It’s everywhere – visiting specialist addresses mental health on Island

Dr. Lisa Machoian is a nationally recognized expert on adolescent mental health. — Photo by Nathaniel Horwitz

Dr. Lisa Machoian met with teachers, students, and parents during a four-day visit to the Island last week to confront growing incidences of stress and anxiety in adolescents. Dr. Machoian speaks at medical schools nationwide and appeared on behalf of the Department of Health and Human Services and the American Foundation for Suicide Prevention. She earned a masters degrees in counselling and a doctorate in human development and psychology from Harvard University.

Dr. Machoian’s specialty is teenage girls. “Girls tend to have higher rates of anxiety than boys, in adolescence, because of the psychosocial pressure,” she said during a presentation in the Regional High School auditorium on Tuesday, March 11. “The value on girls and women still has a lot to do with what they look like, rather than who they are as a person.”

She wrote “The Disappearing Girl: Learning the Language of Teenage Depression,” the first book to focus on the subject.

“I worked at a hospital, and what I’d learned during my masters degree wasn’t being applied in any way to clinical or educational environments,” she said in an interview with the Times. “The research was out there, and I wanted to integrate it into treatment and understanding.”

Theresa Manning, Co-coordinator of the Youth Task Force (YTF), was instrumental in bringing Dr. Machoian to the Island. “She’s a tremendous resource,” said Ms. Manning in a telephone conversation with the Times. “She has great expertise that our community will benefit from.”

Dr. Machoian kicked off her visit with the presentation at Martha’s Vineyard Regional High School. “We see higher rates of depression and substance abuse on the Cape and Islands,” she said at the beginning of the event. She attributed the increase, in part, to “a combination of the isolation and the lack of natural light.”

During the two-hour presentation, she addressed issues from suicide and self-medication to cyber-bullying and peer pressure to perform oral sex, with a focus on the dangers and treatment of anxiety and stress in adolescents. “A little anxiety is normal, a little can motivate people,” said Dr. Machoian. “Too much can cause overload, and that’s when we see kids developing anxiety disorders.”

These disorders, which have been on the rise nationwide according to the Department of Health and Human Services, result in a host of negative behaviors whose cause is often overlooked.

Part way through her presentation, Dr. Machoian answered a question that teachers had been asking before the presentation. “What is stress?” she asked rhetorically. “Stress is pressure that impacts sleep, eating, focus, school functioning. It leaves kids fatigued, with an inability to get things done, and affects their relationships. It can do enormous damage.”

Her presentation alternated between a discussion with the audience of high school faculty and community members, the relating of emotional anecdotes about troubled adolescents, and a slideshow detailing the causes, effects, and treatments of anxiety disorders.

Dr. Machoian invited the audience to ask questions or comment on the subject, and received several responses.

Sue Larsen, education director at the Dukes County House of Correction, hoped Dr. Machoian would speak to the high school student body. “Even a kernel of what you’re saying, if they took that home and said, ‘that makes sense, I should try that,’ could be so helpful,” Ms. Larsen said.

Dr. Machoian responded that she wants to create an ongoing connection with Island youth. She met with the high school’s student support group, Peer Outreach, the following day.

MVRHS vice principal Matt Malowski addressed the involvement of technology in the growth of anxiety disorders at the high school, which several teachers claimed was worse this year than ever before. “The zero tolerance policy didn’t work,” said Mr. Malowski, who helped overhaul the way the school handles mobile devices. “A student would rather take a three-day suspension than hand over their phone.” He also highlighted a lack of education on the topic. “Schools teach about drug use and sex, but no one is teaching about social media,” he said.

High school science teacher Jacqueline Hermann echoed this. “For girls and boys, we’re not teaching social development,” she said.

Dr. Machoian, who believes that social media use is developing from a habit into an addiction, agreed. “There definitely isn’t enough education,” she said. “There are higher and higher correlations between depression in teenage girls and using Facebook, Twitter, Snapchat, Instagram, Tumblr, sites their parents might not even know exist. The way they hurt each other is through inclusion and exclusion: they may put up a picture of a bunch of girls, and another girl will see it and feel left out. All I can do is recommend parents limit time spent on mobile devices, especially at night.”

Although Dr. Machoian specializes in the mental health of teenage girls, she addressed both genders in her presentation, especially the struggle boys face in voicing their emotions.

“A boy can’t say, ‘Mom I’m struggling, I’m smoking weed every day and I’m getting depressed,’ and he begins to turn to driving recklessly or self-medicating instead,” she said. “What they’re trying to do is regulate how they feel, without seeking help.”

The most important cause of anxiety she identified was family altercations. “The largest risk factor is a background of trauma or abuse, divorce or conflict,” she said. “Family problems are huge stressors for kids.”

Dr. Machoian ended her presentation by advocating solutions for excessive stress. “Sleep, eating, and exercise are the three most effective treatments for stress,” she said.

“High but reasonable expectations are important,” she pointed out. “It shows that you believe in them. So does rewarding achievement.”

Lucy Hackney, a former children’s lawyer, added that the examples adults set are vital. “People talk about the kids, the kids, the kids, but the kids need models,” she said after Dr. Machoian’spresentation. “I’m here because it’s important for me to learn more. Children have been my life.”

Dr. Machoian had a packed schedule last week. After presenting to the high school faculty, she gave a similar presentation to middle school faculty, in back-to-back two-hour hour sessions. Wednesday morning, March 12, she met with high school staff including guidance counselors, the nurse, and the assistant principals, and then girls grades 9 through 12 who are part of Peer Outreach, a student support group.

Mary Ollen, a senior at the high school who attended the discussion with the girls in Peer Outreach, thought that Dr. Machoian was excellent. “Her presentation gave us more perspective. It was revealing what other girls, who you wouldn’t normally talk about these things with because you’re not close friends, had to say. It showed you that you’re not alone, that everyone is dealing with stress and pressure.”

On Wednesday afternoon, Dr. Machoian spoke with representatives from the YMCA, Community Services, and the YTF, before returning to the Performing Arts Center to present again, this time to parents and community members. Thursday, March 13, she visited students and teachers at the Charter School, before attending a YTF Coalition meeting. Finally, on Friday, March 14, she finished her Island visit performing grand rounds at the M.V. Hospital.

Lisa Knight, a physical education teacher and girls field hockey coach at the high school, was thankful for Dr. Machoian’s visit. “We should have done this years ago,” she said. “I see stress and anxiety every day, in all groups. It isn’t just the kids on varsity sports teams or in honors classes. It’s everywhere.”