The Healthy Family Connections Podcast:

Healthy Expectations for your Depressed Teenager

Episode 018 · Duration: 00:13:19

Healthy Expectations for your Depressed Teenager
Do you wonder whether or not to lower expectations if your teen is dealing with Mental Health Issues? Today we’re addressing a question from a mother concerned about excusing her depressed and anxious son’s absences from school. It’s a question that comes from Suzanne, of Santa Cruz, California.

Suzanne writes:

My son suffers from depression. He is on medication, has attended Wilderness & RTC (residential treatment center), sees a therapist, etc. He is sometimes absent from school due to anxiety. His symptoms are usually fairly non-descript: headache, stomach-ache, tired, general body fatigue, etc. I know his physical symptoms are real to him but are often a result of his depression and anxiety. He has learned tools to deal with this issue but sometimes fails to use them. Do I excuse his absence from school or let him suffer the consequences of his absence?

Thanks for your extremely important question Suzanne, because your question goes to the very heart of successfully treating depression in teenagers. Let’s take a quick look at what depression is and why it’s so prevalent in Teens today. And then, let’s address this question regarding how to establish healthy accommodations and not counter-productive or enabling ones for your son.

I think depression can be best described as a state of hopelessness where there is no joy, nothing excites, so there is no motivation. The sufferer experiences a sense of powerlessness to change anything and so isn’t inclined to try. Often people with depression will feel “out of it” as though they have an invisible shield around them separating them from others. Doing anything can feel like a chore.

Adolescence is one of those high-risk stages of life for people to become depressed. Let’s stop and think about it, Adolescence is that transitional stage between childhood and young adulthood. So it involves leaving one’s childhood where you live in the socially safe environment of the family and starting in middle school and ending after senior year in high school, developing all the social emotional, educational and vocational skills necessary to be able to function pretty darn independently.

Adolescence is one of those high-risk stages of life for people to become depressed. Click To Tweet

There are many challenges along the way to being able to accomplish that:

Some kids are temperamentally shy and reserved, and they can feel at a disadvantage socially
Many kids don’t believe they fit in in some way and struggle with their self esteem
They may be struggling with sexual or gender identity
Teenagers all face a lack of experience dealing with social situations and peer pressure
Often there are educational expectations from teachers and parents that they feel they can’t meet and they may not know how to ask for help
Teenagers today have the added pressure of being constantly plugged in—So they never get the opportunity to feel at home and that the drama of their peer group is over for the day. The peer interaction goes on and on and they believe that if they don’t stay plugged in, and keep themselves relevant, they’ll be left behind

Just as a side note, I’ve found that when parents take their teenager’s phone and internet access away due to some infraction, the result is that the kids look, feel and act much better, like a weight has been lifted off their shoulders. So it’s always important for parents to have some clear and enforced limits around use of devices.

It’s also important to remember that, teenagers are going through physiological and neurological changes that can throw them and their parents for a loop. Then, of course, there are the challenges of the availability of drugs and alcohol, so kids staying positive and learning and growing in a mentally healthy way all the way to young adulthood, can be a very challenging path to negotiate indeed. Additionally, some kids may have trauma in their background or a family history of depression and that makes the likelihood or vulnerability of becoming depressed that much greater.

So let’s look at Suzanne’s situation with her son: Suzanne reported that her son has received a ton of resources to help him resolve or manage his mental and behavioral health. He went to a Wilderness program that is a wonderful resource for kids who have lost their way. The Wilderness gets them away from all the electronics and the pressures of daily life. They backpack into the wilderness with group leaders who are naturalists and therapists so they learn wonderful skills and the positive peer culture that the leaders develop is a powerful motivator for kids. Teenagers are open and accepting of ideas and behaviors when their peers accept them as well. And being in nature, seeing the milky way, and experiencing the elements is very healing. It teaches our kids what they can accomplish and boosts self esteem. So that experience alone can do a lot to relieve depression. Then Suzanne’s son went to a residential treatment center. In other words, he went to live for a period of time, usually somewhere between six months and 18 months, in an environment that is very managed where he learned a lot of skills for managing his depression. He received a lot of therapy and in general, he got help growing and developing healthy values and behaviors. Once again, a program like this has a positive peer program so kids support each other in dealing with whatever issues they have.

And now Suzanne’s son is at home and he has a psychiatrist, which means he is on medication and his medication is well-managed. He has a therapist to support him and help him manage his feelings and make healthy behavioral choices.

Suzanne has put a ton of resources and support elements in place for her son. Now she asks if her son is feeling anxious or depressed, and he has physical symptoms that result from those states, should she excuse him from attending school?

Let’s answer this question by thinking about what the goal is. And here’s a goal that I think she should have for herself and her son:

GOAL: He should be able to successfully manage his depression and his anxiety independently from his mother.

Why do I think this is important? Because when he reaches his young adulthood, he will need to be able to do that to successfully emancipate. There’s another reason; depression often results from feeling helpless and disempowered, like we can’t make a difference in our own lives or in the world in any meaningful way. As long as the parent is writing excuses for the depressed child, he is not in charge and responsible for his own education and his own relationship with his school. It will reinforce the notion that he is helpless and does not possess the ability to be successful. Let’s just say Suzanne’s son has very difficult issues to deal with; let’s just accept that. Yet if she is the one to deal with them, her son will never effectively reach young adulthood with all the competencies necessary to successfully go forward. Now is the time for him to develop those competencies.

What Suzanne can do, if she has not already, given she is a very proactive a parent, is go to the school with her son and make sure the school understands that he has mental health problems. Have the school and the son work out a plan to address any problems that interfere with his ability to function at school. It might mean visiting the nurse, it might mean going to the gym and shooting baskets for a while, it might mean talking to the school counselor, he could become an aide in the office for part of the day until he is feeling better. These are all just suggestions but the point is that it’s up to him to use his skills and build his own relationship with his own school to manage his mental health issues. If it’s up to Suzanne to manage his issues he’ll never get better. If he’s in charge of managing them he absolutely will get better. And as she pointed out, he does indeed know the skills to use to help himself, but he’s not using them and is relying on his mom to make it okay.

Once it’s been established that going to school and managing his depression is his job, I’m guessing that Suzanne will face resistance. Mother and son may see a control battle based relationship pattern; a pattern where she pushes for him to go forward in a responsible way, and he resists. So he still might resist going to school and since she can’t put him in the car kicking and screaming like a toddler, make sure that if he chooses to stay at home, it is completely without electronics of any kind, that he is grounded, and that he has chores to do; all this without yelling or threatening or otherwise inviting a control battle. All of the communications should be with an emotionally neutral tone of voice.

Depression is a condition that is almost always resolvable. In really tough situations however, it is at the very least manageable. When our teenagers become depressed it needs to be a learning and growing experience for them. In the same way that they need to learn how to do difficult school assignments and eat in a way that doesn’t upset their stomach, they need to learn and use the skills necessary to be emotionally healthy. If we make their problems, ours to solve, that enabling behavior will keep them stuck. If we empower and support them in solving their problems, they’ll grow and thrive. Suzanne has done a fabulous job of developing resources for her son. Now she needs to hold him accountable to using them.

Depression is a condition that is almost always resolvable. Click To Tweet

Please remember, take care of yourself, you need it, you deserve it, you’re worth it.