How to Wisely Parent a Child with Depression or Anxiety

As parents, we are tempted to tell our kids that they have it much easier today than we did when we were growing up.

When it comes to mental health issues such as depression or anxiety, however, that’s probably not true. Most of us have never experienced these issues. But a relatively high percentage of our children will… before they become adults. 

How Prevalent Is Depression and Anxiety among Teens?

Depression and anxiety are classified as mental illnesses, which are defined as mental, behavioral, or emotional disorders. Mental illnesses vary in severity, with the most severe resulting in functional impairment that substantially interferes with or limits one or more major life activities.

What percentage of U.S. teens have a mental illness? Estimates vary. The Department of Health and Human Services pegs it at nearly 50 percent. Other groups place the estimate much lower, at around 20 percent, which is the same rate as for U.S. adults.

With respect to depression, HHS says that, in 2017:

 - Nearly one in seven U.S. adolescents “had at least one major depressive episode.”

 - The prevalence of such episodes was higher among females (20 percent) than males (7 percent).

While anxiety disorders differ by the objects or situations that induce them, they share two aspects: (1) excessive anxiety and (2) related behavioral disturbances, such as an inability to do a job or school work.

Anxiety disorders include panic attacks, a phobia, social anxiety disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and separation anxiety disorder. HHS estimates that:

 - Nearly one in three people has an anxiety disorder sometime in his or her teens, but only 8 percent of those disorders come with a severe impairment

 - A higher percentage of female teens get anxiety disorders than male teens (38 percent vs. 26 percent)

Depression and anxiety are on the rise among U.S. teens. Why? A contributing factor could be loneliness.

Loneliness Plays a Huge Role in Mental Health

Health insurer Cigna's 2018 U.S. Loneliness Index found that nearly half of American adults report feeling lonely and left out some or most of the time. A slightly lower number, 43 percent, report that they feel isolated from others and lack companionship and meaningful relationships with others.

The younger you are, the lonelier you are. Adults ages 18-22 had the highest loneliness scores, and Millennials, ages 23-37, came in second.

Cigna didn’t survey adolescents, but a study by San Diego State University psychology professor Jean Twenge found that loneliness among U.S. teens is on the increase. The study surveyed high school seniors and found that:

 - The percentage who reported that they often felt lonely increased from 26 percent in 2012 to 39 percent in 2017

 - The percentage who said they often felt left out increased from 30 percent in 2012 to 38 percent in 2017

According to Twenge, when compared to teens from a few decades ago, today’s teens are much less likely to socialize in person with their peers. Child psychologist Melissa Sporn says that overscheduling of teens limits their opportunities to socialize. 

Twenge fingers a different bogeyman: the smartphone.

The Double-Edged Sword of Social Media

In The Atlantic, Sporn writes:

Social-networking sites like Facebook promise to connect us to friends. But the portrait of iGen teens emerging from the data is one of a lonely, dislocated generation. Teens who visit social-networking sites every day but see their friends in person less frequently are the most likely to agree with the statements “A lot of times I feel lonely,” “I often feel left out of things,” and “I often wish I had more good friends.”

Teens’ feelings of loneliness spiked in 2013 and have remained high since…when teens spend more time on smartphones and less time on in-person social interactions, loneliness is more common.

So, too, is depression. “The more time teens spend looking at screens, the more likely they are to report symptoms of depression,” Twenge continues. And teens who spend three hours a day or more on electronic devices are 35 percent more likely to have a risk factor for suicide.

While social media links kids, it also exacerbates their concerns about feeling left out. Teens get together in-person less often than they used to but, when they do, they broadcast their hangouts on Snapchat and Instagram. Those not invited feel left out, and the number of teens who often feel left out has reached all-time highs.

Because girls use social media more than boys, girls often feel left out more than boys. Even those who post are not immune. When a post garners few likes--or fewer than expected--the poster can feel that she (or he) doesn’t have many friends.

7 Recommendations for Parents:

As a parent, you have many opportunities to be a positive influence in the life of your child. But what specifically can--and should--you do if your child appears to be struggling with depression or anxiety? I consulted with Martha Flemming, a licensed professional clinical counselor with New Source Counseling, to arrive at these seven recommendations:

1. Do Your Homework

To spot the signs that your child may be struggling with a mental illness, you need to know what those signs are. According to the Mayo Clinic website, your teen may be suffering from depression if he or she is exhibiting significant emotional and behavioral changes. Key emotional changes include:

- Feelings of sadness, which can include crying spells for no apparent reason
- Frustration or feelings of anger, even over small matters
- Feeling hopeless or empty
- Irritable or annoyed mood
- Loss of interest or pleasure in usual activities
- Loss of interest in, or conflict with, family and friends
- Low self-esteem
- Feelings of worthlessness or guilt
- Fixation on past failures or exaggerated self-blame or self-criticism
- Extreme sensitivity to rejection or failure, and the need for excessive reassurance
- Trouble thinking, concentrating, making decisions, and remembering things
- Ongoing sense that life and the future are grim and bleak
- Frequent thoughts of death, dying, or suicide

Key behavioral changes include:

 - Tiredness and loss of energy
 - Insomnia or sleeping too much
 - Changes in appetite
 - Use of alcohol or drugs
 - Agitation or restlessness
 - Slowed thinking, speaking, or body movements
 - Frequent complaints of unexplained body aches and headaches
 - Social isolation
 - Poor school performance or frequent absences from school
 - Less attention to personal hygiene or appearance
 - Angry outbursts, disruptive or risky behavior, or other acting-out behaviors
 - Self-harm — for example, cutting, burning, or excessive piercing or tattooing
 - Making a suicide plan or a suicide attempt

Common signs and symptoms of anxiety include:

 - Feeling nervous, restless or tense
 - Having a sense of impending danger, panic or doom
 - Having an increased heart rate
 - Breathing rapidly (hyperventilation)
 - Sweating
 - Trembling
 - Feeling weak or tired
 - Trouble concentrating or thinking about anything other than the present worry
 - Having trouble sleeping
 - Experiencing gastrointestinal (GI) problems
 - Having difficulty controlling worry
 - Having the urge to avoid things that trigger anxiety

2. Listen to Your Child

Observing your child’s behavior is not enough. It can be difficult to tell the difference between depression or anxiety in your teen and normal responses to the challenges, and ups and downs, that teens face. Talk with your teen. Share your observations and concerns in a nonconfrontational manner, and give your child opportunities to express how he or she is feeling.

When you are interacting with your child, stay supportive, and don't minimize the feelings that your teen is experiencing. Avoid flippant comments such as “What do you have to be depressed about?", "You don't need to worry about that, you're fine", or "You can get new friends."

Such comments can be damaging to your child and are likely to cause him or her to refrain from opening up to you in the future.

Also, don't blame your child’s friends for his or her mood or feelings. While teens sometimes feed off one another's moods, placing the blame on peer interactions could cause you to miss clear signs of depression or anxiety.  If your child says, "I'm depressed" or "I'm stressed out," then take him or her seriously. After all, it takes a lot for the average teen to discuss feelings and emotions with his or her parent.

3. Get Your Child Evaluated

If the symptoms of depression or anxiety continue or worsen – or if you have concerns about suicide or your teen's safety – then set an appointment for your teen to meet with his or her doctor or with a mental health professional trained to work with adolescents. Reassure your child that there is no stigma associated with talking with a doctor about mental health issues.

Make sure that your child’s evaluation includes a medical evaluation that covers such things as thyroid and parathyroid functioning, hormonal changes, anemia, mono, and other possible physical causes. Take a hard look at your child’s diet and consider having that evaluated by a qualified nutritionist.

The average teen diet can contribute significantly to depression and anxiety disorders. Sleep disorders and irregular sleep are also prime causal factors, so limiting screen time and confiscating electronic devices at the end of the day is a wise preventative.

4. Follow Through

Make sure that your child gets the treatment that he or she needs. The HHS reports that three out of five teens who had a major depressive episode did not receive treatment from a health professional or any type of medication for depression.

Even if there are no significant medical issues and no medication is needed, consider counseling for your child. Teens often are more willing to open up to a counselor than to their parents, and counseling sessions will give your child some tools to help stabilize mood and cope with the issues that he or she is facing.

5. Find Additional Opportunities to Interact with Your Child

Loneliness can contribute to depression and anxiety. The obvious antidote to loneliness is interaction with others. According to Cigna, respondents who say they spend the right amount of time with their families, are well-rested, don't feel overworked, and get enough physical activity have lower loneliness scores.

Consider family outings or one-on-one outings with your child that include physical activity, such as walking, hiking, biking, swimming, or, as we head into winter, sledding, skiing, or skating. Be sure to pick activities that your child enjoys.

6. Be in Synch with Your Child’s Other Parent

Make every effort to stay in synch with your child’s other parent, even if you are divorced from them and sharing parenting responsibilities. Share your observations and findings with them, and give them the opportunity to provide their perspective as well as any concerns they have.

The more you both act as a team, the better your child will do in dealing with depression or anxiety.

7. Practice Your Faith.

A new study from Barna and World Vision has found that attending church improves your mental health. A survey of 15,369 millennials across 25 countries revealed that those who attend a weekly worship service are significantly less likely to experience anxiety than those who don’t. People of faith also have more hope for the future and are more motivated, less lonely, and less likely to feel depressed.

What’s the best way to ensure that your child attends church now and when he or she becomes an adult? Go yourself. This is especially critical for fathers.

According to a detailed study conducted several decades ago, a father’s church attendance (regular, irregular, or non-attending) has a much greater impact on the future attendance of his children than a mother’s attendance. The study found that, if a father does not go to church, no matter how faithful his wife’s attendance, only one child in 50 will become a regular worshipper.

On the other hand, if a father does go regularly, regardless of the practice of the mother, between two-thirds and three-quarters of their children will become churchgoers (regular or irregular). Even if a father goes irregularly to church, regardless of his wife’s attendance, between a half and two-thirds of their children will come to church, as least occasionally, as adults.

Your influence as a parent can make a positive difference for your child’s mental health...and spiritual health.

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Chris Bolinger is the author of Daily Strength for Men, a 365-day devotional published by BroadStreet Publishing and available at Amazon, Barnes & Noble, Christian Book Distributors, DailyStrengthForMen.com, and other retailers.

Photo Credit: ©GettyImages/Kikovic