How to Protect Teens’ Mental Health for Life

By Eric Levine, Ed.D with Becky Shipkosky

You are the parent of a teen, and you’re wondering whether or not they’ll become a well-adjusted adult. The short answer is: most likely! You’re not alone, and they’re probably more okay than you think. As for a longer answer, the research paints a fascinating picture about what is happening in the brain during these years and how parents can guide healthy development.

Of course, parenting isn’t the whole picture; its role is often indirect. But the teen years represent an important neurodevelopmental window for long-term mental health, and parents will impact such development, whether intentionally or not. And we only get one chance. No pressure!

What can parents influence, and how do we do it?

Reward and Motivation

The brain’s reward system determines what feels rewarding and how motivation is sustained. During adolescence, the system is calibrating, notably in the nucleus accumbens and ventral tegmental area (VTA) (Murty et al., 2018). Research suggests that stress and substance use are among the most significant disruptors of development in these brain regions (Zhu & Grace, 2022; Reynolds et al., 2023; Smith et al., 2015; Tottenham & Galván, 2016).

One of the most practical ways parents can help teens develop healthy reward and motivation systems is to provide a structured rhythm of daily life. When everyday routines are predictable, life feels more manageable and less stressful. Teens also learn that effort leads to reward, a deterrent to gravitating to immediate, high-intensity rewards from substances or behaviors such as gambling.

To turn such information into practice, parents can implement a daily rhythm that reinforces the effort-reward connection by making transitions between work and relaxation feel like a natural part of the day. A balanced afternoon might look like:

1. 30 to 60 minutes of decompression time after school (snack, preferred activity)
2. Defined work block (homework, practice)
3. Immediate reward (back to preferred activity)
4. Dinner together (social connection)
5. Light responsibilities
6. Wind down (read, journal, meditate, art).

Some families may find they can also add longer-term rewards linked to wins over a week or a semester. Other teens, including those with attention or executive function differences, might benefit instead from shorter work-reward cycles or milestone-linked work blocks.

Stress Regulation

A healthy adult stress response involves activation of the hypothalamus-pituitary-adrenal (HPA) axis followed by regulation through circuitry involving the amygdala, hippocampus, and medial prefrontal cortex.

The response is different in teens for two important reasons:

• Stress reactivity increases in adolescence, especially in response to social or evaluative events such as peer rejection or public speaking (Stroud et al., 2009).
• The prefrontal cortex and hippocampus are still maturing, limiting regulatory capacity.

The result is a system that is more easily activated and less consistently regulated.

What can parents do to facilitate healthy stress regulation development? Research points to four key behaviors: responsiveness, warmth, inductive discipline, and positive regard (Kuhlman et al., 2013; Brown et al., 2020; Gunnar et al., 1998). Good parenting practice might look like:

• Responding to dysregulation with calm: Slow yourself down. Listen. Once the worst passes, offer techniques that you know help your child: breathing, a walk, time alone, a cup of tea.
• Naming and normalizing stress: No wonder you’re upset. It sounds like you’re having some performance anxiety. Isn’t it curious how our nervous systems think we’re literally going to die when we have to give a speech?
• Using inductive discipline: Explain and connect instead of ordering or punishing. I won’t let you go to the movies tonight because you didn’t get enough sleep last night, and that made today really hard. It’s important you rest tonight.
• Staying available: Teens will often push parents away, but it’s important to be there when needed: I’m here to talk when you’re ready. Or Call me anytime you don’t feel safe with your friends. I will drop whatever I’m doing and come get you.

Note: Research regarding parental influence on HPA axis development after age 10 is insufficient, but existing studies almost unanimously agree that some influence continues well into adolescence.

Social Health

As adolescents begin to define themselves as individuals separate from the family unit, several key capacities develop:

• Social cognition: the ability to infer others’ thoughts
• Social evaluation: the ability to assess peer trustworthiness and social hierarchies
• Identity formation: exploration of roles and identities to find and articulate who they are.

Stress and substance use are the leading threats to the social brain regions still maturing during adolescence (Tottenham & Galván, 2016; Salmanzadeh et al., 2020), as well as exposure to family or community violence and social isolation (Bradshaw & Garbarino, 2004; Li et al., 2021). As adults, adolescents who experience one or a combination of such adversities are at increased risk for depression, anxiety, aggression, social withdrawal, and substance use disorders (González-Acosta et al., 2021; Wang et al., 2022; Li et al., 2022; Sahani et al., 2021).

Parenting strategies that support healthy social development can be distilled into two core qualities: high warmth and high autonomy. Teens need both parentalk attention and independence. They may be hostile, but they still deeply need the presence and approval of their parents. Some specific ways to support this stage of growth are:

• Jog social cognition by asking open-ended questions: What do you like about that person? How do you think she felt when he said that?
• Remember that their experience with conflict at home will set their barometer for what is acceptable. Navigate conflict with them in the way you want to see them treated by friends and significant others.
• Coach (not reassure) through social difficulties. Ask: What are the possible responses to this? And then ask questions to get them talking through the pros and cons of each.
• Pay attention to who they’re hanging out with, know their friends, listen to what they’re willing to share, but don’t diminish trust and autonomy by surveilling.
• Encourage their exploration of new hobbies, activities, styles, and other expressions without criticism.

Closing Thoughts

Most conscientious parents worry that they’re getting something wrong. (We are all getting something wrong!) But here is the reassuring news: We don’t have to get it exactly right. Consider these very encouraging facts:

• Most teens make it to adulthood without major long-term impairment and most do not develop severe mental illness.
• One stable parent is enough to significantly reduce risks.
• Even if your child’s early life wasn’t great, the highly neuroplastic adolescent brain offers a lot of opportunity for healing.
• If you get something wrong and then repair it with your teen, you’ve gotten it right.
• It almost entirely boils down to positive attention and structure.