What do you do when you’ve tried everything to help your son who has anxiety and depression, and even the professionals gave up on him.

And if you have a question you’d like me to address on this podcast, don’t be shy, we’ll all benefit from your question so come on over to my website, neildbrown.com click on either For Families or For Treatment Programs, then click on any podcast and scroll down to the end where it says “submit your question” and enter it there and why not do it today.And while you’re there, download a free copy of my Parental Burnout Recovery Guide.

Today we’re hearing from Brandy and Brandy writes:

What do you do with a 16 yr old diagnosed with depression and anxiety?He uses his depression/anxiety to get out of everything including school.He notoriously skips Monday's and Friday's.When grounding, electronics is taken away his behaviour doesn't change.He has done nothing that his doctor or counselors have advised him to do. He doesn’t use the tools they have given him to use.We are at our wits end and not sure what else to do with him. He was hospitalized before for cutting. They gave him strategies to do, he refuses to do any of them.He says the crisis lines don't help and the strategies don't help.His doctor finally told him no one can help him if he doesn’t help himself. What do we do? Let him not go to school and he learns by failing?Not sure what the answer is at this point anymore.

Thanks for your important question Brandy, and it is an important one.

An Overview of The Situation

How do we help our kids who won’t help themselves? Depression, anxiety, learning disabilities, irritable bowel syndrome, ADHD, diabetes, all require that kids learn about themselves, their particular needs, how to be healthy, and what they have to do to prosper, grow and enjoy life.

Now, what do we do when our kids won’t do what they need to do to help themselves?

For starters, how did it get here? 

Many kids are going to have issues to overcome that will require professional input and parental structure and support.Professional input will give an understanding of the problem and guidance for how to improve the condition and maximize the youth’s functioning. In each situation, we will want to support the child or teenager to have their life be as normal and successful as possible. If a child is in a special school environment, how much and how soon can they mainstream? If they have a traumatic brain injury and can’t go to school or read, they get audio books and dictate papers and take oral exams to keep moving forward.

Learning differences, ADHD, depression, anxiety; accommodations can be made, but standards and expectations for learning don’t change.

So how did it start that your son’s depression and anxiety became a reason to not go to school? How did it develop that he wasn’t required to go to school, follow professional advice and develop the skills for managing his depression and anxiety? 

How To Support Your Teen Without Managing Their Responsibilities For Them

Now he and his parents are in a Control Battle and Control Battles are as hard to treat as anxiety or depression. But, you won’t get to treating the anxiety and depression while you are in your Control Battle. Doctors, therapists and parents can’t help a youth who is using his symptoms to control, to get what he wants.

This is a serious situation, Brandy. What we learn in childhood and adolescence become our operating systems in adulthood. That’s why we teach our kids good habits and good values. One important value we teach is; as we encounter problems in life and within ourselves, we seek, learn and apply solutions. That’s how we learn and grow. And learning and growing continues throughout our lives.What is your son learning; avoidance, manipulation, and using problems as an excuse for irresponsibility?And that doesn’t bode well for his adulthood.

That’s why you’re writing me so what can you do now? Well for starters, your professionals haven’t done you any favors.“No one can help him if he doesn’t help himself” is true in one sense, and way off base in another. Of course he has to learn and apply the skills to get better, and no one can do that for him, but the bigger question is why isn’t he motivated to do that. 

Brandy, my assumption is that back when his symptoms were first being identified, he wasn’t appropriately supported to understand and manage them. I’m not sure what went on. Perhaps he was coddled and protected and learned to get love and support by having emotional problems. Maybe some other dynamic but his current behavior is part of a Control Battle that was started way back and now we need to get parents out of the Control Battle to take the power away from your son using his symptoms to get what he wants.

To do that let’s get clear on a few assumptions: 

• Your son is a smart, capable wonderful kid who is caught up in avoiding and resisting instead of learning and growing.
• He can and will do great and we have complete faith in him.

Now, we will stop trying to get him to go to school or manage his responsibilities, we’ll stop trying to get him to treat his emotional issues as instructed.We will let him know that learning and growing is his job, dealing with and treating his anxiety and depression is his job, going to school is his job. We will support him in his recovery. But his recovery, getting to school, and his learning and growing belong to him.

Here’s an example of the kind of conversation you can have with him, and I’ll call him Frank:

Parents to Frank: 

We’re sorry that we’ve been fighting with you and trying to get you to be responsible.Perhaps we’re not supportive and empathetic enough and we can work on that.

We know you are a smart capable kid and that when you’re ready to start learning and growing and decide to conquer your anxiety and depression, you will win the battle.We know it will take time, effort and professional support, but when you’re ready, you’ll be successful.

We apologize for making you feel like a special case, and not holding you to the same standards as other kids.

Going forward, all privileges are contingent on managing your responsibilities like any other kid. Electronics, smart phones, driving privileges, going out are the same for you as for all kids. Manage your responsibilities and have a good attitude and you’ve earned your privileges.If you don’t earn them, you don’t get them.

Brandy, it’s not a matter of if you take away his electronics does it change his behavior or not, that’s up to him.What’s up to you is simply that he only gets his privileges, when he earns them. This isn’t behavior modification or a reward system. It’s how life is. Manage your responsibilities and earn what you get. So it’s not a day-to-day thing. To get his privileges, he needs to 1) be committed to going to school every day and 2) Demonstrate that he can and will follow through with that commitment.

Now let’s say that you’re doing this and he’s not getting his privileges but is not going to school. I don’t think that will be the case, but let’s assume it is. Then we take the next steps in treatment.Outpatient treatment wasn’t successful, so we move to a more intensive setting. Contact your insurance and see what intensive outpatient programs they have available. These are all day treatment programs that may be 4 to 6 hours a day 4 to 5 days a week with parent participation probably one time a week.

Alternative Treatment Options For Your Teen with Depression and Anxiety

Finally, if he refuses to go to school or to this program, which I can’t imagine he will refuse because you are now determined and committed to things moving forward, and when parents are determined and committed, kids get it.But if intensive outpatient isn’t enough, the next level of treatment is residential treatment; where he will go to a program for a period of time.To chose an appropriate program, you’d use a placement professional such as my esteemed colleague Dr. Mark Burdick, whom you can find at www.drmarkburdick.com . Programs exist for all kinds of issues with teens and young adults.From substance abuse and violence to depression and self-destructive behavior such as cutting and eating disorders.Some programs are short to moderate term 30 to 90 days and some are longer up to 18 months and sometimes a short-term program is used in advance of a longer-term program.

Brandy I don’t see this as necessary in your son’s case, but this is the complete range of options. 

My point is that you don’t need to throw in the towel when your teenager doesn’t cooperate.You do need to become aware of the Control Battle, and stop what I call in my book Ending The Parent-Teen Control Battle, “feeding the beast”, or participating in a Control Battle and you throw in the towel on trying to control your son.

Instead, embrace empowered parenting with a healthy vision of your son and an expectation that he earn his privileges by being responsible and doing his best. Brandy, in the book, check out Chapter 8, What If My Child Is Depressed.

Thanks for tuning in today everyone and special thanks to you Brandy for your thought provoking question and if you are a therapist who works in a behavioral health treatment program, and would like to talk with me about improving outcomes in your program, come on over to my website neildbrown.com and shoot me an email or give me a call. I’ll be happy to talk with you.

And please, take care of yourselves; you need it, you deserve it, you’re worth it.Bye for now.

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