By Dr. Anthony Policastro

I saw the play Dear Evan Hansen on Broadway. It was a depiction of adolescent angst. There were a lot of themes about how difficult it was for some adolescents to find their way. They did a good job of showing that. When the play was over, I felt that I had just spent almost three hours in my office seeing adolescent patients.

We sometimes do not realize that some of the ways that adolescents deal with their issues appear to be different. However, they have a common theme. That theme is trying to find a way out. Unfortunately, these young adults do not always pick the healthiest way out.

We know that experimentation with alcohol and drugs is something that is common in adolescence. For many of them, it is nothing more than experimentation. However, during that experimenting, some of them see being high as more than that. It becomes a way to escape the everyday pressures that they see.

These pressures may come in the way of trying to fit in. They may come in the way of getting picked on via social media. They may come in the way of physically being bullied.

You don’t have to think of that pressure when you are high. Therefore, the drug and alcohol use become more than just experimentation. They become a way of getting away from teen pressures.

I have previously written about how this area has changed. Street drugs once were just a way to get away from it all. Now many of them are laced with Fentanyl. Therefore, the plan to just get high might actually be fatal.

Other adolescents find that the pressures are at home. Some of them are physically or sexually abused. They find that the way of getting out of that situation is to physically run away.

I had a 15 year old patient when I was a resident. She had been sexually abused by her father. We had treated her for her psychiatric issues related to that. When I took the trolley to work, I had to walk from the station to the hospital. That took me through the seedy area we called the combat zone.

One day I was walking to the hospital. There was a pimp with group of his hookers across the street. All of a sudden I heard this voice call out: “Hi Dr. Policastro,” it was my ex-patient. She had physically run away from her father at age 16.

There is a third way of getting away from adolescent pressure that is the ultimate running away. That group commits suicide. That is the only solution that they see available.

We may not look at drug use, running away from home and suicide as related in adolescents. However, they are all ways of getting away from adolescent pressures. They are more related than we think. Dear Evan Hansen focuses on a suicide of one of the teens. However, much of the time is spent dealing with all the pressures that adolescents face every day. We have a tendency to ignore them. We just wind up criticizing their coping behaviors.