Allan is a very troubled nineteen-year-old who has been coming to see me since August. Actually, I’m never sure if Allan will make it to the next appointment. Since we first met, I have been amazed at the amount of emotional turmoil and pain he is in. Every appointment seems to bring another “cry” for help. His anguish is noted by his constant crying and threats of harm to himself and others. In fact, he doesn’t seem to filter his words and randomly ensures that I know about his aggressive thoughts. Just last week he told me that nobody ever believes him when he is in pain and so he feels the need to show them – he says that he doused his hand in a flammable liquid and set it on fire just to show others how much pain he is in. (I don’t actually believe he did this, as there was no sign of his hand being burned).
Allan’s life is full of inconsistent events. He seems to have a support system in his parents but I have only met his father, who is very concerned about Allan. On the other hand, his father often feeds into Allan’s overly dramatic behaviours and, at times, seems to compete with him in regards to histrionic scenes.
Recently Allan said to me, “I’m in such agony; my soul is on fire.” What a telling statement – he feels overwhelmed, lonely, humiliated and like a failure. Now you know why I say I don’t know if he will make it to the next appointment. As it is beyond the scope of this article to discuss his situation further, I would like to focus on childhood and teen feelings of distress.
Telling kids that their teen years are the best years of their lives is not necessarily true. In fact, I often say that I would not like to be a teenager today. There is so much stimuli bombarding them at every moment, they so many decisions to make, and they deal with so much stress and expectations – with limited resources at their disposal.
For kids, often the level of stress or distress they deal with is dependent on their familiarity with the situation. When our environment is chaotic or fear inducing, we may have a hard time separating ourselves emotionally from what is going on around us. In fact, internally we become part of the chaos. We all adjust better to more familiar situations. That is, we learn to cope best with situations as they become more familiar to us.
Dealing with personal or family challenges is difficult in the best of times. For children and teens it’s even harder. Life for many young people is a painful tug of war filled with mixed messages and conflicting demands from parents, teachers, coaches, employers, friends and themselves. Growing up—negotiating a path between independence and reliance on others—is a tough business. It creates stress, and it can cause serious depression for young people ill-equipped to cope, communicate and solve problems.
Some experiences are more severe or long lasting, while some kids may react to setbacks in different ways. Children and teens may indicate to their parents or others that they are distressed or unable to cope directly, or more often, through various hints. Most common for a teen is to show his or her distress through changes in mood or behaviour, at home, at school or with friends.
The teen years are emotional, fascinating, tumultuous, exciting, fearsome, lonely and social at the same time and filled with angst over the ultimate question, “Who am I.” What I’m about to say is difficult for adults to hear as well as comprehend. Nevertheless, here it is: I believe that much of an adolescent’s rebellion is, in fact, part of the developmental transition from childhood to adulthood. Almost by definition, adolescence is a time of chaos and struggle for one’s self identity: He or she is no longer the dependent child. Teens go from relying on us (and most of us enjoying that role) to learning to make life changing decisions, becoming independent and a self-fulfilled adult. As they push us away and ask to be allowed to make their own decisions, and mistakes, they are using the only tool they believe they have to become self-actualized.
It is hard for parents going through this process. Our children have been followers and are now taking the lead. We like when our kids do what we want, when we want and how we want. I am not saying this as way of excusing inappropriate teen behaviour. However, we would handle many altercations differently if we remember that this behavior, for the most part, is simply part of the growing up process.
When parents are asked what their biggest fear is in regards to a teen’s unhappiness, it is usually that their child will engage in self-harmful behaviors. Their fear of self-harm or even suicide is often based on the media, but also on statistical realities. In fact, suicide is the third leading cause of death, behind accidents and homicide, of people aged 15 to 24. Even more disturbing is the fact that suicide is the fourth leading cause of death for children between the ages of 10 and 14.
Some serious signs we need to watch out for include:
* Talks about death and/or suicide (maybe even in a joking manner).
* Actual plans ways to kill him or herself.
* Expresses worries that nobody cares about him or her.
* Has attempted suicide in the past.
* Dramatic changes in personality and behavior.
* Withdraws from interacting with friends and family.
* Shows signs of depression.
* Shows signs of a substance abuse problem.
* Begins to act recklessly and engage in risk-taking behaviors. Begins to give away sentimental possessions.
* Spends time online interacting with people who glamorize suicide and maybe even form suicide pacts.
Of course, suicidal ideations are serious and should never be minimized. However, we must realize that death in the eyes of a child or teen is different than the way an adult sees it. Also, when a child talks about death, we must understand the context of the discussion. Are they reacting to the death of a close family member or a popular star? A child who just lost a close family member might talk about death and want to die because they feel badly for the person no longer with them and want that person not to be “alone.” They might feel guilty and even wonder why not them or even if they are in some way responsible. I recently spoke with the mother of a seven-year-old who lost his father to a terrible illness. The child talks about wanting to die to be with his father, so that his father won’t be alone in the ground. It is important for a child to have an outlet for these feelings and a parent should ever fear having a conversation about death or dying. In addition, many child therapists and members of the clergy are prepared to assist parents with this difficult topic.
We all deal with stress and distress differently. For some, behavior changes might be directly related to the stress triggers and may not be something we understand. There are times when the child seems to be coping well and then something changes rapidly. To add complexity to the situation, sometimes it’s difficult to understand what is “normal” for the age of the child or teen. In other words, is this behavior or mood swing typical for a child this age, in this environment and with his or her family history?
Childhood and teen distress usually appears as depression. Kids tend to talk about feelings of hopelessness and anxiety, along with feelings of being trapped in a life that she or he can’t handle – added to that, it is often difficult for a child or teen to talk with someone about feeling out of control.
In Part II we will explore knowing when to seek help and what to expect. We will also take a look at long term pain and pain handed down from parent to child.