This weeks question is from Elena,
“How do I talk to my child about my mental health issues? I struggle with depression and anxiety, both of which have been worse since the pandemic started. I know it impacts my child, but I am not sure how much to say, or whether to say anything at all. I don’t want him to always be worried about me. I also don’t want to give him problems by talking about these issues. I would love your thoughts on how to address it, if at all.”
The question of how to explain mental health to a child is a common one that I think a lot of parents wrestle with. In this episode, I will address when it is appropriate to talk about adult mental health issues with your children and how to approach the topic. There is no one way to approach this. The key is to address it in a developmentally appropriate way. Kids are very intuitive so ultimately you are helping them understand something they may already be perceiving. And in doing so they understand that parents have struggles too and it’s ok to share your struggles with others. Throughout the episode, I provide several strategies to help guide you through this conversation.
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Episode Intro … 00:00:30
Discussing Adult Mental Health with Children …00:02:20
Kids Inherently Know When Parents Struggle … 00:04:50
How to talk to kids about Adult Mental Health … 00:08:00
Tailor Language in a Developmentally-Appropriate Way… 00:11:54
Keys to Address No Matter the Age … 00:15:55
Open Door Communication … 00:20:05
Episode Wrap up … 00:24:40
Dr. Nicole Beurkens
Hi everyone. Welcome to the show. I am Dr. Nicole, and today I am answering a question from one of you. The issue of whether and how to talk about your own mental health challenges with your kids can be a sensitive one. There is no one right way to handle this, and the approach is going to be different with a developmentally young child versus a developmentally older child. In today’s episode, I am hoping to give you some things to consider and some ways that you can talk about your own mental health challenges and needs that are supportive for you, your kids and your entire family. The specific question for today comes to us from Elena, who writes: “How do I talk to my child about my mental health issues? I struggle with depression and anxiety, both of which have been worse since the pandemic started. I know it impacts my child, but I am not sure how much to say, or whether to say anything at all. I don’t want him to always be worried about me. I also don’t want to give him problems by talking about these issues. I would love your thoughts on how to address it, if at all.”
I am really glad that Elena had the courage to ask this question, because I think it’s something that many parents wrestle with at one point or another, whether you have been diagnosed with a specific mental health condition, or you just struggle with some symptoms at different times, we all do, right? And it can be tough to know how to communicate with our kids about what’s going on for us in a way that is supportive, and gives them information without making it their problem or without them having some sort of perhaps a negative response to it. So I think it is important to talk about, and there are several key points that I want to race around this.
The first is that when we share our struggles, our mental health challenges in a developmentally appropriate way, and that is key, and we will talk more about that, we actually are doing our kids a favor by normalizing the fact that all of us as human beings have mental health struggles at times, that we all go through experiences and periods of time where our mood is lower, or we are really anxious and stressed about things, or we are struggling to regulate ourselves, or we are having issues managing our own anger, or whatever it might be. By talking about that we are normalizing it for them that this is part of the human experience, and that actually is so important for kids, because when adults don’t talk about these things, when we sort of keep all of this hidden, or we keep it a secret, we send the message unintentionally, that these are not things that we all deal with, that these are things to be embarrassed about. These are things to be ashamed about. That if you are struggling with any of these things, that wow, that is really abnormal and that is not something that you should let other people know about. And of course, that is not how we want to raise our kids to think about these things. We want them to be willing and able to come to us, to reach out for support, to communicate when they are struggling. And the way that we help them do that is actually by modeling that ourselves when we are struggling, and taking away the stigma of these kinds of challenges, symptoms, diagnoses, by putting it out in the open and talking about it, and by being honest about it, again, in a way that is helpful to kids. But shining a spotlight on these very real things that we deal with as adults and as parents is actually really important for our kids. So I think that is in the big picture. What I would like all of you to take away from this episode today is that by hiding the things that we are going through, by not talking about it, by not engaging in conversation about the struggles that we are facing in our life, we are actually teaching our kids to do the same, which is unhealthy and not what we want for them.
So another piece of this is that kids inherently know when a parent is struggling with something, whether we explicitly say it to them or not. And I think that is important for us to remind ourselves of. We don’t need to sit down and have a conversation with our child about the fact that we are feeling depressed for them to know that something is not quite right with us. Kids are very attuned. Even kids with more severe neurodevelopmental disorders, kids who maybe seem unaware of things that are going on around them a lot of the time or with other people, they know. They feel it. It’s in the environment. It’s in the environment of our relationship with them when we are having issues with depression, or anxiety, or anger, or whatever it is that we are struggling with. It seeps into all the parts of how we are relating to our kids and the parts of everything that is going on in the home. And so kids know even if we don’t tell them. And that is why I think it’s really important to give them factual information, because if we don’t, we are leaving them to their own devices to create stories in their mind about what it is that is going on, and those stories are very likely to be inaccurate, and probably more damaging for them. What often happens, and I’ve seen this in working with kids of all ages over the years, and even in working with adults who when we start to really dig into it, recognize that some of the stories they have about this stuff started when they were young and their parents were struggling. Kids tell themselves all kinds of things like, “My mom is really sad, or really angry, or obviously having a hard time. It must be my fault.” That is very common for kids to go to a story like that in their mind. “I must have done something, it must somehow be related to me.” Now, as an adult, we think, “Well, that is ridiculous. Of course, my child didn’t cause me to have some depression”, or whatever it might be. But we have to put ourselves in the minds of a young developing child, they are looking at the world through the limited capacity that they have and the limited experience they have for understanding the dynamics of people and feelings and interactions, and so of course, they create all kinds of stories. It could be about it being my fault, which is a common one, it could be “My mom or dad don’t like me, they don’t love me.” It can be all kinds of things. So when we aren’t clear with them about what’s going on for us, again, in a developmentally appropriate way, we leave them to their own devices to try to make sense of what’s happening, and that often is much more problematic for them both in the short term and the long term of their life. So they know that something is up, and we owe it to them to have a conversation with them about that so they have accurate information.
When we are thinking about how to talk with kids about this, I love to use the imagery or the idea of a mental wellness spectrum. Now, again, we wouldn’t necessarily use that term mental wellness spectrum with a four-year-old. We certainly would use it with a preteen or older, but this idea that at any point in our lives, we exist somewhere on this mental wellness spectrum. At the two extreme ends, we have got at the one end very severe debilitating symptoms of things like depression, even suicidality, severe debilitating anxiety, obsessions, anger, whatever it might be. And at the other end of the mental wellness spectrum, we have really awesome wellbeing, we are feeling like we are managing things well, we are feeling positive about things the majority of the time. So we have got these two extremes, and then we have got all of this in the middle, which actually is where most of us are most of the time, right? Somewhere in between those two extreme ends of this mental wellness spectrum. Why I think it’s really important to help kids and ourselves think about it in that way, is it gets us out of this black and white mode of, if you are having some kind of mental health symptom or challenge, there’s something wrong with you, and the people who don’t have those things, there’s not anything wrong with them. And that is really problematic, because the reality is that all of us experience mental health issues, mental health symptoms, things that even would rise to the level of some type of diagnosis at some point in our lives. That is just a fact. That is part of what it is to be human. So I think when we approach it this way with kids, of helping them understand that “Look, we are all human beings. We experience things in our lives that impact us in different ways. We have physical health issues that impact us in different ways. Our relationships impact us, and so we move along this spectrum of mental wellness all through our lives”, and to give them examples of how maybe that has shown up in their life so far as a child, and to give them examples for you and to talk about it as, “Right now, here is where I am on that spectrum of mental wellness. I am struggling more. I am having a harder time feeling positive about things, I am feeling a lot more exhausted”, or “I am feeling a lot more worried about things, and I am having a hard time getting my brain to not focus on those worries all the time. So that is where I am right now. But that is not where I’ll be forever. And we all have the capability to move along that spectrum.” And so I think to help kids think about it in that way is really supportive for them, both in understanding what’s going on with you, but also in understanding themselves and their own mental health challenges and needs and experiences as they go through their lives. Now, in talking about this, you can use diagnostic labels or not, if you have been for a professional evaluation or treatment, and you have been given a diagnostic label, and that resonates with you, and you want to use that label with your child, that is great. Go ahead and do that. Using labels like depression, or anxiety, or OCD, or whatever it might be, that is fine to use those labels with them. It’s also fine if labels don’t resonate with you, or if you’d rather not use labels in your discussion of it. That is either way completely okay.
Now, when we think about how to do this in a developmentally-appropriate way, what we are talking about is tailoring the language that we are using, the length of the discussion, the amount of information and detail that we are providing to the child’s developmental level, to their ability to understand what we are talking about, their ability to process and make sense of it, their ability to handle the information. And it’s not necessarily according to their chronological age. You know that I talk about things in line with developmental appropriateness and developmental age or developmental stage, because many of you are parenting kids who chronologically may be one age, but developmentally maybe a younger age in one or more areas. And so we want to think not just about “Well, this is a 13 year old. So what do 13 year olds understand?” But we want to think about “For my child, they might be chronologically 13, but what is their capacity to understand language, to process emotions?” All of those things. So you want to think about what is appropriate developmentally for your particular child. For a young child, we would keep it very simple and very brief, using simple words. It could be something like, “Mommy sometimes gets really sad. And sometimes it’s hard for me to help myself feel better about things. So I need some time alone during the day to help myself. So it’s not that I don’t want to play. Sometimes I will play, and sometimes I need to go into my room and listen to my music, or take a bath, or whatever it might be so that I can help myself, because I just feel sad sometimes, and that is what I need to do.” Simple. “Sometimes I feel sad. This is how I need to take care of myself”. That lets them know. It acknowledges the elephant in the room that the kid even at a young age recognizes, which is “Oh, Mom’s having a hard time. Mom seems to feel sad.” It also gives them facts that it is not about them. This is a problem mom is having, and in fact, you can be clear about that. “I am not sad about you. This is something I am dealing with.” And so it takes that off of their plate, and it tells them that you are handling that for yourself, which is important. With a preteen or teen, we can obviously have a more in-depth discussion at that developmental level. Talking about it as, “I sometimes feel really depressed. I struggle with depression some days, and sometimes I feel more positive with my mood than others. I can’t always predict when or how that is going to happen to me. And when I am in a more depressed place and feeling more depressed, I feel really sad about things, even if there isn’t anything specific to feel sad about maybe in that moment. I feel really tired. It exhausts me to have these depressive times, and it just feels like everything’s really hard. And that is not about you. That is something that I am dealing with, and I just want you to know that. And I also want you to know that I know how to take care of myself; in those times I need to have some time and space to focus on those things. So you might notice that sometimes after dinner, I go into my room by myself for a little bit. What I am doing is listening to some meditation audios that are helpful to me, I am taking a bath, I am reading—those are things I am doing to help myself. Maybe you have noticed that I have an appointment on the calendar once a week. That is my appointment with my therapist where I go and get professional help to support me with this.” So that gives you a flavor of how you can talk with a developmentally older child about that.
Now, a few key things here, no matter the age or developmental level of your child: Number one, make sure that your child knows that what you are experiencing and dealing with has nothing to do with them. They did not cause it; they are not the source of the challenges that you are dealing with. That is really key because kids, 9 times out of 10, in my experience, will go to that story in their mind, as I mentioned. So, making sure that they know this is about you, this is not about them, and that they are not responsible for causing this. Or if you have been going along fine and existing in a better place on that mental wellness spectrum for a while, and then suddenly you start to struggle and you are more on the struggle end of that spectrum, that there is nothing they did to cause that to happen, that is really important for them to know. Also important for them to know that these kinds of symptoms and conditions, especially if you are using a specific diagnostic label with them, that they aren’t contagious like other illnesses or viruses. This is especially important in the era of COVID that we live in, where younger kids especially can be very hypervigilant and tell themselves a lot of stories about catching things and things being contagious. But in general, even before COVID, it’s important for kids to know that mental illness conditions, symptoms, are not things that we catch like a cold going around, and so they don’t need to worry that they are going to catch depression, or catch OCD, or catch whatever it might be with for being around other people that have those things. It’s an important thing for them to understand. Also, really important for them to understand that you have the proper support in place for yourself, and that it’s not their job to prevent you from having symptoms or to take care of you. Now, most parents, when I talk with them about this go, “Of course, it’s not my child’s job.” But again, we need to put ourselves in the minds of kids. They often take that on. I know many of you listening, if you grew up with a parent who struggled with some mental health issues, diagnosed or not, maybe can reflect on this and go, “Yeah, I remember being a kid and feeling like it was my job or my responsibility to make sure that my parents were okay, or to provide support to them, or to help them.” So this is something that comes up for kids, and we want to be clear as their parents that we can take care of ourselves. That we love them, and we love that they support us and that their love and their connection to us is so beneficial to us, and we appreciate that. And, that is our job as the adult to take care of ourselves, not them. And that means that you do need to make sure that you have the appropriate support, treatments, whatever it is that you need to have in place to address the issues that you are dealing with, that you do that because it is not your child’s job to support you. If you are struggling with depression or anxiety, it is not your child’s job to make sure that they are managing their behavior in their emotions in a way that doesn’t trigger you and doesn’t make your symptoms worse. That is not fair. And that happens a lot without us realizing it. We don’t intend for that to be the case, but when we reflect on it, we go, “Oh, man, yeah, actually I do sort of have that expectation.” Kids in their growing up years need to be allowed to have all of the feelings, all of the experiences, and all the behaviors that come out of that, and we can’t expect them to not be real normal kids with those things just because we are struggling. So it’s our responsibility to take care of ourselves, to make sure that we have the support systems in place the therapies in place, the self-care strategies in place, whatever it is that is needed, and making it clear to our kids in doing those things that, “I am taking care of me, and that is not your job.”
I think that those are some of the key things to keep in mind that you want to make sure you communicate, and those can be communicated, again, really briefly and simply. And I think the first time you raise this with kids, it’s important to leave the door open for further conversation, to not feel like “Well okay, we had that conversation about my mental health. Now we’ll move on”, but to let them know that you are open to any questions that they may have at any time, that you want them to feel free to come to you if they have questions or concerns, if they ever want to talk more about this, to leave the door open. A lot of kids may not have much to say about it in the moment, but they may have some questions or some things that come up over time, and you always want to make sure that you have left that door open for them to come to you with those things. Super critical. And periodically check in with them. Let them know how you are feeling, how you are doing. Say “I am checking with you about that. We had that conversation. I just wanted to let you know, here is where I am at now. Any questions that you have for me or anything that you want to share with me around this?” And to just check in periodically. Again, it doesn’t have to be a big deal, it doesn’t have to be some serious sit-down conversation. But just continuing to put it out there is helpful because it lets them know that this is something that is a normal part of life, you are open to it, to having conversations, you are comfortable with it, and you want them to be as well. So again, when we talk about these things, when we give kids this information, when we put this out in the open of our relationships with them, we provide a really important model for them about how to talk about their own issues and challenges both now as a kid, as well as when they get older, and it makes it more likely that if and when they are struggling with these kinds of things, that they will communicate, whether it’s to you or someone else in their life, that they will seek help. And boy, is that a gift to give our kids. So that is the big thing to keep in mind: Our kids always benefit from honesty, from factual information, and from support around these things, no matter what the issue may be. So you can never go wrong if you are approaching difficult, sensitive topics like your own mental health issues, from the standpoint of providing them honest, factual, supportive, developmentally-appropriate information.
So I hope this is helpful for Elena and any of the rest of you who are trying to figure out ways to talk with your child about your own mental health challenges and your own struggles. Remember, if you have a question you’d like to hear answered on a future show, email it to firstname.lastname@example.org. Thank you, as always, for being here and for listening, and I will catch you back here next time.