When Should You Take Your Child’s Mental Health Issues Seriously?
Short answer: yesterday
Content warning: This story involves discussion of suicide in minors.
Over drinks one day, long before I had children, my friend casually mentioned some people he knew back home in England.
“Lost their daughter this weekend,” he said, shaking his head. “Suicide.”
“Oh, my God,” I said. “How old was she?”
“Twelve,” he responded gravely, and all the air left the room.
Twelve. What?
A family finished dinner. A twelve-year-old girl went upstairs. Her parents went up sometime later to tell her it was bedtime. And they found her.
I can’t even write those words without reliving the horror I felt for those parents that evening. But now, layered on top of it, is a near-paralyzing fear for my own children. Because if this happened to those people — that random couple across the world I’d never met — it could happen to anyone. And if it could happen to anyone, it could happen to me.
Mental illness isn’t logical
I can’t remember the first time my daughter began showing signs of anxiety. It seems like it’s always been there, and maybe it was. Maybe that’s what was at play those times I tried having other people watch her, when she would last no more than ten minutes before I’d have to go and retrieve her because her screams were unsettling to the other kids. I did, after all, abandon my plans to return to work when she was four months old because it had become quite clear she couldn’t handle to have anyone else watching her.
No one was particularly surprised when the anxiety became more apparent as she got older. Most people on both sides of our family have anxiety on some level. Some acknowledge it and some don’t. For some of them it’s mild; for some it’s severe enough that it causes problems in their personal lives, from alcoholism to agoraphobia.
What caught me off guard, though, was when a school assessment showed she was actually at more clinical risk for depression than for anxiety. Depression in a child. That’s not something which actually happens, is it? She’s got everything she needs. She’s got a house to live in, her own room. A school with teachers and friends who legitimately care about her. All the clothes and toys and food and anything else she could ever want. What could she have to be depressed about?
After dealing with my own mental health issues, I know the question itself is flawed. Mental illness isn’t a logical thing. It doesn’t listen to reason. You can yell and scream at your mental illness all you want that there’s nothing to be anxious or depressed about, but that doesn’t stop the chemicals in your brain from making you feel anxious and depressed.
In fact, mental illness caused by an imbalance in our brain’s chemicals needs to be understood separately from discrete feelings with a logical source. It’s one thing to feel sad because you lost your favorite toy, or anxious because you have to get up and speak in front of the school. Feeling generalized anxiety or depression “for no reason” is exactly what mental illness is.
Children aren’t always logical
One day, I was visiting my parents with my daughter. She was around a year old at the time, crawling but not yet walking. I put her down for a nap on a mattress on the floor of my childhood bedroom and left to take a walk. I was gone for maybe twenty minutes.
When I came back, I could hear my daughter’s sobs from the back of the house as soon as I walked through the door. “Why didn’t you get her?” I asked my mother as I quickly scooped up my screaming child from the mattress, upon which she had vomited from crying so hard.
“I did, but she wouldn’t stop screaming and crying, so I put her back,” she responded. “She doesn’t have any reason to be crying.”
More than once I have watched my daughter (or one of the hundreds of other kids I’ve known in my years as an educator, parent, and aunt) do something completely off the wall, like write “Baby’s Room” on the door trim in permanent marker or lick an unidentified sticky substance on the counter top. When they were asked why they’d done it, they could never come up with an answer. Kind of like a baby who screams and cries when you think she should be feeling comforted.
Because that’s the thing about children. Often, they have no logical reason to be doing what they’re doing — or no logical reason that you can see, anyway. The behavior which seems so outlandish and uncalled-for to you seems perfectly natural to them.
Children don’t often operate in a logical headspace; their ability to think rationally isn’t even fully developed until after age twenty.
Children don’t fully understand the value of life or the permanence of death
Most kids are fortunate enough not to have experienced significant loss in their lives, and they’ve got short attention spans to boot. Until a certain age, the death of a pet — or even a loved human, with some exceptions — will make its mark for a short time and then fade as more immediate experiences take up their attention.
That’s certainly the case with my daughter. She lost her three great-grandmothers and our beloved dog before she was five or so, but no one especially close to her. The sadness — even over the dog we’d had since long before she was born — faded, for the most part. For kids, the new normal becomes just that: normal. They forget what it was like to have Millie or Grandma Mary around and they don’t really think much about death again until someone else dies.
In the video games we and our children play, people die or get killed. Even in the most kid-friendly games, falling off a cliff or being attacked by a Goomba or jumping into the acid lake means you “die.” We don’t much consider that language. But what happens after you “die” in your video game? You get to play again. You can even choose to run off the cliff on purpose if you can’t figure out how to get out of the pickle you’ve gotten yourself into, and then you magically come back to life and get to try again.
I’m not saying we should stop playing video games, and this obviously isn’t an essay about screen time. But we must understand, all this combines together to make death seem like really not much of a big deal to young children. It wouldn’t be a huge leap for a young child who’s feeling crippling depression or anxiety to think, “Well, maybe I can try again.”
And, as a parent to a child with anxiety and depression, that thought terrifies me.
Take your child’s mental wellness seriously now
I can’t tell you anything about the twelve-year-old I mentioned at the top of this piece. I didn’t know her and can’t know what she was going through. She might have had clinical depression, or she might have been bullied at school, or she might have had a fight with her family. She might have been engaging in self-harm or other risky behaviors. I just don’t know.
But what I do know is that my daughter’s mental illness has always made her feel like an outsider. She’s easily manipulated. She’s desperate for people — even the wrong kind of people — to like her, and terrified they won’t.
I know she overreacts, overdramatizes, and internalizes every situation in her life.
I know that, when my house is too quiet, I get nervous.
I know that when I haven’t seen my daughter in a few hours, and I stand motionless and silent outside her bedroom door, I breathe a sigh of relief only after I hear her sheets rustling or her voice humming along with the song she’s got on her iPod.
I go out of my way to make sure my little girl has access to the services she needs. She has a school counselor, an outside therapist, and various special education teachers who work with her.
I tell her every day how much she means to me and to the rest of her family. I tell her how lucky we are to have her and how terrible it would be if something ever happened to her. I acknowledge her feelings, and try (though often I fail) to just listen and reflect them rather than trying to talk her out of them.
One day, she might want to try medication. If she does, and if that is what helps her stabilize and regulate her emotions, then I’ll be first in line at the pharmacy.
Standing on the other side, I might seem heavy-handed. It might look like I’m going overboard, overcorrecting for something that’s not yet become a problem. I might think the same thing, if I didn’t know that suicide is the second leading cause of death among young people ages 10–24. Read that again. Of all the kids who die, the second largest group of them died at their own hand.
So I contend I’m right to be concerned. And if my kid grows to be safe and happy, I could not care less if it looks like I’m directing too much energy into this. Better that than the alternative.
Even with all these supports in place, I still fear for my daughter. I know I can’t be with her all the time, and kids are so impulsive that I can’t ever be completely certain she won’t engage in self-harm on a whim.
But I do believe that by taking her mental wellness seriously from a young age, I’ve helped her to be aware of her struggles and develop coping mechanisms she can use when things get hard.
And now, if you’ll excuse me, I need to go and give her a hug.
Invisible illnesses are so difficult to manage, in part because it’s hard for others to understand what they can’t see. It can be even more difficult to understand the debilitating effects of trauma on the developing brain, because “trauma” is not a diagnosis. Yet it still manifests itself for a lifetime, a double-invisible influence, informing the beliefs we hold about ourselves and the world and guiding our behavior, especially in times of struggle. For, me everything started with childhood trauma.
Join me here every second and fourth Monday, where I explore the invisible influence of past trauma on current beliefs and behavior. Find all my past columns and subscribe for updates here.