Bringing teen mental illness out of the shadows

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A suicide reverberates with an added layer of loss and heartbreak when the life ended was a young one. And there have been many such deaths in the news recently.

On April 13, a College of William and Mary student killed himself, the fourth to do so this year at the Williamsburg university. Last year, Fairfax's W.T. Woodson High School grappled with its sixth suicide in a three-year span.

With suicide the third leading cause of death in youths ages 10 to 24, it is startling that less than half of adolescents with mental health problems receive treatment, according the U.S. Department of Health and Human Services' Office of Adolescent Health. While the majority of mentally ill teens will not commit suicide, lack of professional help deepens and prolongs suffering.

So what are the reasons for this lack of treatment, what are the warning signs, how are diocesan high schools helping, and what can parents do to offer support?

The silencing power of stigma

Local Catholic Angela Henderson's daughter, Jane (names have been changed to protect the daughter's privacy), was diagnosed with depression when she was 12. But it took the family about a year to realize her symptoms were more than normal teenage angst.

"At first we thought (her yelling and tears) might just be typical teenage acting-out or hormones," said Henderson.

The challenge of sorting out mental illness from typical teen behavior is one reason for delayed treatment, or none at all, said Alpha and Omega clinician Lianna Bennett. Alpha and Omega Clinics, based in Maryland and Virginia, integrate psychology with the Catholic faith.

Additional obstacles to treatment include poor access to care, especially in rural areas, and the high cost of psychological services, according to Brendan Rich, associate professor of clinical psychology at Catholic University in Washington. "Psychological services are not always seen as a necessity by insurance companies," Rich said.

However, mental health experts agree that the No. 1 reason adolescents do not receive treatment is the stigma that still surrounds mental illness. Some see psychological problems as moral weakness or lack of self-control. Teens, naturally prone to be more concerned about appearances, feel the weight of such negative perceptions most acutely, Rich said.

Adolescents might even view a therapist's office as "a place where crazy people go," said Bennett.

The stigma is intensified by the way media often link violent behavior and mental illness.

"People with mental illness have the same level of aggression and antisocial behavior as the general population, but unfortunately we talk about mental illness usually only after an antisocial, aggressive act," Rich said, citing the recent tragedy of the Germanwings co-pilot who was treated for depression and last month crashed a plane killing 150 people.

According to HHS, only 3 to 5 percent of violent acts can be attributed to mentally ill individuals.

To decrease stigma, Rich and Bennett encourage parents to realize that mental illness, like physical illness, is not a choice and to be cognizant of the language they use and attitudes they convey when discussing it.

"If we view mental illness as a weakness or depression as something people need to 'get over,' our children will be much less likely to seek us out if they experience struggles," said Bennett. "We need to have compassion for those who are struggling with mental illness; as our understanding of the brain and neuroscience grows, we realize that biology has a strong impact on mental health."

"Once we started to be more open (about Jane's depression), we learned others had struggled with similar things, but had kept it a secret," Henderson said. "It was a relief to know that we were not alone."

Warning signs

It was a Sunday night and Jane decided a homework assignment needed to be redone. Her distress grew into a tantrum that continued to escalate.

"I was just holding her, her heart pounding, until her breathing returned to normal," Henderson said. "Afterward, she said, 'Mom, that was scary.'"

It was frightening for Henderson, too, and the panic attack served as a catalyst for treatment.

Because adolescents typically don't seek treatment on their own, parents play a crucial role in identifying warning signs and connecting teens with support, said Joel Sherrill, program chief of the Child and Adolescent Psychosocial Intervention Program at the National Institute of Mental Health.

"There are expectations that teenagers assume more independence and that their dependency on parents goes down, … but parents are still very important in their child's life," he said.

Warning signs include "a change in how a youth interacts with peers, if they are becoming more withdrawn or if their class work is suffering," said Sherrill.

Additional indicators (see infographic) include a change in sleep or eating patterns, difficulty concentrating, tearfulness and not finding pleasure in activities once enjoyed.

Symptoms vary depending on the nature of the mental illness, with the most common illnesses being depression and anxiety disorder. Teenagers also commonly struggle with eating disorders; Internet addiction, including to pornography and video games; self-harm, such as cutting; and the effects of bullying.

For many of her young clients, at the core of their illness is "a feeling of worthlessness," said Bennett.

Schools on the frontlines

Along with parents, schools also can help teens emerge from the darkness of mental illness.

"Schools often have a good sense of a student's normal functioning, and many schools … are the first step in getting in touch with resources," Sherrill said.

"Our teachers are very much on the frontlines and encountering early symptoms," said Dan Kochis, director of counseling at Paul VI Catholic High School in Fairfax.

Not all youths feel comfortable initiating conversations about problems with their parents, so teachers, coaches and school counselors "offer them a chance to speak with other adults they trust," said Erin O'Leary, director of counseling services at Bishop Ireton High School in Alexandria.

The diocesan Catholic Schools Office provides a list of specialists based on suggestions from teachers and parents, and several schools supplement it with additional resources.

If a family can't afford treatment, the high schools often refer them to Catholic Charities, which offers therapy on a sliding scale.

Bishop O'Connell High School in Arlington hosted a mental health expert on a professional development day to discuss warning signs. Monthly coffees for parents often focus on mental health, and a fall assembly addresses respect and bullying.

Paul VI has a part-time pastoral counselor as well as a peer mediation ministry. "If someone is struggling with depression, we want them to know they are not alone," said Kochis.

All four diocesan high schools also offer something intangible but equally important: a holistic sense of the human person.

"Our Catholic mission is to form the mind, body and spirit," Kochis said. "If the whole person includes the cross of mental illness, that's OK. That's the child of God and that's how they've been given to us, and we will support and provide for them."

"Being part of a community that cares, that responds and prays makes all the difference," added Tricia Laguilles, director of guidance at Saint John Paul the Great Catholic High School in Dumfries.

Partners in the struggle

Parents frequently blame themselves for their child's mental illness. "As a parent you wonder if they'd just had a happier childhood, different parenting or if you'd prayed harder - if that would have made a difference," Henderson said.

Yet Bennett said parents should not blame themselves. A mental illness "is not a sign that a family is bad or broken or worse than any other family," she said.

Of course family dynamics sometimes contribute to a teen's mental illness, said Bennett, but parents almost always are integral to successful healing. The most important thing parents can do, she said, is to ensure their teen receives treatment.

Bennett encourages parents to talk with their child if they believe something might be wrong. "Parents sometimes worry that if you talk to them about depression or self-harm you'll put the idea in their head," she said. "That's false; it does not increase the risk."

Bennett said it's important for parents to pay attention to changes in mood and behavior and to continually work on their relationship with the child. Take time to have fun with your son or daughter, she said. "If they feel like you enjoy being around them, they are more likely to open up.

"Teens can be rough around the edges sometimes. Our job as adults is to not let them pushing our buttons activate us. Remember, teens are going to say stupid things; our job is to be steady for them."

Faith can also be a powerful source of healing for individuals with mental illness as well as those who support them.

"Remembering that we are a child of God is important for all diseases, but especially when dealing with mental illness," Henderson said.

It therefore was painful to realize that depression had taken a toll on Jane's faith. "With all the darkness she experienced, she has a hard time believing in a loving God …. and rejected anything church-related for a long time."

Henderson did not push her daughter to go to church, "but I kept believing, and friends and family kept praying for her."

Then about a month ago, Jane - now 15 and "relatively stable" - said she wanted to try and go back to church. The family went to Easter Mass together, attending an early service since Jane struggles with social anxiety.

"Halfway through Mass, she snuggles into me and says, 'This is beautiful, Mom,'" said Henderson. "That was my Easter gift."

Henderson said she's thankful for the treatment that's helped Jane emerge from the abyss of depression. And she's also deeply grateful for the ability to turn to God.

"There is struggle and pain like with any other disease," said Henderson. "Faith doesn't cure the problem, but it is a supportive companion. And it allows for these moments of grace that come after the struggle."

Mental health resources

Suicide hotline: 1-800-273-TALK (8255) or go here for a live webchat

Alpha and Omega Clinic: 301/767-1733 or click here

Catholic Charities' Family Services: 703/224-1630 or go here

National Alliance for the Mentally Ill: nami.org

Boys Town, a Catholic organization with resources on parenting and child behavior

© Arlington Catholic Herald 2015