April 9, 2024
Cindy Lopez: Welcome. My name is Cindy Lopez, the host of this CHC podcast, Voices of Compassion. We hope you find a little courage, feel connected and experience compassion every time you listen.
Puberty can be a challenging time, but with guidance parents can help their children navigate it with resilience and strength. Drawing on insights and the expertise of CHC doctoral psychology intern Emma Lecarie, this new podcast episode provides practical advice for parents navigating this transitional period with their children. We explore strategies parents can use to promote positive mental health outcomes during puberty as well as understanding the potential challenges their children may face and how parents and caregivers can recognize signs of distress and offer help.
Hi, Emma. Thank you for joining us today. Why don’t you take a minute to tell us a little bit about yourself and why this topic is an important one for people to understand?
Emma Lecarie: Hi there. My name is Emma Lecarie. I am one of the current doctoral psychology interns here at Children’s Health Council, finishing up my clinical psychology PhD coming from Arizona State University. This topic is one that’s of interest to me just because I’ve always been interested in the mind-body connection or the connection between physical health and mental health. I’m really excited to talk about this topic today, puberty and mental health, and to talk about this transition from childhood to adolescence and how puberty is a really integral piece of that transition and how it impacts teens overall mental health. So yeah, excited to be here today. Thanks for having me.
Cindy Lopez: Thank you, Emma. Well, let’s start by defining puberty. So what is it? Is it about the brain? When does it typically occur? Like, tell us a little bit more.
Emma Lecarie: So to back up a little bit, when we think of adolescence just broadly, we think about so many changes all happening simultaneously. And so we think about, like, changes in the brain, right, neural development, hormonal changes, physical changes, cognitive changes, social changes, where like teens are starting to kind of increase their independence from their parents, spend more time with peers. So there’s just so much going on during this time of adolescence. When we talk about puberty specifically, we’re talking about the neuroendocrine changes that ultimately lead to sexual maturation. So really focusing in on hormones and the physical development that’s happening, that also is promoting rapid brain development. And so our hypothalamus in our brain goes through a series of chain of reactions in our bodies and ultimately sex hormones are produced. So, we talk about testosterone, estrogen, progesterone. And we see a lot of different types of physical development in girls in terms of breast development, in boys in terms of, you know, voice changes and growth of facial hair. And then also just generally for all kids growth of height is kind of one of the first indicators of puberty, you know, oily skin and hair or body odor and why we need to start wearing deodorant. And so these are all different types of indicators of puberty that we see. In terms of when it typically occurs, the onset of puberty is really hard to pinpoint as it kind of continues to change, but for girls, you know, somewhere in the range of between the ages of like 8 to 13, more typically between the ages of 10 to 11 and then for boys, we usually see the onset of puberty around somewhere between ages 9 to 14, more typically between 11 to 12 years old.
Cindy Lopez: As you just noted, all these changes are going on in the body of an adolescent, and if they’re not prepared for it I’m sure it must be shocking, but speaking of the onset of puberty I read that the age of onset of puberty is decreasing in both boys and girls. And you just mentioned a range, which makes sense, where the average age of a girl’s first period in the U.S. and Europe was about 16 about a century ago. So it was a while ago, and today it’s closer to 13, which is interesting. I’m just wondering like, that onset of puberty seems to be happening younger and younger. How does that impact mental health?
Emma Lecarie: I’m really glad you brought that up. There is a lot of literature out there right now that’s really emphasizing this critical point about how the onset of puberty continues to be earlier and earlier for youth. I think I saw recently that like currently about 16 percent of girls and about 6 percent of boys are beginning puberty at age like eight to nine, so when we think about that, we’re talking about like third grade, which like you mentioned is years earlier than it used to be. Although that really varies, right? The age ranges that I gave, its four to five years in variation in terms of healthy children in terms of like healthy development in the range of when they might start puberty, but I think it’s really important to think about because a lot of factors go into the timing of the onset of puberty. And so, I mean, we can talk like genetics, like yes, there is a genetic component. If a girl’s mom started puberty, like, you know, on the earlier side, chances are she will, too, and there’s other factors though, like, I mean there’s some research just starting to look at like, are there chemicals in the environment that’s affecting this earlier onset of puberty, but one factor that I really like to highlight and I think is really important is just thinking about life stress or life adversity. nd there’s a lot of research out there talking about just like stressful family circumstances, in terms of parental care and warmth or family conflict or lower socioeconomic status, all of these different types of like stressful life factors that really do play a role because, you know, thinking about taking whatever we’re more genetically prone to, coupled with that stress, really kind of increases a likelihood for later risk of mental health difficulties.
Cindy Lopez: Mm hmm. It’s interesting because as you just noted, onset of puberty is happening earlier and earlier. What is it that makes maturing early like that so challenging or even too late? I’m going to call it outside the norm. How does that impact youth?
Emma Lecarie: Yeah, yeah. I like that you termed it outside the norm because it really is this conversation of too early, too late or is it both? And I’m starting to think that it’s both. There’s theories out there that talk about how for both boys and girls developing too early or too late puts them at risk. There’s also theories out there that talk about differences for boys and for girls, saying that it’s girls who are maturing early and boys who are maturing late that are most at risk for mental health difficulties. It’s really like so mixed in the literature, which is so interesting because I think historically we think about boys, you know, being big and strong is like advantageous for them while for girls developing sooner might lead to difficulties with body image, or how they feel like they’re perceived by others and social settings, or things like that, but I really do think that maybe some of these like traditional ideas are starting to change. Regardless though, we know that like during adolescence, early adolescence, youth want really nothing more than just to fit in with their peers and so those that are developing at a different time than their peers, whether it be too early or too late, it likely is an uncomfortable situation for them.
And going back to what we mentioned in terms of brain development, the prefrontal cortex in adolescents, it’s kind of like one of the last parts of the brain to mature. And it’s really responsible for planning and prioritizing and making good decisions. And so while youth are going through this different development as compared to their peers and their brain is still maturing at the same time, they’re likely less able to really access those coping skills and resources that might be helpful in like, this, you know, stressful situation of development. And so that’s the piece where it really starts to become a concern for how it might affect their mental health.
Cindy Lopez: Given that puberty is not a moment in time, right? It occurs over years–that complicates things a little bit. How does that happen and how does it impact kids?
Emma Lecarie: Mm hmm. Yeah, yeah, not a moment in time. It’s a series of stages and the Tanner stages are kind of like a gold standard way that we track pubertal development all the way from puberty hasn’t started to it’s fully complete. And when we think of the timing of puberty, yeah, we’re getting at like one moment, one moment in time, but there’s also some other ways of measuring puberty or thinking about puberty, like pubertal tempo is one other one that really gets more at like the rate or progression of puberty across development. And so I think that it’s helpful to think about it in that way too. For example, a girl might start puberty on time, you know, the same timing as many of her peers, but she might progress through the pubertal stages at a faster rate, which might also lead to worries about body image or comparison with peers. It’s harder to measure pubertal tempo because it requires multiple time points. But, I think it’s important to be able to get a full understanding in terms of research that’s still being done of all the stages of pubertal development and helping pinpoint, you know, where we might be able to intervene with things.
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Cindy Lopez: So, Emma, thinking about parents and our listeners who are probably mostly parents and some educators, caregivers, given all the changes that go on in a child’s life, body, brain during puberty, what can parents do to help prepare their kids for this?
Emma Lecarie: Mm hmm. Yeah. You know, with puberty happening earlier and earlier on it’s likely it’s becoming more difficult to prepare and have time and space for that preparation stage…
Cindy Lopez: Yeah, how do you talk to a third grader?
Emma Lecarie: Before things are changing, exactly. And so, you know, schools have puberty education programs, health programs already embedded into their curriculum. That being said, I wonder whether it’s time to start thinking about at what grades and ages those are happening and whether those need to start happening sooner, and I think exactly to your point, like, maybe that’s where parents can start stepping in more because, you know, one point that I want to just emphasize is we all go through puberty. It’s so normal, and it’s just part of development, and I think the more that parents can sit with their kids as they’re going through it and educating them. And a lot of the times puberty feels like this big, scary process, and it’s also an exciting major milestone of development. And so the more, we know, the more parents know, the more they can then provide that knowledge to their youth so that the more that we’re aware of it, hopefully the more positive the outcomes and the experience.
Emma Lecarie: So while all this is happening with our kids, puberty, body changes, brain changes, what signs would parents and caregivers see that might cause them to think that their child’s having a hard time with puberty?
From research, we know that early puberty or developing ahead of peers is most closely linked with depression, particularly in girls, but also linked with anxiety, with substance use, eating disorder, other disruptive behavior disorders. In some of my research in my dissertation, I looked at how puberty is related to anxiety and depressive symptoms. And you know, I actually found that in our sample, it was boys, not girls, who reported increases in anxiety and depressive symptoms as a result of earlier puberty. And I think this is just–it’s such an important finding to highlight because perhaps a lot of our attention thus far has been on girls, you know, they’re the ones who are going through some of the body changes. They’re the ones that are like getting their first period, you know, all of these, big factors. And perhaps that’s where a lot of our focus and attention has been. But it seems like we’re at the point where boys are going through this too. So, and maybe they’re in need of some more support as well.
Cindy Lopez: So can you talk about anything, like, specifically related to the anxiety and depressive symptoms you referenced?
Emma Lecarie: Mm hmm. Mm hmm. Yeah. Parents might want to look out for changes in eating, changes in sleeping. Both of these could be like more or less in either direction, eating more, eating less, sleeping more, sleeping less. Any interpersonal problems, so any like, personal problems, you know, difficulties with peers, any increased stress, or any just withdrawing from, like, activities that, you know, your teen might typically enjoy. I also want to put in a plug for sleep being so important during this stage of adolescence, and how while bodies need, you know, time to rest and recover with all of the change and growth that’s occurring, during this time of maturation. And so, we know that sleep is also so related to our mental wellness. If we get a poor night of sleep, this tends to increase our stress, might impact our mood the next day. We might feel more irritable, less able to focus and so poor sleep is a symptom of both depression and anxiety as well. Each person’s sleep need is different, but I always like to point that out, too, especially during this time of adolescence where they’re starting to get involved in different activities and long school days and just with lots going on remembering that’s an important piece to make sure that they’re getting when their bodies are really going through a time of change and growth.
Cindy Lopez: For our listeners, just so you know, we have a couple other podcast episodes on sleep, one called, “Teens, Stress and Sleep,” another one about “Why Sleep Matters to Mental Health”. So, feel free to check those out to learn more about sleep and the importance of it, the value of it, especially as Emma was just referencing.
So say that parents and caregivers are seeing some things that might be concerning or actually even not concerning, it’s kind of just normal their child’s going through it, but what can they do specifically to support their kids during this time?
Emma Lecarie: I think like we were starting to get up before parents can definitely monitor, right, they can monitor any changes they notice in their child. In one way, it’s normal for a teen to be irritable at times, easily annoyed, even angry at times, especially with their parents, you know, that happens during the stage of adolescence, but if your child never seems to be happy or content it could be a warning sign that they’re struggling with their development.
Cindy Lopez: So what do they do if they see something?
Emma Lecarie: So if they’re noticing any changes in mood, changes in not being involved in activities they typically would, you know, these are all signs that it might be helpful to check with a doctor or mental health practitioner and just get a feel for what the symptoms are that are going on and just get an assessment done and see whether it might be helpful for their teen to talk with someone about what’s going on, like we mentioned it can be really uncomfortable for a teen to talk about how they’re feeling in terms of their development, both physically and mentally. It’s really personal, a lot of the time, and it’s not something that we might just go around talking to friends about, you know, in terms of their peers. So, sometimes it’s nice to have a separate provider who they feel they can trust and they feel like they can open up to about those things.
Cindy Lopez: Yeah, I can see for youth going through puberty, there’s just a lot of comparison at that age, right? There’s a lot of trying to fit in, as you already noted, trying to fit in, wanting to fit in, not wanting to stand out. And so whatever that means to the particular group, the peers of your kids at the time, you know, it’s different. But I think for parents and caregivers, as Emma noted previously, like, it’s just a natural process for everyone. So, you know, helping your kids understand that, staying positive about it and taking cues, like figuring out when the best time is to have conversations with your kids about it. And as we noted already the onset of puberty is younger and younger. So as parents and caregivers, you know, you might want to consider having some conversations with your kids a little earlier. And if you’re an educator that’s a little different because as an educator, you’re trying to respect families and parents boundaries and what they want to set up, how they want to set up the conversation. So, if you’re one of our listeners and you’re a parent or caregiver, just give yourself a little grace and just listen and support your kids. Emma,what final advice do you have for our listeners?
Emma Lecarie: I think my biggest piece of advice would be just normalizing the pubertal process. I think it always helps me to come back to when I’m working with teens, we all go through it, right? And I feel like those words are really, really powerful when we feel so alone or so different as compared to others. We all go through it, but we all go through it in different ways. It’s really like such an individualized process for being a process that we all experience. I think as much as we validate the puberty experience as being stressful, anxiety-provoking, and completely normal, the more likely children will be to opening up and talking about their experience.
Cindy Lopez: If you’re a parent or caregiver of a child and you are thinking that you might need some help, please feel free to reach out to CHC. You can reach us at chconline.org. You can call us at (650) 688-3625, or you can email us at careteam@chconline.org. And please check out some of the resources associated with this podcast episode. There could be something there that would be really helpful for you. Thank you for listening in today and thank you, Emma.
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