Mental health is one of those topics that is so broad and so complicated that many parents don’t know where to start when talking to kids. Some parents have family histories and therefore a reference point and example to draw upon when talking, while others must rely on news reports of tragedies. We spoke with a panel of our experts to get their advice on how to talk to kids about mental health, and how to know when to have those discussions. We’ve compiled their advice as part of our ongoing series on tough talks — making difficult conversations a bit easier.
“The way to bridge into the topics is through concern,” explains Rutgers Social-Emotional Learning Lab Director Maurice Elias. “Don’t label the process. I wouldn’t talk about anxiety or depression, I wouldn’t use any of those terms with my child.”
And just knowing some of the warning signs of mental health issues, like suicide and depression, can help guide parents as to when to have the conversations.
“There are some of the warning signs of suicide and depression: declining school performance, loss of pleasure in social activities, changes in appetite or sleep, agitation or irritability, and substance abuse,” explains Center for Adolescent Research and Education director Stephen Wallace. “Just as we teach our children to look both ways before they cross the street or to brush their teeth before bedtime, we need to arm them with the truth about depression and suicide.”
The truth as told by statistics is staggering. According to the Centers for Disease Control, suicide is the number three cause of death for youth ages 10 to 24, and in the past year, 17% of high school students surveyed said they seriously considered suicide. And yet, many parents and kids don’t talk about mental health issues together.
"Many kids who experience depression think they will always feel bad, and that is definitely not the case," explains Wallace. "This is why I feel that it is absolutely necessary for parents to tell their children that there will be better days.”
With the transition to and through adolescence, many teens appear more moody and emotional. How are parents to know when a moody teenager has moved from simply being a moody teenager into an area that is cause for concern? Parenting expert and education psychologist Michele Borba tells parents “No one knows your child better than you. Trust your instincts. If you think something is wrong, you’re probably right.” She also recommends using a measurement she calls the “too index.”
“Look at your kid’s behavior. You know their normal behavior and moodiness and his normal obnoxiousness,” Borba explains. “But is it lasting too long, becoming too intense and spilling over into too many other areas, like the classroom, social world; and are teachers talking about it? And your household is becoming too troublesome and you’re walking on eggshells. How long? Every day for at least two weeks is a huge warning sign. Too long, too much, too often.”
There may be less obvious clues about your child’s emotional state. Kansas City-based pediatrician Dr. Natasha Burgert recommends monitoring your child’s online searches and web browsing history for warning signs like searching “what is depression.”
“I have kids that learn about the easiest pills to take to make you fall asleep. Or how to cut themselves on a YouTube video,” says Dr. Burgert
She also points out that while your teen may be searching and looking for advice, oftentimes that advice is coming from fellow teenagers — not a professional. If you are concerned your child does have a mental health problem, like anxiety or depression, Dr. Burgert recommends seeing a professional sooner rather than later.
“There’s nothing worse than having a patient come in and say we’ve seen this for about a year and we just came in and found a knife,” says Dr. Burgert.
It might be hard to start the discussion with your child but our experts overwhelmingly recommend speaking up sooner rather than later. One of the best strategies is to approach concerns about mental health as though it is equivalent to concerns about other health issues like diabetes or asthma. You may want to point out what you’re seeing and note your concern or worry. If you start the conversation with your concerns, your child may feel it is less of an attack and more a genuine care for their well-being.
“I would start with ‘I’ve noticed….’” explains school counselor Shari Sevier. “‘I’ve noticed you’re in your room a lot, what is going on?’ Ask more open ended questions than yes/no. Because open-ended questions can get them talking.”
“The next thing you want to say is that you’re willing to talk about it,” Rutgers Social-Emotional Learning Lab Director Maurice Elias says. “That’s where it has to start in the beginning. I think that it’s not realistic to expect your child to immediately want to open up and talk about their issues and problems.”
It’s not just depression that can affect teenagers. Anxiety is another contributor to mental health issues for teens. According to the National Institutes of Mental Health, 8% of adolescents have an anxiety disorder. It’s not surprising when you look at the statistics found by the American Psychological Association — where teens report being more stressed out than adults.
“There is a perception about the right courses, the right schools and that can cause tremendous anxiety and if they don’t achieve they feel like failures,” explains Sevier. “We, as parents, need to be careful about pressure. It’s fine to say, ‘Do you feel like I’m putting too much pressure on you?’”
There are many ways to help children and teens with stress, from helping them find coping strategies that work for them to cutting back on the amount of activities and extracurricular activities they’re signed up for. Sleep can also be a big contributor to a child’s sense of stress, so trying to keep your teen on a healthy sleep schedule can also help relieve stress.
Above all, your child needs your guidance that no matter where they are right now, it will get better. And you can help him or her get better by finding professional help through a counselor or therapist and supporting your child through the difficult time. Even if your child does not have a diagnosed mental health condition, continuing to talk with your child will go a long way to supporting his or her overall mental health. While it may be especially challenging to get teens to open up, our experts say don’t discount the effect your willingness to talk will have on them.
“They need to hear from us that someday, something bad will happen, and it will get better and people can help you," says Wallace. "Parents are afraid to raise the issue of depression and suicide because they think it’s contagious, the healthy way to deal with it is to talk about it.”
If you or someone you know would like more information about the issue, please visit http://www.nlm.nih.gov/medlineplus/teenmentalhealth.html. If you or someone you know needs help, please call the National Suicide Prevention Hotline at 1-800-273-TALK (8255).