A reader raised an interesting point regarding my previous post about what kids reveal to their parents about suicidal urges – and what parents are willing to accept.
I had written that I can only imagine how painful it must be to acknowledge that a child one has “created and raised with such effort and sacrifice” wants to die. The reader called me out, saying that the real problem was a parent adopting this put-upon attitude.
Such an approach to child-rearing would send the child careening into depression, she argued.
Perhaps I characterized the demands of child-rearing inadequately. What I was trying to say is that although I don’t have children myself, I’m sympathetic to the pain parents must feel when they learn their children are so unhappy they no longer wish to go on living. That is, losing a child is not the only painful thing about suicide: knowing one’s child was so miserable that he wanted to end his life is, I think, painful in and of itself.
My point was that children are emotionally keyed in to their parents – especially, research shows, when the parents themselves suffer from mental illness. There is a powerful urge to protect them from pain, and, I was trying to argue, that may include hiding suicidal intentions.
I happen to find the reader’s line of reasoning about parental-imposed guilt leading to suicidal feelings a bit extreme. But I’m grateful to her for raising this issue because it brings me to another topic I want to discuss regarding young people’s experiences of mental illness: the role of parents’ and doctors’ expectations for medications and the extent to which adults and kids talk about the drugs’ intended and perceived effects.
As a growing body of research has demonstrated the power of the placebo effect, it has also become clear to scientists and doctors who study children’s experiences of medication that the attitudes and expectations of those around them matter a great deal in helping to determine a child’s response to the drug and also her feelings toward it (Jeffrey Longhoefer and Jerry Floersch, two social work scholars at Rutgers, have written extensively on this subject, referring to a “grid of medication management” encompassing parents, teachers, doctors, therapists and others, all of whom influence children’s attitudes).
Less discussed but equally fascinating, in my mind, is the topic of what children report back to their parents about their experience of medication. I know of little research on the topic (please, if you do, point me to it). However, in my experience interviewing young adults and in my own experience of taking medication, I have a feeling that such discussion in minimal.
Teenagers in general are not particularly inclined to open up to parents. Kids with externalizing conditions are probably less prone to self-reflection anyway. And a hallmark of depression in children and teens, meanwhile, is irritability and, by extension, a refusal to engage emotionally (I was struck, in Boy, Interrupted, which I’ve discussed previously by the parents’ comments that their son began acting like a sullen, emotionally-closed off teenager at an extraordinarily early age).
Combine children’s inability or refusal to talk with the apparently simple purpose of psychotropic drugs – relieving symptoms – and it may seem there’s little to discuss about meds.
In fact, there’s plenty for parents and kids to talk about. In part, that’s because kids can develop complicated, sometimes unpredictable, attitudes toward psychotropic drugs. The pills can take on symbolic meaning a parent isn’t aware of – a marker of some perceived fundamental flaw, for example, or a substitute for desired parental affection.
Others have advocated for such a discussion to occur in therapy, which I think is also wise and useful. But such questions needn’t, and shouldn’t, be left solely to therapists and doctors, especially in an age of 7-minute pediatrician’s visits, 15-minute psychiatrist’s med checks, and insurance company limits on therapy sessions.
Asking about what medication feels and how kids interpret its effects can even serve as a useful bridge between parents and children, perhaps an indirect way of getting at feelings the child can’t or won’t discuss. If parents want to better understand their children’s pain, this may be one way to begin.
photo credit: SquidHead