No matter how hard you try, your children are eventually going to find out everything about you — the great, the not-so-great and the things you'd hoped to hide away forever. But when it comes to mental illness, the one way parents can ensure their kids don't grow up believing it's shameful to live with depression, anxiety or any other disorder is by opening a line of communication with them and being honest about their own illness.
Easier said than done, of course. While a parent may know in her heart that a truthful discussion about her illness can ultimately lead to less fear in her child, particularly if a genetic influence plays a role in that disorder, it rarely seems like there is an ideal age or moment in which to bring it up. And even when heart-to-heart discussion times present themselves over quiet breakfasts or walks in the park, how much should you reveal — can or should you try to get away with concealing your depression or anxiety?
Absolutely not, says Mayra Mendez, Ph.D., LMFT, a licensed psychologist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John's Child and Family Development Center in Santa Monica, California. Mendez reminds parents that speaking to children about mental health conditions can only help demystify uncertainty and confusion, clarify misconceptions and promote understanding that mental health conditions are real and treatable.
"An honest and understandable discussion with a child about the parent’s mental health issues can support the relationship by reinforcing communication, engagement and help the child make sense of feelings, behaviors and responses of the parent," Mendez says. "Sharing of information at a developmentally appropriate level for the child supports the parent/child bond, reinforces trust and promotes the prevention of distortions, misperceptions and negative stereotypes associated with mental illness."
So, you've decided to be an open book with your children — now what? Believe it or not, Mendez says you needn't wait until your child is a teenager to begin talking to them about mental illness. How you present the information is more important than waiting for your child to reach a specific age.
“The sharing of information about mental illness can be considered as young as preschool age,” Mendez says. “Of importance in the discussion is the developmental capacity of the child. For example, a preschool-aged child is more likely to respond to visual information such as labeling feelings of sadness if the child witnesses a parent sobbing or labeling feelings of concern if the child witnesses a parent pacing or trembling. Preschool-aged children notice behaviors and expressions and pick up on vocal tones. Offering long verbal explanations would not be developmentally appropriate to a preschool-aged child.”
The best time to speak to a child about any condition is a time when the child is relaxed, attentive and perhaps asking questions, Mendez says. If your child asks you a question, your response should contain only enough information to meet the child’s level of understanding — no more, no less.
"It is advisable for parents to use stories, read books that are written at a developmentally appropriate level and share information about getting help using language such as 'seeing the doctor who is helping Mommy or Daddy,'" Mendez says. "It is important for the delivery of the conversation to take place in a quiet, calm environment, in a calm tone of voice and with soothing facial expressions. At any age, the conversation outcome should be one that provides the child with reassurance and does not leave the child in distress."
If your greatest fear in discussing your condition is that you'll instill fear in your child, Mendez says the best thing you can do is provide reassurance that you are getting help so that they begin to understand that mental health symptoms are manageable. Depending on their age, you may need to address the topic several times over the next few years as they grow, mature and want to learn more (which proves you're doing a great job).
But what should you do if you start to see signs of a possible mental illness developing in your child? As a parent who is already knowledgeable about mental conditions, you're in a great position to advocate for your child and help her or him feel empowered to seek help.
If you are concerned about your infant or preschool-aged child, Mendez says parents should consider consulting with a mental health professional that has training in infant or preschool mental health assessment, diagnosing and treatment. For children 6 years of age and older and adolescents, she recommends seeking consultation with a mental health professional who has knowledge and experience of child and adolescent conditions.
There are many ways parents can connect to mental health treatment. These include contacting their insurance provider for a mental health referral; requesting a referral from a child's pediatrician; talking to their own mental health provider about a referral to a child specialist; contacting 211 for community resources; checking with the local department of mental health information line for resources and referral options; asking other parents who may have experience with mental health systems of care or connecting through social media with nationally recognized mental health organizations such as the National Alliance on Mental Illness, National Institutes of Health, Centers for Disease Control or local departments of mental health for the state of residence.
"Getting help early benefits families with concrete assistance, enhances opportunities for emotional support, provides families with developmental guidance, supports the healthy progression of the parent/child relationship, provides early diagnosing and treatment to prevent decompensation and deterioration of functioning and supports families with advocacy information," Mendez says.
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