24
Nov 25

Your Teen’s Emotional Triggers

ConfusedGirl.jpg“Work on one issue at a time, taking advantage of brief visits during your teen’s therapy sessions to get feedback on what is causing the most distress.”

Emotional triggers can prevent a teen from making a full recovery. You can probably identify the triggers that ignite your teen’s symptoms. In fact, you may be more aware of them than they are. During a calm moment, possibly while you’re in a therapy session with your teen, see if they will create a list of their triggers. Some they can and should avoid, but others they will need to address.

Avoiding Triggers
The easiest triggers to remove are the ones that you, the parent, control. For example, if your teen complains that you always prompt them when to speak at the psychiatrist’s office before they can open their mouth, promise to stop. You might slip up a couple of times, but just keep at it. Let your teen know that they are growing and changing so fast that you aren’t accustomed to treating them like they are older. Work on one issue at a time, taking advantage of brief visits during your teen’s therapy sessions to get feedback on what is causing the most distress.

Other triggers may be completely avoidable. For example, if your teen has a particular friend who subtly puts them down, they may choose to see less of that person. If that is not an option, they may be able to develop a few generic responses such as, “That’s an interesting point” or a non-sarcastic “Thank you for sharing your opinion.”  Afterward, they can silently congratulate themselves for having handled the trigger well.

Painful Reminders
Your teen may experience reminders of their early days in the illness. For example, they may feel a stab of depression when they hear a song that was popular during the worst part of their depression. Or they may experience the recurrence of a symptom that once plagued them, causing panic. During these tough moments, they can repeat a phrase to themselves such as, “That time is over” or “Things are better now.” You can reinforce this by using a similar phrase to reassure them. Help them to shake themselves out of their distress by suggesting that they go for a walk or listen to some music they like.

Unavoidable Triggers
Some triggers cannot be avoided or easily deflected. Let’s say your teen has to spend Saturday afternoon with their estranged father. Have them work out in their mind what challenges lay ahead for them and what they can do in the moment to reassure themselves, as well as how they can reward themselves afterward for surviving. Sometimes it helps if the teen can change their expectations. For example, if they keep hoping that their father will compliment them, but he never does, they may be able to reset their thinking to expect no compliments and to look to other sources for support.

A more sophisticated approach that requires quite a bit of patience is for your teen to first identify the trigger and then see if they can rationalize it, meaning that they research its initial cause and exactly why it causes them so much pain. They can then use this information to try to look at the trigger in a clinical fashion, doing their best to remove every scrap of emotion for the time being. Following that, they may be able to pretend that the trigger is happening to another person, someone who does not care. They may decide that they have the power to choose to care less. With each occurrence, they tell themselves to care a little less. Even if they reduce the pain by only a small amount it is still an improvement. Over time, with continued practice, they can reduce what the trigger means to them.

Seizing Control of the Trigger
A powerful approach to reducing the effect of a trigger is to seize control by inducing it. To return to an earlier example, let’s say your teen craves, but never receives, a compliment from their father. Rather than waiting for you to tell him that they got an A in physics or waiting for him to ask them how they did, they might bring it up themselves and provide their own compliment. For example, they could say, “I’m so proud of myself.  I got an A in physics.”  If he responds by saying, “Let’s see how well you do in chemistry next year,” they may be able to say, “Yes. I think I can do just as well.”  Then they can leave it at that.  Maybe they received zero affirmation from their father, but nothing and nobody stopped them from granting their own affirmation. Please bear in mind that your teen may not be ready to take on a challenge like this until they are well into recovery and have gained quite a bit of confidence through therapy. They will know when they are ready.

 


26
Oct 25

When to Call the Police on Your Mentally Ill Teen

Relapse“If your teen’s behavior is so erratic that you think there is a risk of a neighbor calling the police, seize control and call first.”

Parents with mentally ill teens find themselves calling the police for various emergencies, ranging from suicide attempts to threatening behavior. As distressing as it is to have to call the police, the possibility is worth preparing for. Every year, the police shoot to death people who are in the throes of a manic or psychotic episode and are judged to be dangerous. If your teen’s behavior is so erratic that you think there is a risk of a neighbor calling the police, seize control and call first. Many police forces now have personnel trained to deal with psychotic individuals. Do not wait for a neighbor or your landlord or someone else to call because they are unlikely to deliver the full story. If you are still hesitant, ask yourself this: if things escalate and the police do appear, would you rather they take your child to the hospital or to jail?

Let the police know that your teen is in a psychiatric emergency. If there is a weapon involved, tell them; they’ll know to keep their distance rather than walking in there and reacting after being taken by surprise. If your teen has been treated at a particular hospital before, provide the name of the hospital and the name of your teen’s psychiatrist. If your teen is taken to the hospital, call his psychiatrist and leave a message. I recommend that you carry either on your cell phone or on a credit card-sized piece of paper in your wallet, the contact numbers for anyone you might need, including:

  • Psychiatrist
  • Therapist
  • Hospital intake
  • Police psychiatric emergency number

If your teen is arrested, the courts may step in and force treatment. This can be a painful thing for a parent to watch, but it may be the best opportunity your teen ever gets. Your teen will be referred to a mental health professional, who will take over for you so you don’t have to fight with your teen anymore. The court may force medicine. If you do feel that your teen’s rights are being violated, you may choose to consult with a lawyer. Just be clear with the attorney that your goal is for your teen to be treated.

Let’s hope you never encounter such a situation, but an emergency plan is an important safeguard. Keep medicines locked up and absolutely no guns in the house. If you get new health insurance, call and make sure that it covers your treatment team and the local hospital you want to use in case of a psychiatric hospitalization. You don’t want your teen taken to a hospital that is not in your insurance network.

The best resource I have found for preparing for psychiatric emergencies is in a book by Francis Mark Mondimore MD titled, Adolescent Depression: A Guide for Parents. The suggestions in this chapter on handling emergencies helped me come up with my own plan and gave me a great deal of reassurance and comfort.

Recommended Books:
Adolescent Depression: A Guide for Parents, by Francis Mark Mondimore M.D.
When Someone You Love Has a Mental Illness, by Rebecca Woolis, M.F.T.