unfolding during adolescence. These include sufficient sleep, exercise and good nutrition. These things support rangatahi well-being at any time, but may be especially important during challenging times, such as the pandemic.

  1. Sleep
    Sleep patterns change in adolescence, for both biological and social reasons. The combination of these changes mean that rangatahi usually stay awake later than they did as tamariki. When they need to wake early, they often do not have enough sleep to support their well-being.

    Rangatahi need 8-10 hours of sleep per night so they can develop and function at their best,15 although many are having much less than they need. The consequences of not getting enough sleep can be far-reaching, affecting many things including rangatahi mental health, risk-taking, and learning.16 While sleep is important for us at any age, it is particularly important during times of huge development, which includes adolescence. Adolescents are also more likely to struggle to function well, compared with adults with a similar sleep deficit.17

    Some small studies found that rangatahi had more sleep during lockdowns when their learning was online.18 This will have been helpful for those who had longer sleep. A challenge with the return to in-person learning will be supporting rangatahi to maintain or develop sleep habits and behaviour that help them to get the sleep they need.

    Sleep has consistently been associated with mental health among rangatahi.19 Sleep problems increase the risk for poorer mental health, including anxiety and depression, self-harm and suicide.20

  2. Physical activity
    Physical activity, as studied by researchers, includes any form of moving one’s body that leads to “energy expenditure above basal level”; this includes household activities, physical work, recreational activities (e.g. sports) and active transport methods (e.g. walking or biking).21

    Physical activity can help improve sleep,22 which as discussed earlier, is also necessary and beneficial for rangatahi well-being.

    Exercise and physical activity are beneficial to mental health in adolescence and can be protective against some mental disorders.23 An NZ study found that those who exercised during the first lockdown were less likely to report symptoms of depression than those who didn’t exercise.24

    Physical activity is positively associated with academic and cognitive performance in secondary school students.25 However, adolescence is the period of development with the greatest decline in physical activity levels.26

    One of the mechanisms/ways physical activity may benefit mental health is through its impact on brain structure and function.27

    There is some evidence of greater wellbeing after exercise outside, in nature, compared with similar exercise inside.28

  3. Nutrition
    Evidence is growing indicating that what rangatahi eat influences not only their physical health, but also their mental health.29

    A number of studies have found that those consuming a healthy diet were more likely to have improved mental health. Likewise, as the diet becomes less healthy, mental health was found to be poorer.30

    The following are components of a nutritional diet:
    • A variety of fruit and vegetables, whole grains, seafood, nuts and legumes
    • Moderate amounts of low fat dairy products
    • Low amounts of red meat and processed meats
    • Very limited amounts of; processed foods, added sugar and salt, saturated and trans fats.31

Interestingly, it seems to be that both lower amounts of healthy food, and higher amounts of unhealthy food affect mental health, independently of each other. For example, unhealthy foods increase the likelihood of depression, even when lots of healthy foods are also eaten.32

Studies from a number of countries have found that when people eat in ways which are traditional to their country and culture, they are more likely to have good mental health.33

Avoiding substance use

Another important way to support the well-being of our rangatahi is by encouraging them to avoid or delay using alcohol and other drugs.

Drinking alcohol increased for some during the pandemic, with some young people using drugs and alcohol to cope during lockdowns,34 and may need support to develop healthier coping strategies.

Some things worth knowing about substance use by rangatahi:

• The adolescent brain is more vulnerable than an adult to the effects of substances, including alcohol, cannabis and methamphetamine
• Adolescent drinking and drug use can affect their functioning and brain development, not only at the time but also into adulthood
• If an adolescent and an adult drink the same amount, the adolescent is more likely to be harmed by it.

Rangatahi need adults to support them, using their adult wisdom, and to role model healthy behaviour themselves around alcohol and other drugs. If unhealthy habits have developed, the sooner rangatahi are supported to turn this around, the better off they will be. In some cases, conversations with whānau will be enough, while others might benefit from professional help.

Conclusions

It’s early days in terms of understanding how the pandemic has affected rangatahi, and how it will continue to affect them. In time, we will learn more about specific things that supported rangatahi well-being over this time. However, we do already have a lot of knowledge about factors that support rangatahi to develop well. While there continue to be uncertainties, and things we can’t control, it’s good to know there are ways we can all support our rangatahi to navigate this time.

Many factors influence rangatahi well-being. Some of these can be changed, while others cannot. Those where change may be possible include:
• Supportive adult relationships
• Getting enough sleep
• Regular physical activity
• Eating nutritional food
• Avoiding alcohol and other drug use
Every protective factor that is added, and every risk that is reduced, increases the chance of improved rangatahi well-being.

Footnotes

  1. Galván,2021, p.843
  2. Galván, 2021
  3. Galván, 2021
  4. Butterfield et al., 2021; Morris et al., 2021
  5. Sieving et al., 2017
  6. Dahl et al., 2018
  7. Osher et al., 2020
  8. Osher et al., 2020
  9. Morris et al., 2021
  10. Foster et al., 2017
  11. Foster et al., 2017
  12. Masten, 2001
  13. Bowers et al., 2014
  14. Klein et al., 2022; Morris et al., 2021
  15. Galván, 2020; Short et al., 2020
  16. Sleep Health Foundation, 2020; Snyder, 2020
  17. Galván, 2020
  18. Stone et al., 2021; Gruber et al., 2020
  19. Agostini & Centofanti, 2021
  20. Becker et al., 2015; Fernando et al., 2013; Khazaie et al., 2021; Porras-Segovia et al., 2019
  21. Lang et al., 2016
  22. Lang et al., 2016
  23. Belcher et al., 2021; Firth et al., 2020
  24. Gasteiger et al., 2021
  25. Esteban-Cornejo et al., 2015
  26. Esteban-Cornejo et al., 2015
  27. Belcher et al., 2021
  28. Lubans et al., 2016
  29. Hosker et al., 2019
  30. Jacka et al., 2011; O’Neil et al., 2014
  31. Hosker et al., 2019
  32. Jacka, 2019; Rucklidge & Kaplan, 2021
  33. Jacka, 2019
  34. Radford-Poupard, 2021

References

Becker, S. P., Langberg, J. M., & Byars, K. C. (2015). Advancing a biopsychosocial and contextual model of sleep in adolescence: a review and introduction to the special issue. Journal of Youth & Adolescence, 44, 239-270.

Belcher, B. R., Zink, J., Azad, A., Campbell, C. E., Chakravartti, S. P., & Herting, M. M. (2021). The roles of physical activity, exercise, and fitness in promoting resilience during adolescence: Effects on mental well-being and brain devlopment Biological Psychiatry, 6, 225-237.

Bowers, E. P., Johnson, S. K., Buckingham, M. H., Gasca, S., Warren, D. J., Lerner, J. V., & Lerner, R. M. (2014). Important non-parental adults and positive youth development across mid-to late-adolescence: The moderating effect of parenting profiles. Journal of Youth and Adolescence, 43(6), 897-918.

Butterfield, R. D., Silk, J. S., Lee, K. H., Siegle, G. S., Dahl, R. E., Forbes, E. E., . . . Ladouceur, C. D. (2021). Parents still matter! Parental warmth predicts adolescent brain function and anxiety and depressive symptoms 2 years later. Development and Psychopathology, 33, 226-239.

Dahl, R. E., Allen, N. B., Wilbrecht, L., & Suleiman, A. B. (2018). Importance of investing in adolescence from a developmental science perspective. Nature, 554, 441-450.

Esteban-Cornejo, I., Tejero-Gonzalez, C. M., Sallis, J. F., & Veiga, O. L. (2015). Physical activity and cognition in adolescents: A systematic review. Journal of Science and Medicine in Sport, 18, 534-539.

Fernando, A. T., Samaranayake, C. B., Blank, C. J., Roberts, G., & Arroll, B. (2013). Sleep disorders among high school students in New Zealand. Journal of Primary Health Care, 5(4).

Firth, J., Solmi, M., Wootton, R. E., Vancampfort, D., Schuch, F. B., Hoare, E., . . . Stubbs, B. (2020). A meta-review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders. World Psychiatry, 19(3), 360-380.

Foster, C. E., Horwitz, A., Thomas, A., Opperman, K., Gipson, P., Burnside, A., . . . King, C. A. (2017). Connectedness to family, school, peers, and community in socially vulnerable adolescents. Children and Youth Services Review, 81, 321-331.

Galván, A. (2020). The need for sleep in the adolescent brain. Trends in Cognitive Neuroscience, 24(1), 79-89.

Galván, A. (2021). Adolescent brain development and contextual influences: A decade in review. Journal of Research on Adolescence, 31(4), 843-869.

Gasteiger, N., Vedhara, K., Massey, A., Jia, R., Ayling, K., Chalder, T., . . . Broadbent, E. (2021). Depression, anxiety and stress during the COVID-19 pandemic: results from a New Zealand cohort study on mental well-being. BMJ Open, 11.

Gruber, R., Saha, S., Somerville, G., Boursier, J., & Wise, M. S. (2020). The impact of Covid-19 related school shutdown on sleep on adolescents: a natural experiment. Sleep Medicine, 76, 33-35.

Hosker, D. K., Elkins, R. M., & Potter, M. P. (2019). Promoting mental health and wellness in youth through physical activity, nutrition, and sleep. Child and Adolescent Psychiatric Clinics, 28(2), 171-193.

Jacka, F. (2019). Brain Changer. NSW, AU: Pan Macmillan.

Jacka, F. N., Kremer, P. J., Berk, M., de Silva-Sanigorski, A. M., Moodie, M., Leslie, E. R., . . . Swinburn, B. A. (2011). A Prospective Study of Diet Quality and Mental Health in Adolescents. Plos One, 6(9), e24805.

Khazaie, H., Zakiei, A., McCall, W. V., Noori, K., Rostampour, M., Bahmani, D. S., & Brand, S. (2021). Relationship between sleep problems and self-injury: A systematic review. Behavioral Sleep Medicine, 19(5), 689-704.

Klein, D. A., Ahmed, A. E., Murphy, M. A., Pearlman, A. T., Johnson, N., Gray, J. C., & Schvey, N. A. (2022). The mediating role of family acceptance and conflict on suicidality among sexual and gender minority youth. Archives of Suicide Research, 1-8.

Lang, C., Kalak, N., Brand, S., Holsboer-Trachsler, E., Puhse, U., & Gerber, M. (2016). The relationship between physical activity and sleep from mid adolescence to early adulthood. A systematic review and meta-analysis. Sleep Medicine Reviews, 28, 32-45.

Lubans, D. R., Richards, J. A., Hillman, C. H., Faulkner, G., Beauchamp, G. K., Nilsson, M., . . . Biddle, S. J. H. (2016). Physical activity for cognitive and mental health in youth: a systematic review of mechanisms. Pediatrics, 138(3), e20161642.

Masten, A. S. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56(3), 227-238.

Morris, A. S., Ratliff, E. L., Cosgrove, K. T., & Steinberg, L. (2021). We know even more things: A decade review of parenting research. Journal of Research on Adolescence, 31(4), 870-888.

O’Neil, A., Quirk, S. E., Housden, S., Brennan, S. L., Williams, L. J., Pasco, J. A., . . . Jacka, F. N. (2014). Relationship between diet and mental health in children and adolescents: a systematic review. American Journal of Public Health, 104(10), e31-42.

Osher, D., Cantor, P., Berg‐Nielsen, T. S., Steyer, L., & Rose, T. (2020). Drivers of human development: How relationships and context shape learning and development. Applied Developmental Science, 24(1), 6-36.

Porras-Segovia, A., Perez-Rodriguez, M. M., Lopez-Esteban, P., Courtet, P., Barrigon, M. L., Lopez-Castroman, J., & Cervilla, J. A. (2019). Contribution of sleep deprivation to suicidal behaviour: A systematic review. Sleep Medicine Reviews, 44, 37-47.

Radford-Poupard, J. (2021). Experiences of COVID-19 for takatāpui, queer, gender diverse, and intersex young people aged 16-24. Retrieved from Auckland, NZ: https://www.point.co.nz/mahi/experiences-of-covid-19-for-takatpui-queer-gender-diverse-and-intersex-young-people

Rucklidge, J., & Kaplan, B. (2021). The Better Brain: How nutrition will help you overcome anxiety, depression, ADHD and stress. UK: Penguin, Random House.

Short, M. A., Booth, S. A., Omar, O., Ostlundh, L., & Arora, T. (2020). The relationship between sleep duration and mood in adolescents: a systematic review and meta-analysis. Sleep Medicine Reviews, 52.

Sieving, R. E., McRee, A.-L., McMorris, B. J., Shlafer, R. J., Gower, A. L., Kapa, H. M., . . . Resnick, M. D. (2017). Youth-adult connectedness: A key protective factor for adolescent health. American Journal of Preventive Medicine, 52(3), S275-S278.

Sleep Health Foundation. (2020). Quick facts and FAQ about sleep for high school students.   www.sleephealthfoundation.org.au

Snyder, C. K. (2020). Biopsychosocial outcomes of poor sleep in adolescence. Journal of Pediatric Nursing, 54, 114-115.

Stone, J., Phillips, A., Wiley, J., Chachos, E., Hand, A., Lu, S., . . . Rajaratnam, S. (2021). Changes in sleep-wake patterns, circadian timing, and mood in Australian teens during the Covid-19 pandemic. Sleep Advances, 2, A13.