Sunday conversation with … Dr. Stephanie AddisonMedical adolescent specialist says communication is key with teens

Dr. Stephanie Addison, assistant professor of pediatrics at Emory School of Medicine, doesn’t just like teenagers, she specializes in them. As in she spent three years following her pediatric residency pursuing a specialty in adolescent medicine. This past September, Addison became director of the new Children’s Healthcare of Atlanta Adolescent Health Clinic at Hughes Spalding that sees teens with issues ranging from eating disorders to depression to acne. She talked about the need for the clinic and why, for Pete’s sake, she chooses to spend her day with teenagers. “They are a vulnerable population and at the same time, they are resilient,” she said. “They are growing and open and you can still make an impact on their lives.”

Q: Why is the clinic needed?

A: Teenagers need their own space. They need a provider who is comfortable taking care of them.

Q: What issues are specific to teenagers?

A: They may be around sexuality, pregnancy, drug use, sexually transmitted infections, eating — both eating disorders or overeating. Some teens have chronic medical conditions around coping or medication adherence, puberty or growth concerns, depression and ADHD.

Q: Are adolescents underserved?

A: They are definitely underserved and we miss opportunities to serve them. When they are young, they go to the doctor all the time for vaccines but then that falls off. There are teenagers who have not had a regular physical in years. Many teenagers are healthy but there are a good portion who need support during this time of change.

Q: How can you tell if a teenager needs to see a doctor or is just going through normal adolescence?

A: One in five teenagers will have a diagnosable mental health disorder. You can distinguish between a depressed teenager and a normal teenager because a normal teenager is going to have ups and downs. They are not going to be sad or angry or withdrawn all the time.

Q: Do teens need a doctor who specializes in adolescents?

A: Less than one percent of teens are seen by a medical adolescent specialist. There are not enough of us and there are so many teens. One of the biggest impacts we can have is training medical students and residents to be comfortable taking care of teenagers.

Q: What kind of patients do you see?

A: It is a mix. I’ve seen a teenager with sickle cell, patients who have been victims of violence in their neighborhoods, healthy teens who want to go into the military. I have seen a quite a few Spanish-speaking families who have immigrated and want to establish health care. I see teens with depression and mood disorders.

Q: What are the toughest cases to treat?

A: Eating disorder patients are difficult because when they look in the mirror they see something you don’t see. It is a long therapeutic process with those patients. Taking care of perinatal HIV teenagers born with something they had nothing to do with is tough.

Q: What are some of the easier cases?

A: Acne. It is relatively easy to treat. And it is huge because it affects self-esteem.

Q: Seems like adolescence is starting earlier and earlier. Is that the case?

A: Usually you think of adolescence as starting with puberty but young people are exposed to a lot through TV and social media. I do feel like society had become more sexualized but that doesn’t mean that the conversation has gotten any better.

Q: What is the key to raising a teenager?

A: Communication, having an open door policy. If they have a concern about anything going on, they need to know they can come to you.

Q: Do you like teenagers?

A: I am the one of the few people who does. I can see teens who are homeless or going through the worst thing and yet, they still have great dreams and aspirations.

The Sunday Conversation is edited for length and clarity. Writer Ann Hardie can be reached by email at ann.hardie@ymail.com.

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