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Ages & Stages

What’s Going On in the Teenage Brain?

By: Andrew Garner, MD, PhD, FAAP

A growing child's body goes through physical changes that are obvious to all parents. Less obvious are the vital changes taking place in a child's brain, particularly as they enter their teenage years. The brain, after all, is a part of the body and, more importantly, it is the organ that controls—or tries to control—the body's activities.

Teens often confront many challenges, pressures, temptations and sources of stress before their brains are fully developed. It's not just that teenagers haven't had the time and experience to acquire a wide sense of the world; quite simply, their brains just haven't physically matured yet.

Brain development in tweens & teens

Dealing with pressure and stress is no small challenge for a fully mature brain. So, it can be much trickier for a brain that's in transition from childhood to adulthood, and from concrete to abstract thinking. It's important for parents to understand the changes a child's brain is going through as they monitor—and often worry about—their children's social, academic and emotional challenges.

How brain growth affects adolescent behavior

Different children's brains develop at different speeds, just like their bodies do. Not only that, brain scans show that different parts of the brain mature at different rates. In fact, some parts of the brain, like the prefrontal cortex, do not appear fully mature until 24 years old! Other parts of the brain, like the walnut-shaped amygdala that sits deep in the brain, appear to be fully mature much earlier.

Many neuroscientists think that this mismatch in brain maturity may explain much of adolescent behavior. For example, the prefontal cortex plays an important role in regulating mood, attention, impulse control and the ability to think abstractly. This includes both the ability to plan ahead and to see the potential consequences of one's behavior before taking action.

The amygdala, on the other hand, is activated by potential threats and strong emotions like fear and anger, leading to "fight or flight" behaviors, aggression and reflex-like responses. Neuroscientists have long thought that the mature prefrontal cortex regulates the amygdala, putting a break on emotional, aggressive, or instinctual outbursts. But the reverse seems to be true as well: when the amygdala is activated during emotional experiences, it shuts down the prefrontal cortex.

Risky decisions: when the prefrontal cortex can't keep up

The fact that the amygdala matures, or "finds its voice" sooner than the prefrontal cortex may be one reason that adolescents tend to be more moody and impulsive. While the prefrontal cortex does function during adolescence, it may be more of a whisper—particularly when the amygdala is screaming—until it matures later in life.

That difference in brain maturation can have tragic consequences. If you ask teenagers whether it is a good idea to get into a car with friends who are drunk, most will ay, "no way." That's the prefrontal cortex talking.

In calmer moments, the prefrontal cortex is able to think abstractly and see the potentially dire consequences of drunk driving or other risky decisions. But in the heat of the moment when their peers are anxiously waiting for them to get into the car, the relatively more developed amygdala screams "just do it" before the PFC knows what happened. The same process might pay a role in teen violence, substance use, and even suicide.

Managing extreme emotions & behavior in teens

Extreme behavior and emotions clearly call for professional support, especially as teens face an ongoing mental health crisis. But it's also true that all adolescents have at least occasional outbursts or episodes of misjudgment. Teenagers are human, after all—and so are their brains.

Here are three important ways you can help your teen get through the transition to adulthood:

1. Helping teens slow down & think things through

Knowing that a teen's behavior may reflect a normal part of brain development, parents can help. We can get them to slow down and help them think through what they are doing.

But to do that, we need to regulate, relate, and then reason. First, we need to regulate our own emotions. If we are scared, upset or angry, we will likely trigger their amygdala and end up with a teen who is also scared, upset or angry. Once we are calm, we can try to relate to what the teen is experiencing. Feeling heard or being understood may help the teen to calm, to turn off their amygdala, and to engage their prefrontal cortex. Only then can we actually work with them to begin reasoning out what the potential options and consequences might be.

2. Focus on the future

Having a plan for after high school can help. That plan will likely change, so it is not that we expect teens to have their entire life mapped out. But a future orientation helps teens to tolerate the bumps along the way and to remain hopeful about better days ahead. Having that future focus is a good predictor for transitioning through adolescence well, as it may be a good marker for prefrontal cortex functioning and the ability to handle abstract thought.

3. Watch for signs your teen needs more support

Be alert to the warning signs of emotional problems—whether or not those problems are directly related to brain development. As long as teens are still social, sleeping, eating and exercising well, and have future goals that they're working toward, then I'm reassured that they are maturing appropriately.

If, on the other hand, they are withdrawn or acting out, not eating, exercising or sleeping regularly, or are letting their grades or dreams pass them by, then I would encourage parents to talk with their child's doctor to see if some additional supports might be helpful.

More information

About Dr. Garner

Andrew Garner, MD, PhD, FAAP is a Clinical Professor of Pediatrics at Case Western Reserve University, and a primary care pediatrician with University Hospitals Medical Practices in Cleveland. A member of the American Academy of Pediatrics (AAP) Section on Developmental and Behavioral Pediatrics, Dr. Garner is co-author of the AAP policy statement "Preventing Childhood Toxic Stress: Partnering with Families and Communities to Promote Relational Health." In addition, Dr. Garner is co-author of an AAP-published book, Thinking Developmentally: Nurturing Wellness in Childhood to Promote Lifelong Health.

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American Academy of Pediatrics Section on Developmental & Behavioral Pediatrics (Copyright © 2023)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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