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What you need to know if your child is depressed. (No. 1: You are not a failure.)

September 24, 2023

A woman walked into an emergency room with her 13-year-old son, her lips pursed. He was there for a psychiatric evaluation for suicidal thoughts that he had voiced to his school counselor. After my evaluation of her son, I sat down with her to talk. She didn’t look pleased. “I hope you’re here to tell me you’re discharging him,” she said. “We have to get to soccer practice in an hour.”

What I was about to tell her was the opposite. “Actually, I’m here to tell you about your son’s depression,” I said to her gently. I told her he had been struggling for the past few months and that the past week had been especially tough. I told her about his difficulty falling asleep, and how much of a struggle it was for him to get out of bed in the morning. I told her that what she saw as teenage snippiness was stemming from something much deeper, based on my assessment as a child psychiatrist. What was hardest to tell her, however, was how far the depression had gotten.

“For the past few days, he has been feeling like he doesn’t deserve to be alive,” I said. “I’d like to refer him for hospitalization to get more help in a safe setting, because what’s going on here is perfectly treatable, and he doesn’t need to struggle this way anymore.”

“Safe setting?” she shouted. “Home is a safe setting! And that’s where I’m taking my kid right now!” She pulled out a notebook from her handbag to show me the appointments she had made for him to see a new therapist. She reviewed the activities she had scheduled so that he could feel connected to peers, get exercise, and stay healthy. “I’m doing all the right things, and my kid is fine,” she said. “How dare you tell me he’s not safe?”

leaned in closer. “You are, in fact, doing all the right things. You’re a loving parent, taking all the right steps to protect your kid. But sometimes even the best parents can’t save their kids from their depression, anxiety, or other mental health symptoms. If he were here for an asthma attack, would you keep him from getting the treatment he needs?” Her face softened, and she burst into tears, slowly shaking her head.

The more I sat with her, listening, the more she shared. She admitted that the idea of acknowledging that her son was depressed made her feel like a failure. She had been feeling isolated from her friends, wondering what they would think if they knew. She had become less intimate with her partner, spending most nights thinking about what she could have done differently for her son. She eventually reached for a tissue and quietly agreed with the treatment plan.

For parents who have a child struggling with mental illness, the most important thing to remember is that you are not alone. According to the National Alliance on Mental Illness, 17 percent of kids ages 6 to 17 experience some sort of mental health disorder, and 50 percent of all mental illness starts by age 14 (75 percent by age 24). If your child is struggling, here’s what you need to know and how you can be most supportive in their time of need:

Mental illness is just like any medical illness. It can’t always be prevented, but it can be treated.

The brain is an organ, just like anything else in the body. Sometimes your kids are going to fall sick. And, just as you would take your child to see a doctor to get treated for a broken arm, a seizure disorder, or pneumonia, you can take them to see a doctor when things go wrong with their brains.

At the end of the day, a lot of illnesses are genetic, and no matter your environment, no matter how much you nurture your kid, sometimes the nature part – the genes – will win. Sometimes no amount of parenting books, organic food or breaks from screen time will help. And that’s OK. As long as you are able to acknowledge mental illness for what it is, you’ll be able to help address it sooner rather than later.

In fact, the sooner mental illness is addressed, the better. Studies have shown that the average delay between the onset of symptoms of mental illness and first contact with a psychiatrist is 11 years. You wouldn’t wait 11 years to take your child to see a doctor for a broken arm, would you? Their mental health deserves the same treatment.

It’s critical to reflect on your own feelings so that they don’t get in the way. Finding out your child struggles with their mental health isn’t easy, and there are likely going to be tough emotions involved. But just because your child is depressed, that doesn’t necessarily mean it’s a reflection on you or your parenting ability.

Some parents struggle with feelings of guilt, and others feel helpless, distraught, scared or confused. Some might even feel relieved, knowing that it’s not them but something medical for which they can seek help.

Whatever the feelings may be, it’s critically important for parents to recognize them so that they don’t come out in ways that inadvertently harm the child or keep them from getting the help they need. Although it’s normal to feel these things, parents should be warned that emotions often do impair judgment and cloud decision-making, as many studies have shown. It’s best to anticipate this and leave the treatment decisions to the professionals. If you continue to struggle with your own feelings and reactions, consider looking for help yourself; you’ll need all the strength you can find to really be there for your child during this tough time.

Recognize where you can be the most helpful – and leave the rest to the experts.

You are the expert on your child. Your clinician is the expert on treatment for your child’s condition. To be the most helpful, focus on helping the clinician understand the ins and outs of who your child is and what’s going on with them. How would you describe their personality? Their strengths and weaknesses? Whom do they connect with? Whom do they look up to? How do they talk about the future, if at all? A timeline here is particularly helpful; try describing when you first noticed that your child was not seeming like himself. These are the things you can provide to best equip your clinician with the information they need.

Your clinician will make a diagnosis and recommend a treatment plan that’s in your child’s best interest. Although the idea of leaving this to the professionals may seem daunting, keep in mind they’ve often had a decade or more of training; this is an area where they’ve learned the medicine behind it all and have seen patterns in practice from many other kids. You and your child aren’t alone in this, after all.

About the Author: Neha Chaudhary

Chaudhary is a child and adolescent psychiatrist at Massachusetts General Hospital and Harvard Medical School. She is a co-founder of Brainstorm, the Stanford Lab for Mental Health Innovation, and is on the APA’s Committee on Innovation.

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