How do you talk to children about mental illness?

[LynnS6]

Advice for explaining my anxiety attacks and anxiety/depression to my kids?

I had pretty severe PPD, got medication and I don't think my kids remember the last time I had a downswing. I'm having one now, and while  I hope it isn't going to be as bad as it was when they were each newborns, it's noticeable to them.  Actually dd (age 7) more or less thinks that I'm having stomach trouble because of one of the side effects of my anxiety attacks is nausea. Ds (age 10) is a bit more perceptive and knows something is up. (OK and he saw me crying my eyes out after church. The crying was good for me, and helpful for me to know I've got a supportive community. But it freaked him out, I think.)

I'm working with my doctor and should be OK in a few weeks, I hope. But since this is more than 1-2 day down period, I'm feeling the need to perhaps explain a bit more. Partly so they understand what's wrong, but also partly because anxiety/depression runs rampant through my family. There's a pretty good likelihood that one or both of them will suffer from this as they get older. (They're already sensitive kids who are more anxious than others their age.)

I just have no basis for starting/holding this conversation since it was never ever discussed in my family of origin (even though my mom has had severe depressive episodes, my oldest sister fights a continual battle with depression, and several other sibs have had issues with anxiety). There was a fair amount of self-medication with alcohol in the grandparent/great-grandparent generation, and that's another reason I'd like to talk to my kids about it.

Ideas? Resources?

[Mummoth]

I have anxiety and depression and tried to explain it to the kids. Basically I said that our bodies have special juices inside them called hormones, and your body has a recipe to make you feel like you normally do. When something scary happens, your body changes the recipe and lets out more scary juice so you'll feel scared. This is good, because if you didn't feel scared, you might not stop yourself from falling or something like that.

When you get a hug, or something funny happens, your body changes the recipe so that you feel happy. This is good because we need our friends and family, and feeling good around them makes us want to be with them. When something doesn't go the way we want, our body changes the recipe so we feel stressed or frustrated. It's a little bit like when we are scared... we don't like the feeling, so we try and make things better.

You go through as may feelings as you want like that, and then you explain that you have a thing called anxiety where sometimes your body mixes up the recipe and puts in scary juice at the wrong time. You have medicine that helps your body get the recipe right, but it's going to take your body some time to learn. Crying is one way that you let the extra juice out, so they don't need to worry about you crying, it's just you trying to help your body feel normal again.

You can tell them that if their body ever gets mixed up, they might feel sad or scared for no reason they can think of. Ask that they tell you, or they ask to see the doctor and you can help their body fix their recipes. It will probably take some repetition, at least of the "If you ever feel sad for no reason..." part, but I think kids can understand this. I hope you feel better soon!

[meemee]

first i'd make sure they understand MI is an illness for which one needs medicine.

express yourself for a bit. like after you had a good cry - let them learn that it was a good release. 

they dont need to 'know' what exactly is going on with you, unless they directly ask - but they need to understand why you are behaving in an uncharacteristic manner. 

just understanding mama is going thru a hard stage, that she is taking medicine to help her - that sometimes she is sad or tired.

i would imagine all they care about is will my mommy be ok. 

i am sorry i dont have resources to help you with. you always have such great recommendations. 

[AllisonR]

MUMMOTH - what a lovely example. Lynn, maybe you can use this, in a more detailed way for your older DCs?
 

Originally Posted by LynnS6 

I'm working with my doctor and should be OK in a few weeks, I hope. But since this is more than 1-2 day down period, I'm feeling the need to perhaps explain a bit more. Partly so they understand what's wrong, but also partly because anxiety/depression runs rampant through my family. There's a pretty good likelihood that one or both of them will suffer from this as they get older. (They're already sensitive kids who are more anxious than others their age.)

All the more reason to be very clear with them. They are old enough for a fair explanation. Also because it may help them see the same problem in themselves, and how you deal with it - openly, will show them the options. In my family MI is a deniable, shameful and sinful issue. I haven't even discussed my own problems with my mother, because I really don't need the added harassment. But - I plan to be open with my kids, in a very age-appropriate way. As I see DD takes after DH and DS so clearly takes after me - I want them to have the info and resources they need. 

[Miss Information]

I lean towards depression too, for various reasons.  I also have some other issues stemming from childhood that contribute to my moods today.  

I'm currently unmedicated...and I'm trying more cognitive-behavioral approaches.  But sometimes I do just end up crying.   And in front of my girls.  I just tell the truth and very simply.  Sometimes I get sad...and crying helps me release some of the sadness.  If I can think of something specific that triggered it (a memory or a current event) then I'd add that too (for example, sometimes I think about people I care about who are sick...that makes me feel sad for them...and I cry...and I feel better afterward). 

Emotions are normal.  I try to teach my children (and my husband) that "happy isn't the only acceptable emotion."

I thought I might add other thoughts to the mix.

You don't have to answer these questions...just something to think about.

Are you hypothyroid or anemic? 

You can be hypothyroid and still have normal blood results (the test range they use in the US is not like ones they use elsewhere...so you may actually be in the hypothyroid range and not know it).  Hypothyroidism and anemia can cause physical sluggishness too which can make someone think they are depressed.

Have you or anyone in your family been diagnosed with celiac disease?  Undiagnosed celiac disease can cause mood issues (and a lot of other auto-immune problems), the reason being damaged small intestine will prevent absorption of nutrients.  If you don't get nutrients to the brain...you won't get those feel good chemicals either.

Do you exercise? Get out in the sunshine (for the vit D3) enough? 

Do you take calcium/magnesium?

Do you drink too much coffee...consume too much sugar?  Those things definitely affect mood when you crash from them.

I'd say that some (if not most) forms of depression are due to not taking care of our basic needs and our thoughts which can be changed without medications. 

Are you also using therapy to help along with medications?  I think it should be required to to both for optimal recovery.  Mostly because the long-term use of antidepressants will decrease your lifespan by about 25 years (of course if you are suicidal without antidepressant medication, I'd take the medication, so you would need to weigh out the pros and cons).

If possible, think of the meds as a short term bridge while you build a repertoire of better coping skills.

Have you heard of David Burns Feeling Good?

The good news is that anxiety, guilt, pessimism, procrastination, low self-esteem, and other ′black holes′ of depression can be cured without drugs. In Feeling Good, eminent psychiatrist David D. Burns, M.D. outlines the remarkable, scientifically proven techniques that will immediately lift your spirits and help you develop a positive outlook on life.

I had found a very helpful couple of articles from Dr. Joseph Carver about Emotional Memory Management which may help head off depression and anxiety.

Rule: The brain operates on chemicals.

Rule: Thoughts change brain chemistry.

Rule: The brain is constantly, every second, pulling files (old memories) for our reference. It scans and monitors our environment constantly.

Rule: The emotional part of a memory begins 90 to 120 seconds after a file is pulled.

(the implication is that if you can refile that triggered memory before you feel the emotional pull of it, you can avert a downward spiral).

Rule: The brain only allows one file out at a time.

Rule: The brain doesn't care which file is active. 

(you can pull HAPPY files too!)

Rule: Like the files, the brain only allows one feeling or emotion to be active at a time.

Rule: You can't argue with a file.

Rule: Any stimulation can pull a file.

Rule: The brain pulls the most recent and most powerful file first.

Rule: The Brain doesn't know if a file is real or imagined!

(you can alter old files by adding new scenarios to them).

Also, I like his article on depression that brings a 'garbage truck' of negative thoughts...

Your mind speed will increase. Your mind will race at what seems like 200 miles per hour. Depressed people often tell their doctor "I can't get my mind to stop!" The minute you wake up in the morning - it will start up. Your brain will then turn against you. It will reach in your memory and pull out every bad memory it can find - abuse as a child, failed relationships, etc. - anything to make you feel bad and especially guilty. You will be tortured by your own thoughts.

As your mind speed picks up, the "garbage truck" will arrive. While the brain is already torturing you with the past, it will create/invent new ideas/thoughts to torture you. In every case of depression, if the depression stays long enough, you will receive the same "garbage" thoughts from your mind.

Good luck

Edited by Miss Information - 8/29/11 at 3:56pm

[K1329]

I have an illness and have cried in front of my kids. I'm just honest - I'm crying because I dont feel good right now - but, also am sure to stress that it has NOTHING to do with them. You've gotten some great advice, but, I would also let them know that they are not responsible for it in anyway.
Good luck - I hope things normalize for you quickly.

[LynnS6]

Mummoth,

Thank you for your thoughts -- I think I can do that for my kids. I'll change the word 'special juices' to 'body chemicals' because they're old enough to understand that, but I like the idea of explaining different kinds of body chemicals and what they do for you. The fact that I'm getting the wrong ones is helpful too.

Originally Posted by Miss Information 

I lean towards depression too, for various reasons.  I also have some other issues stemming from childhood that contribute to my moods today.  

I'm currently unmedicated...and I'm trying more cognitive-behavioral approaches.  But sometimes I do just end up crying.   And in front of my girls.  I just tell the truth and very simply.  Sometimes I get sad...and crying helps me release some of the sadness.  If I can think of something specific that triggered it (a memory or a current event) then I'd add that too (for example, sometimes I think about people I care about who are sick...that makes me feel sad for them...and I cry...and I feel better afterward). 

Emotions are normal.  I try to teach my children (and my husband) that "happy isn't the only acceptable emotion."

Thank you -- it's good to remember that happy isn't the only emotion. It's good to remember that it's OK for my children to see me unhappy. I had a fairly bad day today -- don't know if the kids noticed or not. I spent a lot of time crying this evening. Called my sisters. Dd is busy watching TV and may not have noticed, but she's sharp, so she may have. Hopefully she'll see me modeling reaching out for help.

As for the other suggestions, I am going to look for a counselor. I saw someone briefly after I had PPD, but didn't really click, and her idea was that this was 90% hormonal. Having had this happen 3 times now, I'm thinking there's more I need to learn.  Right now I'm not in a place where I can make use of a lot of the information about feeling good without drugs, but I hope I'll get there.
 

Originally Posted by K1329 

I have an illness and have cried in front of my kids. I'm just honest - I'm crying because I dont feel good right now - but, also am sure to stress that it has NOTHING to do with them. You've gotten some great advice, but, I would also let them know that they are not responsible for it in anyway.
Good luck - I hope things normalize for you quickly.

Yes, that's one of my big concerns -- I don't want my kids to think their the cause, and I also don't want them to think that they're responsible for helping me feel better.

I need to find a time to have this talk with the kids.

[Linda on the move]

  (that's just one of my favorite icons and I hardly ever use it.)

I've struggled with depression off and on all my life, and it runs in my family. I said very little to my kids about it when they were young, but have gradually become more and more open about it as they've gotten older because of the chance of one (or both) have them having some issues as they get older. They are teens now, and I'm pretty frank at this point. 

It's MUCH easier for me to talk to my kids when I'm not depressed, so I would keep in mind that you can explain this to them a bit more when you are feeling better. It isn't something that you need to work out this week.  "I"m going through a hard time right now and I feel sad" is a perfectly acceptable thing to say. Letting them watch more TV than usual, or hiring some help with house work, or whatever you need to do to get through the day is OK. This is very temporary. These feelings will pass, and it may be easier for you to speak about them with your kids when they do.

I'm open with my kids about the fact that I see a counselor. I'm not depressed right now, but I see my counselor once a month anyway, just for a little check up. My sister has an untreated mental illness (bi-polar) and what I stress is that getting the help one needs is the key -- if that means taking meds or talking to a counselor or whatever works, then that is what a person really ought to do so they can have the best life possible. Dropping all judgements of myself and others helps in these conversations. As long as I was still feeling shame about my struggles with depression, it was hard for me to just talk about with my kids -- about that fact that yes, sometimes things get to me more than they need to, but that's OK. It's really all OK -- even when it doesn't seem OK in the moment, it's still all OK.

Peace -- I hope tomorrow feels better for you than today did.

[LynnS6]

thank you Linda. You're right. I don't have to explain everything now. Part of my depression/anxiety is that I want everything to be taken care of NOW, including my mental health. I will probably do a better job when I'm feeling well.

My daughter saw me crying this morning, and I was able to tell her. "I'm not feeling well, and crying helps me feel better. Even moms get sad sometimes." It does freak my kids out to see me like this.

Thanks for the wishes for a better day. Even over the internet, that helps. I had an OK day today. I don't know if it was better, but it wasn't worse. For now, I'll take that.

[Learning_Mum]

My kids are only 3yo and 6yo and I have just told them that my brain doesn't work properly and that sometimes I feel sad for no reason. That's why I take medicine in the morning because it helps my brain work properly and then I don't feel sad so often.

[Imakcerka]

The more you tell them and how often you tell them about MI the more they understand.  A friend of mine was so happy when she found out we told our kids from an early age that DH is Bipolar and he takes medication for it.  Her whole life she didn't understand what was wrong with her father and felt so isolated.  DH recently got off of paxil and welbutrin and has found other ways to combat his ups and downs.  We work together as a family to help foster a stress free enviroment too.  I think having them understand that yes you may need a kid tantrum now and then but remember use those tantrums wisely, sometimes they can have a negative effect on the whole family.  ex.  I have a 6 yr old that will periodically tantrum about what's in her lunch or how her shoe feels.  She's got 5 minutes to get it out... when her 5 minutes are up she can go outside because the rest of us should not be effected, it's too much stress on DH.  If DH is having an episode, we all know that we need to give him his time to get through it.  Tantrums are suspended and we work together as a family to create a peaceful enviroment.  The care they put into this is pretty amazing.  I've seen it spill over into their own social lives in a positive way.  There is only so much they are will to deal with, unless your problem is real you may not disrupt their space, if your problem is serious, you have all the time in the world and a positive shoulder to cry on. 

I've had numerous people tell me that I'm doing this wrong, but we weren't dealt a perfect hand.  However both DD's were given a loving father who sometimes needs extra help.  As a family we have learned how to help.  I know that if I were ill or god forbid one of my girls were ill, we have a family unit that will do whatever it takes to care for each other. 

Though you should see little DD's face when I suspend tantrums... she looks like a blueberry and I get the wagging finger and the just you wait look... oh and yes she will hold that tantrum in til we're alone and tell me all about her crappy lunch.  While the older DD has learned to reflect over what she was upset about.  But we all talk about it together when the time is right.

So just be honest, just tell them.  And don't be afraid to tell them what you need, they may be young but they certainly understand.  It's no different than one of their friends having a bad day in their eyes.  And for the most part, little kids will get together and try to help their little friend. 

[LynnS6]

Has anyone done family counseling because one parent has depression/anxiety? It was suggested to me that we need it. I'm not sure that after a week of my being in a really bad space that we need to jump there. 

[Miss Information]

Lynn -

I haven't done it...but only because dh and I are both unemployed right now.  In general, I would like to get family therapy.  I think if you can afford a few sessions, do so.  I don't think it would hurt...and it may help give support to all of you.  I'd try to screen the family therapist first...and find out if they are compassionate and in line with your values.  I would hesitate to pick on someone who isn't all about compassion.  I would also try to seek one that understands giftedness too.  IIRC you frequent the gifted children forum, right?  So a child or two in the family is gifted.  It might be helpful for the family to understand which ones of you might be impacted due to high sensitivity/giftedness.  And, it would help to have someone else help the kidlets know that it's not THEIR responsibility to make things all better for their parents (as much as they'd sometimes like to).

My middle daughter picks up on the family tensions.  When I cry, she tries to comfort me.  I let her hug me a little, and then I thank her, but also make sure she knows it's MY responsibility to feel better, not hers.  Kids often want to make it all better...but it's not their job.  It's our job to comfort them, not the other way around.  But I don't want to reject her attempts to comfort me, because I think that would hurt too.

Personally, I think depression/anxiety isn't simply an individual problem.  It's a more of a societal problem. If you are the type to CARE about what happens to other people...then you can't let some of this go. There is just so much more to worry about these days.  We have only so much ability to shoulder the knowledge of all that is wrong in the world today that permeates into our homes.  It's difficult to shake some of this off.

That's just my $0.02

Edited by Miss Information - 9/3/11 at 12:35pm

[AllisonR]

I highly recommend family therapy. MI is not a locked illness that affects only person A, while everyone else carries on 100% the same, totally untouched. For example, in my case DH is my support person, and has to take up some of the slack when I am having trouble. My kids know, on some level, and I do NOT want them walking around on eggshells. That would not be good for them. Everyone is affected, so it is fair that all have a right to be helped. And therapy can help.

Family therapists are like every other profession, there are some great ones, some awful ones, and a lot in between. Shop around. 

I went to family therapy twice. With my XH, for about 4 months, to determine if our marriage was worth salvaging. She was great, said if we were still seeing her in 6 months than she hadn't done her job, because we needed to be making clear progress in one direction or the other. She even gave us homework assignments! I didn't always like what she had to say, and could deny some things, but I would rethink it an hour, a day or a week later, and what she said made sense. And it made it really clear to me that leaving my XH was a great decision. 

The second time was with my current DH after the birth of our DS. I suffered PTSD due to the birth and afterwards, and was quite enraged with my DH at that time. We needed a therapist to get all of this out into the open, to talk about it, and to be able to heal. She wasn't fantastic, but she was good enough, and it helped get DH and I over a rough spot. 

[LynnS6]

Yes, on a logical level I think you're both right. We have good insurance, we can afford to go if we can find someone who would work well with us. Part of me doesn't want to admit I'm 'broken'. Even less of me wants to admit that my brokenness is affecting my children. On the other hand, my rational mind (which has taken a vacation over the last 7-9 days) wants my children better equipped

We've got a number of 'issues' that the therapist would have to be mindful of -- ds and dh both have SPD (sensory processing disorder) -- meaning they're beyond highly sensitive. Dh literally can't stand too much touch (and sob, I need a lot more touch when I'm like this). Ds shuts down when emotionally overwhelmed. Dd is moderately-highly gifted, highly sensitive and very emotional. Ds is mildly-moderately gifted (I'm not sure how much is masked by his sensory/motor struggles -- his reading scores are off the charts, but his math scores are 'average' he scores super high in 'concepts' but just average in other areas -- he can't do tangrams or do the block test on whatever intelligence test he was given to save his life).

Add to that the typical family background issues (parents of the depression who didn't talk), some fairly major family tragedies on my mom's side, regular money struggles with us (dh runs his own business and has had a couple bad hits over the last 5 years), probably a bit of ADHD on dh's part, a bit of hoarding behavior on his part, some control issues on mine.... Yeah... we probably need one.

How do you find one that fits?

[cparkly]

I am going to chime in as the adult child of a parent (and a sibling) with bipolar disorder.

1. Talk about it as a family, regularly. Be sure that your partner is involved. It is very scary and isolating if it become (even unintentionally) a "family secret". No one outside our family had any idea what really happened in our home or how we struggled.

2. Be honest. Depression is a sickness like any other. Validate it. Talking openly about it as such helps to remove the mystery and stigma.

3. Reassure them that it is NOT THEIR FAULT. I internalized all the confusion and sadness and thought that it was my fault.

4. Reassure them that you are seeking professional help and taking steps to get better. And, that they are not responsible to make you feel better. I felt responsible for the care of our home and my younger sibling. It was a HUGE load to carry. Get support to cover those everyday things; cleaning, meals, transportation, etc., if necessary.

5. Ask your partner to help buffer the questions that may come up. When you are feeling better prepared, talk with them about how to talk to others. They will need words and examples, so that they can talk to trusted adults about what is going on at home.

6. Plan special, relaxing time with them when you do feel better. And ask your partner to plan times with them ("dates") when you are not well. Simple things make a huge difference; hiking, ice cream cones, swimming, etc. It need not be time-consuming or expensive.

I would ask your family health practioner for suggestions for a family counselor and post in your MDC Tribal Area. Then, interview them. Try them out. I think the most important thing is to not wait, hoping to find the PERFECT therapist right away.

You are a wonderful mother to be thinking of your children with such love and respect, even in your "dark" times. 

[Linda on the move]

Originally Posted by cparkly 

3. Reassure them that it is NOT THEIR FAULT. I internalized all the confusion and sadness and thought that it was my fault.

I have a question. I have a sister with untreated bi-polar with 3 kids. She refuses help. She often goes off on speeches about how her life is harder than any one else's and no one understands how hard it is blah blah blah. One of the things she brings up repeatedly is that she has 3 kids. I feel deeply sorry for my 2 nieces and my nephew. I'm wondering if there is anything I can say to them, esp as they get older and I can have a relationship with them away from her, to help them know that it wasn't their fault.

I worry esp. about her youngest child. I can't imagine growing up hearing that all the time, and thinking that the insanity was caused by my existence on the planet.

Talking to my sister doesn't do any good. It only makes her angry.

[Imakcerka]

Linda, just tell them when you get the chance any phone call any letter.  They are special and not a burden.  DD1 & DD2 both know that their father is Bi polar and both know what it means at 6 & 8.  I made sure they knew that some of the things he says are not really meant to hurt them.  And they know.  When he says things that are off, they usually wait until he's in a different emotion and ask him about it.  And because he's open with it all he'll explain what he was thinking at the time and that it was irrational.  Hearing from your parent or family member over a therapist is better IMO.  Their words mean more than an outside source at this age. 

Also, Bipolar people are known for their pity parties.  We all have them but if you're BP, you're unable to see past your stressors and see anything differently.  Her anger is just her being defensive, DH gets very defensive if he feels he messed up in someway, I have to approach important subjects gently.  I've spent a lot of time learning how his mind works.  And it's not easy.  Hard as it is it's best to try to keep a good strong bridge with your sister for the kids.