independent

Wednesday 16 April 2014

David Coleman: There are ways to prevent mental health issues from casting a shadow over entire family

David Coleman says when explaining things to children, their age and maturity has to be taken into consideration

IT CAN be a real challenge for parents to know when, or even if, to tell their children about a mental illness that is affecting themselves, a partner, an older sibling or a close relative.

Sometimes our fear is that by raising the topic of mental ill health we might frighten, or just unnecessarily worry, our children.

However, in practice, children are usually aware that something is up in their family and it can be very reassuring to find out what it is that seems "wrong".

Research has shown us that when children don't have information about their parent's mental ill health life can be more worrisome and confusing for them.

When parents are very burdened with things like depression or anxiety, it can be a real burden for their children too.

Children are, typically, very attuned to their parents' emotional states.

They spot when we are sad, anxious or distressed. Many children will assume that they have caused us to feel the way we feel, through something that they have said or done.

So, it can be a real relief to have their parent's difficulties explained to them.

Naturally, when explaining things to children we need to take their age and maturity into consideration.

Very young children, for example, may simply be aware that a parent cries a lot, or gets very stressed or angry in certain situations.

Even school-age children tend to think very concretely about what they observe in their parents' moods and behaviours.

It may not be until in their teenage years that they can fully understand the complexity of certain mental illnesses.

An early challenge, then, may be simply to know what to explain to your child, depending on their age. Depending on the mental health issues involved, the unwell parent may or may not be able to contribute to any discussion with their children.

Ideally, both parents can talk with their children. Your first task may be to try to understand fully your own, or your partner's, mental health issues.

Learn as much as possible about the depression, anxiety, bipolar disorder, schizophrenia or other mental health problem that is affecting your family.

Do try to familiarise yourself with information about who can get these illnesses, what causes them, how diagnoses are made, and what treatments are available.

Some parents may have to do a little homework to be better informed.

If it is you that is unwell, then your own therapist or the mental health services that you avail of could be the best source of information about your illness.

They may also be able to assist you in the language you use to describe how you feel and how you experience the world.

Sometimes it can really help children to draw an analogy between mental ill health and physical ill health.

So for example, you may describe how many people get colds that leave them feeling a bit unwell, but that rarely need medical intervention.

Similarly, many people feel sad or worried at times and can cope fine in dealing with those feelings.

However, for other people, what appears to start as a common cold can develop into something more serious like pneumonia, at which point they may need lots of medical intervention, including medicine and hospital admission.

Similarly, the sadness, distress or anxiety that some people feel becomes overwhelming to the point that they can't cope with everyday situations; they, too, may need support, medicine and hospitalisation.

When talking with your children, pay attention to how they seem to be receiving the information. Look for signs of confusion, distress, disinterest and so on. These may be the best indicators of whether you are pitching things at the right level for them.

Do be prepared for questions. Especially with older children or teenagers, the questions can often centre on how your illness may be affecting, or how it is going to affect, them. They may worry about whether this is hereditary or not.

Older children and teenagers may also have gathered quite a bit of misinformation that may need to be clarified.

They may be worried about perceived stigmas around mental ill health and could feel embarrassed about having a parent who relies on medication or who needs hospital care at times.

Talking about mental illness is not a single event either. While you may choose a time and a place when you and they are relaxed and feeling relatively secure to initiate a conversation about your mental health, it is unlikely that this will be a one-off discussion.

Indeed, it may be lot for your son or daughter to take on board in one sitting and they may have questions or concerns that only emerge later. So take further opportunities to 'check in' with them about how they are feeling about what you have discussed.

Similarly, be open and prepared for their questions and their feelings whenever they are expressed. Try to acknowledge their reactions and see if you can understand how they may feel, from their perspective.

Then, as they learn that you do understand that this may be difficult for them to get their head around, you can reassure them that you will do all you can to keep minding yourself so that you can continue to mind them.

By David Coleman

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