Caring for Your Hurting Teen

Could This be Something Besides Mental Illness?

“Some illnesses mimic mental illness…some medicines can incite symptoms like depression, anxiety, and even psychosis “

Let’s say you’ve been told that your daughter has been thinking about suicide. You may find it impossible to believe. Your bright, outgoing teen always seemed happy before. Why would she suddenly feel suicidal? You wonder if there is a medical cause for her depression or if something traumatic happened to her that you don’t know about. Let’s examine these two possibilities.

Some illnesses do mimic mental illness. The doctor will often order blood work to rule out something physical, such as a thyroid condition. Some medicines can incite symptoms like depression, anxiety, and even psychosis. Before you begin treatment, make sure your doctor performs a physical examination, blood work, and a careful appraisal of any medicine your child currently takes.

The second possibility, that there’s something she isn’t telling you, is equally worth pursuing. Even if you don’t suspect that anything could be amiss in your child’s life, follow up with some gentle questioning. I have often been astounded at the things my kids told me when I respectfully asked. Here is an example of the type of dialogue I mean, between a mom and her uncommunicative daughter, Chelsea.

Mom: Chelsea, I know you’ve been depressed and you say you don’t know why, but I want to make sure there isn’t something else going on.

Chelsea: Like what?

Mom: Sometimes teens hide things from their parents because they feel like they’re responsible for what is happening, when in fact, they’re actually being victimized.

Chelsea: Mom, what are you talking about?

Mom: Will you bear with me while I throw out a few wild guesses?

Chelsea: Sure, let’s hear what your wild imagination has conjured up.

Mom: Sometimes a teen is bullied at school and feels so ashamed she doesn’t tell the parents. Bullies know how to psychologically browbeat their victims into making them feel like it’s their fault. Other times, a teen might think she’s gay and is so worried about what the parents would say that she feels she has to hide it. Or maybe a teacher or a neighbor is sexually abusing her.

Chelsea: Mom, you read the newspapers too much.

Mom: Either that or I just haven’t named what’s troubling you.

Chelsea is silent.

Mom: I just want you to know that whatever is going on, I promise not to judge you or blame you. I promise not to overreact.

Chelsea remains silent. Now that she has stopped objecting, Mom suspects that her instincts were right.

Mom: Do you want some time to think about whether you can trust me? I hope you can.

Chelsea: This isn’t something you can handle, Mom.

Mom: Then let’s find someone who can. Someone who has heard it all and knows how to help. Will you see a therapist?

Chelsea: If I can’t tell you, I sure as hell won’t be able to tell a stranger.

Mom: You like to write though. Would you be willing to write me a letter?

Chelsea: Maybe. No, probably not.

Mom: Then I’m going to make an appointment for us to visit a therapist together. I’m not going to allow you to suffer when I know there’s help available. I’m also hoping that you’ll find the courage to take me up on my promise not to overreact or judge you.

If nothing else, at least the door has been opened a crack. Teens don’t want to keep their troubles to themselves; they believe that they must. We start with tiny steps in building their trust. While we’re on the subject, the phrase, “I promise not to overreact or judge you” can really open the door to communication.

Caring for Your Hurting Teen — Comments Off
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Feb 24

Caring for Your Depressed Teen

“It can be useful to have your teen rate her depression each day… It’s important for her to visually see that it is improving.”

If your teen is severely depressed, they may not want to do anything besides lie in bed and stare at the wall. It is ironic that the things that will most help us are often the things we least want to do. Exercise is a wonderful antidote for depression, as is sunshine, but the depressed person wants nothing to do with either. Negotiate with your teen. Say that if they’ll go for a twenty-minute walk in the morning and a brief outing in the afternoon,they can lie in bed for an hour each morning and afternoon. When they return from these walks, simply say, “You did well to get out there and walk.” It takes a long time for exercise to produce benefits.Your teen will need a tremendous amount of encouragement during these early days of recovery.

Afternoon outings may be equally difficult for the depressed patient, so take it easy. A visit to the psychiatrist suffices, as does a visit to the therapist.The therapist may keep your teen for only 30 minutes or so. Now is not the time to worry about getting your money’s worth.Therapy can be exhausting for the severely depressed person and it does no good to push them past a tolerable limit. You may need to go into the therapy session with your teen for the first few minutes to get the discussion started since they may not be able to start on their own.

If your teen does not want to go out of the house, offer three choices. Give them some time to think about it. They are not good at making decisions right now. Keep the outing brief and close to home since they will tire easily. Remember, too, that if they’re getting used to new medicine, they will not have their usual stamina. They may also get dehydrated or overheated, or they may experience minor side effects they do not think to mention such as constipation or dry mouth.

Do not bring up any stressful subjects, such as upcoming exams. Dole out their homework in small chunks. Avoid topics about the future that may overwhelm them. The phrase “one day at a time” will come in handy here.

While you’re waiting for your child to respond to treatment, observe their carriage. Do they walk with a slump? Do their eyes look hollow? Do they seem confused? Write your observations down in their medicine log. After they are well, you may forget these important physical characteristics, and they are important forecasts of relapse.

I once heard a psychiatrist say that he often noticed his patients begin to look better two weeks before they begin to feel better. He didn’t tell them this, but he did make note of it when they looked improved. One day, about three weeks after my son had started on a new medicine, I noticed that his face seemed brighter and his eyes looked less strained. I followed the doctor’s lead and kept my observations to myself, not wanting to irritate him when I knew he didn’t feel any better. But my pulse quickened with hope. Sure enough, two weeks later, he admitted that he was feeling better. The week after that, he was even better, and the week after that, better yet. It continued until he was well. It will happen for your child too. So keep watching and encouraging.

Meanwhile, it can be useful to have your teen rate their depression each day. I can almost promise you that they will not want to do this, but you can do it for them. At the end of each day, ask them to rate their depression on a scale of 0 to 5. Record the number. The reason for this is that depression is insidious. It creeps up slowly and retreats just as slowly. Often, the patient insists that they are still depressed when the illness has actually subsided.

Sometimes the news of recovery isn’t welcome. Many people come to identify with the illness if they’ve been depressed for a long stretch of time. They may hate it, but they may also feel that once it is gone, nothing of themselves will be left. As paradoxical as it may sound, recovery can be the hardest part of the healing process. For more on this, see Factors That Can Delay a Teen’s Emotional Recovery.

Your Hurting Teen Help for emotionally troubled teens

Could This be Something Besides Mental Illness?

Caring for Your Depressed Teen