“Get your teen talking about recovery. Can you help them name five things they did right this time?Once your teen recovers from an emotional illness, it can be scary to think about the possibility of a relapse. Sometimes as a teen improves, the parents’ concern diminishes and their expectations increase. This alone can trigger a setback or relapse. The teen may find it too difficult to be well. Ask your teen if they are feeling overwhelmed by their own recovery and if there is anything you can do to make it less stressful.
Is It Sadness or Depression?
Begin by helping your teen identify if there is a specific cause. Sometimes a teen who has been through a long depression is unable to discern between feeling depressed and feeling sad. They may think they are relapsing and becoming depressed again when, really, they are simply sad or disappointed due to a recent event. It can be a relief for your teen to realize that they can feel sad without it signaling a return of depression. Similarly, stress over an upcoming exam may be nothing more than what every other high school student is experiencing. They will come to learn that negative emotions are a part of normal life and are not necessarily a danger.
Relapse versus Setback
If, however, it seems that your teen is experiencing some of the symptoms they did when they were ill, contact the psychiatrist. Growing teens experience many physical and emotional changes and may need their medicine adjusted. Occasionally, a previously reliable medicine will stop working altogether. Watch closely while you wait for their psychiatry appointment. The early signs are often subtle and barely detectable to the patient or parent. If you think you are catching the symptoms early and it looks like your teen is relapsing, point out the difference between a setback and a relapse. With relapse, the patient ends up back where they were at their worst. With a setback, the patient regresses a little. Tell them that you and the therapist will help them to capitalize upon the skills they have learned so that they can quickly get back on track. Help them to maximize their odds of success by limiting any unnecessary stress in their life. Even postponing something like starting orthodontia treatment can provide the extra breathing room they currently need.
Get the School Involved
Notify the school immediately, even if your teen is not missing any school. Once alerted, the staff can work with the teachers. If it looks like your teen will miss a substantial amount of school, the counselor or caseworker may set up an individualized education plan (IEP) to form a plan of action for keeping them from getting too far behind. At home, remember to maintain your teen’s medicine log, recording as much detail as possible. It may help to review past episodes to remind yourself that setbacks eventually end.
Maintain Perspective
If your child does end up in full relapse, you have my sympathy. It is painful to relive the old feelings of confusion and fear, especially if your teen is back in the hospital. Although it can feel like failure, it is important to realize that a return to the hospital signals that serious healing has commenced. It may help to think of it as a booster shot, a necessary treatment to maintain wellness. It is not uncommon for someone with bipolar disorder or schizophrenia to require two or three days in the hospital once a year. If you think about it, it’s not much different from being laid up with a cold or a sinus infection.
Capitalize Upon Past Experience
Take heart, and point out to your teen all the things they have in their favor that they did not have last time. They know how the hospital treatment program works. They may have a working relationship with a good therapist. You have learned how to best help them. Encourage them by saying that you are more educated than you were before and that together they will get through it much quicker this time. There is an old saying that all good things must come to an end. All bad things must end too. There will be more good days soon.
Stay Positive
As your teen improves, remain watchful. Even though the worst of the symptoms are under control, your teen may be discouraged about their illness and contemplate suicide, especially if they have had more than one relapse. For example, a patient with chronic schizophrenia may recover from a hard relapse only to find themselves dreading the next. You may be feeling discouraged yourself, but for the moment, there is still work to do. Get your teen talking about recovery. Can you help them name five things they did right this time? The two of you might point out to each other new things you have learned, whether it is a feature of the illness or a strategy for taking their medicine at a more effective time. Acknowledging the fact that you made it through before and learned more about how to manage the illness should be encouraging for both of you.
Resume Activities
If your teen is free of symptoms but spends a lot of time complaining about having a mental illness and not being like other kids, it may be time to challenge them. Resuming a former activity such as music lessons or chores will take their mind off their anger and make them feel more in control of their life. Start off small and slowly build the expectations. Say encouraging things like, “You made it through your whole music lesson. Nice work.” If your teen rebuffs your compliments, try the indirect approach, by describing the accomplishment to your spouse or a grandparent when your child is present. While I’m on the subject of motivating your teen, I highly recommend reading Bringing Out the Best in People, by Alan Loy McGinnis. This short book will give you quick insight into what to say to your teen to keep her feeling inspired and appreciated.
How You’ll Get Through It
Don’t forget to take care of yourself. If your boss is sympathetic, let her know that a relapse has occurred and that you expect things to go more smoothly this time. If your boss is not understanding and you have some vacation time, it might be a good idea to take a couple days off so you can meet with hospital staff, your family therapist, and the school. Try to do something nice for yourself during that time, whether it’s going to a movie or buying a magazine and a latte. It is often times like these that we most appreciate a close friend or relative who always knows the right thing to say. Indulge and unburden yourself, then remember to thank her the next day.
Recommended Books
Adolescent Depression: A Guide for Parents, by Francis Mark Mondimore MD
When Someone You Love Has a Mental Illness, by Rebecca Woolis, MFT
Bringing Out the Best in People, by Alan Loy McGinnis
“Summer vacations can wreck havoc with a teen’s mood, but you can help your teen continue to improve mentally by providing goals and activities for the summer.”