Anyone out there have a child diagnosed with ADHD, depression, anxiety or other mental disorders? This article addresses the challenges associated with your child being given a psychiatric diagnosis. Recently a mother talked with me about a struggle she was having; how to talk to your child about their mental health diagnosis. It got me thinking about about how difficult and sensitive an issue a psychiatric diagnosis is for individuals and families. I have talked with parents about this issue several times The concerns are complex and broad ranging. For instance, what affect will knowing the diagnosis have on my child? Will my child feel bad about himself because of this diagnosis? Will she use this diagnosis as an excuse to not strive for success in life? How will others possibly change their perception of my child if they hear about diagnosis?
The meaning that people assign to mental disorders is a big concern. Only in recent history have people stopped seeing mental disorders in a negative light. I should clarify that people aren’t viewing mental disorders quite as negatively as they used to. There is still a fear that one will be stereotyped and stigmatized; that because of their psychiatric diagnosis they will be seen as defected in character and judged as “less than” others who are “normal.” Normal only exists in the world of statistics and psychological theory. Any individual examined in depth will reveal some abnormality of psychological function.
Another significant concern is that when a child is given a psychiatric diagnosis, it will change their self-concept and their motivation to succeed. Many of us have witnessed the child who, knowing they have been diagnosed with ADHD, will say things like; “I have to take my ‘smart pill’ to do good in school”, or “the reason I misbehave so much is that I have ADHD.” Because of their misunderstanding of their disorder, they see it as a permanent handicap, a character flaw or have mistakenly assumed it means they aren’t intelligent enough to succeed in life. This turns into learned helplessness. Unfortunately children often learn these things directly from their parents or teachers.
There are two approaches I recommend that parents and educators take in talking to children about their mental disorder. The first is to educate the child about the disorder, and the second is to understand that taking a medication is only one of many things the child should do to manage or effectively cope with their disorder. Changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) have made it much easier to understand mental disorders. The newest version doesn’t even have “bipolar disorder” as a diagnosis for children. Instead, there is Disruptive Mood Dysregulation Disorder (DMDD). This diagnosis more adequately explains the mental disorder as a disorder of mood stability that is disruptive. Its much easier to understand this as a mental disorder than the “bipolar” term which insinuates that someone is one step away from true insanity. Similarly, there is also no more “Asperger’s Syndrome” but instead there is Autistic Spectrum Disorder (ASD). We now understand that several different diagnoses actually are the same disorder but vary in severity. Therefore its a spectrum.
One of the best ways to start a conversation with your child about their mental disorder is to talk about the brain as an organ in their body, just like their heart, liver, pancreas, and kidneys are organs. Each organ serves a function, and the brain is like the conductor of an orchestra or the captain of the team. It processes information from outside and inside the body and takes care of many functions to keep us alive. When people have mental disorders, the brain is not functioning properly. It could be, like in the case of ADHD, that certain parts of the brain are not active enough. When people struggle with anxiety, depression and mood stability the brain is not producing or regulating important chemicals well enough. This is very similar to the reason some people have physical problems resulting from other organs not functioning correctly.
For instance, people with diabetes have a pancreas that is not producing enough insulin to regulate the blood sugar levels in the body adequately. So then, just like diabetics have to take insulin to keep their sugar levels within a normal range, people with mental disorders have to take medications that keep their brain chemicals (neurotransmitters) and brain function at healthy levels. When we start to understand mental disorders from this perspective, we lose the negative stereotypes. Who considers a person with diabetes to be defective in their character? Nobody. Why then, should we consider someone whose brain doesn’t regulate their serotonin or dopamine levels adequately to be morally weak?
Something else that we understand about diabetes is that not only should diabetics check their blood sugar levels and take insulin that will keep their levels balanced, they also need to make lifestyle choices that help maintain healthy blood sugar levels. This would include exercise and healthy diet. The same is true for mental disorders. In addition to the medication, there are lifestyle choices that help people regulate their moods and other brain functions. Healthy and functional life behaviors and ways of thinking are important. Learning stress management and communication skills are essential. This is why individual and family therapy can be so helpful.
When we see mental disorders as we do physical disorders, the negative connotations that have been ignorantly assigned to them are removed. Instead, we can consider mental disorders as the result of an organ of the body (the brain) not functioning properly. A child shouldn’t feel demotivated, guilty or inadequate if their thyroid doesn’t properly so why should they feel that way if their brain isn’t working properly? Once the negative labels are removed, people are free to access resources and treatments they need to succeed in life. Otherwise, a diagnosis is not only worthless it becomes a barrier to freedom and independence.