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Parenting - teenagers and mental health

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Parenting - teenagers and mental health Powered By Docstoc
					[ parenting the teenage years ]

             It may surprise some
             parents to learn that
             one in five people will
                                                   & your teenager
             experience a mental
             illness in their lifetime.
             Teenagers are no
             exception, with one
             study finding more
             than 20% of
             adolescents between
             12 and 16 have mental
             health problems.

             Kids Help Line, a confidential telephone          Similarly, eating disorders aren’t just         Promoting good mental health in young
             support service, has seen a 200%              out-of-control diets, but mental health         people is the key to preventing mental
             increase in mental health calls since         problems which need to be addressed.            illness. Young people need to learn how
             1994. Depression, anxiety, attention              Parents of teenagers with mental health     to deal with life’s obstacles. A healthy
             deficit disorders and problems managing       problems will often wait to see if a problem    self-esteem, good relationships with family
             anger were major concerns for kids            sorts itself out. However, if a problem         members and school friends can help
             aged 10 to 14. For callers between            lasts for more than a few weeks and has         teenagers weather the ups and downs
             15 and 18, the major problems were            a significant effect on the young person’s      of adolescence and help ward off potential
             depression, self-harming behaviours,          day-to-day functioning, it is probably time     mental health problems.
             suicidal thoughts and anxiety.                to seek help. Remember the earlier the
                Unfortunately, some people still think     intervention, the better the results. Like        common adolescent
             of mental health in terms of ‘madness’ or     most physical illnesses, mental health            mental health
             ‘craziness’. This stigma can discourage
             parents from contacting services when
                                                           problems can be treated. Effective
                                                           treatments including counselling and
             their children need help. Your General        support from community-based services             x Depression
             Practitioner or community health centre can   can make a difference and can help                x Eating disorders
             be a good starting point for getting help.    prevent problems recurring.                       x Anxiety disorders (such as panic attacks)
                Depression, for example, has a big                                                           x Challenging and disruptive behaviours
                                                           Promoting good mental health                      x Attention deficit hyperactivity disorders
             impact on a young person’s life. It can
                                                           Young people today face unprecedented               (difficulty concentrating, easily distracted)
             impair their ability to enjoy life, affect
                                                           levels of expectation. Even some older            x Post-traumatic stress
             school performance and relationships
                                                           people spend their lives thinking, “this          x Psychoses (distorted perception,
             with friends. But rather than being seen
                                                           relationship (or these children, this job)          hearing voices, paranoia)
             as an illness, depression is sometimes
                                                           will make me happy”. Today’s world is             x Suicide
             seen as a personal weakness or failure.
                                                           also intensely competitive. Teenagers are
             Extracts from the                             having to face these challenges much earlier.
                                                                                                           Sources for Mental Health, Depression and Eating
                                                           Too many end up seeing themselves as            Disorders: NSW Health, Kids Help Line, Reach Out
                                                                                                           website, NHS website. Additional information for
                                 Family Help Kit           failures or ‘losers’ at an early age.           Suicide and Depression pages came from ‘Leaving
                                                                                                           Early’ by Bronwyn Donaghy
[   12   ]
                                                                                                                           [ health & wellbeing ]

                                                                                                                                                                          mental health
eating disorders
                                            – they’re not just about being thin
 case study                                     Fashion pressures                               Anorexia and bulimia
 Alison’s parents were becoming                 Many girls also experience pressure             – the warning signs
 concerned that she wasn’t eating               from a society that promotes thin females.      If the answer to many of these
 as well as she used to. It had been            The media, advertising and popular culture      questions is ‘yes’, your teenager may
 nearly three weeks since she’d had             all glamorise a thin ‘look’ in women by         have an eating disorder.
 a proper ‘sit down’ meal. She was              promoting the illusion that a perfect body      Is your teenager:
 also becoming increasingly moody               brings with it a perfect life.                  x significantly underweight for their
 and argumentative which was unusual                But most women do not conform                   age and height?
 for her. Each time her parents tried           to this ‘fashionable’ thin look. Research       x binge eating then feeling guilty?
 to talk with her, she would tell them          shows that if women were the same               x telling you or friends that they’re fat
 to “leave me alone!”                           size as mannequins they would not have              no matter how thin they become?
    Her brother Mark said a few weeks           enough body fat to be able to menstruate.       x saying they have a sense of control

                                                                                                                                            Photography by Warwick Orme
 ago he heard some girls at school                  Nature did not get it wrong but the             when they say ‘no’ to food?
 teasing her about being a bit chubby.          pressure to be thin makes some girls            x going to extreme lengths to
 She wasn’t – but one of the girls was          dissatisfied and unhappy about their                control/reduce weight such as:
 jealous because a boy they all liked           body image.                                         – inducing vomiting
 asked Alison out on a date. As if                  Though disordered eating is common,             – fasting or restricting food intake
 this wasn’t bad enough, Alison’s face          serious eating disorders are not common.            – over exercising
 began to break out in pimples soon             Eating disorders affect both sexes,                 – misusing laxatives, diuretics
 after which made her feel even more            adolescent girls are particularly vulnerable.          (fluid tablets), diet pills or
 unattractive.                                  Surveys indicate that girls as young as                purgatives?
                                                6 to 8 years-of-age can believe an ‘ideal       x avoiding eating with the
                                                weight’ is thinner than their own body.             family or going straight
Alison’s story shows how problems can               More and more boys are also worrying            to the bathroom after
arise from seemingly trivial events. As         about body image. For example, some                 eating?
adults, we tend to ‘shrug off’ these            young men feel they need to ‘bulk up’           x eating large amounts
moments, but for adolescents this is not        to be accepted and successful.                      of food without gaining
always so easy. They’re often experi-               Eating disorders are serious concerns.          weight (due to vomiting
encing many changes in their lives              As with all mental health issues, the earlier       or laxatives)?
and lack an adult’s self confidence             professional help is sought the better the      x eating compulsively,
or experience to deal with them.                outcomes.                                           hiding food or eating
   Feeling they can control at least one        Anorexia and bulimia – the most                     in secret?
part of their lives through eating is common                                                    x wearing loose clothes
                                                common eating disorders
among female teenagers (and a smaller                                                               to hide their body?
                                                Eating disorders are preoccupations with
percentage of boys) with eating disorders.                                                      Have they:
                                                food, weight and appearance to the point
   For some, not eating acts as an                                                              x stopped having
                                                where a person’s health, relationships and
emotional ‘pain reliever.’ Nothing else                                                             their period?
                                                other aspects of their day-to-day life are
matters except how much they’ve eaten,                                                          x lost their appetite
                                                affected. Anorexia Nervosa (anorexia) and
what they weigh, what they’ll eat next and                                                          for more than
                                                Bulimia Nervosa (bulimia) are the most
how much control they can exercise over         common. With anorexia, a person worries             2 or 3 weeks
their food intake. By limiting their feelings   about becoming fat or gaining weight no             (not just temporarily
to only food, other problems seem to            matter how thin they become. With bulimia,          from a cold, upset
disappear or become easier to manage.           the person has repeated bouts of binge              stomach or minor
   Family problems, bullying, study             eating and then tries to compensate in ways         illness)?
pressure, low self-esteem, poor self-image,     such as dieting or vomiting. A sufferer can     x lost some of their
and physical and sexual abuse can all be        have symptoms of both problems in their             hair?
underlying problems for an eating disorder.     eating disorder.

                                                                                                                                                      [                   13   ]
       [ parenting the teenage years ]
eating disorders

                     The high cost of anorexia               How to help your teenager develop
                     and bulimia                             a positive body image
                     The physical and emotional costs
                     of anorexia and bulimia are high. In    Young people are very conscious and critical of their weight, shape and
                     extreme cases they can cause death.     appearance. Like self-esteem, helping your teenager develop a positive body
                     Physical effects                        image is a ‘gift for life’.
                                                             x Reassure them about body changes during puberty (see page 4 for more
                     x Constipation
                                                               about puberty).
                     x Growth of fine, downy hair
                                                             x Help your teenager discover what they like and value about themselves.
                       over the face and body
                                                             x Discourage family members from criticising each other’s appearance.
                     x Difficulty thinking clearly
                                                             x Think about how your own eating habits and attitudes to body image may affect
                     x Sensitivity to cold
                                                               your teenager.
                     x Fertility problems
                                                             x Don’t single out overweight kids for special health regimes and include the whole
                     x Erosion of tooth enamel
                                                               family in the goal of health and fitness.
                       and tooth decay
                                                             x Encourage your teenager to express their emotions in effective and appropriate ways.
                     x Osteoporosis (weakened bones)
                                                             x Keep plenty of healthy snacks such as fruit and bread in the house.
                     x Anaemia (problem with the blood)
                                                             x Point out that healthy, attractive, successful people come in many shapes and sizes.
                     x Kidney problems
                                                             x Explain how TV and magazine images are often changed to make women look
                     x Abnormal heart rhythm
                                                               slimmer than they are.
                     x Ruptured stomach
                                                             x Start early – the best time to help your child develop a positive body image
                     x Seizures
                                                               is well before their teens.
                     Psychological, social
                     and emotional effects
                     x   Depression
                                                             where to get help
                     x   Mood swings                         x Your family doctor
                     x   Social isolation                    x NSW Association for Mental Health, Mental Health Information Service
                     x   Family conflict                       02 9816 5688 or 1800 674 200 (freecall outside Sydney)
                     x   Guilt                                 Monday to Friday 12:30pm – 4:30pm
                     x   Secretive or deceptive              x Eating Disorders Support and Information Line on: 02 9412 4499
                                                                                                                      Source: ‘NSW Health Family Help Kit’

                          – when the ‘blues’ won’t go away
                    Everyone gets the ‘blues’ now           Recent surveys suggest up to 1 in 5
                                                            people will experience depression at
                    and then, but people who feel           some time.
                        down for more than a few                It can be hard to know if your adolescent
                        weeks may be depressed.             is depressed. After all, teenagers are often
                                                            moody – but depression is more than this.
                       Adolescence is a period of           Depression is a serious illness, and it is
                            significant change and          important your adolescent gets help, just
                                                            like you would seek professional advice
                          development. For some
                                                            for a physical illness.
                    adolescents, it can be a difficult          Sometimes it can be easy to see why
                       and confusing period of life         your teenager is depressed. But often
                                                            depression can appear from nowhere.
                          and this can make them                Teenagers don’t always understand
                         vulnerable to depression.          why they feel down, or even know how

       [   14   ]
                                                                                                                           [ health & wellbeing ]

                                                                                          mental health
to express what they feel. This makes
it hard for parents to work out when
                                             what are the
the ‘blues’ have turned into something       causes?
more serious.
                                             There is no single cause
    Many depressed young people appear
                                             for depression. It may be
to be angry or irritable rather than sad.
                                             a psychological, chemical
They may become hostile, take risks
                                             or social problem, or a
and push people away.
                                             combination of any of these.
    If left untreated, the problem can
                                             x Psychological – life events such
spiral into alcohol and drug use. This
                                                as the loss of someone close can
can lead to more problems and make
                                                lead to feelings of hopelessness
their depression worse. In some people,
                                                about the future
alcohol, drugs, prescription medicine or
                                             x Chemical – changes in brain
physical illness can trigger depression.
                                                chemicals can cause depression
People whose close relatives have
                                             x Social – a reduction in activities
depression are also at greater risk of
                                                or interests can both cause
developing the illness.
                                                depression and arise from
    Many people falsely believe teenagers
should be able to shake off the emotional
symptoms caused by depression.
“If only they tried hard enough,” is often
the thought. This is dangerous, as it can
                                             what can                                     where to get help
make teenagers feel weak or ashamed          you do?                                      In an emergency contact your
and discourage them from seeking help.                                                    General Practitioner or local
                                             When your teenager is feeling down,
It also fails to recognise that depression                                                hospital Emergency Department
                                             it’s important to listen and offer help
is a mental illness.                                                                      24 hour telephone services are:
                                             and support them to seek help.
    The good news is that depression can                                                  x Kids Help Line 1800 55 1800
                                             Encourage them to:
be treated effectively with counselling                                                   x Lifeline        13 11 14
                                             x talk about their feelings (let them
and sometimes with medication. With                                                       x Youthline (youth counselling)
                                                 know they don’t have to carry the
treatment, many people start to feel                                                         02 9633 3666 (Parramatta).
                                                 whole load)
better in just a few weeks.                                                               For other help, the first point
                                             x talk to other people they trust
                                             x ask for help when they need it             of contact can be:

what are the                                 x spend time with their friends
                                             x join in sports, school activities
                                                                                          x Your local Area Health Service
                                                                                              (during business hours) including
warning signs?                                   or hobbies which they enjoy and              community health centres or
x persistent sadness or anger,                   that help build their confidence             specialist child and adolescent
  frequent crying                            x get involved in organisations that             mental health services.
x difficulty thinking or concentrating,          support them and help them to            x Other specialists who work with
  a worsening of school performance              develop interests                            children and adolescents such as
x feelings of guilt, worthlessness,          x exercise (exercise releases brain              paediatricians, child psychiatrists
  hopelessness, helplessness                     chemicals which help lift our spirits)       and psychologists may also be
x lack of interest in friends, family and    x find ways to relax (these can be               able to provide help.
  activities they previously enjoyed             simple such as seeing a movie            If you would like more information
x lack of energy, enthusiasm or                  or going for a walk or a surf)           about mental health and services
  motivation (feeling slowed down)           x write down what they’re thinking           contact:
x restlessness, irritability or agitation        or to express their thoughts in          x NSW Association for Mental Health,
x changes in sleeping patterns                   other creative ways like painting.         Mental Health Information Service
  – not being able to sleep or               If your teenager is depressed for              Monday to Friday, 12.30pm – 4.30pm
  sleeping more than usual                   a significant period of time it is             02 9816 5688 or 1800 674 200
x changes in eating patterns                 important to seek professional help.           (freecall outside Sydney)
  – eating more or less than usual           If you or they are not taken seriously
x thoughts of death, suicide or              at one place then seek help else-
  harming themselves.                        where until you are both satisfied.                          Source: ‘NSW Health Family Help Kit’
                                                                                                               Extracts from the

                                                                                                                                   Family Help Kit   [   15   ]
                              [ parenting the teenage years ]

                                           preventing suicide
                                                                     – when young people need help
                                                                                                                         to identify which behaviours are
                                               Suicide prevention is     While all of us feel sad or unhappy
                                                                                                                         associated with an illness like depression
                                                                         at some time, when young people
                                              everybody’s business.      are depressed they may feel hopeless,           and which behaviours are part of their
                                                                                                                         teenager’s personality.
                                             Suicide attempts rarely     helpless or overwhelmed by despair.
                                                                             Remember, not all young people
                                              happen without some        with depression are suicidal, and not            who is at risk?
                                             warning. Learning how       all adolescents who attempt suicide are
                                                                                                                          All teenagers are vulnerable.
                                                                         depressed. However, if young people are
                                              to recognise the early     depressed they should be assessed for            Few will have learnt how to deal
                                                                                                                          with everything that life can throw
                                           warning signs and taking      suicide risk.
                                                                                                                          at them and some people have
                                                                             Suicide may take one life, but it affects
                                            them seriously may help      whole communities. It is a human tragedy,        stronger coping skills than others.
                                                                                                                              The following stress factors may
                                             someone close to you.       especially when it involves the lives of
                                                                                                                          make a young person more vulnerable
                                                                         young people.
                                             Often this is the crucial       Some young people resist asking for          to suicide risk:
                                                                                                                          x loss of an important person through
                                                 first step in suicide   help simply because they aren’t aware
                                                                                                                              death or separation
                                                                         of the range of services available to them.
                                                          prevention.    Your GP or local community health centre         x recent suicide of a friend or relative
                                                                         is a useful starting point.                      x breaking up with a girlfriend or
                                                                         Possible warning signs                           x trouble with school or the police
                                                                         Many young people may, as part of their          x feared or confirmed pregnancy
                                                                         adolescent development, push the limits          x being a victim of sexual or other
                                                                         at home, isolate themselves from family              abuse (now or in the past)
                                                                         members and experiment with risky                x family conflict or domestic violence.
                                                                         behaviour. Some families need help

                                                                          what are the warning signs?
                                                                          There are lots of factors which are             x giving away personal possessions
                                                                          linked to youth suicide. Although               x talking about death and suicide,
                                                                          it is not possible to prevent every               such as “I wish I was dead”,
                                                                          suicide, knowing about some                       “no one cares if I live or die”,
                                                                           of the warning signs may help                    “does it hurt to die?”
                                                                            people intervene sooner.                      x feeling worthless or letting parents
                                                                              These include:                                or others down
                                                                               x expressing feelings                      x withdrawing from friends
                                                                                   of hopelessness                        x a sudden bout of cheerfulness after
                                                                                 x a drop in their standard of              a long period of sadness or anger.
                                                                                       school work and attendance           This is critical. Having made a
Photography by Warwick Orme

                                                                                           x painting, drawing or           decision (i.e. to die) they may feel
                                                                                              writing about death           as though they can now stop
                                                                                              or suicide                    worrying about their problems.

                              [   16   ]
                                                                                                                     [ health & wellbeing ]

where to get help
x In an emergency contact the
  Emergency Department of your
  local hospital or dial 000.
x Your local Area Health Service (during
  business hours) including community
  health centres or specialist child and
  adolescent mental health services
x Other specialists who work with
  children and adolescents such
  as paediatricians and child
x The ‘Reachout’ website which
  provides a comprehensive online
  database of services to prevent youth
x Your local General Practitioner
24 hour telephone services are:
x Kids Help Line        1800 55 1800
x Lifeline              13 11 14
If you would like more information about
mental health and services contact the
NSW Association for Mental Health,                               While all of us feel sad or unhappy at some time,
Mental Health Information Service                                when young people are depressed they may feel
Monday to Friday, 12.30pm – 4.30pm
on 02 9816 5688 or 1800 674 200
                                                                 hopeless, helpless or overwhelmed by despair.
(freecall outside Sydney)

            Source: NSW Health Family Help Kit                                        It happens to all sorts
                                                                                      of families
 what you can do to help?                                                             “When I first started working in this

                                                                                                                                                mental health
                                                                                      area I was looking for reasons why
 Although parents may have difficulty in talking with young people about              this awful thing had happened to
 personal issues, good communication is important to understanding what               these particular families. I was
 they are feeling and thinking.                                                       looking for flaws, for faults in the
 x Listen to them. Giving them your full attention and listening can immediately      way they ran their lives, for mistakes
   say, “I care”.                                                                     in the way they raised their children.
 x Let them know you take their concerns seriously (no matter how minor they          I wanted to feel safe in the
   may seem to you).                                                                  knowledge that it couldn’t happen
 x Ask them if they’re thinking of hurting themselves.                                to me or mine. I discovered that
 x Take any talk of self-harm or suicide seriously.                                   there is no such guarantee. These
 x Tell them that if they need help you are there for them.
                                                                                      people were just like me. These
 x Don’t promise to keep any threat to hurt themselves a secret (keeping their
                                                                                      families were just like mine. Suicide
   confidences is important, but you may need to break a confidence to save
                                                                                      can happen to anyone, anywhere,
   their life).
 x Stay with them if you think there is an immediate risk they’ll hurt themselves.    any time.”
 x Give them messages of hope and support; talk to them about alternative             Gail Kirby, Community Health Educator
                                                                                      in ‘Leaving Early – Youth suicide: the horror,
   ways of solving their problems.                                                    the heartbreak, the hope’, by Bronwyn Donaghy,
 x Help them make and maintain contact with a professional who can help               Harper Health 1997

   (few teenagers will seek help on their own).
                                                                                                      Extracts from the

                                                                                                                          Family Help Kit
                                                                                                                                            [   17   ]