When a parent has mental illness, how to support kids

When a parent has mental illness, how to support kids

Between the long hours, many responsibilities, and lack of control, few jobs in our society are as demanding as parenting. If a parent has a mental illness like depression or anxiety, raising kids becomes even more difficult. Many parents live in secrecy, believing that they are the only ones who struggle like they do.

But parenting with mental illness is far more common than many people suspect. In a survey of U.S. parents, more than 18 percent reported having a mental illness in the past year. While a parent’s mental illness increases child’s risk for a future mental disorder, this is by no means the only possible outcome.

“Having a parent with mental illness does not always lead to clinically significant distress in a child,” says Dr. Patricia Ibeziako, associate chief of clinical services in the Department of Psychiatry and Behavioral Services at Boston Children’s Hospital. “It depends on many factors, including the type and severity of the parent’s mental illness, how long it lasts, and the age of the child.”

A parent’s mental illness affects children differently at different ages

Children are most vulnerable to the effects of a parent’s mental illness at specific stages of emotional development. The first stage starts early, from infancy until about age 5. “This is an important period of brain development when infants and toddlers form strong attachments,” says Dr. Ibeziako. But a parent with mental illness may not be able to meet their child’s need for bonding. An infant or toddler deprived of positive emotional connections may develop problems regulating their own emotions and behavior. This may play out in tantrums, trouble sleeping, regression in potty training, or bedwetting.

The next vulnerable period is adolescence. As difficult as their behavior may be at times, adolescents rely on their parents for structure and positive reinforcement. But a parent struggling with mental illness may be less attentive to their teenager’s needs. Or they may focus entirely on things their child is doing wrong without balancing negative feedback with praise. “A parent’s depression, irritability, or low frustration tolerance can cause teens to act out in disruptive ways,” says Dr. Ibeziako.

The lack of energy that depressed parents often experience may also affect their ability to pay attention to their child’s school routines. Without a parent’s support, school-aged children may struggle to get to school or after-school activities on time. Completing homework can become an overwhelming challenge.

A parent dealing with an anxiety disorder may be overprotective, depriving their child of the chance to learn problem-solving skills. Or a child who witnesses their parent’s anxious behavior may in turn develop fears and worries.

How to help kids develop positive coping skills

Despite these challenges, many children do find positive ways to cope. Parents can help.

What Type of Friend Are You? How ADHD Influences Friendships

What Type of Friend Are You? How ADHD Influences Friendships

Whether you collect new friends easily or lean on a few, long-term friendships dating back to kindergarten, there’s no wrong way to build relationships. This is true especially for people with ADHD, who often report that their symptoms complicate, challenge, and color friendships. The ones that work are the ones that accept and celebrate their ADHD.

What Type of Friend Are You?

“I fall in the Selectively Acquisitive Friendship Style category; I am very careful and particular about who I label a ‘friend.’ Anybody who I don’t refer to as a friend is my ‘acquaintance.’ My ex used to laugh at this distinction, but it’s super important because it helps me decide how much time I spend with these people, and if I make an emotional investment in them. Yes, I help everyone when in need, but I will do it much more for my designated ‘friends.’” — BAT

“I’ve always migrated toward long-term friendships that can tolerate long gaps in communication, as well as friendships where we can talk for hours about things we’ve read or learned, or be just as happy sitting on the same couch each immersed in our own hyperfocuses.” — Anonymous

“My husband says I’m like a semi-truck with an engine that’s too small. I genuinely want to be friends with everyone, but I have difficulty keeping up with the logistics of maintaining friendships (due to my executive function weaknesses and anxiety). So, I have a long to-do list of people I need to text, call, email, etc.” — Anonymous

“Since I graduated from college, I have had trouble establishing friendships. I feel anxious about reaching out to potential friends outside of work or other organized activities; I worry that they will be too busy or uninterested in doing things with me. I once invited a co-worker and her husband over for dinner with me and my family. She accepted the invitation, but a few days later told me, ‘My life is too busy — I don’t have time for any more friends.’ That really stung!” — Anonymous

“I prefer intimate hangouts because boisterous get-togethers often overwhelm me. I tend to focus on a few long-term friendships, but being a military spouse means I have to be able to pick up new friends easily whenever we move.” — Anonymous

“I typically gravitate toward people who excite me. I’m also a bit co-dependent and find I search for long-term, meaningful relationships.” — Anonymous

“I’m extremely nervous around quiet people. I start to do nervous chatter, and they don’t reciprocate so I move on. I dread being around them! But I also get overstimulated in noisy environments. I like intimate hangouts with a few good friends who like to talk. I was the one who got moved in elementary school for talking too much. But then I’d make friends with the new table.” — Anonymous

“I would say I’m an ambivert. I can be really social for a few hours and then I’m socially spent. I have lots of lifelong friendships but also make spontaneous new friendships. However, I often don’t have the energy to maintain new relationships.” — Anonymous

“When I’m in good social form, I love talking with everyone. I’m a little afraid to put all of my friends together in one room because I’m not sure how well they’d get along. I love my ADHD friends because they are a less judgmental bunch. If I’m late or crazy-spontaneous or any of the other quirks that come with the territory, they get it. And they like me, for me. Recently, I realized that I’m a social chameleon who adapts to the people around me, hiding the ‘unacceptable’ parts of myself depending on the company. As a result, I’m not sure who the unvarnished, unmasked me is — I’d like to find that person. It probably would be less stressful and not so freaking isolating.” — Anonymous

“I really need friends who don’t need me to call every day or plan things regularly, but when we get together there seems like no gap in our friendship. We trust that we are always there for each other. My best friend and I could talk forever (we’re both time blind), and the subject can change mid-sentence or at least every two minutes. I am sure she has undiagnosed ADHD; we understand each other far too well!” — Glenda

What to Know About Social-Emotional Development

Many parents have heard the term “social-emotional development,” but what does it mean in the real world?

Put simply, social-emotional development refers to children’s ability to “experience, manage and express” their feelings, build relationships and actively explore their environment, according to a 2005 report from the nonprofit Zero to Three.

Managing one’s behavior, expressing emotions appropriately and developing empathy are all part of the journey.

It’s “understanding how our bodies and minds feel and think in relationship to the world around us,” says Mary Hadley, a speech-language pathologist in Texas who has spent 15 years helping adults and children communicate.

Children record many physical and mental milestones, especially in their first few years of life. Likewise, social-emotional skills grow throughout childhood and adolescence – also with milestones – and can be just as important.

Dr. Toya Roberson-Moore, a child and adolescent psychiatrist, says that social-emotional development relates to brain health, making it an element of both physical and mental health. Human development takes place simultaneously across many related areas, and it can look different for each child.

Social-emotional development changes as a child grows. A mother providing a feeling of safety for her baby begins the child’s process of healthy social-emotional development. Toddlers engage in pretend play and learn how to interact positively with others. As children enter school, they develop the ability to regulate their emotions and work well with others.

Just as children never stop learning, social-emotional development doesn’t stagnate. It builds as youngsters progress through school, allowing them to relate to others and handle challenges in healthy ways. For example:

  • Elementary school. In elementary school, social-emotional development often focuses on executive functioning skills, Hadley says, such as memory and self-control. Students engage in play-based skills, learn to advocate for themselves and practice empathy for others. When children feel safe and calm, Hadley says, parents can work on helping them recognize how their emotions feel and how to regulate themselves.
  • Middle school. Development in middle school looks similar, Hadley says. “We can teach students to be aware that the way their body and minds feel will affect their social communication,” she says. The goal is to help children understand that everyone experiences emotions, both good and bad. Yet, while middle-schoolers can verbalize their feelings, they also sometimes hide their concerns, Roberson-Moore says. They may feel ashamed of their emotions or want to avoid burdening others. This can raise additional challenges.
  • High school. “At the high school level, relationships with peer groups become very important,” says Kelly Oriard, a family therapist and co-founder of Slumberkins, a company that makes emotional learning products. As teenagers figure out where they fit in the world, it is normal and healthy for them to establish an identity outside of their family. That often means managing friendships, dating, workplace colleagues and other more complicated relationships.

When it comes to social-emotional development, parents are a primary resource for children, and experts say there are many ways to help. Here are some suggestions:

Study examines bonds between babies, parents

Study examines bonds between babies, parents

It may seem obvious, but the emotional bond babies develop with their parents is crucial — not only for their survival, but also to ensure positive outcomes throughout life.

Less-obvious, however, is how this bond — known as attachment — develops.

Secure attachment during infancy predicts healthy social-emotional outcomes across the lifespan. Insecure attachment foretells less-positive developmental outcomes for children, such as behavioral and academic problems.

Patty Kuo, assistant professor of child, youth and family studies, is leading a pilot project to explore how attachment security to mothers and fathers develops in a baby’s first 18 months — and how those attachment configurations predict outcomes in the child’s first three years.

She aims to identify key factors that influence how attachments are formed based on variations in parental sensitivity and availability, such as accessibility to the infant.

“While we know a lot about attachment security to moms, we don’t know much about attachment security to other caregivers, especially in family contexts,” said Kuo, a Child, Youth and Family Studies research affiliate. “But we do know the whole family unit matters to those relationships.”

Funded by an Office of Research and Economic Development Layman Award, Kuo worked to better understand what was happening at home with children and their parents. She recruited 50 parents — 25 couples — with infants in the Lincoln, Nebraska, area.

For three hours a week in one-hour segments, parents wore GoPro cameras to document their interactions with their children and each other in their home.

At first, researchers were concerned people would alter their behavior or interactions, knowing they were recording. But as Kuo and her team began to analyze the footage, they quickly discovered that was not the case.

“People got used to the camera and just went on with their daily lives,” Kuo said. “We got candid footage of people folding their laundry or doing other household chores, playing on their phones and otherwise not changing their routines — which is what we wanted for a nuanced view of what caregiving looks like in 2021.”

When the infants are about one year old, each parent will visit Kuo’s lab individually with their child to complete a Strange Situation test — a semi-structured procedure that enables researchers to observe and measure attachment security in young children within the context of caregiver relationships.

Kuo’s motivation for the project stemmed from “pure curiosity” about findings from her previous research that examined various infant attachment configurations to either or both parents.

“In those projects, we found that infants with a secure attachment to dad, but not mom, resulted in more negative outcomes — abnormal stress response, defiance toward parents, less ability to pay attention and focus,” she said. “One would think having any secure attachment to either parent would be good, but that wasn’t what we found. I continue to be puzzled by that and want to understand that phenomenon.”

To supplement her Layman funding, Kuo also has been awarded an Office of Research and Economic Development Biomedical Research Seed Grant for a related project to explore children’s stress and health biomarkers. Her team will collect saliva samples for cortisol, and stool samples to study the gut-brain axis, which consists of communication between the central and enteric nervous systems, and links the brain’s emotional and cognitive centers with peripheral intestinal functions.

For the new project, Kuo will work with Nebraska researchers Lorey Wheeler, CYFS research associate professor; Jessica Calvi, research assistant professor at the university’s Center for Brain, Biology and Behavior; and Jacques Izard, associate professor, Department of Food Science and Technology.

How Parents Can Keep Kids Talking and Protect Mental Health

How Parents Can Keep Kids Talking and Protect Mental Health

My community is grieving. Everyone knows someone who has been affected by the suicides this past month in our local high schools. “That was the fifth suicide this month,” one distressed mother told me. “They were successful kids; some were top athletes. I worry for my kids. How can I keep them talking to me so this doesn’t happen to us?” Her kids were in elementary school.

Parents know that keeping our kids talking to us is one of the most important things we can do. But how can we make sure that happens? There are specific and actionable steps parents can take to create a culture of open communication in their families. If parents set the right tone, kids will keep talking. When parents provide support, they can make a huge difference in their child’s mental health.

Mental Health Crisis in Our Youth

Kids and adolescents have just faced more than a year and a half of intense pandemic stress at a vulnerable time in their development. They experienced social isolation, fear, and uncertainty, and unique educational challenges. Now, they are back in school with teachers who are under pressure to increase student workloads to make up for lost time — all while the pandemic smolders on.

The impact of sustained stress on these young brains has now materialized into a rapidly worsening mental health crisis. In my own pediatric practice, I have never seen anything like it. Both the number of kids and the severity of their mental health struggles have skyrocketed. Tragically, so have the suicide attempts by teens across the United States.

There are no guarantees, and terrible tragedies can and do happen to parents who are trying their very best. But parents do make a difference in preventing suicide. In one research study on middle schoolers, parent support was found to buffer the effect of life stress on the kids. Middle schoolers with supportive parents had notably lower rates of suicidal ideation — i.e., thoughts that they’d be better off dead or of harming themselves.

Creating a Culture of Communication

When kids are young, the goal is to create a family culture of openness and honesty about hard things. One of the first steps is to simply call things what they are. Either minimizing problems or blowing them out of proportion sends the message that we can’t really talk about things. But telling it like it is sets us free to grapple with challenges.

For example, when kids in my practice ask me, “Doctor, will the shot hurt?” I say, “Of course it will.” Because kids are used to adults soothing them with lies, my response surprises them, and they start listening. “Would you like to know what you can do to make it hurt less?” I ask them before telling them how.

Once you’ve told the truth about a situation, try to take a collaborative problem-solving approach with your kids. Instead of telling them what to do, express your faith in them by exploring the issue together. Listen to them without immediately trying to fix them. When your message is “We can figure this out together,” and you invite kids to work with you, it is amazing how often kids will simply tell you the solution. Practice with little things so you have the skills in place when the big problems come up.

Kids are more likely to engage in collaboration with us if we have sent a consistent message that their opinions matter. When they are young and are constantly telling you about what they notice, say, “That’s an interesting observation. Tell me more.” When they are sorting something out, ask, “What’s your perspective on that?” or “How are you thinking about that?” These questions send a message of respect for them and their abilities to figure things out.

Avoiding Shutting Kids Down

When taking steps to open communication, well-meaning parents often undermine themselves with two bad habits. Often, these mistakes happen when parents get worried about what they should say and forget to listen openly. But both of these habits shut down communication by sending the message that emotions are unacceptable.

Why unstructured free play is a key remedy to bullying

Why unstructured free play is a key remedy to bullying

October was National Bullying Prevention Month , and in my decade of teaching in high-poverty public elementary schools, I’ve seen strategy after strategy and initiative after initiative implemented to decrease bullying.

While every case is unique, having a general understanding of why a student chooses to bully can be helpful.

Kids usually bully for one of the following reasons: they are frustrated with life’s circumstances and don’t have the emotional tools to cope, they don’t have many friends and are lonely, they have issues with emotional regulation, or they feel powerless to control their life for any number of reasons. Our school’s approach to bullying is simple, yet effective: Unstructured free play. Seriously? Yes. Stay with me.

In the years since my school began incorporating more and more unstructured free play into our school day (before school by opening up our playground, during school by adding an additional recess, and after school by adding a Play Club), our students are happier, kinder, have fewer behavior problems, have made more friends, feel more in control of their day and their life in general, and in some cases have dramatically changed course from bullying behaviors and frequent office referrals to no bullying behaviors and no office referrals.

When we understand the root causes of bullying behavior, we can see why unstructured free play is helping our students so dramatically.

Unstructured free play addresses–head-on–making friends, learning empathy, learning emotional regulation, learning interpersonal skills, and it greatly empowers students by helping them find a healthy place in their school community–all while teaching them life’s most important skills like creativity, innovation, critical thinking, collaboration, communication, self-direction, perseverance, and social skills.

It turns out the skills our students need most can’t be learned through direct instruction from a teacher, but instead are acquired through real life experiences with their peers. When my school stopped treating students just as empty brains to fill with knowledge but instead holistic people with a huge social-emotional component to nurture, adding more time with their peers in free play was a no-brainer. So what have we seen, and how does this help fight bullying?
Let me tell you a story. A few years ago I had a student who walked around with a chip on his shoulder. He never smiled, never laughed, and always seemed angry. He was cruel to other kids, had frequent behavior issues in class, and in the course of one week had three office referrals from three different teachers for his extreme behaviors. Other kids would label him a bully, but where they saw a bully , we as teachers saw a hurting and lonely child in need of friends. He was the kind of student who was always disciplined by […]