Decaf with low-fat milk.
3/13/16 by Stacie McLean
It’s not just a saying: Watching your child suffer is the single hardest thing you are called upon to do as a parent. When their moods and behaviors get your Parent Senses a-tingling, you may hear yourself asking these questions:
1) Are they in some kind of trouble?
2) Are they involved in drugs and/or alcohol?
3) Is this just a difficult breakup?
4) They never listen to me anyway; is this just another phase?
Many parents, maybe even most parents, come to me worried that something is wrong, but they are often convinced it is primarily a disciplinary issue. Their child is being difficult. She’s acting sick for attention. Teenagers are dramatic, this is probably just normal for his age. She doesn’t care about her grades. He’s so fixated on this girl.
You’ve probably developed a certain tolerance for bumpy patterns of behavior. After all, your child is a teenager and teens certainly can be dramatic. A tough upset here and there that seems to resolve is nothing to be too worried about as long as your kiddo comes back to you and you can reconnect in some fashion.
If you start to notice a shifting pattern, however, and your teen seems to drift further away from you as their behavior gets harder to understand and even scarier, take stock.
The first things I want to know when I see your kiddo is:
- How long has this been going on?
- Was there a particular trigger?
- Are there any ongoing stressors at home: An absent parent, a blended family change, substance abuse, a blaming/shaming family pattern? (For a really good picture of what the blaming/shaming pattern can do, see the work of Brene Brown, Ph.D.).
- Is there ANY history of mental illness or substance abuse in your child’s genetic heritage? Look for clues: “Aunt Sally had a nervous breakdown,” “My dad was an alcoholic,” “My mother-in-law was just crazy. Seriously. She should have been hospitalized.” “My brother has a drug problem.”
Be aware that a pattern of drug abuse in families may be a form of self-medication; there is often a mood or anxiety disorder that has gone unrecognized and drugs/alcohol are a form of easing the pain. If this is the case, don’t dismiss the possibility that your child may have inherited symptoms of this pattern.
Here are some tips to help when you get the nagging sensation that something is really wrong:
- DON’T PANIC! The instant you panic, your teen will stop trusting you. Period. If you have already acted in panic, redirect the panic to another adult. Shield the kid.
Realize that help is available. Even if you are worried about your child being “labeled” or “diagnosed,” it’s okay. It’s a perfectly understandable fear. No parent wants to think their child will get stuck with a label or sickness. But here I want to be very clear: DO NOT LET THIS STOP YOU FROM GETTING YOUR CHILD THE HELP HE/SHE NEEDS. A diagnosis is just a description of what is happening in this moment in time. It helps clinicians understand what is happening, helps insurance companies understand what they are responsible for covering, and helps doctors understand what to prescribe, if anything. A DIAGNOSIS IS NOT A LIFE SENTENCE!
2. Don’t automatically assume that your child is being dramatic or difficult. This will lead to 2 probable outcomes, neither of which is productive. Some parents try to shame their child into behaving, “Stop acting crazy. Pull yourself together! You’re just not listening to me! It’s like you WANT something to be wrong!” This just makes their pain more intense and drives them away from you. Some parents may try to use natural consequences, but if these parenting techniques are not working, consider that your child is not processing information and emotions like they usually do. Emotional or mental illness is not a teaching-and-learning issue; it’s a brain chemistry issue. Trying to teach consequences isn’t going to fix it.
3. Remember that your child didn’t ask to feel this way. It is not something they are doing TO YOU. Even though learning about difficult emotions is a normal part of adolescence, persistent feelings of anxiety, depression, or big, scary mood swings are NOT a normal part of adolescence.
4. ASK, ASK, ASK. If you have any kind of relationship with your child at all, even if you wish it were better, your teen still values your feedback, presence, and opinion. This means you can (CALMLY!!) use your leverage to ask if your child feels like harming themselves, is hearing voices or seeing things, or wants to hurt anyone else. A caring, neutral tone is critical in this conversation. If they sniff out that a disclosure of this sensitive information will lead to any kind of punishment, shame, blame, or panic, they will clam up. If they can tell you that this is happening, reassure them it’s going to be okay, it won’t be like this forever, and get them to a counselor, psychologist, or psychiatrist right away.
5. If you are at all concerned they might hurt themselves or someone else before you can get in to a provider OR if they are hallucinating, take them to the emergency room right away. Again, do yourself and your kiddo a BIG solid: Don’t panic. Just be calm and insistent. If you panic, they will instantly learn it’s not safe to trust you with this kind of info and they will stop cooperating. If you are panicking inside (parents are human!!), save it for a partner, friend, or other support person.
6. DO NOT blame, shame, or dismiss their concerns. Instead, reassure them that it’s okay, and it happens to lots of people, and they won’t feel this way forever (notice I used that again — you should, too). Now that you know about it, you can help. NEVER, EVER tell your teen that something is “just a phase.” Even if it does change later, it’s very real to them when they are experiencing it. There is nothing useful at ALL about trivializing their feelings in this way.
Realize that this is going to be an inconvenience. There are appointments, costs, and emotional upsets that will come and go. But it will be okay. You will have experienced professionals to help guide you through the maze.
In cases of anxiety and depression, take your teen’s feelings about medication seriously. YOU may have fears about stigmas and brain development and big pharma, but if your child is feeling crappy enough that they are willing to try, my advice is to let them. This is their journey; they must walk in their own shoes. If they are resistant and you feel like it can help, assure them you will look for someone who is willing to try psychotherapy first, then if that doesn’t work, you can revisit the meds conversation. Most psychotherapists are willing to go that route as long as there is no imminent danger.
If you child is experiencing psychosis (delusions or hallucinations) or has been diagnosed with bipolar disorder, meds are pretty much a non-negotiable. Standard of care is that they are, in combination with psychotherapy and psychoeducation, a first line of treatment. It’s like diabetes: no amount of patient education will make the pancreas start playing nice. Same with the brain in these cases.
The biggest peace of mind that I want to give you, though, is that no matter what you find out when you take your kiddo in to get some help, it won’t be as scary as NOT addressing the problem. You don’t have to wait until your teen starts cutting, experimenting with drugs, running away, or contemplating suicide or homicide before you get involved. If it’s already at that point, help is just a phone call or a drive to the hospital away.
Don’t fear that your child’s condition will preclude her or him from living a happy, fulfilling life. People learn to live with chronic health conditions all the time and still love being alive and waiting to see what tomorrow will bring. The sooner they learn to manage it, the easier it will be for them. In addition, treatment has advanced so much in the last 10-20 years that their journey will look very different from your older relatives’ journey.
They may also be one of the lucky ones who just need to learn to manage situational episodes now and again.
But get to the bottom of it. Don’t panic, don’t blame & shame, and don’t wait. Your kiddo will thank you for it in the long run.