06
Mar 25

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.

 


04
Feb 25

Antipsychotic Weight Gain and Teens

Teenager“The routine helped her to get through the days, and the activity improved her mood.”

It can be heartbreaking to watch your teen put on unwanted pounds after starting a new medicine. My daughter once gained twenty pounds in one month on a new antipsychotic. It was as though her brain was no longer getting the message that she was full after eating. She would eat a meal and half an hour later be starving. This is a positive story about how a psychiatrist and his patient worked together to get her through it.

While my daughter’s psychiatrist set to work adjusting her medication, she and I began focusing on exercise. She was barely out of psychosis and had been sedentary for some months. Her psychiatrist wanted her to walk for an hour and twenty minutes a day, but the extra weight made her feel exhausted and winded.  He told us to break it into four 20-minute segments per day. Somehow, this seemed manageable to my daughter and we were able to get in a total of 80 minutes of daily walking. The routine helped her to get through the days, and the activity improved her mood.

I removed every scrap of sugar from the kitchen and replaced it with fruit, cut vegetables, and whole grain breads for when she was desperate. I reasoned that if she was going to overeat, at least it would not be calorie-rich food with no nutrition. This limited the weight gain. The psychiatrist also urged me to push high-protein, fiber-rich foods, which satisfy the appetite longer. I tried not to let her eat after dinner. Fortunately, she only had to make it to bedtime because her medicine made her fall asleep ten minutes after she took it.

Fortunately, her doctor had the problem resolved within a month. He slowly cut her offending antipsychotic with a smaller amount of the antipsychotic Geodon. The Geodon counteracted the hunger issue. The nightmare was over, but she was up twenty pounds. We continued with the walks. I took her to the Lily Pulitzer store, and I saw what a difference a well-cut garment can make in terms of flattering a heavy figure. Patterns hide a paunch better than a solid color. The tops I bought her were designed to be worn out, not tucked in, and they were sewn to glide over her hips so that it slimmed her and made it look like she had a waistline. She wore jeggings with boots and that was slimming too. I’ll never forget the day I saw her look in the mirror and smile at herself.

She lost the twenty pounds in two months. Geodon requires food to work. In fact, a couple of clinical trials suggest that 500 calories is the magic number. So I fed her a 500-calorie breakfast and dinner with her medicine, which is taken twice a day. Once we became rigorous about getting her calorie count up with each dose, the appetite-suppressing effect kicked in. Now she wasn’t hungry. She ate a light lunch, usually some low-fat cheese or turkey and a piece of fruit, along with a bottle of water. After the weight came off, it was easier for her to walk and we condensed our walking times. She began running ten minutes a day before our morning walk. When her psychiatrist ran blood work again, we held our breaths, but her cholesterol levels were the best they had been. Then something completely unexpected happened. My blood work was better than it had ever been too!