It was late when Natalie’s cell phone rang, and it was a dreaded call. “Your daughter is on her way to the emergency room. She blacked out. We were afraid to leave her because she was so drunk.”

This mom called me last week to tell me about the incident… no, she didn’t want to tell me about the actual incident as much as she wanted to tell me how she handled it.  She was proud that she had handled this terrible incident with relative calm and with control,  keeping things in perspective even while in the midst of the crisis.  She wanted to report to me that they had “been through the fire”...and had survived.

How many other parents have faced crises with your teens this summer?  Have your teens misbehaved?  Gotten into trouble?   Did they let you (and themselves) down in some way?  Teens don’t all misbehave, but enough of them do that this is an important question:  How will you survive a crisis you may face?

Preparing for the unexpected can be difficult, but being prepared is key to your success in a crisis.

Natalie was prepared. She invests time to make sure she is a smart, tuned-in parent for her teenagers.  She reads,  she speaks with friends and peers,  she is involved in her kids’ schools, and she works hard to share their lives and understand their point of view.  In fact she so values the opportunity to share ideas with other parents she has been in (and even led) several Please Stop the Rollercoaster parent discussion groups.

So when she spent those awful hours at the hospital while her daughter was severely under the influence of alcohol, Natalie kept her cool.  And after the crisis had passed over the next couple of weeks they processed what happened that night.  She huddled with her daughter,  her daughter’s friends and the other parents.  This incident became a valuable teachable moment because Natalie didn’t over-react.   And she didn’t allow it to devastate her or ruin her summer.

Lessons learned.  Relationships intact. That’s about the best you can ask for, isn’t it?

So, here’s the question for you: Will you be prepared if you face a crisis with your teen?

Here is my Crisis Response Plan*

When a crisis occurs, this four-step process can help you stay on track and respond productively:

STEP ONE:  Breath deeply This slows things down so you can think logically and deliberately.

STEP TWO: Identify objectively what has happened Make sure your response is properly aligned with reality. This is probably not the end of the world,  and you  probably will survive this crisis.

STEP THREE:  Ask yourself  “What’s the best outcome we can have?” Identify the best that can happen now, and set your sights on that.

STEP FOUR: Ask “How can I help make this happen?” Put yourself in action to help make the best outcome a reality.

*Note: This crisis response plan is one of our “Secrets to Success in Parenting Your Teen” available in our free, downloadable e-book.  Download it, share it, put it on your website… and send us a link so we can see how you are supporting parents too.

I was scolded yesterday on a blog where I posted a list of guidelines for monitoring your teen. The mom who commented on my post at The Partnership for a Drug Free America’s blog Decoder says

“All of the touchy-feely advice given throughout this website absolutely does not address the needs of parents such as myself with real problem kids.The list implies a level of cooperation from the teenager that they don’t have to give you. My son is purposely secretive about his friends, their names, where they live, where they go and what they do. I seldom get more than a “I’m with a friends” when I call his cell and if he doesn’t want to give me that much he simply doesn’t pick up the phone. When he was in middle school some of the above was within my power but now as an older teenager he has taken away my ability to parent and control his actions. Frankly, i resent these websites because i believe they are as unhelpful as the “just say no” campaign. Everyone including his therapist gives the same advice; i’ve done it all and it hasn’t worked – now what? I’ve just finished cleaning up the mess in his bedroom caused by his first bout of binge drinking until 3:30 AM, i can’t imagine what the next shoe to drop will be.”

Over this past weekend I received an email with the subject line “Teenage boy locked out of his house.” A crisis was occurring in real time, and the writer was trying to figure out if and how to intervene.

Just this morning I received a note from a Mom with two children in rehab who shares:

“Yes, mothering teenagers has been the rollercoaster ride of my life–but without the breathing room the rollercoaster offers between big hills and sharp curves.”

Raising teenagers can be really really hard. And when the teenagers ratchet up the bad behavior, guess what? Parents need to ratchet up the response. The stakes are high. You are not dealing with small issues here, but very possibly life itself. And, for parents, risk is involved. Your kids may not act rationally, they may not respond well to your intervention, no matter how well intentioned. It is vital that you work with a professional. And some professionals will be more suited to your situation than others…so if you are not getting realistic input or advice, find somebody else.

I completely understand why the mom who admonishes the advice on the Partnership for a Drug Free America’s site feels it is irrelevant to her. It is. Her situation is now more serious and requires more serious intervention. I am not going to advise her on what action to take because each situation is unique and different. Blogs and websites are wonderful places to get lots of information…but there is a limit. And when you have teens who are using drugs and binge drinking you need personal and professional assistance.

The reader with two kids in rehab shares some of her story:

I empathize completely with your correspondent’s sense that she is dealing with far more than the usual level of teen trouble, and that the usual responses just don’t work. As it turned out, for instance, my daughter was stealing the family car, driving to houses with older teens/adults, and drinking until she passed out. At one of these “parties” someone burned her with cigarettes. In short, her life was in danger,and it was no longer enough to take her cellphone or ground her. I couldn’t keep her grounded. Instead, I had to arrange an intervention with her therapist and have her admitted the next day to a residential treatment program. (The same happened with my stepson as well, who is in the facility now.) We were lucky, of course, to have insurance that covered much of the cost of their stays, but even then, it has been an expensive–emotionally and psychologically–experience. We reached a point where I had to act on what had once been idle threats. When my teenaged son came home drunk, I called the police. When I recognized that my daughter’s drinking was so extreme, I had her committed to residential treatment. None of these decisions was easy to make, much less to enforce. But I had come to understand that I would lose my children–to serious injury or death–if I did not act. For parents whose children aren’t engaged in this totally over-the-top behavior, it can be impossible to understand or empathize. People tend to think that if only we were better parents–stricter, more involved, more consistent, more something–our children would toe the line. Too often, the reality is that we are dealing with children who have mental illnesses that exacerbate their behaviors. Depression can really manifest itself quite differently in teens than in adults.

If the reality with your teen is looking grim, don’t wait to get help and to take action. Don’t wait for the other shoe to drop.

Here is a link to the helpful resources on the Partnership for a Drug Free America’s website: click here

Owen Jennings is just completing his sophomore year at Dartmouth. Don’t miss his compelling essay Sober in the Animal House in the New York Times. Make this must reading for your teenager….especially if college is not far off.

Drinking to excess has become a social crutch with consequences for young adults that can have far reaching consequences. Beyond the inherent and hopefully obvious dangers of alcohol poisoning, unwanted sexual activity, violence and addiction, some heavy-drinking teens actually fail to mature during this vital stage of growth and development. Lest I fall into clinical talk that fails to adequately capture the tragedy here, let me quote from one of the reader comments on the NYTimes’ blog posting:

For those of you [who] think that college alcoholism is a problem only for C-students and Greeks, I’m hear to tell you that in my experience, it cuts across all levels of academic success. Only one of my regular drinking buddies was in a fraternity and none of us had a GPA below 3.5. We’re now pursuing careers in law, medicine, business, chemistry, physics, social work, government and international aid.

So “no harm, no foul” right? Just kids being kids? Looking back on those wasted nights and their unfortunate consequences, not the least of which is forgetting how to socialize without drinking, I think it’s time for a change.

Rotten Little Girls is a blog written by two current college students who maintain their anonymity, but in an authentic voice share a viewpoint about college drinking. One says:

• “Pre-gaming” became a ritual and I attributed my new confident self to alcohol. Instead of being a relative wallflower like I was in high school, suddenly I had the confidence to go up to cute guys and hit on them, or talk to people who seemed cooler than I. Granted, I was friends with people I would now consider alcoholics or alcohol abusers, but I thought that beer and cheap vodka was the holy grail of social lubrication. I was fearless.
  

Koren Zailckas’ sadly moving portrayal (Smashed: Story of a Drunken Girlhood) about college drinking from a young woman’s personal experience was eye-opening for parents. I don’t know the impact it has had on kids’ experiences in college…. seems not much has changed from Owen’s account. Koren’s point in sharing her alcohol enmeshed adventures through high school and college seems to be captured in this quote from her introduction:

• “Nine years after I took my first drink, it occurs to me that I haven’t grown up. I am missing so much of the equipment that adults should have, like the ability to sustain eye contact without flinching or letting my gaze roll slantwise to the floor. …I should be able to stop self-censoring and smile when I feel like it. I should recognize happiness when I feel it expand in my gut…. Clinicians report some [of these] women, who seek treatment for alcoholism in their mid-to-late twenties, not only look younger but act younger too…it seems some women’s emotional development arrests as a result of alcohol. They stall at the age they were when they had their first drinks.”

(Smashed, preface, xvii – xviii)

I’ve shared this quote from Zailckas’ book previously, because this theme comes up over and over again. The ““unexpected consequences” aren’t limited to the car accidents, the blank memories, the nasty hang-overs; it’s sadder than that. It’s failure to launch into full adulthood.

Owen Jennings says “I realize that drinking is a way to rebel and revel in the newfound freedom that college brings. But it’s also a veil, a way to manipulate, distort and enhance who we really are.”

Try that line of argument as you talk with your kids about their drinking habits, and please share Owen’s essay and Koren’s book. Let me know if this gets their attention.

A good sense of smell goes a long way in determining if your teen is using alcohol or smoking marijuana, but it probably won’t help if prescription drugs are involved.Mary Bono Mack got my attention when she was on the talk-show circuit last week talking about her son’s drug addiction, noting that the lack of telltale odors made it more difficult to tell that he was using. There is a long list of well known families who have suffered with drug abuse and addiction, but this doesn’t only happen in famous families….it happens next door. Do you know that more teens abuse prescription drugs than any other drug except marijuana? How can parents tell if kids are abusing prescription drugs?

An excellent resource, PARENTS:theAntiDrug.com website shares some signs and symptoms that your teen might be abusing prescription and/or over-the-counter (OTC) drugs. They include:

constricted pupils,

slurred speech,

or flushed skin.

Parents should be alert to the following:

personality changes,

mood swings,

irritability,

excessive energy,

sleepiness

avoiding sleep,

sweating,

loss of appetite,

forgetfulness,

clumsiness.

Their website offers an innovative interactive house tour, impactful video messages, resources and conversation tips for parents. In addition, they have asked me to share this Q & A with you:

Q&A with Karen Reed, spokesperson for the American Pharmacists Association

Q: I hear about kids taking various pills – uppers, downers, painkillers, etc., that have been prescribed for their parents. What can those drugs do to teens who have not been prescribed those medications?

A: It is always difficult to predict what type of reaction teens will have to medication not prescribed for them, especially when we don’t know the dose they will abuse — and if it will be taken with other drugs or alcohol. Uppers can cause hostility, paranoia, or seizures. These drugs can affect motor skills, impair judgment, and affect the heart. Downers and painkillers can decrease concentration, impair judgment, and slow motor skills. Taking downers and painkillers in excess can also cause sedation and seizures. Imagine a teen driver under the influence of these drugs driving a motor vehicle — this combination could prove deadly as well.

Q: We keep cold, cough, and other over-the-counter medications in the house. What is the best way to monitor those medications?

A: Over-the-counter medications are safe and effective for some people when used properly under a medical professional’s guidance. However, the ingredients, when abused, can be taken to get high. Therefore keep them in limited quantities and monitor their use as you would a prescription drug. Never use them to help your teen or yourself sleep. Children (regardless of their age) mimic adult behavior. Be a good role model and never abuse OTC products yourself.

Q: My child has prescribed medications she takes regularly. How do I ensure those pills are not abused?

A: Keep track of the number of pills that should be on hand. Keep track of refills, lost pills, and request for refills. Paying close attention to use will help prevent abuse.

Q: My son tells me his friends take pills that aren’t theirs and sometimes take them when they’re drinking alcohol. What is the resulting effect and what can I tell him to scare him away from experimenting?

A: No one, adults or teens, should take medication with alcohol. Teens who are taking medication that is not prescribed for them are probably also taking excessive doses. And mixing that medication with alcohol could prove deadly for teenagers. The effect of the medication could be intensified, causing the teen to stop breathing or have a seizure that could be fatal. If this practice is combined with driving, others could be injured as well. The combination of medication and alcohol could lead to poor judgment that could cause serious injuries or worse. Teenagers often feel invincible. The combination of drugs and alcohol may intensify this belief.

Q: What are some of the signs I can look for if I suspect my teen has been abusing prescription drugs?

A: It is easy for parents to miss prescription drug abuse because mood changes, temper outbursts, changes in sleeping habits and interests are typical teenage behaviors. You can smell alcohol and tobacco and marijuana — you can’t smell pills. Watch for changes in grooming, habits, and interests. Watch for negative changes in school work, school attendance, and declining grades. Watch for increased secrecy, changes in friends, and increased needs for money. Monitor your own prescription drugs and encourage friends and family to do the same.

Karen L. Reed, the American Pharmacists Association’s national spokesperson for American Pharmacists Month.

The arrival of spring brings many opportunities for teens to celebrate at parties, proms and graduations. Parents want your teens to enjoy these special times, but history shows these celebrations can turn deadly in an instant. Can you guess what the single biggest influence is on whether teens use alcohol? It is parents. Parents have far more influence than you may believe. Use your influence to keep your teens safe this spring. Here are eight helpful tips:

1. Don’t try to be a “cool” parent. Parents who allow parties with alcohol are breaking the law and creating a dangerous situation for everyone. If you try to be cool and look the other way, you are giving permission for your teen to misbehave.
Action: Suggest and encourage activities that are fun for teenagers and keep them engaged appropriately and safely. Volunteer to drive or to organize such events for groups of your teen’s friends.

2. Help your teen make an escape plan. With your teen, create a code word that can be used to tell you he or she needs to be picked up immediately. If you help your teens save face they will trust and rely on you to help them avoid risky behavior. Try to brainstorm with them various ways to say “no” and get themselves out of bad situations.
Action: Talk with your teen to create a plan; role play how they can handle this. Assure them that you will pick them up at any time under any circumstances.

3. Define the rules and be consistent. Parents who provide clearly stated and consistent rules and expectations help kids make better choices. Your consistency will help your teenager stick to the rules.
Action: If your teen breaks the rules, apply consequences. Your teens expect this, and they value fairness. Failure to apply consequences makes you lose your credibility.

4. Be in touch with other parents. Know what is going on; don’t allow yourself or your teen to be duped. Parents who are connected with one another are more informed and better prepared.
Action: Call ahead to teen’s parties and make sure they will be supervised and safe.

5. Assess your own behavior. Do you always have alcohol in social settings? Is alcohol offered to every guest who arrives to your home? These are powerful messages to kids – and may not be helping to successfully teach them about alternative choices. Remember your teens are always watching you.
Action: Set a good example for safe ways to have fun.

6. Learn the danger signs. How do you know if someone has had so much to drink they need hospitalization? Will you recognize drug use? The answers to these questions are important, and you need to know how to recognize the important signs.
Action: Do your homework. Study up on these issues and know what is going on in your community.

7. Keep your communication open and honest. Parents and teens who are able to communicate openly and honestly create the environment in which they can discuss the dangers and temptations of risky behavior. This allows an opportunity for parents to help teens problem-solve and plan strategies to get out of potentially dangerous situations.
Action: Let your teen know that you are aware that using alcohol and drugs can be tempting. Demonstrate that your teen can talk to you about these issues honestly and that you can provide knowledgeable guidance without getting upset.

8. Strengthen your relationship. Teenagers who have a mutually respectful relationship with their parents are much more likely to engage in behavior that will maintain that relationship. Teens who have a positive relationship with their parents don’t want to disappoint them.
Action: Spend time together; invest in this relationship continually. Be someone your teen enjoys being around.

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An interesting discussion about teaching teens about alcohol use caught my eye over at Lisa Belken’s MotherLode at the NYTImes. Catch this from the comments:

“…I have relatives who go out of their way not to drink. They are “holistic purists” and their son developed a drinking problem at 16. They were in denial when I told them that their house was the “After-School Party Place”. And when they started finding the stashes of vodka bottles and beer cans… they started to realize there was a problem. Now they let him party all he wants and I ask them if they feel uncomfortable about what’s going on at their house when their not there. They say it’s normal teen behavior and that he’s “responsible”.

This seems so ironic to me and I worry about their son.”

This all-or-nothing approach strikes me as irresponsible, to say the least. Their “holistic purist” attitude may be dangerously ineffective with a teen who prefers experimentation and life in the fast lane, but giving a teen like this complete free rein is a cop out. These parents must not be aware of these facts:

In our entire population, alcohol dependence rates are highest among 18 – 20 year olds.

Teenagers who have started drinking by age 15 are four times as likely to become dependent on alcohol as people who begin at 21.

Those two reasons alone should be enough to make parents intervene and apply some reason and good judgment. Teens like the one in this story don’t seem to be able to show good judgment himself, so wouldn’t a caring and tuned-in parent want to apply more influence?

It’s not difficult to find news stories circulating about suburban teens using drugs, alcohol and what have you. The latest such story from a wealthy suburb outside of Hartford, CT made me recall a recent conversation with a mom whose 28 year old son is struggling to make it on his own. We’ll call him Tom. He’s affable, kind, and bright, but he has yet to graduate from college after no less than five attempts. He’s not quite able to support himself, he seems emotionally and socially behind most of his peers, and he’s never had a mature loving relationship with a young woman. (No, he’s not gay.) These things worry his mom greatly, as she wants nothing more than for him to be the wonderful, mature man she believes he is capable of being. He is 27. It’s time.

What’s this got to do with the title of this piece? It happens he comes from a community much like the town mentioned in this article, which may be why it jumped out at me. Tom’s mom attributes his developmental delays and emotional problems to the alcohol and drugs he consumed during his high school years. She knew he was drinking (and more) at the time, and felt she was handling it correctly by allowing him and his friends to indulge in her basement – so they weren’t out driving. Looking back on it now, she wishes she had managed things very differently. Tom and his various therapists all feel that his delayed developmental state is due to his alcohol and drug use in high school.

Parents who worry about teens and risky behavior usually focus on the car accidents, the overdoses, and obvious life-threatening consequences of the abuse of drugs and alcohol. But sometimes the consequences are much more subtle and insidious. When teens use alcohol and drugs they are doing so at a critical time of development…and this can interfere with and even delay their normal development in very significant ways.

Koren Zailckas in her 2005 shocker Smashed: Story of a Drunken Girlhood spoke about this eloquently:

“Nine years after I took my first drink, it occurs to me that I haven’t grown up. I am missing so much of the equipment that adults should have, like the ability to sustain eye contact without flinching or letting my gaze roll slantwise to the floor. …I should be able to stop self-censoring and smile when I feel like it. I should recognize happiness when I feel it expand in my gut…. Clinicians report some [of these] women, who seek treatment for alcoholism in their mid-to-late twenties, not only look younger but act younger too…it seems some women’s emotional development arrests as a result of alcohol. They stall at the age they were when they had their first drinks.” (Smashed, preface, xvii – xviii)

Adolescence is a time of critical development; essential developmental learning must take place on numerous fronts. Teens learn who they want to be, they learn what they value in themselves and others, they develop confidence and social skills…. but if they are experiencing most of their social outings through the cloudy haze of alcohol or drugs, they may fail to grow – and even fully feel -these essential experiences.

It’s another take on why just taking the keys away from the kids isn’t such a great strategy.

Food for thought.

“My daughter seems angry most of the time,” I read in the email from a worried mom. “I often don’t know what has her angry, and if it weren’t for that I’d think she was great. She does well in school, she’s busy and successful in her many activities….I think she lives a charmed life! So why do I feel in my gut that something is wrong?”

Gut feeling and intuitive hunches count a lot when you are trying to assess your teenager’s behavior and understand it. This mom probably really is onto something, and it’s worth revisiting the important topic of depression in teenagers.

Depression isn’t always easy to spot or even diagnose in teenagers. This may surprise you, but depression in teens can present as anger or irritability, in addition to the more usual appearance of sadness. And mixed in with the common ups and downs of adolescent behavior, parents can find it too easy to write off problematic behavior as a passing phase. This can be dangerous.

It’s not always easy to determine which is the cause and which the effect, but depression is often linked with vulnerability to drug or alcohol abuse and other destructive behaviors such as self-injury and eating disorders. If a parent feels in your gut that something might be wrong, it is vitally important that you take action to help your teen seek assistance.

Families for Depression Awareness is a non-profit that provides help and support for the family members of those dealing with depression. In one case study on their site dealing with a 17 year old, they tell about his parents’ initial denial, and about his difficulty in putting into words how he was feeling. Kids facing depressive illness may be in the impossible position of being expected to describe how they feel…a task in which they are unlikely to be able to succeed. Families for Depression Awareness offers a free mood questionnaire you or your teen can take which can help you assess if professional advice should be sought.

The challenge of diagnosing depression is increased because the symptomatic behavior that can signal depression is the same list of behaviors most teens are likely to exhibit at one time or another.
Symptoms of teenage depression include:

• depressed or irritable mood
• decreased interest or pleasure in activities
• change in appetite or weight
• sleeping more or less than usual
• fatigue or loss of energy
• feelings of guilt or worthlessness
• decreased concentration
• substance abuse
• recurrent thoughts of death or suicide

Your intuition about your teen’s overall mental health will inform your initial assessment. A parent may pick up a sense from your teen about a fundamental change or shift that doesn’t feel right, or you may see worrisome behaviors such as those in the list above that last more than two weeks….two weeks is the guideline the professionals use beyond which you begin to take action. Another assessment guide for a parent is to compare your teen’s current behavior to her past behavior and make note of the duration, intensity and frequency of the behavior. Obviously an increase in any or all of these will be cause to take some action.

Teens who appear angry, irritable and different from the child you used to know, may indeed be dealing with depressive illness. Depression can take a toll on a teen -even one who continues to bring in good grades and participate successfully in outside activities. So, listen closely and tune in to your teen. If you have reason to be concerned, gather input from others who interact with your teen on a regular basis, and don’t hesitate to call a a school psychologist, guidance counselor, physician or therapist if you have any reason to wonder.