How to Help a Depressed Teen

A quick note to readers: This post reflects my experiences with depression, and may not be applicable to every case. If you feel your teen is in immediate danger of committing suicide, contact law enforcement or your health care provider and let them know.  

Depression IS a disease, and like any disease, it claims its due. The information in this article is to help parents prevent teen suicide. Please understand, however, that sometimes there really was nothing more you could have done. If you are the parent of a teen who has committed suicide, it doesn't mean you have failed-as a parent, and as a person. I share these thoughts with you in the hope that they, and your personal experiences, will help you reach out to others in your community.

 

Earlier this year, a friend of mine lost his nineteen year old son to depression and suicide.

I look at my children, now entering those difficult teenage years, and like so many parents, I am afraid. I am afraid of what these years are going to bring us. No one should ever have to bury a child. I can only imagine that family’s pain and loss.

I can, however, understand, intimately, the pain his son felt in those final days before he took his own life. Depression has been an enemy I have fought for what feels like my whole life, and it’s an enemy that too few people ever truly understand. Because it’s sneaky. Like diabetes, it’s chronic-some days will be better than others, but you’re never truly “cured”. It’s always sitting in the wings, waiting. Perched to pounce the minute you make a mistake, or have a bad day, or start feeling overwhelmed.

I can’t bring the Fiorellas’ son back, although I desperately wish that I could. I wish that I could look that young man in the face and be able to tell him, I understand. I’ve been there. I know this road you’re walking.

You’re right-you’re never going to get off this road. You’re never going to be the carefree person that you want to be. You’re never going to see life through the same lenses your friends do, no matter how hard you try.

But if you’re willing to fight, if you’re willing to reach out, it can get better.

Because I can’t do that, I want to share the lessons I’ve learned through a lifetime of depression with other parents like Sam. Like myself. Parents who watch their teens grow and wonder what they’re going to do if the black spectre of depression comes to claim them. Parents of teens with depression who feel helpless to bring their children out of the hell they’ve made their home.

Parents, you CAN help. But before you can help, you need to understand.

Understand that your child needs you to listen, not talk. As parents, we want to share our life experiences with our children. We hope through our experiences, they’ll be spared from learning some lessons the hard way. But your child with depression isn’t walking the same road you did. They need to be able to share THEIR road with YOU.

Understand that your child needs to be freed from your expectations for them. People with depression believe one of two things: Failure is inevitable, or failure is unacceptable. Either way, they feel shoehorned into a position where they have no right to be human. To try new things. To make mistakes. To them, criticism and encouragement are fatal in equal measure, because both make them feel as though they have failed in being themselves.

Understand that right now, they are incapable of being happy. It’s not that they’re choosing to be morose and dramatic. It’s not that they’re choosing to be critical or miserable or apathetic. Their minds are choosing it for them. The person who is severely depressed feels apathetic on their best days and like they’re going to fall apart on their worst. Which is why they need you to…

Understand that their feelings need to be validated. It’s too easy to look at their lives and think, “What do you have to be depressed about? You’re a kid. This is the best time of your life!” They know that. They understand, through the message you send, that they are expected to be happy and carefree. And so that’s the face they put on, for your benefit, for their friends, for their teachers. Then they leave you swinging in the wind when they explode, having bottled their feelings up to the point where they literally cannot take it anymore. 

If your child is angry, let them be angry, even if what they’re angry about seems ridiculous to you. (I once sat and cried for an hour because I couldn’t get a sweater to stay on a hanger.) If they are sad, let them be sad.

Understand that depression is as insidious as cancer…but no one judges a cancer patient for getting chemo. Depression, and other mental illnesses, still carry too much stigma. For a period of time in my twenties, I was on antidepressants following a major breakdown. I told no one I was going to the doctor, didn’t even tell my husband I was on antidepressants until months later. 

It was too embarrassing to admit that I needed help to get through the day. I was humiliated that I was carrying so many fewer burdens than people I knew, and I still couldn’t handle it. People with depression are embarrassed and scared to ask for help. They need you to encourage them to seek medical care.

Understand that people with depression feel isolated. They feel like no one understands them. Watch out for teens who appear to be “good listeners”, always listening to their friends and family and sharing little about their own lives. Beware if it seems as though your teen is always deflecting the conversation away from themselves. It may not be because they’re shy, or modest. It may be because they don’t see the point. No one is going to care anyway.

Understand that “I don’t understand what’s wrong with you!” is the worst thing you can say to a teen with depression. To anyone with depression.  Especially when it’s followed up with bits of parental wisdom like, “You’re a kid! What do you have to worry about?” Or, “You have a roof over your head, food on your plate. You have a thousand dollar computer. You have everything!” This will only push them away.

Understand that teens with depression need to take things day to day-sometimes minute by minute. Long term planning may literally be too much for them. Big projects are overwhelming-to this day I still have to break my to-do lists into teeny tiny micropieces that don’t take more than a few minutes each, then write them down so I can check them off in order to feel like I’m accomplishing something, even if that something barely scratches the surface.

The severely depressed may need help walking through their tasks one at a time, and learning that what they’re doing right then is the only thing they need to think about. Multi-step instructions like get out of bed, take a shower, eat breakfast, brush your teeth and get on the bus may seem overwhelming. Cleaning their entire room may literally be more than they can handle. (Especially if it looks anything like mine used to.)

Be willing to be flexible. Let chores wait until another day if they have a lot of homework. Help them with tasks that are usually their responsibility if you see them struggling. I promise you, they need the helping hand more than they need the reminder of what their responsibilities are.

Understand that your teen has to know they can come to you. Pushing someone with depression to talk about their depression leaves them feeling trapped. Not pushing them, on the other hand, can leave them feeling like you don’t really care. It’s a lose-lose situation….but it doesn’t have to be.

If you have a teen who suffers from depression, it’s up to you to open the door. Spend time with them alone, in a low stress environment. Encourage non-specific conversation about their lives, and ask them questions that make them know they’re the center of your attention. I know it’s almost instinctive, as parents, to remind teens that the world doesn’t revolve around them, but the teen with depression sometimes needs to feel like it does. “What do you want?” is a big one-often people who are living with depression are too wrapped up in day to day survival to worry about the future.

It can be hard, at times, to feel like they have one.  

An Open Letter of Apology to My Pediatrician

To Our Amazing, Wonderful Pediatric Providers: 

You see me, and other mothers like me, in your office every day. Overtired, under-caffeinated, without two brain cells to rub together to have a real conversation, looking at you with desperate eyes, expecting you to magically fix whatever brought us there in the first place. 

I see you once or twice (or five or six times) a month twelve months out of the year, so you know my face. But you don’t know me. In fact, there’s a good chance we’ve never met. Because that woman in your office? She’s not really me. 

I’m not really that crazy.

This is how I pretty much figure our pediatrician feels after every visit. (T-shirt for sale at Zazzle.com)

Please understand, by the time we make it to your office, I’m usually on day three or four (or ten) of not nearly enough sleep, often buried under the guilt of missed work hours and trapped in a house with a sick, whining, clingy, fussy child who is all too aware of the fact that I’ve failed as a parent. It doesn’t matter how magical or mysterious my mommy powers may seem when I can produce another lollipop out of my purse or immediately recognize ‘who started it’ from two rooms away.

Those magical mommy powers are useless here. I can’t make whatever is wrong with them go away. They need you…

…But they don’t want you, because even though you’re wonderful, and the kids really like you (I swear they do), you are the bringer of shots and things that taste yucky, and therefore should be avoided at all costs.

A typical visit to your office begins with me crawling bleary-eyed out of bed 30 minutes after the child that screamed all night long magically falls asleep, punching buttons on the phone I can’t even see, praying I got the right ones and that you’re there and that you have an opening. The sooner we get in, the sooner I can give the shrieking devil child that body snatched my little angel some medication that will make them feel better and maybe, just maybe, we can both go back to sleep for an hour or two.

You have no idea how badly I want to bake your receptionist a cake. Or send her flowers. Or buy her the Taj Mahal. Because the minute she answers the phone and tells me you can squeeze us in, an invisible weight lifts off my chest. Once we walk through the doors of your office, I don’t have to be Supermom anymore. You’ll know what to do. All we have to do is get to you, and so, without showers or breakfast or songs or games or cartoons or coffee or the million little things that start our day, we pack up and head out the door.

Do you know how much whining and complaining can take place between my front door and the moment you walk into the examination room? I do. Right down to the very last clause. It’s too cold. Too boring. Too hot. Too wet. Too boring. Too dry. It smells funny. It’s too noisy. Too quiet. Too scary. Too boring.

Did I mention it’s boring to sit and wait instead of swinging off the bed or the fan or the doorknob like a giant monkey (somehow they’re never too sick for that) and the only cure for this fatal condition is to drive mom as insane as humanly possible by tap dancing on her last nerve??? (Hint: Before coffee and a shower, it doesn’t take much.)

I’m not writing this to complain. I never mind waiting for you, because I know once you get to us we’re going to have your full, undivided attention for as long as we need it. That matters to me. It’s a big part of why we chose you to be our doctor in the first place.

But I am so, so sorry doctor. Because by the time you walk into the room, I…am…done.

I really WANT to ask you about your kids, and your garden, and where you’ve been that you’ve gotten so tan, because I know it wasn’t here. (Believe me, if there’d been that much sun, I would have noticed.)

I want to ask where you bought your shoes, and answer your questions about the book on my lap with the witty enthusiasm I’m known for in certain circles.

I want to know what you thought about the movie I saw you and your family at last weekend.

I want to let you chat with my child, because their face lights up every time you do and they giggle about it for days afterward.

I want to know YOU, because you’re one of the most important people in my family’s life, and that deserves to be recognized.

This is what I want to do, but I can’t. The minute you walk into the room my exhausted, tired, stressed-out brain loses touch with my mouth. Instead of greeting you politely and asking about your day, which is what I really mean to do…

…I hit you with a list of symptoms and complaints, because by the time you get to the party I just want you to figure out what’s wrong and write me a prescription so I can get the hell out of there, spend half an hour at the pharmacy while they explain to me how their e-prescribe didn’t work (again), call and interrupt your busy day yet again so you can fax it in, go home, put on cartoons, pour the Gatorade, then hide somewhere for half an hour to suck down a cup of coffee and gather up what’s left of my mind before I have to go back out there and be Supermom all over again.

This is when I’m going to start feeling guilty for the way I once again managed to walk into and out of your office without letting you know how much I appreciate the fact that you are who you are, and you’re there, and we’re so lucky to have you.

This is also usually where I come to grips with the fact that you probably think I’m my own special brand of crazy, and I’m REALLY sorry about that.

You know what amazes me most, doctor? That you see people like me all day, every day, and yet you still do what you do.

You are savior and inconvenience, with people looking to you for answers while at the same time wishing they were anywhere but there.

And yet, you’re still smiling.

Even when your eyes are dark with exhaustion and I can see how badly you want to be irritated with me, you smile.

Even when I’m being over the top and paranoid in the way that only a parent can be, you listen.

Even when you’re pretty sure at a glance that nothing is really wrong and you could be spending those 20 minutes sitting at your desk instead of on your exhausted feet, you do a full exam, order tests and follow up, just to be sure.

Even when you don’t have to, and no one expects you to (I swear, I really didn’t), you once spent the first half of your lunch hour calling for lab results instead of eating a meal in peace because you knew that I was waiting, and then spent the second half going over each and every piece and part and translating every result so I could be informed and involved rather than patting me on the head, giving me the short story and sending me on my way so you could enjoy your break. You’ll never know how much that meant to me.  

Even when you have office hours in the morning, when you’re on call I know you’re going to be understanding while I panic over fevers and rashes and casts that fall off and a million other little ailments that could have easily been dealt with in the office the next day.

No matter how irrational I’m being, or how badly you’d love to tell me to leave you alone for five fricking minutes so you can think (and maybe pop an Advil or two for that headache you’ve had brewing all day), I know you’re going to be patient with me.

Regardless of how long your day has been, or how very much of it is still ahead of you, you smile.

Do you know what that smile says, doctor? It says, “You’re not alone. It’s going to be okay. I’m here now, and together, we’re going to fix this.”

Right then I want to cry, because thank you isn’t enough to tell you how much that smile is exactly what I need.

And I’m sorry that I’ve never found the words to say how much I appreciate it, and you, and everything you do.

Notes to Myself as a First Time Mom

That used to be me.

Sitting around the dinner table, listening to moms of infants and toddlers and babies-yet-to-be, talking about diaper rash and fevers and agonizing over breast vs bottle. Walking through the park on a hot day and looking at little babies in cute little outfits and sweaters, with color coordinated socks and booties. Listening to moms agonizing to pediatricians about colds and fevers and rashes and what to do when baby won’t eat.

That used to be me-and for the record, Dr. Bradshaw, our kids’ pediatrician from the time Princess C was about 6 months old until we moved up here when G-money was three, deserves a gold medal for putting up with me!

Thirteen years of parenting later, I wish I could look back at my younger self and say, “Hey, breathe! Guess 

what?”

The world isn’t going to end if the baby’s socks don’t match. Two kids later, it’s a miracle if the socks have been folded. They usually end up in a basket somewhere. You’re going to lose half of them. Your youngest child will delight in wearing one sock pulled up to his knee and one too short to cover his ankles. “Doesn’t have to match, just has to fit” is going to become a motto, so you may as well get used to it now.

Your child is not going to be mentally stunted if you can’t breastfeed. I could have saved myself months of mental anguish over this. Yes, breast is best, but after 12 more years of fighting over the fact that peanut butter and jelly was never intended to be eaten 3 meals a day, the floor is not an efficient food delivery system, vegetables won’t kill you and tortilla chips aren’t a food group, the whole issue of breast vs. formula makes its way to the back burner. (Also, you’re going to have the only kid your doctor has ever seen that manages to self-wean from the bottle at 8 or 9 months old. You’ve got bigger problems.)

Mommy and Me classes are so worth it. Not because your kid needs additional enrichment, which is what you’re going to be worried about at the time, but because you’re going to need an hour or two out of the day where someone ELSE is responsible for coming up with ideas to keep your toddler occupied. Don’t let anyone talk you out of it. 

Don’t stress the birth plan. 13 years and two pre-term c-sections later, you’re going to give up any hope of birth going the way you wanted it to. You’re barely going to remember most of the details, and the only time you’re going to talk about it is as a cautionary tale to moms who are thinking about waiting until the last minute to get an epidural. (Bad idea. Just saying.) So do your homework, talk about it with your OB/GYN, but don’t freak out when the plan goes flying out the window. DO, however, start thinking about whether you want to breast or bottle feed, because that’s going to determine whether or not you get the good drugs on the way out the door.

It’s okay to hate being a stay at home mom. After having to put Mr. A in daycare when he was only a few months old, I was thrilled at the idea of being able to stay home with Princess C. That lasted 18 months, which is probably six months longer than it would have if I’d just kicked guilt out the door and faced up to the fact that some women aren’t meant to be a SAHM. I worked part time from the time she was a year and a half old until G-money was in second grade, and that worked out great for all of us.

Naps and sleep schedules matter (knowing when you’re going to have some adult time is vital for your sanity), but it’s also okay to toss them to the curb every once in a while. There will be some nights where the kids just aren’t ready for bed at bedtime for one reason or another, and it’s easier to toss a movie on and let them lie down in the living room and wind down than it is to argue with the tossing and turning and cups of water and “I gotta go!” that are going to still be going on for the next three hours if you try and send them to bed now.

Get some perspective. Sometimes it’s just not worth the fight. Learn to pick your battles, and try and give your kids as much independence and responsibility as possible without turning them into juvenile delinquents. You’ll all be better for it in the end.

Your husband is the most important relationship you’re ever going to have. You’re going to be a great mom, and your kids are going to love you for your patience and adventurousness and the easy-going, laid back manner you’re going to have one of these days. (Stop laughing. It's going to happen, I swear.) Don’t let being a great mom turn you into a crappy wife though. Your hubby still needs some time with just you, even if it’s just curling up with a cup of coffee while the kids watch morning cartoons. Your kids will learn what to expect from love and marriage by watching you, so make it good.

Take 20 minutes a day with each kid to just be together. The dishes will wait. The laundry will wait. People will judge you for your crappy housekeeping skills, but you know what? It doesn’t matter. What does matter is that your kids have the chance to be with you, because the bond you form with them now determines whether or not you’re going to be allowed to hug them in front of their friends when they get to be teenagers. (And sometimes the answer is still going to be no, no matter how snuggly they are when they’re at home. That’s okay too.)

In short, younger me, chill out. It’s all going to be okay.