I wanted to add a section on Mental Health because it has been a big part of our entire family's story. The first entry is a piece that I cut from my book, but wanted to publish in some way. I will continue to add articles and resources to this section as I come across them and/or as I write them!
I am a huge proponent of mental health awareness and self-care. I also happen to love my therapist, who is on the shortlist of people I credit with helping me save my life. In fact, I believe everyone should see a therapist. It just makes you a better person; the best version of yourself so you can be the best wife, mom, friend, daughter, etc.
And while I am delighted that mental health is no longer the overshadowed, ugly duckling of western medicine; that encouragement to care for our mental health is almost on par with caring for our physical health, our country is quite literally in a mental health crisis. According to Mental Health America’s 2019 annual State of Mental Health report, major depression in our youth has increased 4.35% over the past six years despite an increase in awareness. Yikes!
Adolescence is a critical period for mental health because many mental health disorders show onset during and directly following this developmental period (Kessler et al. 2005, 2007). Recent US estimates of adolescent past-year mental health diagnoses indicate that 10% demonstrate a mood disorder, 25% an anxiety disorder, and 8.3% a substance use disorder (Kessler et al. 2012). Further, suicide is the third leading cause of death for youth ages 10 to 14 and the second leading cause of death for those ages 15 to 24 (CDC 2012). (ARCP)
These are startling numbers, and they beg answers to some unsettling questions. First, why are the numbers still increasing when overall awareness is also increasing? Second, what are the underlying potential causes that all youth have in common? Third, what shifts are needed across the board (mental health professionals, parents/families, schools/organizations, youth)?
Thankfully, mental health awareness is increasing. It is quite a large umbrella, so here is a very basic breakdown of teen-specific signs and symptoms of depression and anxiety disorders:
· Feeling negative and worthless
· Increased fatigue and sleep problems
· Irritability and anger
· Changes in appetite and weight
· Poor performance in school
· School refusal
· Feeling misunderstood and extremely sensitive
· Substance abuse
· Loss of interest in normal activities or social interaction
· Self-harm and suicidal ideation
· Difficulty concentrating
· Avoiding normal activities or social interaction
· Isolating from friends
· Frequent headaches
· Gastrointestinal issues
· Sleep problems
· Poor performance in school
· Symptoms of panic attacks (rapid heartbeat, sweating, shaking, difficulty breathing, chest pain)
There are many tools and treatments available. The first step is to be aware and to support your child. Talk with a mental health professional. The earlier your child learns coping techniques, the easier it will be. I have seen it with my own kids. All four manage their own flavor of depression and/or anxiety. As we dug deep the past three years to learn all we could and stripped away all stigmas about seeing a therapist, all six of us have benefitted greatly. My 14-year-old daughter Grace knows that music, drawing, or designing one of her fabulous special effects make-up creations helps calm her anxiety. My 16-year-old daughter Isabelle employs several breathing techniques, music, or quiet meditation when her anxiety kicks in. It is trial and error. Do not get discouraged.
Knowing what adolescent mental health looks like is helpful when understanding the mental health of our LGBTQ youth.
Numerous studies conducted both in the United States and internationally consistently conclude that LGBT youth report higher rates of emotional distress, symptoms related to mood and anxiety disorders, self-harm, suicidal ideation, and suicidal behavior when compared to heterosexual youth (Eskin et al. 2005, Fergusson et al. 2005, Fleming et al. 2007, Marshal et al. 2011). Furthermore, any or all of these have shown to be a precursor to substance use, abuse, and dependence; Marshal et al. 2008). (ARCP)
In youth 14 to 21 years old, Fergusson and colleagues (1999) found that LGB youth were more likely to report suicidal thoughts or attempts, and experienced more major depression, generalized anxiety disorders, substance abuse/dependence, and comorbid diagnoses, compared to heterosexual youth. Results from a more recent US study that interviewed a community sample of LGBT youth ages 16 to 20 indicated that nearly one-third of participants met the diagnostic criteria for a mental disorder and/or reported a suicide attempt in their lifetime (Mustanski et al. 2010). When comparing these findings to mental health diagnosis rates in the general population, the difference is stark: Almost 18% of lesbian and gay youth participants met the criteria for major depression and 11.3% for PTSD in the previous 12 months, and 31% of the LGBT sample reported suicidal behavior at some point in their life. National rates for these diagnoses and behaviors among youth are 8.2%, 3.9%, and 4.1%, respectively (Kessler et al. 2012, Nock et al. 2013). (Annual Review of Clinical Psychology)
While these statistics are startling, there is some good news. Changes in societal acceptance of LGBT people have made coming out possible for youth. Compare today’s average age of 16 to age 18 a decade ago and 20 in the 1970’s. However, the age of coming out now intersects with the developmental period characterized by potentially intense interpersonal and social regulation of gender and sexuality, including homophobia. Given this social/historical context, and despite increasing social acceptance, mental health is a particularly important concern for LGBT youth. (ARCP)
What we know now is that Connor’s mental health journey has pretty closely mirrored the above statistics. However, we did not know this at the time of his coming out or even prior when he struggled for years with anxiety (ages 10-12) and both anxiety and depression (ages 13+).
Knowledge is half the battle. Solid information helps give us options and helps us create a plan (or plans) of action. While it doesn’t eliminate the trial and error of figuring out the root cause and coming up with a toolbox of tactics, understanding mental health will definitely point you in the right general direction.
You know your child. Even if they seem like a stranger at times, the parent-child bond speaks many silent truths. Listen to what is being said between the lines, listen to what your intuition is telling you and advocate for your child if need be.
Whenever I bring one of my kids to our pediatrician when they are sick, she first talks to them, checks all of the basic symptoms and then turns to me and asks what I think is going on. I have always loved that because as parents we know our kids best, even when it feels like we don’t.
For a time at the height of the intensity of our journey, I had one professional tell me that they knew Connor’s thoughts better than I did – after only meeting with him once! For a period of four-five months, we had professionals telling us that Connor’s issue was that he was addicted to marijuana. My husband and I fought, persevered, and advocated for him, insisting they dig deeper to find the root cause. Was he smoking to numb the feelings of anxiety and depression, or was it deeper – had he not fully dealt with his coming out process?
You know your kid. Just like I always knew that Connor taking a bath meant depression was overcoming him, you know your child’s signs. Don’t be afraid to speak that truth.