3) Normalcy- Teens can often minimize symptoms for themselves and others to retain a sense of normalcy. They are often reluctant to talk to a primary care provider, seeing it as a weakness. To this effect, medication is also rejected as an option because it would make them less normal. They didn't want to be identified by their depression and so considered information related to it to be highly private and volatile. You can help your teen by ensuring them that depression is common at their age and that any treatment they have will remain confidential. This may include confidentiality from you, be prepared to offer this as an option.
POTENTIAL QUESTIONS
1) Connectivity- Teenagers want to feel connected to their healthcare provider, and fear being judged by them. They report frustration when providers listen only to parents. Teens want privacy when speaking to their provider and often chose not to disclose when parents are not asked to leave (they find it difficult to ask). You can help by telling them it is important that they feel comfortable with their provider and that you will give them confidentiality they need.
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2) Autonomy- Interviewed teens report a desire for autonomy. Not having a voice in their treatment or getting little information about what is happening is particularly distressing.They report wanting the involvement and guidance of parents and providers, but the freedom and autonomy to make their own decisions. Those receiving this are able to make informed choices that help them feel empowered. Give your teen access to information about their situation and allow them to assist in decision-making.
Can you tell me more about what is happening? How you are feeling?
Sometimes you need to talk to an adult about your feelings. I’m here to listen. How can I help you feel better?
Have you had feelings like this in the past?
Do you feel like you want to talk to someone else about your problem?
​​I’m worried about your safety. Can you tell me if you have thoughts about harming yourself or others?
Assure your child that you will not take any action without their consent, unless you are really worried about them and the situation is dire.
Often adolescents believe that they can deal with depression on their own, this is especially the case for boys. Explain to them that treatment actually does better the outcome of depression, as opposed to dealing with it alone.
When talking about mental health problems with your child you should:
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Communicate in a straightforward manner
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Speak at a level that is appropriate to a child or adolescent’s age and development level (preschool children need fewer details than teenagers)
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Discuss the topic when your child feels safe and comfortable
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Watch for reactions during the discussion and slow down or back up if your child becomes confused or looks upset
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Listen openly and let your child tell you about his or her feelings and worries
Remind your child that you care about them and that you can help them by working with them to find a solution or treatment.
WHAT TO KEEP IN MIND
STARTING A CONVERSATION
Teens have certain desires that often facilitate or limit their decisions regarding interacting with or accepting advice from providers (or parents), and they report increased satisfaction and benefit when these desires are addressed:
Sources
U.S. Department of Health & Human Services. For Parents and Caregivers. Retrieved July 28, 2017, from https://www.mentalhealth.gov/talk/parents-caregivers/
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TeensHealth. Talking to Parents About Depression. Last Revised by D'Arcy Lyness, PhD, August, 2016. Retrieved July 28, 2017, from http://kidshealth.org/en/teens/talk-depression.html
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Jorm, A. F., Kelly, C. M., Wright, A., Parslow, R. A., Harris, M. G., & McGorry, P. D. (2006). Belief in dealing with depression alone: Results from community surveys of adolescents and adults. Journal of Affective Disorders, 96(1–2), 59–65. https://doi.org/10.1016/j.jad.2006.05.018
Wisdom, J. P., Clarke, G. N., & Green, C. A. (2006). What teens want: Barriers to seeking care for depression. Administration and Policy in Mental Health and Mental Health Services Research, 33(2), 133-45. doi:http://dx.doi.org/10.1007/s10488-006-0036-4
Starting a conversation with your teen can seem daunting. It can be potentially awkward and may be unwelcome by your child, but this is the first step you can take to understand what they're experiencing. Try your best not to invalidate or downplay their feelings, and don't trivialize any of the fears or thoughts they share with you. Remember that their emotions are not a reflection or a direct result of your parenting. Try not to take their emotions personally, right now you need to be there for them, they should not need to comfort you. The most important approach is to listen to everything they have to say, take it at face value, and to be open, frank and honest with them during any discussions that follow.