At Age 18, the Game Changes

As your adolescent enters the therapeutic world, a door opens and you learn loads of new information.  From therapists, to medicines, to educational consultants, to therapeutic boarding schools, it is a world I had no idea existed until we entered it a year ago.

As I have learned to navigate the therapeutic world, there was something I had no idea about and am grateful did not come into play with our family.  The entire game changes when your child turns 18, and you as a parent are reduced to having no decision making ability of your adolescent’s care.  At 18, an adolescent becomes an adult. This means they have the right to decide about their care, whether or not they have the ability to does not matter.  You as a parent have no control over what substance abuse counseling or other treatments they receive. Plus, if they are in a program of any type they have the ability to sign themselves out on their 18th birthday.  And you as a parent can do nothing to stop it.   This is a scary, but true fact.  To put someone over 18 in care you have to either get their permission (they can still sign themselves out at anytime) or you have to go through the legal system and get an involuntary care order signed by a judge.

I’ve seen a variety of examples of this over the past year.  In one case a mother was crying uncontrollably as her son chose to check himself out of a residential treatment facility on his 18th birthday, against everyones recommendations.  In another case, parents were able to negotiate with their child about their care when they turn 18 and make family decisions.  In the best case scenarios, a child will be at a point in their care when they turn 18 that they understand the importance of continuing on the path forward.

Bottom line, therapy and substance abuse issues are another place where early intervention is key.  I’m so grateful we fall into that category.  If you are a parent with an adolescent who is struggling, don’t wait too long.  Follow your gut, and know when your adolescent turns 18 the whole game changes.  At that point, you as the parent have no control.  We all know that as a parent, there is no worse feeling than feeling helpless when it comes to our children.

Celebrate Every Tiny Victory

This past weekend I had the opportunity to attend Family Days at my son’s residential treatment center.  I not only got to spend time with my son, but also engaged in parent support groups, educational discussions about processing struggles, and teacher conferences.  It was an exhausting but informative few days, and reassured me that my son’s placement is the correct one.

On the way down in the car my phone rang and the number was one associated with my son’s school.  I immediately engaged in “phone flinch” thinking, what happened now, did he do something again, is he struggling?  This has been the pattern of phone calls and texts for over a year.  Every time I have a call from him or where he is, my heart stops because I fear the bad news.

As my son was on the line he said, “Mom, they are short players for the basketball game tonight is it okay if I go?”  “We have to travel so I won’t be able to see you tonight, but I can meet you in the morning.”   I quickly had to process what he was saying and practically screamed “of course” into the phone.  My child, who had barely wanted to leave his room at many times during the last 18 months is asking to go play in a basketball game?   Amazing!  For some, your child asking to play in a basketball game is a regular occurrence.  For us this was a large step forward, and a sign he was beating the depression.  He was choosing to engage in the program and life.  After I hung up the phone, I cried some tears of joy in the car and thought I can’t believe how happy I am that my son asked to play in a basketball game.

That event was the start of me working to celebrate the little victories throughout the weekend, and on our journey thus far.  During the weekend, multiple staff approached me to share how much they enjoy my son, and how his smile brightens their day.  I also sat back and smiled as he went up to the kitchen staff  and thanked them for their hard work preparing a yummy lunch for 100 students and parents.  Plus, he informed me that he has decided to continue to play basketball and was excited about it.  As each of these events occurred, I smiled, praised him, and thought we are making progress.  The young man I know and raised is starting to emerge again.

On the way home, I reflected on these little victories and had a new appreciation for them.  So often we focus on the large celebrations of our children.  During this journey I can’t sit and wonder why me, why our family. I can’t focus on how hard it has been for all of us to have him struggle and gone. I know there are going to be steps backward in this process, but I need to get off the daily roller coaster of the ups and downs and make a conscious effort on focusing on the path forward and celebrate the tiny victories.  This is allowing me to take joy in him finding himself, the light, and his path again.

The Plight of the Gifted Child… and how this can lead to depression and anxiety

During the past week, I had the opportunity to participate in two panels on gifted students.  One involved a group of teachers and the other involved a group of parents.  Both discussions looked to the social-emotional struggles gifted children seem to have.  Is it more than other students?  Why is this happening?  As an educator with a son identified as gifted who struggled with school, my experiences have made me passionate about gifted education in our school system.  It is an issue that strikes particularly close to home.

The statistics here do not lie — depression and anxiety are on the rise amongst teens.  Some statistics show that depression and anxiety have risen 70% in the last 25 years.   Anecdotally, there appears to be an increase in depression and anxiety amongst gifted students.  However, there does not seem to be any sustained research analyzing these issues in the context of gifted students.

Why do gifted children seem to be so much more anxious than others?  First, these kids are told they are smart their entire lives. It becomes part of their identity.  So if they face a challenge or are not successful in school, even once, they often do not have the skill and resiliency to work through their difficulty.  The gifted children take the struggle as a  personal attack on their self esteem because being identified as intelligent often becomes a large piece (if not the entirety) of their identity.  This was definitely true with my son last year when he had always whipped through math and struggled with geometry.  He took it as a judgement of who he was as a person, and that somehow he was not smart anymore.  This type of behavior leads these students to be anxious about school as they set incredibly high, and often unattainable expectations for themselves.

The gifted brain works differently.  Gifted children often approach the world differently. This can lead to social isolation from peers (real or perceived),  being overlooked as being “at-risk” (“Too smart to play with drugs”), being emotionally immature (asynchronous development between their IQ and emotional intelligence), and subject to bullying, teasing, and name calling.  

Based upon my own experience, gifted children facing these types of issues can easily go and look for somewhere to escape — finding solace in gaming or being in front of a screen.  It calms their brain, they can have social interactions without being present, plus they get brain reinforcement as they achieve various levels.  Research has shown that screen addiction leads to further social isolation and depression.  I believe that these screens have been even more detrimental to gifted children than others.

So what do we do to help our gifted children?  First, we need to be more aware of their screen time than others and help them find healthy coping skills for their struggles.  Second, we need to advocate for our gifted children within our school systems.  Our school systems (public and private) are built for high achieving children (those who have a great motivation to achieve, not an actual high IQ), not gifted (those with a high IQ). Third, we need to teach our gifted children a growth versus fixed mindset.  This will help them realize they grow from challenges and failures.

This is clearly easier said that done.  I often wonder if, in some ways I failed my son in these matters.  He has a wicked screen addiction which we are working through, and he has a very fixed mind set.  I have always been an advocate for him for his education but perhaps it was more about what I thought he needed, not what was in his best interest long term to become a life long learner.  But I know that he can learn, as can I, and I am hopeful for the future as we all try to change our patterns.



To Medicate or Not Medicate? That is the eternal question for parents of children with mood disorders.

Medication is one of the trickiest parts of dealing with a child that has any type of mood disorder from ADHD to Bipolar Disorder.  As a teacher I have seen medications be a complete game changer for students who are struggling.  I also have seen students who become zombies of their normal selves due to being over medicated.

When it became obvious last December my son was struggling with depression I did what most parents do.  I took my son to the pediatrician and he started seeing a therapist.  The pediatrician suggested he start an anti-depressant, also known in the class of drugs as an SSRI (selective serotonin rebuke inhibitor).  I reluctantly started him on 10mg of Prozac and gave it to him at night as per the doctors orders.    This was done with a lot of thought and reluctance on my part because research shows SSRI’s can cause an increase in suicidal thoughts in adolescents .

During this time, the depression became worst and my son slept less and his behavior became more erratic and irritable.  I was told the Prozac could take up to 6 weeks to work effectively so in the midst of me working full time, and dealing with his struggles I never thought the medication would be making things worse.  Then when he got to wilderness last spring, the psychiatrist their immediately pulled him off the Prozac.  She also informed us he shouldn’t take it at night because it is a stimulus, and that with adolescents Prozac rarely works and often makes them more aggressive.  She felt strongly that the increase in his aggressiveness and lack of sleeping were probably directly related to the Prozac.

Bottom line, I couldn’t feel guilty and I can’t through this process.  As Bruce and I say, “We make the best decision we can with the information we have at the time.” We cannot play the rabbit hole game of ‘what if?’ or we will drive ourselves insane.  Needless to say I now approach medicating my son very differently.

First, I work with an amazing nurse practitioner psychiatrist based in Utah who is experienced with adolescents and these medicines. Skype is an amazing tool for doctors appointments. Do not let location deter you from finding an effective medical professional.  Our psychiatrist will stay with him long term through his various placements in order to have that continuity in his needs.  Second, I’m not using my pediatrician who does not have the experience in the class of medications he is taking.  Finally, the psychiatrist and I see eye to eye on our philosophy for using meds for him.  Start slowly and lightly and only change one variable at a time.  As she says if he doesn’t notice real differences then the meds are working correctly.

Therefore, my son is going to be in wilderness a few more weeks.  More and more they think he has a major chemical imbalance in his brain.  He will stay in wilderness a little longer as we are tweaking his meds slowly in a stable environment where he has supervision and they can watch for side effects.  We are also starting with a light dose of a new medication and will slowly raise or lower the meds based on need and, of course, his growing fourteen year old body.

So what is my conclusion on meds?  We are fortunate to live in a time when medications are an option to help chemical imbalances.  I strongly suggest you use a child psychiatrist that you see eye to eye with philosophically.  Then, you as the parent(s) have to “make the best decision you can with the information you have at the time.”  Can you tell this is becoming our new family mantra?