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Caring for Your Hurting Teen — No Comments
09
Jun 25

Stabilizing Mania or Psychosis in Your Teen

Teenager“Try not to challenge her. Listen, but keep your comments neutral and non-judgmental.”

It is distressing to see your teen suffering from mania or psychosis. The psychiatrist will make it a top priority to shut down the symptoms, but it may be up to you to get your teen through the days. Hopefully, you can be present throughout this time, even if it means working from home for a while. It is best to provide vigilant supervision since the teen’s behavior may abruptly change and worsen.

Stabilizing Mania

Teens with bipolar disorder often experience mania. The manic teen may have pressured speech in which you cannot interrupt them, or they may pace, not sleep, or carry on about ideas that do not make sense to you. They may overspend or indulge in some other activity to excess.

For now, remove your teen’s access to Facebook, e-mail, or any other media form in which they could write something they later regret. Hide all credit cards and debit cards. Since mania can lead to dangerous behavior, make sure their psychiatrist is monitoring their progress. Follow his orders and record your teen’s behavior every day so that you can give him specific examples of what you are observing. It is easy to forget incidents when you are in the midst of an emotional turmoil. A faithful record can also encourage you when you see that there is improvement.

One of the toughest features of mania is that it often feels good to the patient. For this reason, your teen may resist medicine. Remind them that a crushing depression awaits at the end of mania, if left untreated. Tell them that you are not trying to spoil their good mood but that you want to see their mood leveled out for the sake of their mental health. Try to avoid getting pulled into lengthy, circular discussions that do not lead anywhere. It is okay to say that you need to go do some work for the time being. If your teen wants to talk to you all day, designate a specific time for discussion, such as from three o’clock to four o’clock. If they have a lot going on in their head, encourage them to write about it in a journal. Do not allow your teen to exhaust you.

Managing a Psychotic Episode

Psychosis occurs when a person begins to lose touch with reality. It can include hallucinations (hearing voices, for example) or a delusion (believing that people are out to harm them, for example). It may be a symptom of bipolar disorder or schizophrenia, but it can also occur with depression. It can be brief or it may persist for years.

Some medicines can cause psychosis, so your teen’s doctor will ask for a list of any medicines your teen takes. Street drugs such as LSD and marijuana can cause psychosis. If your teen is paranoid one night and fine the next day, suspect drug use. Talk to them and let them know that if they continue the drug use, the paranoia may worsen and can persist even after the drug use is suspended.

Sometimes a teen becomes psychotic from using illegal drugs and even after they stop the drug, the condition continues and has to be treated with antipsychotic medicine. If your teen seems paranoid for any reason, or if they are saying things that do not make sense, they need to see a psychiatrist. During treatment, the doctor may prescribe an antipsychotic, and he may provide a benzodiazepine like Ativan for short-term use to briefly suppress the psychotic symptoms.

Meanwhile, you will need to deal with your teen, who may be frustrated with the effort to explain to you what is going on because you do not see reality the same way they do. Try not to challenge them. Listen, but keep your comments neutral and non-judgmental. Trying to convince them that they are seeing things wrong will make the condition all the more frustrating, making them feel desperate, misunderstood, and alone. They may decide it is necessary to hide their beliefs from you, and then you will not know if they are still experiencing psychosis.

Although you are listening to your teen, do not encourage them to keep carrying on about their belief. It will only further flame the delusion. Try to keep the environment calm and quiet. Turn off the television, since they may misinterpret what they see and hear. If they try to engage you in their thinking, you may find yourself walking a fine line. Do not indulge the delusion by saying things like, “It’s okay, honey. I’ve put this cross on the door and the aliens won’t be able to get past it.” Maintain a tone of neutral empathy. For example:

Your Teen: There are people out there who want to kill me.
You: I can see that you’re scared.
Your Teen: You don’t believe me, do you?
You: What matters to me is that you feel scared. It must be awful to feel this way.
Your Teen: But you don’t believe me.
You: I sympathize with what you’re going through.  I want to reassure you that your safety and well-being are my top priority right now.
Your Teen: Lock the doors! They’re coming. You don’t understand. Let me explain this to you again…
You: I hear you loud and clear. The doors and windows are locked, just as they always are at night. I know that the world is not always a safe place, so I take sensible precautions to keep our family safe.

Choose your words carefully, avoiding anything that could sound judgmental. Think before you respond. In their confused state, they will not notice any slight hesitations.

If the paranoia persists for months, you may want to make certain accommodations to make your teen feel more comfortable. For example, if they think people are out to kill them, they may not want the garage door open until they are safely inside the car. This is not the same as saying that you agree with the false belief. It is simply a courtesy to make life less stressful for them.

During auditory hallucinations,remember the following:

  • Your own voice will be a source of reassurance. When the voices are at their worst, your loving tone may cut through the nonsense.
  • During a lucid moment, ask your teen to list all the things the voices have said. It may comfort them to realize that the voices always lie.
  • Getting your teen to talk can refocus their attention and make the voices stop. Some people find that singing makes the voices disappear. If they say they will feel silly, sing along with them.
  • Hide anything that could be used as a weapon, including knives in the kitchen or tools in the garage.

Don’t wait until things become out of control. If you feel you are in danger, get out of there and call 911. Explain that your teen is in the midst of a psychotic episode and that you need an ambulance. The police will come too, but they will not arrest your daughter if they are clear on what is happening. Inform them if there is a weapon so that they are not taken by surprise.

If your teen is taken to the hospital, do not despair. Let the professionals take over. Afterward, avoid talking about the things your teen said at their worst. If they did something that now has consequences, such as over-spending, offending someone, or getting into trouble with the law, reassure them that there will be time and opportunity to fix it. For now, it is time to focus on getting well. After your teen is well, it is a good idea to work together on an emergency plan.

Recommended Books:
The First Episode of Psychosis, by Michael T. Compton, M.D., M.P.H. and Beth Broussard, M.P.H., C.H.E.S.
When Someone You Love Has a Mental Illness, by Rebecca Woolis M.E.E.C.

 

Fostering Wellness and Growth / Uncategorized — Comments Off on Recovery From Mental Illness Requires Patience
19
May 25

Recovery From Mental Illness Requires Patience

Teenager“In many ways, teens who have suffered are better equipped to handle setbacks than people who have never struggled.”

I am constantly reminded of how long the process of healing from a mental illness takes. If that sounds discouraging, it is not meant to. It is simply an important reality. Some illnesses clear up more quickly; others never improve. Mental illness is in-between. With treatment, things will improve, in fact, so steadily that it can be quite astonishing. My son has been in treatment for seven years; my daughter for five. Even after all of this time, I continue to see improvement.

In my son’s case, he has been able to cut back on his dosage of medicine. Early on in his treatment when the medicine was addressing his depression, I noticed that he did not make jokes any longer. After a couple of years, though, his humor returned. At age fourteen, I felt like his deep depression had soured him toward life, and this attitude continued for many years. He is still not the cheeriest of people, and a lot of his cynicism has remained, but he is more relaxed about life and the waythe world is.

My daughter was initially miserable with the awful symptoms of schizophrenia. Somehow, at the time, I had it in my head that all we needed to do was get the symptoms under control. I wasn’t prepared for the residual challenges of the illness, including depression, fatigue, lack of motivation, and mental slowing. Although she has not been able to cut back on her dosage, she is now energetic and excited to start each day and seems fulfilled in many ways. She has resolved the early stigma she dealt with regarding the name of her disease. Feeling better has made the illness a smaller part of her life. Slowly, she is building a social life, something that for a long time I thought I would never see again.

One thing that helped my teens’ progress has been staying steady with the medicine. Most of these drugs take two weeks or more to begin working, and improvement is so subtle and slow it can be barely noticeable. If you see any improvement at all, you are likely on the right track. But it will probably take months and possibly years for your teen to really recover, depending upon the severity of the illness.

Another thing that helped was the fact that neither of my kids had used street drugs. Drugs like marijuana or alcohol can cause serious delays and setbacks in treatment. Still, even when drugs are involved, if the addiction is resolved, the teen can make progress. One thing that all kids with mental illness go through, whether addiction is involved or not, is an early realization that life can be tough. As painful as this is for them, young people are resilient and the early challenges they have with depression, drugs, and more can actually help them mature more quickly. Learning how to get something like a drug addiction or a deep depression under control can help them to cope with future obstacles. In many ways, teens who have suffered are better equipped to handle setbacks than people who have never struggled.

Time is a big healer. Every year that your teen recovers is also an additional year of maturation. Simply growing older can help a teen heal and recover. With both of my teens, I found it helpful to encourage them to take on more responsibility. I am talking about little things like filling out their own medical forms at the doctor’s office and big things like learning how to drive. We cannot let our teen’s illness keep them from growing up, even if we feel bad about what they have been through.

Your teen will be able to forget and move on more easily if you encourage them to do all of the things that other teens do: learn to cook, do laundry, start a part-time job. If it seems like these skills are beyond your teen right now, don’t worry. Have them tackle one thing at a time and stick with it until it has become comfortable, then move on to the next thing. My daughter took five years to finish high school. We could have pushed hard and gotten her out in four years, but she was much better prepared for college this way. The important thing is seeing progress and remaining patient while it continues.

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