Clinical psychologist David Coleman addresses your parenting queries.
Question: My 17-year-old daughter has been dealing with depression and anorexia for nearly two years. She is seeing a therapist, but seems to be constantly going backwards and forwards.
She has threatened suicide, but I don't know if she is serious or just getting at me. How can I tell the difference, and what can I do to prevent her suicide if she is serious about it? I'm afraid to go out and leave her alone. My husband and I strive to be patient and understanding but I worry that I can't see a way out or an end to all of this suffering.
DAVID: It sounds like a heavy weight just sits in your family. Your situation shows the power of a family system, where one person's mood and behaviour can impact on everyone else.
In many ways, your situation typifies the experience many families have. A grumpy parent coming home from work can drag the mood of a whole family down. One person's excitement and success can give everyone a lift. I often think of each person in a family as a cog in a gear system. Because we are all interconnected, like cogs in a gear, what happens to one person will have a knock-on effect on everyone else.
In this situation you sound like you are despairing, in response to the despair and depression of your daughter. It is really hard to make changes in our lives at times. We can become very set in our patterns of behaviour and thinking, and altering that can be a real challenge. Relapsing into old ways of behaviour is very common, even when we have been determined to try something new.
So your daughter's experience of her mood improving and regressing happens a lot. Sometimes this is because the effort required to do things differently is too great, sometimes the old habits are too firmly established and sometimes progress can be slow and we can feel demotivated because change doesn't happen quick enough.
Whatever the reason, we usually need support, encouragement and advice to kick-start a change process all over again. Critically, we can sometimes need the same level of support and guidance to maintain our improvements too.
Try not to be too disheartened by the forward and backward nature of your daughter's progress - it is often a natural ebb and flow linked to her motivation, energy, and the support she feels.
Your concerns about her suicidal thoughts and feelings sound like they are the biggest emotional drain on you. I can imagine that you are terrified, and even horrified, at the thought she might kill herself. The most effective thing you can do is to keep talking with her about those thoughts/feelings. It can be difficult to judge the risk of someone actually following through to kill themselves. However, someone having a distinct plan, taking steps to put the plan into action, tidying up their affairs, giving away prized possessions and writing a note to leave behind are all indicators of greater risk.
Sometimes, when youngsters feel very distressed, suicide may seem like an easy or preferred relief from the internal suffering they are experiencing. Thinking about suicide, at this point, is more common than we might think.
Talking about feeling this way is actually quite psychologically protective. Many youngsters who talk about their distress and their suicidal thoughts reduce the risk that they might act on those thoughts. So your daughter 'threatening' suicide may actually help her to avoid taking any action or carrying through on the thoughts. She may also be subconsciously (or even consciously) hoping to share her level of suffering, giving you and her dad a taste of how upset she feels.
I strongly recommend you get therapy yourself. The more you mind your own emotional health, the better you will be able to support your daughter. It might also help you to speak to your daughter's therapist about your fears about her suicidal thoughts, and the pressures you feel. Her therapist may be able to give you some ideas of how to best support your daughter, without wearing down your own coping skills.
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