05
Feb 25

Caring for Your Depressed Teen

Dad and daughter hug“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.


27
Jan 25

How Long Will My Teen’s Mental Break Last?

HowLongWillItLast.jpg“Think of your teen’s recovery in three phases: crisis phase, healing phase, and recovery phase.”

Mental illness tends to emerge slowly in teens. It can be difficult to pinpoint exactly when it started and even more difficult to estimate when it will resolve. Nevertheless, it is important for parents to have an idea of what to expect so that they can plan in terms of their job, their other children, and their teen’s school year.

First, keep in mind that your child has probably been ill for a while already. Mental illness is insidious in the sense that it comes on so slowly that the victim barely notices, and the changes in the patient are so gradual that it can take a while for loved ones to notice. Recovery is equally slow and gradual.

Think of your teen’s recovery in three phases: crisis phase, healing phase, and recovery phase.

Crisis Phase: Your teen may be in a state of crisis This can be a confusing time because parents have to figure out what is going on and how to find help. It helps if everybody can remain patient and hopeful. Remember, if you cross a therapist off your list, you’ve gotten closer to finding the right person. It usually takes a month or two to find the right therapist and psychiatrist and to notify the school.

Healing Phase: Your teen will begin the process of improving, regressing, and then improving some more. Medicine trials can take weeks to months. Take comfort in the fact that your teen is receiving good care and everyone is doing the best they can. This phase of learning about the illness and stabilizing the symptoms is likely to take six months to a year. This may seem like a long time, but it may be comforting to know that your teen’s rate of progress is rather typical.

Recovery Phase: Your teen will continue to improve but may not be able to handle as much schoolwork or as many activities as in the past. They may also still be trying to deal with medicine side effects. In addition, this final recovery phase may include changes in friends, interests, and activities. This phase is likely to last a year.

Remember that these are estimates. Your child’s timeline may be different, but hopefully it will help you to plan. Don’t hold back on alerting the school about what is going on with your teen. They can be your best ally, possibly providing on-campus support and assistance with classes and scheduling. Depending upon your work situation, you may find it helpful to let your boss know what is going on. This is a decision that must be carefully weighed. It is likely that you will need to be available to your teen more in the early part of recovery than later.

Keep a weekly record of what is going on with your teen. Progress can be so slow that it feels like none is occurring. With a record, you can occasionally look back and realize how far your teen has come. In the case of something like depression, it can be useful to rate the severity of the depression on a daily basis using a scale of 1 to 5, with 1 being barely depressed and 5 suicidal. Often, the patient believes he is still depressed when, really, he is considerably improved. Watch for significant changes that indicate improvement and praise your teen for making strides. Something as simple as being willing to resume walking to school again instead of being driven is cause for celebration.