10
Jan 25

If Your Teen Refuses Treatment

I am not Sick by Dr Amador“In his book, Dr. Amador recommends a method called LEAP.”

It can be frustrating to try and convince a teen with a serious mental illness to accept treatment. Some teens find the idea of taking medicine unnatural and some hope that the symptoms will go away without medicine. Often, the teen is unconvinced that he or she is sick. Forty percent of individuals with bipolar disorder and sixty percent of individuals with schizophrenia have an accompanying symptom called anosognosia. It means that they do not recognize that they are ill. It looks like denial, but it is actually a part of the disease.This can be extremely disheartening and frustrating for a parent because it greatly impairs treatment. Not surprisingly, family members often focus on trying to convince their relative that they have the illness, which only makes the patient feel misunderstood.

Fortunately, being on medicine removes this symptom. But how to get there? You can work around your teen’s disbelief, using a strategy described in the excellent book, I am Not Sick I Don’t Need Help, by Dr. Xavier Amador. This book has helped many families with recalcitrant loved ones, using a method called LEAP. I summarize Dr. Amador’s LEAP method below:

L is for listen:  Listen to your teen’s concerns about medicine. Don’t interrupt, but feel free to ask for clarification if you think you are misunderstanding them. Don’t argue or try to dispute what they say.

E is for empathize:  Forget about your own frustrations and fears for the moment and let your teen know that you understand how they feel. Offer sympathy for what they are going through.

A is for agree:  Try to agree upon something, even if it’s something as simple as the fact that your teen is depressed and wants to feel better.

P is for partner:  Tell your teen you want to help them achieve their goal. If they don’t want to take medicine, what will they agree to do? If the two of you can agree to a plan—any plan—at least you’re working together.

LEAP won’t give you the immediate outcome you’re looking for, but it’s a start. It’s also an improvement over arguing. Sometimes a first step leads to another. The book explains the steps in detail and will give you ideas for how to be effective with each one. It has helped many families get their loved ones into treatment.


30
Dec 24

Regulate her Day; Regulate her Mood

Family-on-Bicycles.jpg“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.”

Even if your teen is taking medicine for depression, anxiety, or another mental illness, you can hasten their recovery by making some lifestyle adjustments. The human brain thrives on routine. This is even more critical for someone with mental illness. If your teen is in school, they have an advantage because their day is already regulated for them. One of the best things for our brains is to simply walk outdoors for twenty minutes at the same time each day. The daylight lets our circadian rhythm know that it is daytime, serving as a natural sleep-regulator, and the exercise helps the brain to awaken and sharpen.

Exercise is a great way to boost mood and lower stress. If your teen is trying to decide between physical education and another class, physical education may be a better choice, especially since it does not include homework. If PE isn’t in the cards, an after-school run each day can substitute. A mid-morning snack of fruit or nuts, along with some water, can also keep your teen from mentally slumping. If your teen is on multiple medicines, they may require extra fluids since they can be dehydrating. This can be offset by drinking a large glass of water with the medicine. Some of the psychotropic medicines carry increased risk of overheating or sunburn. It may be too hot for them to exercise outdoors in the summer heat.

Beyond exercise, it is crucial that the teen go to bed at the same time every night. For an hour or two before bed, they should avoid the blue light emitted from glowing television or computer screens, which confuses the brain by making it think it is daylight. Bedtimes and exercise routines often get thrown off on the weekend. As tempting as it is for your teen to sleep in until noon on Saturday, it disrupts the brain’s rhythm. Try to keep the weekend routine as similar to the weekday routine as possible. Your teen may agree to sleep in only one hour later than usual if you promise to make them something special like French toast for breakfast.

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. For example, they may be willing to attend summer school if they knows that they’ll get a study period the following school year. This is a good way to keep them in a healthy routine while also easing the transition back to school.

If summer school is not an option, have your teen set some goals for the summer so that they have some structure, such as volunteering or learning a new instrument that requires daily practice. Ask them to set up a schedule for these activities and agree to a time for waking and bedtime, even if it is later than the school year routine.  As long as they keep to a routine, they’ll be okay, and they can slowly transition back a week or two before school resumes. Have them perform the exercise of their choice at least once a day for 40 minutes to an hour. At a minimum, they can walk the dog each morning and each evening, but establish a set time for the walks. They can make their afternoons unstructured for relaxation. The key is to maintain as close a schedule as possible.