Scarleteen Confidential: Teens and Mental Health

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Mental illness is often a hard thing to talk about even at the best of times. There's still so much stigma attached to it and mental healthcare, and a lot of misconceptions about what someone with a mental illness looks or acts like (and they are not positive misconceptions). It can be doubly scary and intimidating if the person dealing with that illness is your child.

We see many users struggling with mental health issues (most commonly anxiety and/or depression). Sometimes these issues are primarily situational (they're anxious about a particular incident), and sometimes they're part of a bigger, ongoing pattern of worries or fears.

We encourage users feeling this way to seek professional help from counselors or therapists. But many users are reluctant or afraid to do so, and that reluctance is often tied up in what they know (or fear) the reactions of their families will be to their asking for mental healthcare. They may forgo the care they need because asking for help is hard, and sense -- or get clear, explicit messages -- that their family may not support them, which makes getting help even harder, especially for a young person who often lacks the resources to get mental healthcare without adult help.

Sadly, there's a great deal of data that shows their concerns are based in realities: for instance, the majority of young people with even severe mental illness generally do not get treatment or help, with parents often being one of the biggest barriers to getting that care. As well, many parents' parenting styles, or approaches to mental illness, not only don't help, but often make mental health problems worse.

During a really bad fight when I had a mental breakdown, my dad told me that if I ever did that again he would consider me insane and banish me from the family, and even hinted at sending me to a mental home.

I feel a lot of guilt for feeling depressed and having panic attacks. I feel like I'm being self-indulgent and selfish because when I try to talk to my mom about this stuff she just says, "You just focus on it too much. Stop thinking like that." Which is code for "This is your fault you're feeling like this. Stop it." So I feel like I'm starting this new part of my life completely alone.

What can you do to create a more supportive environment for a child who may be coping with mental illness?

For starters, you can pay attention to the way you talk about mental illness, or even just stress, in your daily life. If a teen starts to think that they may have mental illness, they're going to reflect back on how you've talked about these issues in the past when they're evaluating what (if anything) to tell you.

Do you tend to talk about how their aunt who has clinical depression is just lazy and needs to exercise more to feel better? Or say things about how people with mental illness are "just doing it for attention?" If you find that your talk about people with mental illness, or mental illness in the abstract, tends to be judgmental, nonsupportive, dismissive or negative, consider the clear message that sends to your child (or to other loved ones who may be dealing with those issues). That way of speaking perpetuates the stigmas attached to mental illness, and your children listen to what you say about things, especially the things that really matter. If they sense you look down on people who have mental illness, they will be understandably hesitant to ask you for help.

If a teen comes to you and says that they have been feeling depressed/anxious/otherwise off-kilter and think they need to see a therapist, there are several things to do in that conversation to help them. The first is to stay calm and tell them that you're glad they told you. Even if what you feel in the moment is closer to fear or confusion than gratitude. They are using the lines of communication to let you know something is wrong, and that's ultimately a thing to be grateful for.

"I have also approached my mom asking if she could help me get help and she responded with "We really don't have the money. Also, maybe if you had Jesus you wouldn't be feeling this way."

As many folks with mental illness will tell you, voicing what's happening to them often results in some unhelpful reactions from the person they're talking to ("but you're too ____ to have ____, or "that's just how puberty/school/life is, stop overreacting," etc). So, to quote Captain Awkward, "let your brain catch up with your mouth" when having this initial conversation with your child. If you're finding yourself overwhelmed in the moment, something along the lines of "that is a lot to process, but thank you for telling me. I love you, and I'm here for you" should do the trick.

Next, check in with them if there's anything specific they want you to do with this information, and then listen to them. There may be something concrete they need, like help finding a therapist. Or they may want more general support. You're their parent, and what they want right now may be someone to acknowledge their worry or pain and give them a hug.

Lastly, resist the urge to ask if there's something you've done or are doing to cause this. While it may come from a place of genuine concern, that line of discussion can very easily tip into making the situation about your feelings rather than theirs.

In a similar vein, avoid treating their illness/possible illness as a puzzle to be solved. Again, this impulse may come from good intentions, from the belief that if you could just figure out what was causing this, you could remove that variable and make everything better for them. But there are two issues with this mindset. The first is that mental illness generally doesn't work that way, and for most people, even those who are treating it, it will be part of the background noise of their daily lives for a long time. Secondly, taking this approach can make the person with the illness feel as though you're treating them them as problem that needs solving. And that's not a fun way to feel. Instead, focus on reassuring them that the lines of communication with you are open, if they need them.

I want to pause and say that, if you're a parent and have a mental illness, like anxiety or depression, yourself, there can be some serious feelings of guilt when your child expresses concerns about their own mental well-being. You may blame yourself for somehow passing your illness on to your kids (even if the diagnoses is not the same for both of you). However, the same advice about not making those feelings of guilt your kids problem still hold. Talk with a mental healthcare professional about them. If you're seeing a counselor/therapist, you may even want to ask them for suggestions about how to support your child while also taking care of yourself.

I think my mom is depressed. She's struggled with it before and her father had a nervous breakdown and committed suicide which puts her at high risk for both depression and suicide. And its hard to be around her sometimes because she gets so negative about things that seem really random, like what someone else is dressed like.

And I guess right now I'm just really broken up about it. No one ever warns you about what to do when your mom gets depressed. And I feel guilty which I know isn't logical but I just feel like I should be saying more to help. I put so much of my energy towards making my life explosively positive and now I feel selfish for that...I was struggling with depression last semester and I told my mom about it but she didn't think therapy or counseling was a good idea. I don't know what to do, some days I feel a lot better and then other days like today, its like I'm seeing everything through dirty saran wrap.

If you're not getting any help or treatment for your own mental illness -- not because you lack access or the ability, but because you refuse to, or feel you don't need it -- please understand that that choice is one which puts you and your whole family at risk of great negative impacts, increases in mental illness in the family, and is known and broadly shown to have nearly universal detrimental effects, including very scary stuff like increasing the risk of teen suicide and a young person's chances of winding up in abusive or unhealthy relationships.

We've also heard quite a few teens who appear to be struggling with things like severe depression or anxiety tell us that they won't ask parents for help, or even seek out healthcare for themselves, because their parents have it too, and have told them that they "do just fine" without treatment, and treatment isn't necessary for anyone. In other words, it's clear, not just in studies, but in our interactions with young people, that when parents with mental illness refuse to get help, or even just acknowledge help is available and valid, young people get the message that they should refuse or avoid care, too. Also, know that often when describing the family dynamics of a parent who says they're "doing just fine" without treatment, it's usually made quite clear that they are not, in fact, doing fine at all.

Taking care of yourself, as you probably already know in other contexts, is the best way to show your children how to take care of themselves, whether that's about health issues and care, like mental health and healthcare, about healthy relationships, positive self-esteem or plain old safety. In the event you're avoiding diagnosis, treatment or care because you feel you can't focus on yourself and your own care, or they have to come first, know that when it comes to this, taking care of yourself is also caring for them. If you can't get started by doing it for yourself, and recognizing that you get to be a priority, too, remembering how much you getting this care is going to help them may help you get started.

After an initial conversation, a sound course of action is to check into what mental health resources you have access to. If you're on a health insurance plan or part of a public health plan, look into what (if any) types of mental healthcare may be available. Most of the time, you can start with a general physician or pediatrician and get referrals from there for mental healthcare. You can also look into community resources, such as clinics or support groups (for you, your child, or both). If money is a concern, check out what low-cost or sliding scale resources might be available. You may not end up needing all of the information you gather, but it's better to have than not, and the act of gathering it can help you feel calmer about what's going on by making you feel more prepared for whatever comes next.

Take some time to do some self-care. Even if it's just fifteen minutes worth, pausing to make yourself feel more grounded, relaxed, or happy is never a bad thing. This is another place where also doing self-care with your child, too, models the how-to of self-care for them, and sends a message about how much it matters.

In terms of ongoing support, listen to your child if they bring up thoughts or concerns about whatever treatment they're pursuing. For both counseling and medication, it can take awhile to notice the effects of it (and those changes will be gradual rather than instantaneous, which can make them harder to spot). So, encourage them to keep pursuing treatment, even if it's going slower than they'd like. However, do not automatically dismiss any concerns they have. Some people need to try multiple therapists before finding one whose treatment approach works well for them. Or, they may find that the medication they have been given has side effects that are making their life really, really difficult, and they want to talk to someone about changing prescriptions.

Be prepared to also see some behavior changes, either from medication that is prescribed or from recommendations from the therapist. Often, therapists will suggest techniques or strategies for clients to help them cope with difficult emotions or situations. Sometimes these techniques involve drawing new boundaries within the persons life, or trying to break old habits, so you may see some shifts in how your child goes about their day or their interactions with other people.

Finally, let them take the lead on what information they want other people to have. Some people find that being fairly open about what's happening helps them deal with it, while others prefer to only have a few close loved ones know. So, unless a teen has told, or lets you know it is okay to tell, someone about their situation, refrain from discussing it with people.

In the end, coping with mental illness will be your child's issue to handle and learn how to negotiate. But if you listen to them and support them when they need it, it can make the process a little easier for them, and for you.

You can find some more reading on these topics at Scarleteen here: