Category: troubled teenager

Welcome to the 911 Club for Parents of Troubled Kids

Welcome to the 911 Club for Parents of Troubled Kids

Let’s start a 911 Club, a community for parents who depend on emergency services for managing their mentally ill child. Our T-shirts would be black and blue like bruises. Only people raising a mentally ill child or young adult could join. Club rules would be simple:  1. No one is ever judged. 2. We keep things confidential. 3. Everyone is made to feel like a hero. 4. Everyone accepts that they are not guilty or failures, and neither are their children.

Every day, an emergency is just around the corner.

Parents with troubled children, no matter the age or diagnosis, are forced to make difficult decisions and take extreme actions… like calling 911.  It’s not something they choose, and they’ll avoid it if possible.  They are like any other parent with a severely disabled or physically ill child—they will do anything to help their child, but instead of wheelchairs or chemotherapy, they need emergency responders.

Most parents with normal children will never need to do the following 10 things that parents of troubled children often do:

  1. Call police
  2. Call an ambulance
  3. Or call a crisis line repeatedly
  4. Search a child’s room, especially if the child is a teenager or may be suicidal
  5. Spy on their child: read their email, texts, social media or search histories, read their journals
  6. File criminal charges or get a restraining order
  7. Lock up common household items (matches, knives, scissors, fuel, and anything conceivably dangerous in the wrong hands)
  8. Participate in endless meetings, appointments, and therapy sessions. Complete dozens of forms and continually pursue financial or community mental health resources
  9. Block out people who used to be friends
  10. Never share our stories with ‘normal’ people lest we get bombarded with uninformed and unsolicited opinions.


Parents can see an emergency coming, but can do little to prevent it.

All parents of troubled children have barriers to getting help, even when it’s blatantly obvious that the child needs it.  Why?  The aftermath of a recent high school shooting in Florida by provides details:

  1. The tragedy has to happen first: “A neighbor warned the sheriff’s office …and begged them to intervene. She was told there was nothing deputies could do until Cruz actually did something.”
  2. Mental health professionals don’t take history into account; and they are ignorant that children can behave well in their presence: “An investigator … spoke to Cruz, and advised that he was “not currently a threat to himself or others” and did not need to be committed.
  3. Family and other eyewitnesses are ignored by the people and institutions they depend on. “Lynda Cruz’s cousin warned deputies Cruz had rifles and pleaded for them to “recover these weapons.”


Policymakers, mental health professionals, and emergency responders out there:  fix this!

Part of the reason parents or family of the mentally ill person can’t get timely help is because of civil rights laws.  To those in the mental health community, start talking about how to handle this.  The present situation is unacceptable!  Stop protecting an acknowledged dangerous person’s rights over those of innocent victims.  It’s not OK.  This is just like some gun advocates who think it’s more important to sell assault rifles to protect their personal rights over those of innocent victims.

True Story

An upsetting thing happened in my city about 10 years ago that could have been my story. A man took his grown son to the emergency room because the son had been insisting he was going to stab someone—he suffered from untreated schizophrenia. When there, the staff found no reason to hold the son despite his history of violence and his father’s testimony. The father pleaded with them to put his son in a 72-hour hold and they refused.

Within minutes, the son ran off into the surrounding neighborhood, and within an hour, had stolen a steak knife from a restaurant, and ran out and stabbed a man walking on the sidewalk. (The victim lived, fortunately.) The father told the reporter that he’d been trying every possible means to stop this from happening in the hours before the event. Getting the son to go with him to the ER was an extraordinary feat in and of itself. He was beside himself with frustration and sadness and anger.  Now his son had aggravated assault and attempted homicide charges, and faced prison instead of a hospital.

–Margaret

 

U.K. needs to be a “999 Club”; Germany needs a “112” Club; a “110 Club” in China…

School Shootings, Guns, and Child Mental Illness

School Shootings, Guns, and Child Mental Illness

Up until recently, news of devastating school shootings swerved to public fights about gun control.  I had hoped past shootings would stimulate discussion of mental health treatment (see Guns and Mental Illness: the Debate from a Parent’s Perspective,” written 5 years ago in 2013). After this recent shooting in Florida, it now is.  But be careful what you wish for.  Mental illness is on the radar, but the subject swerved off into mental illness as a significant lethal threat to the public.  (I think this is compounded by a morbid fascination with psychopaths. The lurid TV series “Criminal Minds” plays to this–the entire plot line equates mental illness with psychopathy, torture, and murder.)  Damn it.

Look at the raw numbers below.  Shouldn’t the other deaths caused by children’s mental illness be on the table too?

Deaths by school shootings in elementary, middle, and high schools in the U.S.:

2000-2018 – Deaths by school shootings:  110 children*

2000-2018 – Foiled attempts at school shootings:  19 schools*

Child deaths by suicide in the U.S.:

2014-2015 – Between the ages 10-24:  17,304**

2013 – Suicide by firearm between the ages 10-19:  876***

*(Wikipedia, based on contemporaneous news reports)
**National Institute for Mental Health (latest available numerical data)
***Centers for Disease Control and Prevention (latest available numerical data)

Effective advocacy for preventing suicide (via mental health treatment) requires effective ‘marketing.’

Parkland, Florida, image from metro.co.uk

I wonder about the marketing aspect–the campaign that tells a gripping story that motivates others to act.  Let’s compare:  School shootings are public tragedies, with images of ambulances filmed from helicopters, and wrenching quotes from the anguished.  But suicides happen alone; they are private self-inflicted tragedies.  No helicopters, no candlelight vigils.  People keep their distance.  Money doesn’t pour in to support the victim’s family or increase the availability and use of treatment.  And then there is this awful irony:  if vulnerable children hear the news of a peer’s suicide, it risks suicide contagion.

Maybe the activism of the student survivors in Florida are symbolically opening a door.

Dublin, Ireland, in 2014, irishtimes.com

Maybe there’s a way if victim’s families and friends are willing to tell their anguished stories, too.  I don’t know how it feels to be you–my child made suicide attempts but didn’t succeed (insert deep sigh of gratitude here).  How do you feel about telling your stories to cameras in a large group?  Could you carry signs with photos of your precious lost ones?  or bombard the Twitter-verse to get to the hearts of the public?

Be prepared for the next round of horror, and be prepared to go public.

Our mental health professionals have been warning the public and lawmakers about the magnitude of child suicide for years–the psychiatrists and psychologists and all the other caregivers.  But they use facts, which don’t count in the public eye, whereas personal stories do.

Your comments are encouraged.

–Margaret

The Dysfunctional Family and the “Black Hole” Child

The Dysfunctional Family and the “Black Hole” Child

Many families living with the proverbial “black hole” child start to cope in unhealthy ways. Everyone gradually alters their normal behavior to avoid stress, frustration, anxiety, or anger, but these behavioral accommodations actually make things more chaotic. It’s unintentional, but parents, siblings, extended family and friends take on psychological roles, and the resulting dynamics are harmful. This is the “dysfunctional family,” and these are some common roles:

    • Protector is the emotional caregiver and defends the child regardless.
    • Rulemaker wants Protector to stop enabling the child and set boundaries.
    • Helper smooths over conflict, calms others, and sacrifices for others.  They become “parentified,” and miss important childhood experiences, like play.
    • Escapee stays under the radar for safety, and finds ways to stay away from home to avoid the stress.
    • The Neglected shows a brave face but hurts. They need nurturing but don’t ask for help because the parents are so distracted.  They become depressed.
    • Fixer has all the answers and keeps trying to make everyone do things ‘right’.  They repeatedly jump into everyone’s lives and stir up chaos.
    • Black Hole Child devours everyone’s energy, and gets trapped in their own black drama. For complex psychological reasons, they learn to manipulate, split family members against each other, and blame their disorder for behaviors they can control. Due to insecurity, they act out repeatedly to test if those they depend on still care.

If this is your family, it’s not your fault. Forgive yourself and everyone else. Families living with an alcoholic or addict behave similarly, but they have specialized 12 Step programs like Al Anon and Narc Anon to help them become functional again.  Their 12 Steps would help you too!  I’m not aware of a similar 12-Step approach specifically for families living with mental illness, but I strongly recommend a support group.  Look for one near you (in the US or Canada) at the National Alliance on Mental Illness (www.nami.org) or the Federation of Families for Children’s Mental Health (www.ffcmh.org).

For a child to be well, each person around the child must be well.

First:  A stress relief meeting.  Meet together without the “black hole” child present… now is not the time to include them.  Meetings might be held with the guidance of a family therapist or support group to keep emotions safe. The goal is to ease everyone’s fears by bringing them out into the open. Each member vents their true feelings.  Brace yourself.  You may hear upsetting things, but once feelings are out in the open people will feel better.  There will be more problems to solve, but now everyone knows what they are.  No more secrets.  All everyone needs is to feel heard and understood.  Clearing the air helps people move on.

It is a relief to tell your story and have someone listen and understand.

Check in with family members (perhaps not the troubled child yet… use your best judgment).  Ask everyone how they‘re doing. What is working well? and what isn’t?  Be prepared to hear more complaints and venting.  Just listen and ask clarifying questions until they get it out of their system. (It’s like vomiting, and feeling so much better afterward.)  Brainstorm solutions together.  Ask for ideas on what needs to happen differently.  You don’t need to agree or comply, just listen.

At some point, the troubled child’s own opinions and needs need to be woven into the new family system.  This can be very tricky.  If you feel things will get out of control, get help from a therapist or counselor for yourself or for your family.  The methods for doing this are too lengthy for covering in this article, but you can find out more by exploring books or websites on family interventions for an alcoholic or addict.

Warning:  Once family teamwork improves, prepare everyone for an explosive defiant backlash. This is actually a good sign, so plan for it in advance.  It is a sign you are regaining your authority.  Visualize standing shoulder-to-shoulder to keep everyone safe while the child explodes.  Stick together.  The child may blow-up multiple times, but stick together.  The explosions fall off over time.  This article explains the reasons for these explosions, called “Extinction Bursts” by psychologists. They are the  final act of defiance when limits are firmly enforced and the child loses power.

Ultimate goal:  The child’s behavior improves!  The child stabilizes; they are surrounded by a caring but firm team that locks arms and won’t be shaken by chaos. Surprisingly, this actually helps the child feel more secure and less likely to cause distress.

How it might unfold:

  • Protector steps back; cares for themselves; and accepts that Rulemaker has some legitimate reasons for boundaries.
  • Rulemaker steps in to help Protector as needed and gives them a break. Rulemaker and Protector work out acceptable structure and make two to three simple house rules for everyone that are fair and easily enforced.

Rulemaker and Protector also make two to three simple agreements between themselves.  Number one:  no fighting or disagreements in front of the child.  Next, checking in with each other and agreeing on a plan or strategy.  Ideally, their relationship improves, and trust and safety is reestablished.  This can happen between parents who are divorced too.

  • Helper gets a life of their own, accepts they are not responsible for everyone, and is encouraged to spend time with supportive friends or doing activities they really like.
  • Escapee and The Neglected need lots of support and comfort and emotional connection to a nurturing adult. They are at risk of mental health problems in the future, especially depression and addiction.  They may suffer from PTSD as adults, from enduring years of emotional distress or neglect. Both may need mental health treatment such as therapy and relaxation skills.
  • Fixer: withholds judgement and realizes there are no simple answers. Their education or experience does not necessarily apply to this family. They should ask how to help instead of trying to make people change, and they should be gracious and supportive.

Helping a troubled child means helping the family first, and family teams are the best way.  As each member strives for a healthier role, each gets support from other family members and hears things like, “Atta girl!”, “You rock!”, “Go Mom!”. Teamwork creates therapeutic homes and strong families. Research proves that strong families lead to better lifetime outcomes for the child.

–Margaret

Your comments, questions, and stories are encouraged because they help others


If you would like to get ongoing updates on the latest news and research in child & adolescent mental health, follow my Facebook Page.

Use the “S” word: talk openly with your child about suicide

Use the “S” word: talk openly with your child about suicide

Don’t be silent on the subject of suicide, even if there’s no evidence your child has considered it.  Bring it in the open, especially if you have a hunch something is wrong and they may have suicidal thoughts.  This article addresses:

  1. Why you should talk about suicide with your child
  2. How to respond if there’s been a threat
  3. How to respond if there’s been an attempt

Parents talk about many uncomfortable subjects with their child; and suicide must be one of them.

Don’t let suicide become a ‘sensitive’ subject.  Your child needs to hear about it from you.  They should feel safe talking about it.  Don’t expect them to bring this subject up.  They may fear you will overreact, and worsen their depression, or you could under-react or dismiss it because you’re uncomfortable.  Neither response helps.

Won’t this give my child ideas and encourage suicidal thoughts?

No.  Children usually know what suicide is and will have wondered about it—even young children. Ask what your child thinks. Children as young as 7 and 8 have asked about suicide or communicated they had suicidal thoughts.  Children as young as 10 and 11 have attempted or completed suicide.  The ages of highest suicide risk are between 10 to 24.

Talk with your child. Don’t leave him or her alone with thoughts or questions about suicide.

An 11-year-old boy died of suicide a couple of weeks before this article was written. There had been no prior signs.  He killed himself after receiving a prank text saying his girlfriend had committed suicide. He told no one beforehand.  His parents had no idea he was even at risk.

Why might my child become suicidal?

Mental health professionals assess risk by using the Biopsychosocial Model.  The more negatives in the biological, social, and psychological aspects of one’s life, the higher the risk of suicide or other mental health problems.

The major risks of suicide are in the central part of this diagram: drug effects, temperament, IQ, family relationships, trauma.

From Pinterest and the blog, Social Workers Scrapbook

What can you control and change at home?
What do you and family members need to reduce these risks?
Communicate about these with everyone. (Can be hard to do, but try.)

What can trigger suicidal thoughts?

Examples from two states that did the research:

Oregon: Survey results for an exceptionally high suicide rate among 10-24 year olds by population, 180 individuals in one year (“Suicide circumstances by life stage, 2013-2014”).

  • 62% – Current depressed mood
  • 53% – Relationship problems
  • 47% – Current mental health problems
  • 43% – Current/past mental health treatment
  • 42% – History of suicidal thoughts/plans
  • 31% – Recent/imminent crisis
  • 22% – Family relationship problems
  • 21% – Non-alcohol substance abuse problems
  • 8% – School problem

New York: Life situations of children completing suicide, 88 individuals; (“Suicide Prevention, Children Ages 10 to 19 Years”, 2016)

  • Feeling hopeless and worthless (often because of bullying at school, home, or online)
  • Previous suicide attempt(s)
  • Physical illness
  • Feeling detached and isolated from friends, peers, and family
  • Family history of suicide, mental illness, or depression
  • Family violence, including physical or sexual abuse
  • Access to a weapon in the home
  • Knowing someone with suicidal behavior or who committed suicide, such as a family member, friend, or celebrity
  • Coping with homosexuality in an unsupported family, community, or hostile school environmental
  • Incarceration (time in juvenile detention or youth prison)

What if my child has threatened suicide?

A threat opens a door for a discussion.  A good approach is to interview your child about their feelings, plans, needs, and reasons.  Listen earnestly without input.*  You might be surprised to find their problem is solvable, but their depressed mood paints it as hopeless.  Listening helps them get clarity and feel heard and respected.  Once you understand their problems, you assist them in identifying options and provide emotional support.

* I have a friend who worked for a suicide hotline, and he said the job wasn’t difficult at all.  He said, “All I did was listen and show understanding of their feelings and just let them talk. “

After a frustrating discussion about my teenage daughter’s suicidal threats, I gave up and said “No.  I’m telling you not to commit suicide.”  She was incredulous; “You can’t tell me what to do!  You can’t stop me!”  I responded, “Don’t commit suicide. You’re important to us.  You have important things to do in life.”  She made a few attempts in the following years (they were always public… as if she wanted to be discovered and prevented), and she always reached out to her family afterwards for support.  Did my words make a difference?

What if a threat is just for attention?

It’s hard to tell. It could be genuine  or manipulative.  Some children use threats to prevent parents from asserting rules.  Angry children, especially teens, use threats to blame and hurt parents emotionally.  If you think a threat is not genuine, open up the suicide discussion.  “Talk to me about this”, “It seems like an extreme reaction to something we can fix.” “What needs to change?”  “How can I help?”  Focusing on the threat will either expose the ruse or draw out important information for addressing an underlying problem.

What else can I do if my child threatens suicide?

  1. Observe and investigate.
  • Do they have access to unsafe objects or substances?  You can legally search their room.
  • Do they frequent unsafe places or spend time with people who encourage drug use?
  • Do they have extreme mood swings (up or down), or a chronic dark mood?
  • Do they take dangerous risks and seek dangerous activities?
  • Are there any other danger signs?
  1. Build a network of eyes–choose people who will observe your child and keep you advised of risk, e.g. a mature sibling, a teacher, your child’s friend or the friend’s parents, your child’s boyfriend or girlfriend, a relative, or a trusted person who knows your child.
  1. Make changes you have control over, and solidly commit to these changes. Bring the whole family along on the plan.  FOLLOW THROUGH.
  • In family life – reduce chaos, fighting, blaming, or bullying; express appreciation; neglect no one including yourself; create 2 – 3  house rules that are easy to enforce and everyone follows, even you.
  • In social and online life – learn as much as you can about the nature of your child’s relationships, whether romantic or social. Support them if they distress your child. Can they remove themselves from a toxic relationship? or cope effectively with anxiety? Can you help them address bullying at school or online?
  • Biological health – Sleep, Exercise, Diet.  Limit screen time at night because blue light inhibits sleep.  Pay attention to digestive health, which affects mental health. These are some natural approaches.
  • Psychological health – Ask a school counselor about your child.  Seek a working diagnosis and mental health treatment.  Help your child find outlets for personal self-expression:  journaling, music, art, poetry, or a website such as this one, where teens help teens.  Mind Your Mind is an excellent example.

What if my child attempted suicide?

He or she is still very fragile, even if in treatment!  They have taken the action, they’ve been there, and have the option for taking it again—a high percentage try againSuicide attempts are long-term emergencies. You need to be on alert in the following days, weeks, months, and possibly years.  In addition to intensive mental and physical health treatment, ensure your child gets regular deep sleep, exercise, and a good diet.  Ask them if they’ve had suicidal thoughts if you sense something is wrong.  Don’t be shy about checking in.

Pay attention to events that trigger suicide.

Check-in with your child when something traumatic happens or might happen, especially if someone he or she knows attempted or committed suicide, or a suicide was in a TV drama or covered in the news.  Triggers are an emergency, act immediately.

You have the power to prevent a child’s suicide.
Be strong. You can do this. 

Take care of yourself.

–Margaret

Is my teen ‘normal’ crazy or seriously troubled?

Is my teen ‘normal’ crazy or seriously troubled?

girl in rear view mirrorA high percentage of teenagers go through a rebellious or ‘crazy’ phase that is normal for their age and brain development. The difference between normal teen-crazy and truly troubled behavior is when the teenager falls behind his or her peers in critical areas.  At a bare minimum, a normal teen will be able to do the following:

  • Attend school and do most school work if they want to;
  • Have and keep a friend or friends their own age who also attend school;
  • Develop a maturity level roughly the same as his or her peers;
  • Exercise self-control when he or she wants to;
  • Demonstrate basic survival instincts and avoid doing serious harm to themselves, others, or property.
  • Enjoy activities that interest them.

boy in baseball capIt is normal for many teens to be inconsistent, irrational, insensitive to others, self-centered, and childish.  Screaming or swearing is normal–regard this the same as a toddler temper tantrum.  Outlandish imagination and ideas are normal in the adolescent phase too. These are behaviors that crazy teens grow out of unless something else is holding them back.

This is your challenge:  How do you tell the difference?  Troubled teens with mental disorders have the same challenging behaviors as ‘normal’ crazy teens… How do you know if they need serious mental health treatment?  Look for pervasive patterns of social and behavioral problems that stand out against their peers, patterns which persist or occur in different settings.  The patterns repeat themselves and are increasingly worse.  You suspect your troubled teen is slipping behind and won’t grow out of it.

screaming boySigns of abnormal behavior

A sudden change in behavior.

  • An abrupt change in friends and interests, and loss of interest in things your teenager used to enjoy.  This might indicate the onset of a serious mental illness or drug use or both.
  • Unusual ideas, or obsessive beliefs, or unrealistic plans, see:  “Unsettling: what psychosis looks like in children and young people.”
  • Others think there is something abnormal about your child.  (e.g., your child’s friend comes forward, their teacher calls, other parents keep their children from your child, or someone checks to see if you’re aware of the nature of his or her behaviors).


Unsafe behaviors
 (“Unsafe” means there’s a danger of harm to themselves or others, property loss or damage, running away, seeking experiences with significant risk (or easily lured into them), abusing substances, and physical or emotional abuse of others.)

  • If a troubled teenager does something unsafe to themselves or others, it is not an accident, but something impulsive, intentional, and planned.
  • They have a history of intentional unsafe activities.
  • They have or seek the means to do unsafe activities.
  • They talk about or threaten unsafe behavior.


How psychologists measure the severity of a child’s behavior 

“Normal” is defined with textual descriptions of behaviors, and these are placed on a spectrum from normal to abnormal (or “severe emotional disturbance” – SED).  Below are a few examples of a range of behaviors in different settings.  These descriptions are generalizations and should not be used to predict your child’s treatment needs, but they do offer insight into severity and the need for mental health treatment.

School behaviors

Not serious – This child has occasional problems with a teacher or classmate that are eventually worked out, and usually don’t happen again.

Mildly serious – This child often disobeys school rules but doesn’t harm anyone or property.  Compared to their classmates, they are troublesome or concerning, but not unusually badly behaved. They are intelligent, but don’t work hard enough or focus enough to have better grades. They could use help from a school counselor, teachers, and possibly a therapist for themselves or the family.

Serious – This child disobeys rules repeatedly, or skips school, or is known to disobey rules outside of school.  They stand out in the crowd as having chronic behavior problems compared to other students and their grades are poor even if they’re very intelligent.  This child needs mental health or substance abuse treatment.

Very serious – This child cannot be in school or they are dangerous in school.  They cannot follow rules or function, even in a special classroom, or they may threaten or hurt others or damage property.  It is feared they will have a difficult future, perhaps ending up in jail or having lifetime problems.  If they cooperate, this child requires intensive mental health and or substance abuse treatment.

Home behaviors

boy looking right

Not serious – This child is well-behaved most of the time but has occasional problems, which are usually worked out.

Mildly serious – This child has to be watched and reminded often, and needs pushing to follow rules or do chores or homework.  They don’t seem to learn their lessons and are endlessly frustrating.  They can be defiant or manipulative, but their actions aren’t serious enough to merit intensive treatment, though a school counselor or private counselor would be very beneficial.

Serious – This child cannot follow rules, even reasonable ones.  They can’t explain or take no responsibility for their behavior, which can include damage to the home or property, or harm to themselves or others.  They need mental health treatment or substance abuse treatment.

Very serious – The stress caused by this child means the family cannot manage normally at home even if they work together.  Running away, damaging property, threats of suicide or violence to others, and other behaviors require daily sacrifices from all.  Police are commonly called.  This child needs intense psychiatric treatment and/or substance abuse treatment, and likely residential treatment.

Relationship behaviors

somber boyNot serious – The child has and keeps friends their own age, and has healthy friendships with people of different ages, such as with a grandparent or younger neighbor.

Mildly serious – This child may seem extra immature.  They will argue, tease, bully or harass others, and most schoolmates avoid them. They are quick to have temper tantrums and childish responses to stress that always require extra attention from parents and caregivers.

Serious – The child has no friends their age, or risky friends, and can be manipulative or threatening. They can have violent tendencies, poor judgment, and take dangerous risks with themselves and others.  They don’t care about others’ feelings, or may readily harm others physically or emotionally.  This child needs therapy and psychiatric mental health treatment or substance abuse treatment.

Very serious – The child’s behavior is so aggressive verbally or physically that they are almost always overwhelming to be around.  The behaviors are repeated and deliberate, and can lead to verbal or physical violence against others or themselves.  This child needs intensive psychiatric and/or substance abuse treatment.

Pay attention to your gut feelings.

If you’ve been searching for answers and selected this article to read, your suspicions are probably true.  Most parents have good intuition about their child.  If you’re looking for ways to “fix” or change your child, they’re aren’t any easy answers nor medications or therapies which do this.  Treatment means multiple life changes in addition to medication and therapy, and these can include help for insomnia, a change in diet, treatment for digestive system problems, and household changes to reduce stress.

Mental illness is serious and recovery is a long slow process.  It is  understandable if you want them to recover quickly–your stress can be intolerable.  Avoid pushing for recovery because it will only stress your child and lead you to disappointment.  Instead, cooperate with professionals (teachers, treatment providers), and prepare yourself for a parenting marathon.  What’s the best way to prepare?  Work hard on your own mental health and wellbeing.  This advice and wisdom from other parents may help you face this daunting task.

boy in plaid shirtEarly treatment, while your troubled teenager is young, can prevent a lifetime of problems.  Find a professional who will take time to get to know your child and you and the situation, and who will listen to what you have to say–a teacher, doctor, therapist, psychiatrist or other mental health practitioner.

–Margaret

Your comments are encouraged.  Your story helps others who read this article.


If you would like to get ongoing updates on the latest news and research in child & adolescent mental health, follow my Facebook Page.

What to do about screaming teenagers

What to do about screaming teenagers

When their screaming starts, you brace yourself.  You armor your gut to protect it from the verbal pummeling.  Their cruel words pierce your heart.  When it’s over, you want to strangle them or abandon them in a wilderness.  In his  play, King Lear, William Shakespeare wrote, “How sharper than a serpent’s tooth it is to have a thankless child!”  That was 500 years ago and little has changed.

BUT THIS WILL PASS.  Your teen will quiet down and apologize someday… it may take a few years, but someday.  Until that bright day, remember that you’re tough enough to take it, and tough enough to persevere in the face of high drama and lots of noise.  You are not failing as a parent, but proving you care enough to be a good parent.  Paradoxically, your screamer appreciates your engagement because it’s reassuring to them.  Screaming teens are horribly insecure, and need you to prove you care for them.  This isn’t rational, or fair, but don’t take the screaming personally.  And don’t take it seriously unless the behavior is new or out-of-character, or unless your screamer makes threats of harm.

Difficult teenagers are inconsistent, irrational, insensitive to others, self-centered, childish and…  should I go on?  It may have nothing to do with a disorder per se.   Screaming teens are as normal as screaming babies.  Regard their screaming as you would a toddler temper tantrum.  It is a phase that most teens grow out of unless something else is holding them back.

The way to handle a screaming teenager is to handle yourself first, because you are the king or queen, holder of all power in the parent-child relationship, and you must use your power wisely.  Don’t scream back. Don’t reward screaming by losing your cool. Don’t get hooked.

When the screaming starts, do a personal check-in on your thoughts and feelings

How am I doing?
I am handling it.  This isn’t as serious as it seems.  It’ll be over in less than 10 minutes.

How am I feeling?
I choose how to feel and I won’t let this bother me.  I will rise to the occasion and come out stronger.

What are my options?
I will be persistent until I regain power over our household.  I will live within my values.  I will take care of myself when it becomes stressful.

Keep your expectations realistic

  • You don’t need to be in total control, just one step ahead of your teen.
  • Be prepared for screaming to worsen before it gets better.
  • If you get an apology, accept it, even a weak apology.
  • Don’t expect to hear that they love you, or that they appreciate what you’ve done for them.
  • They will not give you credit for being the good parent you are, yet.

Two simple demands:
1. lower the volume,
2. clean up the language.

Set the boundary on the loudness of screaming and the use of mean-spirited, foul language.  Remind your teen that it’s OK to be angry; it’s not OK to assault with screaming and ugliness.  Give them an example of what you’d rather hear, for example:  “You are not being fair to me;”  or “Don’t say that about my friends…”

If they can’t communicate themselves in a straightforward non-screaming manner, then restate what you think they mean, using different words so they know you got their message: “You think I’m being unfair to you,”  “You don’t like me criticizing your friends.”  Ask them if you are correct.  Make it clear you got the message even if you disagree with them.  It becomes awkward to scream once you’ve shown you heard them.  It will take them off guard as they think of some other thing  to be upset at you about.

Until a teen can manage basic communication with you, they are not ready to discuss the substance of their complaint.  Make a sincere effort to look deeper and try to understand what’s bothering them.  You will often get this horribly wrong and upset your teen immeasurably, but they will realize on some level that you are aware of  their deep pain and seething rage… and feel more secure.

This mother should be texting her daughter instead

Use technology and avoid screaming altogether.   Get on your cell phone and text your child, or use email.  This works surprisingly well because you’ve entered their virtual world where they feel safe from your presence, and have time to contemplate and cool off.  Writing/texting is slower, and that’s the point.  Therapists often direct feuding parents and children to communicate only by email for a while.

Listen to what they need and feel, not to what they say.

Most teens have similar needs: to feel heard, to be loved, to make one’s own choices.  Take these away and you have an angry screaming teenager.  But teens also struggle with emotional distress:  family instability, problem with a love interest, or something else they don’t want to share with you because they’re afraid of how you’ll react.  Teenage years are emotional hell, remember?  Ugly rumors on social sites, bullying, grade worries, frets over appearances… would you want to go through your teens again?  Does the thought make you want to scream?

A teenager may be a screamer because of genuine physical discomforts.  Physical things make people irritable, and teens more so:  lack of sleep, dehydration, lack of exercise; excessive sugar and fat; constipation; the monthly period.  A change in the length of daylight affects mood, whether going into the spring or into the fall.  Don’t forget to assess the home environment.  Has there been a significant change in family life?  a traumatic event?  Always consider drug and alcohol use.  If their behavior is unusually or uncharacteristically aggressive or violent, or if it’s changed for the worst recently, get a urinalysis and look for methamphetamine or marijuana. UA kits are available at drug stores or online.  Go through a  medical diagnostic checklist when the misbehavior starts.  Sometimes a few glasses of water is all your teen needs to become human again.  Have a glass yourself.

What if you, the screamee, are the problem?  Are you too strict?  lenient?  picky?  Do you nag without realizing it?  You might be the one who needs to change.  If so, admit when you’re wrong and be the first to apologize and set the good example.  My first apology to a recalcitrant child was awkward and defensive, but I had to swallow my pride and apologize for something I said.  Over time, it got easier, and apologies happened normally and easily in the family.

Self care, find a way to let yourself down easy

Leave people and chores behind for a while, go scream in a pillow, and pull yourself together.  Talk to someone who can listen or provide a point of view that’s helpful.  Set aside a dollar after every screaming fit, and treat yourself to something special later.  Let your screamer know that you’re looking forward to their next screaming episode so you can save more and get something nice.

Humor heals

Don’t forget to laugh.  Any parent who’s survived the teenage years will understand that we all need a sense of humor.  It may be a little twisted, but I find these bumper stickers funny.

“Mothers of teenagers know why some animals eat their young.”

“Grandchildren are God’s reward for not killing your own children.”

“Few things are more satisfying than seeing your children have teenagers of their own.”

 

Do you like this article?  Please rate it at the top, thanks!

–Margaret

Don’t let siblings lose their childhood

Don’t let siblings lose their childhood

Siblings suffer when a brother’s or sister’s chronically severe behavior overwhelms the family.  Usually parents are too stressed and exhausted to give them attention.  Their needs are overlooked because their brother or sister demands so much.  ‘Normal’ siblings can be very negatively affected and start to have trouble in school, troubled behavior of their own, and emotional scars that affect them in the future.

It’s easy to see how siblings are affected, but there’s little information on how to raise well-adjusted siblings in a home with a troubled child.  On the one hand, they need to be kids with plenty of love, support, and opportunity.  On the other hand, siblings also need to be part of a family team when there’s a crisis.  They can’t avoid being involved!  I found it necessary to coach the siblings on precisely what to do, with the promise they could be a kid afterwards.  I found it necessary to normalize our peculiar family situation to them.  We were a ‘normal’ family for families like us.

The Siblings’ Bill of Rights

  1. The right to our own life outside the family
  2. The right to have our own concerns acknowledged
  3. The right not to be “perfect” to compensate for our troubled sister or brother
  4. The right to be treated as fairly as our troubled sister or brother
  5. The right to a safe environment
  6. The right to have our own friends and spend time with them
  7. The right to helpful information about our troubled sibling
  8. The right to be supported in our choice of future, and to pursue our future without continually caring for our troubled brother or sister
  9. The right to one-on-one time with our parents-caregivers
  10. The right to have our achievements and milestones celebrated
  11. The right to have our needs and opinions included in our sibling’s treatment plans.

From the Sibling Support Project – a national effort dedicated to the life-long concerns of brothers and sisters of people who have special health, developmental, or mental health concerns.  http://www.siblingsupport.org/

 

Find ample time to put the siblings first.  You cannot let your difficult child rob them of their childhood, their need to grow and be social and do well in school.  Your other children will be part of their brother’s or sister’s life forever, and they will need to be strong and supportive when the troubled one needs help as an adult.  To the parent or caregiver, this is for you:

“Most siblings of people with psychiatric disorders find that mental illness in a brother or sister is a tragic event that changes everyone’s life.  Strange, unpredictable behaviors in a loved one can be devastating, and your anxiety can be high as you struggle with each episode of illness and worry about the future.  It seems impossible at first, but most siblings find that over time they do gain the knowledge and skills to cope with mental illness effectively.  They do have strengths they never knew they had, and they can meet situations they never even anticipated.”
— National Alliance on Mental Illness (NAMI) July 3, 2001  www.nami.org

Sibling quotes – I once asked several young people about their experience living with a brother or sister with a mental disorder, and this is what they said:

“I escaped, I left in my mind.  I wouldn’t let anything bother me.  I dropped compassion and pretended nothing happened, I tried to forget about my family.”  Her sister was diagnosed with schizoaffective disorder at age 15.

“All I did was tried to get away when she blew out.  Then I got jealous of all the time my parents spent on her and not the rest of us.  Now I just let them handle it and I take my younger sisters away to protect them but they still hear the noise so I help them feel safe, but it’s hard sometimes.”  Her sister was diagnosed with bipolar disorder at age 9.

“To me, it was a death.  The brother I knew and who was so much like me in so many ways had died, and I didn’t know who this person was who was living in my house anymore.”  His brother was diagnosed with schizophrenia at age 18.

Share these messages with your other children. They will probably help them learn to live with or accept their troubled brother or sister:

  • “You cannot cure a mental disorder for a sibling.
  • No one is to blame for the illness.
  • No one knows the future; your sibling’s symptoms may get worse or they may improve, regardless of your efforts.
  • If you feel extreme resentment, you are giving too much.
  • It is as hard for the sibling to accept the disorder as it is for you.
  • Separate the person from the disorder.
  • It is not OK for you to be neglected.  You have emotional needs and wants, too.  The needs of the ill person do not always come first
  • The illness of a family member is nothing to be ashamed of.
  • You may have to revise your expectations of your sibling.  They may never be ‘normal’ but it’s OK.
  • Acknowledge the remarkable courage your sibling may show when dealing with a mental disorder.  Have compassion, they suffer and face a difficult life.
  • Strange behavior is a symptom of the disorder.  Don’t take it personally.
  • Don’t be afraid to ask your sibling if he or she is thinking about hurting him or herself.  Suicide is real.
  • If you can’t care for yourself, you can’t care for another.
  • It is important to have boundaries and to set clear limits.  You should expect your sibling to show respect for others.
  • It is natural to experience many and confusing emotions such as grief, guilt, fear, anger, sadness, hurt, confusion, and more.  You, not the ill person, are responsible for your own feelings.
  • You are not alone.  Sharing your thoughts and feelings in a support group has been helpful and enlightening for many.
  • Eventually you may see the silver lining in the storm clouds: your own increased awareness, sensitivity, receptivity, compassion, and maturity.  You may become less judgmental and self-centered, a better person.”

Excerpted from “Coping Tips for Siblings and Adult Children of Persons with Mental Illness.”  NAMI, 2001, www.nami.org