Within the past few years, you’ve probably heard more people talking about the issue of mental health– and for good reason. According to the National Mental Health Association, mental health problems affect one in every five young people at any given time. Moreover, an estimated two-thirds of all young people with mental health problems are not receiving the help they need. Luckily, increased awareness has led to better information. As parents raising this next generation, we now have a firmer grasp on mental illness – what it is, what to look for, and how to talk to our children about it. But, what happens next? The truth is, for many people, the battle with mental illness does not stop at a diagnosis. So, how do we grow the conversation from identifying a mental health issue, to living with one?
Understand the diagnosis
The first step in helping a child living with mental illness is ensuring they’re properly diagnosed by a mental health professional. However, it’s not always that simple. One of the most difficult parts of discussing mental health is the range of illnesses, as well as the levels of severity each can entail. According to the National Institutes of Health (NIH), a mental illness can be defined as “a health condition that changes a person’s thinking, feelings, or behavior (or all three) and that causes the person distress and difficulty in functioning.” This can include depression, bipolar disorder, anxiety disorder, schizophrenia, attention deficit hyperactivity disorder (ADHD), autism, and obsessive-compulsive disorder. While each illness is different, the symptoms being exhibited can often be confused. Consulting with a mental health professional and understanding your available resources can help you learn about your child’s specific diagnosis, the potential symptoms, and how those symptoms can manifest differently in individuals.
Process the diagnosis
Once a child has been diagnosed, they may display a range of emotions, such as fear, anger, sadness, confusion or apathy. Dr. Bobbi Wegner, a clinical psychologist at Boston Behavioral Medicine encourages parents to remind their children – and themselves – that their child is not their diagnosis. Yes, they may have mental illness, but that’s only a part of who they are. In other words, a person with depression is not necessarily a depressed person. They may also love animals, be an avid reader, or have a sincere connection to poetry. By addressing these other valuable qualities, you can help your child – and yourself – see their mental illness as only one part of their whole identity.
Another component of processing your child’s diagnosis is working to understand your response to it. How you react can depend on many things, including the type and severity of illness, your relationship with your child, how you’ve approached parenting prior to your child’s diagnosis, and your experience with mental illness. According to Dr. Natasha Burgert, a Kansas City-based pediatrician, having a child with mental illness can cause parents to lean into their parenting style. For example, some parents may increasingly emphasize “tough love,” while others may become more protective or accommodating of their child. Additionally, if you don’t have any family history of mental illness, there could be a sense of shock – even denial – about the diagnosis. However, a lack of knowledge may energize you to be proactive in seeking out answers and making a plan. Alternatively, if you, or someone close to you, have struggled with mental illness, you may feel more equipped to deal with it. Keep in mind that your child will likely have their own unique experience dealing with mental illness. Overall, try to be aware of how these preconceived notions may come into play when working through your child’s diagnosis.
Many parents grapple with what it means to have a kid with mental illness. Am I a bad parent? Have I failed my child? Is there anything I could have done differently? Wegner cautions parents to avoid self-blame. While environmental factors like adverse childhood experiences can certainly have an impact on a child’s development, research shows mental illness is associated with changes in the brain's structure—proving it does indeed have a biological basis. “Having a hormone imbalance that is causing symptoms of mental illness is no different than needing to wear glasses,” Burgert says. Your child’s mental illness is not necessarily a consequence of your parenting, but a condition of how their brain is wired.
Start assembling a network of support for your child. Mental health issues often are managed with some combination of medication and therapy, so having a solid team of specialists – from a psychiatrist to a school social worker – is crucial. If your child is resistant to therapy, Wegner recommends checking in after three sessions. If they’re still not making progress, consider exploring other options. “Therapy is based in connection. At the end of the day, the patient is the consumer. If it’s not working, there are many other people out there who can provide more support,” Wegner explains.
Get support for the whole family, too. Burgert recommends at least one or two sessions of family therapy. “When one family member struggles with mental illness, the whole family is affected,” Burgert says. “Going to family therapy helps children understand why their sibling may be getting certain attention or leaving school more often. It also equips parents with age-appropriate language to use with their kids when addressing their other child’s mental illness.”
While it’s natural to hyper-focus on the well-being of your child and your family, Wegner advises parents to make a point to take care of themselves, too. “Modeling good behavior, such as sleeping enough, eating well, exercising often, and seeing your own therapist is setting an important example for your child,” Wegner says. For example, if you see a therapist, it will not only set the precedent for your child, but it will also give you professional insight on how to navigate their behavior. By investing time to help yourself, you’re inevitably helping your child.
In addition to therapy, attending support groups can be extremely helpful. They can give you exposure to how other families have learned to cope during different stages of a child’s mental illness, as well as an idea of what it could look like long-term.
Create a supportive environment
One of the best things you can do for a child with mental illness is to make them feel safe and loved. “Create an environment in your home that is highly supportive, and low in stress,” Stephen Wallace, the President and Director of Center for Adolescent Research and Education (CARE), recommends. Structure can be crucial to creating a low-stress environment. Wallace suggests making a social contract with your child that says they’ll let you know if they’re spiraling out of control and when they need help. This gives children a way to explain their feelings. Also, Wallace advises creating a consistent daily schedule so kids know what to expect. “If we constantly change how we respond to kids [with mental health diagnoses], it’ll put them on edge,” Wallace says.
Part of a safe environment is having the space for open communication and constant dialogue. “Get them well-versed in self-identifying by asking how they are and checking up,” Wallace says. “It’s important for parents to help kids dealing with mental illness learn how to calm themselves down, identify emotions, and understand how it affects their behavior. Sometimes, kids don’t follow that trail naturally.” But when you talk with your child about their emotions is just as important as what you’re talking about. “When kids are really upset, it’s usually a not helpful time to address issues. It’s when we most want to respond and jump in and correct behavior, but sometimes we need to wait until kids are calm and open and receptive to feedback,” Wallace explains.
Some parents fear that the beginning of mental health issues is the end of having a happy, healthy life, but this isn’t usually the case. In fact, many people who struggle with mental illness lead extremely fulfilling lives. Fortunately, they don’t have to do it alone. Plenty of resources can help kids and young adults live—and thrive—with their mental illness.
Of course, the options you seek out will depend on the age of your child. “Parents of younger children will be more involved in the process, while parents of older children may promote functionality and independence,” Wegner says. Organizations such as Child Mind Institute, can provide parents with information, in-person trainings and care centers to help children manage their behavior while they’re still under their parents’ roof. For young adults moving out and moving on to pursue higher education, the National Alliance on Mental Illness (NAMI) has a guide for managing a mental health condition on a college campus. And Boston University’s one-semester program, NITEO, offers support in developing wellness, academic skills, resilience, and work-readiness.
Give yourself time
It’s virtually impossible to be completely prepared for what’s to come when a child is diagnosed with mental illness. Naturally, there can be a huge learning curve. Wallace warns parents that there will be moments when you’ll have to first make a decision and then gauge how your child responds to it in order to figure out what works and what doesn’t. Additionally, you may have to step back at times and ask yourself, 'what is a result of the child’s mental illness and what might be a natural response to frustration?’ Kids with mental health issues are still kids. They’ll still have the same struggles. It’s important to pick your battles and differentiate between what’s harmful behavior, and what’s generally annoying,” Wallace explains.
In the end, your experience navigating your child’s mental illness will be personal to you. While it’s almost inevitable that you’ll make mistakes along the way or react poorly at times, you have to be able to forgive yourself. You will likely experience a combination of many conflicting feelings along the way, and that’s okay. You are not alone—there are many resources there to help you and your child. Ultimately the most important thing you can do is to love and support your child. Just remember: it’s a process.