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Caring for Your Hurting Teen — Comments Off on Caring for Your Mentally Ill Teen
04
Jan 25

Caring for Your Mentally Ill Teen

Mom shows confidence in daughter“The teen who is going through a difficult time emotionally may tire easily, become confused, or get frustrated. You can help by maintaining an air of quiet encouragement.”

If only mental illness were like strep throat: you feel terrible for a few days, you take medicine, and a week later you’re back in shape. Recovery from mental illnesses is slow, measured more in months than in days. Fortunately, there are many things you can do to hasten your teen’s recovery.

Show Some Confidence

At this early point, it is easy to feel like things are out of control, but try to show your teen that you are confident about their recovery. Save the tears, anger, and self-flagellation for the therapist or for private moments with your spouse. On the other hand, it is okay to admit to your child that you’re worried. If they say they’re angry about it all, you can confide that you too feel angry that this is happening to them. Here is an example of what I mean:

Her: Why is this happening to me, Mom?

You: I don’t know why, honey. I honestly never expected something like this. I admit that I’m very worried. But I have a lot of confidence in the people who are helping us. We’ll get through this.

Her: I saw you crying last night. Admit it, you think I’m losing my mind.

You: I’m sorry you saw that. I have had some tough moments. It’s hard for a parent to see her child suffering.  But I don’t believe for a minute that you’re losing your mind. I want you to know that Dad and I are working together to get you the care you need. We’ll get through this.

Note the repetition of, “We’ll get through this.” Sometimes there is nothing more to say. Don’t feel that you have to have all the answers.

Managing Your Home Environment

Now for the good part: the things you can do to promote your teen’s recovery. The brain heals and becomes regulated by routine. Get your teen to wake up and go to bed at the same time each day. Establish a routine and have them stick to it, eating meals, exercising, and doing schoolwork at the same time each day. They will rely upon your encouragement in the early days of treatment. It can be a slow and discouraging process, particularly when a medicine trial does not go well. Reassure your teen that you intend to do everything you can to help them get well.

Meanwhile, keep the household calm and quiet. Try to serve dinner at the same time each day. Cut everything out of your schedule that you possibly can so that there is less irregular activity (besides, you need to trim your own obligations in order to take care of yourself). If you are in the habit of shouting questions to your kids, try to stop. Instead, go to them directly and speak in a normal tone of voice. If conflict is a regular part of life in your household, you may want to address it now while you have the benefit of a family therapist involved. Many families find that they become stronger when a crisis such as this occurs.

Avoid Teasing and Sarcasm

Emotionally ill teens do not perceive sarcasm or teasing the same way that we do. Their pain is always at the forefront, and everything you say to them gets filtered through that tender layer. When my teens were depressed I was astonished to find them taking what I had said literally. When I tried to explain that I was joking, they became confused and hurt. Having a teen with a mental illness can make you a better communicator.

Get Your Teen Talking

The most powerful thing you can do during this time is listen. If you are in the habit of lecturing or criticizing, your child’s recovery will be considerably delayed. I don’t mean to sound sanctimonious. After years of knowing better, I still have to work to keep the negative tone out of my voice and to avoid lecturing. There is no such thing as a perfect parent, and your child is still expecting you to be you. But why not go for an even better you? I recommend that you allow yourself to do ten percent of the talking and let your child take the other ninety percent. Maybe you’re thinking that your house will be awfully quiet with a ratio like that. But think about it: the more you talk, the less they have to speak, and you need to know what their symptoms, fears, and needs are if you are to help. One of the best ways to get your teen to talk is to reflect back what they say.  If they say, “I’m sick of hearing you and dad fight,” you can say, “It sounds like our arguing is causing you a lot of stress.” It might encourage them to further explain how they feel.

If your teen does open up and start talking, congratulations! Keep it up by saying things like, “I’d like to hear more about that.” They may very well oblige you. Don’t be afraid of long pauses. If you speak too soon, you cut off the possibility of hearing what else they have to say, and this is where the good stuff often lurks. If they finish a heated explanation and you’re quiet, you leave the door open for more. You’ll be amazed at what else you can get from your teen by just patiently waiting for more.

One thing I’ve learned about talking to kids is that they often hear the first sentence and then tune the rest out. So make that first sentence count.  Better yet, make it your only sentence. Then they’ll really remember it.

Consider Your Teen’s State of Mind

The teen who is going through a difficult time emotionally may tire easily, become confused, or get frustrated. You can help by maintaining an air of quiet encouragement. You may need to write things down for them each day. If their confusion is severe, help them prepare an index card each night, listing everything they have to do the following day. It is also wise to help them organize the books and assignments they’ll need the following day. A little planning on your part will help your teen have a better day. Eventually, they’ll be able to handle this themselves.

Caring for Your Hurting Teen — Comments Off on Preventing an Emotional Relapse in Your Teen
02
Jan 25

Preventing an Emotional Relapse in Your Teen

Teenager“Get your teen talking about recovery. Can you help them name five things they did right this time?

Once your teen recovers from an emotional illness, it can be scary to think about the possibility of a relapse. Sometimes as a teen improves, the parents’ concern diminishes and their expectations increase. This alone can trigger a setback or relapse. The teen may find it too difficult to be well. Ask your teen if they are feeling overwhelmed by their own recovery and if there is anything you can do to make it less stressful.

Is It Sadness or Depression?

Begin by helping your teen identify if there is a specific cause. Sometimes a teen who has been through a long depression is unable to discern between feeling depressed and feeling sad. They may think they are relapsing and becoming depressed again when, really, they are simply sad or disappointed due to a recent event. It can be a relief for your teen to realize that they can feel sad without it signaling a return of depression. Similarly, stress over an upcoming exam may be nothing more than what every other high school student is experiencing. They will come to learn that negative emotions are a part of normal life and are not necessarily a danger.

Relapse versus Setback

If, however, it seems that your teen is experiencing some of the symptoms they did when they were ill, contact the psychiatrist. Growing teens experience many physical and emotional changes and may need their medicine adjusted. Occasionally, a previously reliable medicine will stop working altogether. Watch closely while you wait for their psychiatry appointment. The early signs are often subtle and barely detectable to the patient or parent. If you think you are catching the symptoms early and it looks like your teen is relapsing, point out the difference between a setback and a relapse. With relapse, the patient ends up back where they were at their worst. With a setback, the patient regresses a little. Tell them that you and the therapist will help them to capitalize upon the skills they have learned so that they can quickly get back on track. Help them to maximize their odds of success by limiting any unnecessary stress in their life. Even postponing something like starting orthodontia treatment can provide the extra breathing room they currently need.

Get the School Involved

Notify the school immediately, even if your teen is not missing any school. Once alerted, the staff can work with the teachers. If it looks like your teen will miss a substantial amount of school, the counselor or caseworker may set up an individualized education plan (IEP) to form a plan of action for keeping them from getting too far behind. At home, remember to maintain your teen’s medicine log, recording as much detail as possible. It may help to review past episodes to remind yourself that setbacks eventually end.

Maintain Perspective

If your child does end up in full relapse, you have my sympathy. It is painful to relive the old feelings of confusion and fear, especially if your teen is back in the hospital. Although it can feel like failure, it is important to realize that a return to the hospital signals that serious healing has commenced. It may help to think of it as a booster shot, a necessary treatment to maintain wellness. It is not uncommon for someone with bipolar disorder or schizophrenia to require two or three days in the hospital once a year. If you think about it, it’s not much different from being laid up with a cold or a sinus infection.

Capitalize Upon Past Experience

Take heart, and point out to your teen all the things they have in their favor that they did not have last time. They know how the hospital treatment program works. They may have a working relationship with a good therapist. You have learned how to best help them. Encourage them by saying that you are more educated than you were before and that together they will get through it much quicker this time. There is an old saying that all good things must come to an end. All bad things must end too. There will be more good days soon.

Stay Positive

As your teen improves, remain watchful. Even though the worst of the symptoms are under control, your teen may be discouraged about their illness and contemplate suicide, especially if they have had more than one relapse. For example, a patient with chronic schizophrenia may recover from a hard relapse only to find themselves dreading the next. You may be feeling discouraged yourself, but for the moment, there is still work to do. Get your teen talking about recovery. Can you help them name five things they did right this time? The two of you might point out to each other new things you have learned, whether it is a feature of the illness or a strategy for taking their medicine at a more effective time. Acknowledging the fact that you made it through before and learned more about how to manage the illness should be encouraging for both of you.

Resume Activities

If your teen is free of symptoms but spends a lot of time complaining about having a mental illness and not being like other kids, it may be time to challenge them. Resuming a former activity such as music lessons or chores will take their mind off their anger and make them feel more in control of their life. Start off small and slowly build the expectations. Say encouraging things like, “You made it through your whole music lesson. Nice work.”  If your teen rebuffs your compliments, try the indirect approach, by describing the accomplishment to your spouse or a grandparent when your child is present. While I’m on the subject of motivating your teen, I highly recommend reading Bringing Out the Best in People, by Alan Loy McGinnis. This short book will give you quick insight into what to say to your teen to keep her feeling inspired and appreciated.

How You’ll Get Through It

Don’t forget to take care of yourself. If your boss is sympathetic, let her know that a relapse has occurred and that you expect things to go more smoothly this time. If your boss is not understanding and you have some vacation time, it might be a good idea to take a couple days off so you can meet with hospital staff, your family therapist, and the school. Try to do something nice for yourself during that time, whether it’s going to a movie or buying a magazine and a latte. It is often times like these that we most appreciate a close friend or relative who always knows the right thing to say. Indulge and unburden yourself, then remember to thank her the next day.

Recommended Books

Adolescent Depression: A Guide for Parents, by Francis Mark Mondimore MD
When Someone You Love Has a Mental Illness, by Rebecca Woolis, MFT
Bringing Out the Best in People, by Alan Loy McGinnis

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