15
Apr 24

Factors That Can Delay a Teen’s Emotional Recovery

Teenager“Keeping your depressed teen busy will energize them and stimulate their interest in life.”

Parents often feel that their teen has not returned to normal even after treatment for depression. It may seem like your teen can’t put the illness behind them and move on with life. For example, they may continue to sit in their bedroom playing video games, refusing to go out with friends or join school clubs. You may find yourself asking, “Shouldn’t he be better by now?”

Medically, he may be. But there are some factors that can keep a teen “stuck” even after depression has cleared up. This article explains some of these factors and provides ideas to help push your teen toward a more productive state.

Identifying With the Illness

If your teen was depressed for a long time, that state may have come to feel normal. Keep in mind that the illness was probably building for some time before you or they became aware of it. Two years may not seem long to you, but to the sixteen-year-old, it represents an eighth of their life. They may not even remember what life was like before the illness. Going through old photographs, family videos, or revisiting a special place can help stir up the way that normal used to feel for your teen.

Do not be afraid to gently confront your teen with the fact that they are not showing the signs of recovery you expected. Say something like, “I’ve noticed that you’re still doing similar things to those you did when you were ill, like playing video games and avoiding friends. We had talked about you joining the chess team or calling some of your old friends. Do you feel like it’s been difficult to get back into the swing of things?”

The question may take your teen by surprise. They may have never noticed that they are stuck. If so, remain gentle. Realizing that there is a problem is the first step forward. They may not run out to join a club or pick up the phone to call friends right away, but give it time. This is going to be a process. Be patient and, above all, encouraging.

If your teen disagrees that there is a problem, ask them to think about it and say you’ll bring it up again in one week. They clearly are not going to do anything about it on their own, so you must push them. The next time they see the therapist, go in with them and bring it up briefly, then let them talk about it. If your teen has stopped therapy, it’s possible that they told the therapist they feel better. It will be up to you to let her know that things are not okay.

When your teen is ready to admit that they need to move forward, have them tackle one thing at a time. They can attend a chess club meeting just to see if they like it, not necessarily to make a commitment to join. Change can be stressful, but a single weekly goal is manageable. Over time, you can remind them how uncomfortable they were walking into that first chess club meeting and how now they think nothing of it. Reassure them that today’s challenge will become a matter of ease before long too.

Lack of a Goal

Even if your teen had not experienced depression or another illness, they may have lost interest in their former friends or activities. Teens do change, but without a new interest or goal, they may remain stuck. Now might be the time to ask them about a career goal or other plan for their life. Enroll them in a class or buy books on their subject of interest. If they have no immediate interests, fill their schedule as much as possible with low-stress activities, such as volunteering at an animal shelter. Keeping your depressed teen busy will energize them and stimulate their interest in life.

Fear of Recovery

Some teens resist giving up their illness for deeper reasons. Maybe the illness has earned them special treatment in the family and they no longer have to do as many chores. Maybe it has brought you and your ex-husband together and they do not want to see that cease. If you have learned through therapy to relate to them better, they may worry that you’ll revert to your old ways if they let go of the illness. If you suspect something like this, you can bring it up on your own, but presenting it in a family therapy session or with their individual therapist has some advantages. The therapist can take note of it and incorporate it into her treatment plan.

Your own Resistance

If you find yourself balking at pushing your teen to move forward, either of two things may be occurring. You may be afraid of getting into a conflict with them, especially if they were angry with you in the past. Remember that you are still their parent and therefore responsible for speaking up in their best interests. When they were three they may not have wanted to brush their teeth either, but you insisted because it is your job to promote their well-being.

Your own comfort level may be keeping you from pushing your teen. Some parents find that they become closer to their teen when they are depressed or otherwise mentally ill and may not want to give that up. When my son started feeling better and going out with friends, I was surprised to hear my daughter say that she missed the depressed version of her brother because he was closer to her when he was ill. She felt guilty for feeling that way because she did not want him to be depressed, but her feelings were understandable. It can be hard for everyone to move on, even when it’s for the best.

 


10
Apr 24

Putting the Recovery Model Into Practice at Home

Teenager“When mental illness hits at a young age, the teen is often behind his or her peers in many areas.”

As awareness about mental health grows and patients continue to beat the odds and achieve higher levels of wellness, there is a push for the mental health recovery model. This ideal goes beyond using medicine for the suppression of symptoms. It addresses the patient’s quality of life and level of functionality.

In an interview about the recovery model for patients with schizophrenia, UCLA psychiatrist, Stephen R. Marder, explains that families want more than just stabilized symptoms for their loved one. He goes on to say that, “Patients are asking to be able to return to work, to return to school, and even are suggesting that psychiatrists may be underestimating the ability of people with schizophrenia to function in the community.”

Families and patients are often frustrated because they are not offered the kind of specific training Dr. Marder advocates, including social skills training, supportive employment, psychoeducation, and cognitive behavioral therapy. Parents of teens do not have to be told that their work is double if the teen has a mental illness. Besides getting their teen through the illness, parents must simultaneously get their teen through the developmental stages that all teens encounter. This includes learning self-sufficiency skills such as driving and budgeting money, as well as developing social skills. When mental illness hits at a young age, the teen is often behind his or her peers in many areas.

Unfortunately, society is just beginning to understand mental illness. We are still in the young years of fighting ignorance and stigma. Only recently have insurance companies begun to treat behavioral health issues as illnesses. Fortunately, your teen has you. Using your community’s resources, you can address the areas of employment, social skills, psychoeducation, and therapy.

Helping Emotionally Ill Teens Find Employment

If your teen is able to handle a part-time job or volunteer position, this can be a low-pressure way to introduce him or her to the work force. If your teen’s illness requires special support, look to organizations that understand mental illness. For example, your teen can volunteer at the National Alliance for Mental Illness (NAMI).

Try contacting your state’s Department of Rehabilitation, who will sometimes begin working with your teen in high school. My daughter met with her Department of Rehabilitation counselor right at the high school. Her counselor gave her access to career inventory testing, so that she can figure out where her strengths lie. Together, they created an education plan that will lead to her future employment.

Helping Emotionally Ill Teens Develop Social Skills

Teens who are behind in social skills have a number of options, starting with a friendly club at high school.There are many volunteer opportunities for teens to test the waters of socializing while having a purpose. Check your community newspaper for activities available to teens or ask your school psychologist.

It is common for teens who are struggling with a mental illness to declare that nothing appeals to them. If you think your teen is ready to handle a social activity, have him or her choose one activity and attend for at least one month. If you think it will help, provide an incentive for taking this step. If your teen is still too scared to try an activity, see if a local therapist offers group therapy for teens. Sometimes a large behavioral health medical office or hospital offers teen group therapy. It can be a safe way for your teen to get to know other teens with similar struggles.

Often, teens with a mental illness become especially close to their parents. They may find that they prefer to be around adults. If your teen frets about being able to relate more to adults than peers, say that before long he or she will be an adult. Often, kids who have been through a tough time emotionally are more sophisticated in understanding the real world than their peers are. This is especially true if the teen has had extensive therapy or been in the hospital and witnessed a range of teen issues. Teens like this often find that they can relate to their peers better when they get to college. In the meantime, they often find like-minded teens in some of the more interactive classes at school, such as art, drama, or yearbook.

Sometimes teens are overly sensitive about their social mistakes, believing that an awkward moment means that they aren’t cut out for socializing. At these times, remind your teen of the following:

  • Other teens make the same mistakes and get equally upset at themselves.
  • Regret over a social situation signifies that they now understand how to handle a similar situation next time.
  • Growth can be painful, but the results are worth it.
  • There are only so many types of social mistakes a person can make, so every time they make one, they cross one off of the list. Practice develops skill.
  • Teens feel less self-conscious if they focus on trying to understand how other teens feel.

Psychoeducation for Teen Mental Illness

As one therapist told me, “It is not possible to become too informed about your loved one’s mental illness.” There are a number of outstanding books on mental illnesses. These books will increase your understanding and help you to think of your own solutions to the issues that face your teen. In many cases, teens are not interested in reading these books, but you can read them and explain what you have learned. If you look through Amazon, you can find books specifically geared to teens. Here are some of my favorites, listed by diagnosis:

Essential Books for Teen Anxiety

The Anxiety Workbook for Teens: Activities to Help You Deal with Anxiety and Worry, by Lisa M. Schab
The Mindfulness and Acceptance Workbook for Anxiety, by John P. Forsyth and Georg H. Eifert 

Essential Books for Teen Bipolar Disorder

Bipolar Disorder: A Guide for Patients and Families, by Francis Mark Mondimore 
The Bipolar Disorder Survival Guide, by David J. Miklowitz
BP Magazine

Essential Books for Teen Cutting and Self-Injury

When Your Child is Cutting, by Sony Khemlani-Patel, Merry McVey-Noble and Fugen Neziroglu
Helping Kids Who Cut, by Michael Hollander

Essential Books for Teen Depression

Rescuing Your Teenager from Depression, by Norman T. Berlinger
Overcoming Teen Depression: A Guide for Parents, by Dr. Miriam Kaufman
Adolescent Depression: A Guide for Parents, by Francis Mark Mondimore
NAMI: What Families Need to Know about Adolescent Depression (read it online)

Essential Books for Schizophrenia

The First Episode of Psychosis, by Michael T Compton and Beth Broussard
The Everything Health Guide to Schizophrenia, by Dean Haycock and Elias K. Shaya
Surviving Schizophrenia: A Manual for Families, Patients, and Providers Paperback by E. Fuller Torrey
Sz Magazine

Other Essential Books for Teen Mental Illness

When Someone You Love Has a Mental Illness by Rebecca Woolis
I Am Not Sick, I Don’t Need Help! How to Help Someone with Mental Illness Accept Treatment. by Xavier Amador

Therapy for Teens

Cognitive Behavioral Therapy (CBT) focuses on how one’s thoughts and feelings affect their choices and behavior. This approach helps teens to step away from their emotions in order to evaluate their thinking and decisions. Working with a therapist, teens can understand that they are separate from their illness. They will learn positive coping skills and apply them to their daily life and relationships. Finding the right therapist for a teen can take some patience and diligence. Try these suggestions from Hiring the Right Therapist for Your Teen.

Remember Physical Health for the Mentally Ill Teen

Sometimes when a teen has been ill for some time, the patient, doctor, and family can become so focused on mental health that physical issues may become neglected. For example, teens sometimes gain weight when they take antidepressants, mood stabilizers, or antipsychotics. Some of the medicines worsen acne or increase thirst, risk of sunburn or overheating. Make sure you are aware of the side effects of your teen’s medicines. If there is a new complaint, suspect the medicine first and have the doctor address it. Recently, my daughter was struggling with more fatigue than usual. I assumed it was related to her illness or to her medicines. Then the doctor checked her iron. To my surprise, it was low. It’s easy to get so sidetracked by the illness that you forget other aspects of the teen’s health.

Your teen should have blood work done regularly to make sure the medicine is not affecting such things as cholesterol or liver function. Try to incorporate some exercise into  your teen’s daily routine, but be watchful of overheating or dehydration. Try to identify things that give him or her pleasure, then help make time for these activities or opportunities. Joy and pleasure, even in small things, should be a regular part of life. If there is something your family enjoys doing together, try to make time for it so that it happens often.

The teen years pass quickly. I remember some very good advice I received from my children’s pediatrician when my son was still recovering from bipolar disorder and my daughter was struggling with psychosis. He said, “Even though you’re going through all this, don’t forget to enjoy life.” I think that summarizes the goal of the recovery model.