At first glance, Maddie seems to be a typical teenager. She paints her nails, attends high school and spends time with friends. She has a big personality you could bask in for hours and dreams of becoming a nurse.

But at age 8, she experienced her first panic attack.

Now 17, she is no stranger to the complex world of mental health challenges. She deals with chronic severe depression and anxiety, along with post-traumatic stress disorder. "I knew [when I was a child] I had struggled with anxiety and depression because of what happened in my own life. Losing my mom. Dad's in and out. A lot of things that I shouldn't have had to go through as a young child, just play over and over in my head."

Maddie is not alone in facing mental health challenges. Nearly 50% of youth in the United States, ages 13-18, have a mental health disorder; youth also face higher rates of co-occurring mental health disorders than adults. Anxiety, depression, post-traumatic stress disorder and substance abuse can be common for teenagers, which can lead to significant turmoil in their lives at pivotal growth milestones. Perhaps typical might need to be redefined.

On anxiety and depression

At a young age, Maddie began to lose significant support pillars, including her grandpa and mom. She often felt purposeless. Her home life wasn't always safe. Major negative events began to take a toll on her mental health. Eventually she turned to substance use to numb her negative experiences.

For Maddie, anxiety and depression are constant, built into her daily routine. She wakes up, checks her phone, gets ready and heads to school-but there are thoughts she can't quite shake. "I'm worried about what other people are thinking. I'll bet you that person hates me," she says, "I can never win in my own head."

She can start to feel angry or overwhelmed, especially at night. "It hits the worst when I'm alone. Being alone at night is really hard," she says. Anxiety and depression often feel like a losing game. No matter how many rounds she plays or different paths she chooses-they are always there to trip her up.

The anxiety is unrelenting, gnawing away at her confidence and attempting to spread lies about her only she can hear. The repetition of these thoughts makes for days of confusion, doubt and exhaustion. Over time this breaks her down and allows the depression to seep in. The weight is heavy, full of emptiness. When the depression gets unbearable, the spiral begins to take hold-creating a new game of survival in her mind. Even small interactions or tasks, like speaking with a peer or participating in class, can feel impossible. This cycle reminds her that she's haunted by traumas and losses that sometimes feel too big to face.

Turning to substances to cope

After her grandpa's passing, substance use was prevalent. "He was my home and when it got ripped away from me, it sent me down a huge spiral, which started my addiction," she says. She was aware this was not the right way to deal. "I'll be honest-addiction didn't really help. It was just a way to block out what was going on." She used psychedelics, alcohol and prescription drugs during this time. "When I started using, I thought that I could get away with it. My dad was an addict, and nobody noticed him. But I didn't think about the fact that, you know, [addiction] killed my mom."

She started down a path toward someone she didn't quite recognize, even though the signs were right in front of her. "In my head I was able to justify it. 'I'm not an addict-they were addicts. That's not me!'"

But life soon shifted. Others shared a growing concern for her well-being, which led to a confrontation with a family member.

Rebuilding her community

Maddie was sent to rehab. This was the wakeup call she needed, and it put her on a course toward bettering herself. After rehab, she used therapy and medication to help support her mental health. Although she still finds these difficult to get right, she remains hopeful that it won't always be that way.

Maddie now attends Harmony Academy, a high school dedicated to providing a safe, sober and supportive educational resource for youth in recovery. In a search for more resources, she found 4D Recovery, a youth center providing peer-based recovery services, social and familial support, and outside-of-school activities. With access to these life-defining spaces, Maddie can take on her mental health without the obstacle of substance abuse. "You can't build a house on shaky foundation. When you have that foundation of trauma, you can't just build new experiences on it," she says.

Maddie is still working on achieving her ideal reality and has come a long way. She is persistent in finding ways to get through it all.

Outside of clinical care, she has many coping mechanisms and supportive people in her life: She has her family and her boyfriend and enjoys watching TV, cooking and making tea to self-soothe. The resources and mentors at 4D Recovery and Harmony Academy remind her that she is not alone in her experience. At night, if the lonely creeps in, she gives her dog a treat in exchange for much-needed cuddles.  

Perhaps most important, Maddie has her 'comfort person', someone she finds integral to her growth. "She's someone I can trust, and I can say that with my heart," she says about a fellow 4D Recovery peer. She draws on that as she continues to build her community. "I'm always there for my friends. If you need anything, you can always come to me," she says, "there's help, you just need to find the right person."

Maddie has found that other teenagers going through similar situations are looking for connection, understanding and dialogue from their peers—something she believes is most important in coping with mental health challenges.

Advice for parents of teens

Maddie has some clear advice for parents helping their children to navigate the challenges: “Don't yell at your kids for not knowing how to deal with things. Don’t tell them it isn’t real. Show them support but don’t force mental health treatment—it’s not going to work if they don’t want it,” she says. Teenagers dealing with complex emotional states and without the proper support from parents are more at risk for poorer physical and mental health.

Maddie has found that while substance use doesn't help with this process, pressure or lack of support from parents doesn't help either-it widens the rift in relationships. When your teenager comes to you about these challenges, avoid getting angry and instead focus on listening, she advises. Take time to cool down before reacting to highly emotional situations. It can be the difference between a healthy and unhealthy interaction with a teenager-thus helping to lay a better foundation of trust and communication moving forward.

Reintroducing Maddie, the optimist

Now more than a year in recovery, Maddie is making the progress she hoped for and feels confident in her recovery process and her ability to support her mental health. She is assured and excited to share her journey with others. She laughs, hypes up her friends and gestures wildly with her hands while talking. It’s not always easy working through her mental health day-to-day, but she has found an outlook worth sharing. “I still get anxiety and depression, but it gets easier. Today is a new day. Tomorrow's going to be a new day. I’m trying to stay in the present.” This typical teenager has great things ahead of her.

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CareOregon is a long-time community partner and supporter of 4D Recovery Youth Center.

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If you or someone you love is struggling with mental health, or in recovery, visit us online to learn more and find resources. Nếu quý vị là hội viên của gói Oregon Health (OHP), chúng tôi sẽ chi trả cho nhiều dịch vụ khác nhau. Learn more on our Mental Health and Substance Use Treatment page.