Teenagers with mental health problems at a time of coronavirus – A Guide for Parents

Teenagers with mental health problems at a time of coronavirus – A Guide for Parents

It is hard to talk about mental health problems when everyone, no matter what their situation, is struggling with the challenges caused by the coronavirus. It is an exceptionally hard time for us all. Everyone will experience anxiety and stress as a result of these circumstances.

For young people there are particular issues that they are having to face. There is a huge amount of loss. This is partly because the normal structure of their lives has disappeared. But also because many of the opportunities and good things that they might have expected this Easter and this summer have simply been swept away.

It is not surprising that some young people feel cheated and angry. It is difficult to know what to do with such feelings. For a small number of teenagers these feelings will be expressed in behaviour that is worrying for those around them, especially their parents.

If you have a teenage son or daughter who is experiencing mental health problems, it may be difficult to get help in the normal way. Clinics are under huge pressure, and people in the helping professions are having to work extra hard to provide assistance to their clients.

I have heard of a number of young people who are really struggling at this time. I will just highlight a few of the situations that have come to my notice.

 

Here they are:

  • A 16 year-old girl who cannot stop crying. She cannot say why this is happening to her.
  • A 15 year-old boy who vandalized a neighbour’s car, something that he has never done before. All he can say is that he feels angry with the world.
  • A 17 year-old girl who has started cutting herself. She says she hates herself.
  • A 17 year-old boy who has gone to bed, and won’t get up and won’t talk to anyone.
  • A 14 year-old girl whose anorexia has got worse since the virus appeared. She says she needs to take control of her life as everything else is out of control.

 

It is very hard for parents

The suggestions I make here will not be easy. One of the key challenges for parents who are at home with their teenager will be to find a way of managing their own anxiety. The more anxious you are as a parent, the harder it will be for the young person to accept any help or support.

There is a reason for this. We know that young people worry about the effect of their distress on their parents. In most cases they want to be able to protect their parents, no matter how troubled they are themselves. They also go through a stage when they want to keep things to themselves. This is a normal part of teenage development.

Parents will be more able to provide help if they show that their anxiety is under control. It is so important to try and take a neutral position, as far as this is possible.

So here are some suggestions.

 

Acknowledging their distress

Find a way of letting your teenager know that you are aware of their distress, and that you want to help. However, it is important to avoid any words that can add to the teenager’s sense of guilt.

It is also important to avoid any wording that implies that you understand how they are feeling. Teenagers hate that, as they say it is patronizing. The usual response is: “You can’t understand me”.

So, what words to use?.  “My heart goes out to you”. “I feel so sympathetic”. “I can see this is very hard for you”. “I want to help, if I can”.

 

Reassurance

This is about letting the young person know that you won’t be shocked, frightened or damaged by their thoughts and feelings. One of the fears that young people may struggle with is the idea that their problems will have a terrible effect on you, the parent.

Somehow you have to find a way of letting the teenager know that, however shameful or frightening their thoughts, you are strong enough to cope. However bad it is, you can bear it, and you will try and help.

 

 

Being there for them

Another important message is that you will be there for them. They need to know that you love them, and that no matter what happens, you will do your very utmost to help. Teenagers need to know that you will stick with them, and you won’t reject them because of their distress.

If is possible, think about actions that will let the young person know you are wanting to offer support. Could you make their favorite food?. Could you give them more responsibility in the home?. Could you get out old family photos to emphasize good experiences that you have had in the past?.  Could you play games with them that they would enjoy?. Being available is the most important message.

 

 

Things it is best not to say

If at all possible, try to avoid begging or pleading with the young person. Try not to lecture. Try not to criticize. Try not to judge the teenager’s behavior.

 

 

Why do I say this?

Because all these approaches represent your views, and your agenda. At this time the teenager cannot cope with your agenda. The only way to open up communication is to find a way into their own agenda. And to show that you will be really, really listening to them.

Of course, this is not to say they will talk. But you can be sure they won’t talk if you plead, judge or criticize.

 

 

The role of the school

Although schools are closed at this time, many parents will have a contact within the school system who may be able to give advice. This may be a Head of Year, a pastoral lead, or a Head of Well Being. Schools vary in their support structures, but most will have some way of providing a link to helping services. Some may also offer telephone guidance for parents on the best steps to take if one of their students is showing mental health problems.

 

 

The very worst thoughts

The possibility of suicide is the worst fear of any parent. There are many myths about what to do and what not to do if you worry about this. It is also of course incredibly hard for any parent to open up this topic.

However, there are ways of showing that you won’t be shocked, and of showing that there are ways to get help if this is something the young person is struggling with. You might say something like:.

“I know people who are in distress sometimes do think about death, about ending it all. If you do. have thoughts like that, there are people you can talk to. You may not be able to talk to me, but there are others who will listen and try to help you”.

This does two things. It acknowledges the distress. It also shows that you are not frightened by the distress the young person is experiencing.

 

 

What next?

You will notice I have mentioned talking a lot. Since it may be difficult to get professional help at this time, finding a way to encourage your teenager to talk is something you may want to try.

The first thing to note is that they may not be able, or not want, to talk to you. However, if they can do so, that will be a good thing. So, you can try, and keep trying. If the first or second attempt does not work, just make it clear that you are always going to be available to listen.

Here are some things you might want to say.

“However hard it is, talking about your thoughts and feelings will help you.”. “ I know it’s difficult, but it is worth having a go”. “Putting your thoughts and feelings into words really will help you.”.  “You may feel ashamed, or worried about talking.”. “It may be hard for you to talk to me, but perhaps we can find someone else you can talk to.”

 

If they can’t talk, don’t want to talk, or say it is a waste of time

If this is the case, here are some other options.

Perhaps your teenager might be able to send you a text or email?. Or message you in some way about their feelings?

If this is not appropriate, you might want to suggest simply writing down thoughts or feelings. This might be a good start. Sometimes it is helpful to get ideas out of your head and onto a piece of paper.

If none of that is possible another option is to try and find someone in your family network who might be a possible listener. If there is no one like that, then perhaps someone who is known to the young person in your social network.

 

 

What to say when you don’t know what to say

Because of the situation we are all in, it may be hard to know what to say when your teenager is clearly distressed. Keep in mind that you don’t have to say anything. In a difficult situation we often feel that we have to say something, we have to respond. In fact, just being there, being available to listen may be all that is needed.

 

 

What services are available?

If none of the above is appropriate then there are helplines and on-line resources that might be a possible route for seeking help. There are also apps that young people can download on to their phones that provide guidance about managing things like depression or anxiety. There is a list of sources of help at the end of this blog (see Appendix 1). If your teenager is taking medication and you need advice about this, your GP should be available on the phone or on-line.

 

 

Another option to encourage communication between you and your teenager

At the end of this blog I have included a very short quiz. This does not address mental health problems, but it does ask some questions on young people’s feelings about the virus and about their present situation. It may be possible to start a conversation with your teenager through the use of the quiz. (see Appendix 2).

 

 

Social media

There has been a lot of publicity about the negative effects of certain websites on the mental health of teenagers. Fears have been expressed that some sites encourage harmful behavior such as self-harm or anorexia. However, there is another side to this. Research has shown that, for some, the on-line world does provide support and reassurance. This is not true for everyone. But there are certainly those for whom social media enables them to get in touch with others who are helpful to them. The lesson for parents is that not all social media is harmful. If at all possible, try and keep an eye on what your teenager is doing on-line. Don’t be afraid to ask about this. The more you can keep the conversation going about what your teenager is doing on-line the better.

 

 

Getting help for yourself

The situations I am imagining here will be extraordinarily stressful for any parent to manage. So, it is important to think about getting support yourself. This will be good for you, and will of course enable you to provide more help for your teenager. There are a number of organizations now that offer support for parents in your situation. Some are virtual support groups through platforms such as Facebook. Others provide helplines and chat rooms. A list of these can be found at the end of this blog (Appendix 1).

 

 

Talking and listening might not be enough

This will depend on the nature of the distress that is being experienced by the young person. For some circumstances talking will not be enough. You may want to know how to manage behavior that appears destructive or damaging to other people.

Firstly, it is essential for you to be able to set boundaries in relation to behavior that is harmful to your teenager or to others in the family. If you believe these boundaries are being crossed then you must act. This is the time to seek help from the emergency services. You can also call the helplines detailed at the end of the blog.

Secondly, there may be things you can do to keep people in the family safe. Identify any potentially harmful substances in the house, or any knives or weapons. Give some thought to the domestic arrangements around you. Ask yourself if there are things you can do to reduce the risk of harm to any members of your family.

 

 

 

 


APPENDIX ONE

HELPFUL RESOURCES

There are many helping organisations which offer support to parents and teenagers. I will select three for teenagers and three for parents here.

For teenagers

The Mix. Essential support for under 25s. This provides support through many media, including group chat, discussion boards and so on. Telephone 0808 800 4994. www.themix.org.uk

Shout. Again, providing support in many different formats. Text Shout to 85258 or email info@giveusashout.org

Childline. The most well- known support organization for young people. Telephone 0800 1111.

 

For parents

Family Lives. Provides a comprehensive range of support services, including an informative website. Telephone 0808 800 2222. www.familylives.org.uk

Rollercoaster Family Support. A specialized organization which provides support for parents who have teenage sons or daughters with mental health problems. Telephone 0741 538 0040.

Young Minds. A mental health charity having a specialized helpline for parents. 0808 802 5544. www.youngminds.org.uk

 

 


APPENDIX TWO

 

THE QUIZ (a tool to get you talking)

For teenagers – complete this by circling a number that represents your feelings. Share the reasons for your answers with someone in the family who you are able to talk to.

 

I FEEL SCARED ABOUT THE VIRUS. . (1 = I feel very scared, 5 = not scared at all)

1 . . . . . . . . . .   2 . . . . . . . . . .   3 . . . . . . . . . .   4 . . . . . . . . . .   5 . . . . . . . . . .

 

I HAVE LOTS TO DO NOW I AM AT HOME.  (1 = I have lots to do, 5 = nothing to do)

1 . . . . . . . . . .   2 . . . . . . . . . .   3 . . . . . . . . . .   4 . . . . . . . . . .   5 . . . . . . . . . .

 

I FEEL ANGRY ABOUT WHAT HAS HAPPENED (1. = I feel very angry, 5 = not angry at all)

1 . . . . . . . . . .   2 . . . . . . . . . .   3 . . . . . . . . . .   4 . . . . . . . . . .   5 . . . . . . . . . .

 

I THINK THERE IS MORE I COULD DO TO HELP MY FAMILY. (1 = there is more that I could do, 5 = I am doing all I can)

1 . . . . . . . . . .   2 . . . . . . . . . .   3 . . . . . . . . . .   4 . . . . . . . . . .   5 . . . . . . . . . .

 

I FEEL CHEATED BECAUSE OF THE VIRUS. (1. = I feel cheated, 5 = not cheated)

1 . . . . . . . . . .   2 . . . . . . . . . .   3 . . . . . . . . . .   4 . . . . . . . . . .   5 . . . . . . . . . .

 

I FEEL CLOSER TO MY FRIENDS NOW.  (1 = I feel closer to my friends, 5 = not as close to my friends)

1 . . . . . . . . . .   2 . . . . . . . . . .   3 . . . . . . . . . .   4 . . . . . . . . . .   5 . . . . . . . . . .

 

I WORRY ABOUT MY FAMILY BECAUSE OF THE VIRUS. (1 = I worry a lot, 5= I do not worry about my family)

1 . . . . . . . . . .   2 . . . . . . . . . .   3 . . . . . . . . . .   4 . . . . . . . . . .   5 . . . . . . . . . .

 

I FEEL LONELY NOW THAT I HAVE TO BE AT HOME. (1 = I am lonely, 5 = I am not at all lonely)

1 . . . . . . . . . .   2 . . . . . . . . . .   3 . . . . . . . . . .   4 . . . . . . . . . .   5 . . . . . . . . . .

 

I AM ANXIOUS ABOUT WHAT THE FUTURE HOLDS FOR ME AFTER THIS VIRUS IS OVER. (1. = I am really anxious about the future, 5 = I am not at all anxious)

1 . . . . . . . . . .   2 . . . . . . . . . .   3 . . . . . . . . . .   4 . . . . . . . . . .   5 . . . . . . . . . .

 

 

 

 

 

Parents and teenagers at a time of Coronavirus

Parents and teenagers at a time of Coronavirus

Contents

  1. A brief guide for parents
  2. Making sense of teenagers’ emotions
  3. Tips for parents
  4. Tips for teenagers
  5. A quiz for teenagers to complete

 

A brief guide for parents

Being stuck at home for weeks on end will be a huge test for all families. Even if parents and young people get on reasonably well, there will be many problems that arise because of being in the house or flat day after day.

Space

  • However small or cramped your home, try and find a space for a young person to feel that they can own. If they have their own bedroom, allow them more freedom than might be the case in normal circumstances.

Time – routines

  • One way to manage anxiety is to create daily routines. This is true for us all, but especially for teenagers. Do think through with your teenager how a daily routine can be created. This also applies to night-times of course.

A structure to the day

  • It is sometimes assumed that teenagers do not need structure. This is incorrect. In fact, a structure set by adults makes young people feel safe and cared for. Teenagers may argue against it, they may even say they hate it. But a major role for parents is to create boundaries and structure for teenagers. They need it.

Screen time

  • The simplest thing to say about this is – do not worry about screen time in these circumstances. We are all living through the on-line world. Teenagers need all the contact they can get with their friendship network. Also of course school work is now being delivered on-line. The digital world is a life-line.

Social media

  • The same goes for social media. What we say in normal times is true now. Do talk with your teenager about what they are doing on-line. Open communication is important. If you are worried about how much they are gaming, for example, do discuss this with them. Parents should keep an eye open, but also allow more freedom than would be the case in normal times.

Eating and sleeping

  • Things like eating and sleeping are often markers of how young people are coping. It is good for parents to be alert to how these things might have changed under these new circumstances. Don’t be afraid to discuss health issues with your teenager. Talking about such matters shows the young person that you care about them and their welfare.

 

Making sense of teenagers’ emotions

It is clear that teenagers are having a rough deal. Most young people will have lost all the usual structures. This experience is tough for them. Their expectations of what would be happening this spring and summer have been blown out of the water.

Feeling cheated

  • Although it may strange to some adults, it will be common for young people to feel that they have been cheated out of important experiences that they were owed. They may be missing the last term at school, or even the last part of their university education. They have also been separated from face-to-face experiences with their friendship groups. If you are young, these experiences loom very large in your world.

Feeling angry

  • Because of this, many will feel angry. Even if they recognize that it is no one’s fault, angry feelings can be over-whelming for teenagers. It can feel extremely unfair for this to have happened to them and their friends. It may be easier for adults to see the larger picture. Adults can recognize that this will be over at some time in the future. For teenagers, however, this will seem like the whole of their life that has been taken away from them.

Feeling anxious

  • There is also the question of worry and anxiety. Will my parents stay safe?  What about my grandparents? Am I safe from the virus?  Of course, adults will have these feelings too. Adults will worry about elderly parents, or have fears for their own health. However, the emotions of young people may be harder for them to cope with.

Teenagers and emotion

  • Why is it harder for teenagers to manage their emotions? One reason is that at this age the structures in the brain that process and manage emotions are still changing and developing. These structures are not yet completely mature. Also, hormones play a part in helping us manage our feelings. The hormone balance for teenagers is more variable than it is for adults.
  • It is also important to recognize that young people will have experienced a real loss at this time. This is part of their life that they will never get back. It is very tough, especially at a time when they are changing and maturing. Adults will struggle with many challenges at this time. It is just important to recognize that the challenges for teenagers may not be quite the same as those for adults.

 

 

Tips for parents

  • Talking is important. But  ……
  • Teenagers do not want to be lectured or to be interrogated;
  • Teenagers like to talk at times that feel good for them;
  • Teenagers like to know that they are being listened to;
  • Teenagers do need to hold some things back till they feel safe to open up.

 

Tips for teenagers

  • Talking is important, but ………
  • Parents want to listen, but they may sometimes find it hard to really listen;
  • Let them know you want to talk, but when it feels right for you;
  • Encourage them to talk about themselves, not just to focus on you;
  • Let them know what you need from them. It is ok for you to let them know that;
  • If you feel uncomfortable talking to your parents, try and find some you trust. Sharing your fears and worries at this time is SO IMPORTANT.

 

What can you do?

As a start, teenagers can use the quiz provided here. This should be a way of starting to talk about some of the feelings they may have at this time. It should also lead to a discussion of anything that could be improved to make things a bit more manageable in the family.

 

QUIZ (a tool to get you talking)

For teenagers – complete this by circling a number that represents your feelings. Share the reasons for your answers with someone in the family who you are able to talk to.

 

I FEEL SCARED ABOUT THE VIRUS    (1 = I feel very scared, 5 = not scared at all)

1                          2                                3                               4                               5

 

I HAVE LOTS TO DO NOW I AM AT HOME   (1 = I have lots to do, 5 = nothing to do)

1                           2                              3                                 4                              5

 

I FEEL ANGRY ABOUT WHAT HAS HAPPENED (1  = I feel very angry, 5 = not angry at all)

1                           2                            3                                  4                              5

 

I THINK THERE IS MORE I COULD DO TO HELP MY FAMILY  (1 = there is more that I could do, 5 = I am doing all I can)

1                           2                           3                                  4                               5

 

I FEEL CHEATED BECAUSE OF THE VIRUS  (1  = I feel cheated, 5 = not cheated)

1                            2                         3                                  4                               5

 

I FEEL CLOSER TO MY FRIENDS NOW   (1 = I feel closer to my friends, 5 = not as close to my friends)

1                           2                          3                                 4                                 5

 

I WORRY ABOUT MY FAMILY BECAUSE OF THE VIRUS  (1 = I worry a lot, 5= I do not worry about my family)

1                             2                         3                               4                              5

 

I FEEL LONELY NOW THAT I HAVE TO BE AT HOME  (1 = I am lonely, 5 = I am not at all lonely)

1                             2                        3                               4                               5

 

I AM ANXIOUS ABOUT WHAT THE FUTURE HOLDS FOR ME AFTER THIS VIRUS IS OVER  (1  = I am really anxious about the future, 5 = I am not at all anxious)

1                             2                         3                              4                                5

 

 

 

 

 

 

 

Information management

Information management

A parent recently asked me why her daughter was willing to tell her certain things, but clammed up when asked about other topics.  I replied by telling her the story of one young woman who said to me:  “I do tell my Mum things, but not at the time they happen.  I have to get them sorted in my mind first”.   This response underscores a topic that has been the subject of research in social psychology recently, a topic that is known as “information management”. This refers to the fact that young people take an active role in managing the flow of information between themselves and the adults around them.

A young person may not disclose because they think the information will be hurtful, or will worry the adult. They may hold back because they think it is none of the adults’ business! Topics to do with sex and romance probably come into this category.  Or, as indicated above, they may wish to wait till they are clear about the consequences of talking about a particular topic.

The conclusions of this are clear.

  • Young people think carefully about how to manage information;
  • They make decisions on what to talk about based on all sorts of reasons, some of which may be to do with protecting their parents, or not wanting to worry them;
  • Teenagers have clear and well-thought out views about what parents ought to know, and what they do not need to know;
  • This topic – information management – illustrates clearly that communication is a two-way process. Simply giving instructions, or asking questions (thought of as “interrogation” by young people) is unlikely to lead to good conversations!
  • Good communication between parent and teenager depends on the adult being willing to listen and well as talk. Most importantly it is worth remembering that young people take an active role in deciding what to communicate, and when to do so.

 

 

 

 

Knife Crime

Knife Crime

The deaths and injuries to young people in our city centres as a result of knife crime are both a disgrace and a terrible tragedy. Yet the response of politicians and policy makers has been to lay the blame almost entirely on falling police numbers. As a result of this claim the suggested solution almost always comes down to increasing stop and search and putting more police on the streets.

This is clearly ridiculous. Even if the current number of police were to be doubled, there would be relatively little impact on knife crime. The reason for this is clear. Knife crime has many determinants, and is affected by a wide range of social, psychological and economic factors.

Firstly consider the impact of austerity. Youth work has been decimated, and leisure opportunities for the less academic teenagers in inner city areas have largely disappeared. Add to that the fact that all types of support for social and emotional problems, both in school and in the community, have been drastically reduced.  This has meant that any early intervention work is now extremely difficult. In addition when a young person is identified as having a problem there is little chance that very much help will be available.

We cannot ignore the fact that almost all knife crime involves boys and young men.  So we need to give some thought to adolescent development for the more vulnerable males in our society.  These young people get their support from the peer group. Their identity is tied up with the experiences of others, either older siblings or friends, who have poor experiences of school. It is hardly surprising that they turn to alternative activities, those that are based on the street and neighbourhood.

What routes to adulthood are available for vulnerable young men in inner cities?  Politicians would do better to consider this question rather than arguing over stop and search and the number of police on the streets.

 

 

 

Teenagers and sleep

Teenagers and sleep

It has been really exciting to see the development of sleep lessons for young people, developed by Dr Michael Farquar in association with the PSHE Association.  I have long believed that good sleep is a key element contributing to the health of teenagers.  It is hugely encouraging to see that schools and the general public are at last taking this seriously.

As part of the wider range of research on brain development in adolescence, we have learnt that the hormone melatonin is released later at night in young people than in adults.  Melatonin is the hormone which signals that it is time to go to sleep.  This finding, that melatonin is released later in teenagers, is critical as it highlights a key reason why many teenagers find it hard to go to sleep at night.

This has big implications.  Sleep is important for teenagers, probably more important that it is for younger children.  If young people have to get up early for school, they may be missing some hours of much needed sleep.  Research tells us that sleep deficit (less than seven hours a night) can have a negative influence on both learning and behaviour.

Why is sleep so important?  Firstly it is the time when growth hormones are released.  Adolescence, particularly early adolescence, is of course a time of significant growth and development.  Secondly we have learnt that something very important happens to memory during sleep.  It is a time when memories collected during the day are consolidated.  The brain is really busy during sleep, so learning is affected if the individual is not getting enough sleep.  A good book on this is “Why we sleep” by Matthew Walker (2018).

The idea of providing sleep lessons in school is so that the problem of sleep loss can be overcome.  It seems unlikely that schools will agree to what is known as “ delayed starts”, i.e. starting the school day at 10.00 or 11.00.  Trials with this plan have not been popular with teachers or with parents.

However if schools can include lessons on the importance of sleep, and offer advice to young people on how to overcome the melatonin problem, this can only have a positive influence on school performance and on the emotional health of students.

Here are some ideas about developing good sleep patterns for teenagers:

  • Turn off all digital devices at least a half hour before bedtime;
  • Turn lights down, put on soothing music;
  • Have a hot drink of some sort (without caffeine);
  • Most important of all, get into a good sleep routine. Routines make all the difference;
  • Lastly, many teenagers may find these suggestions hard to carry out. This is where adults come in.  Parents and carers can play a key role in helping in the development of these routines.