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Talking About Depression As a Family

When it's more than the mid-winter blues

Published on: October 30, 2018

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Jennifer Mott of Burien was 12 years old when she began experiencing symptoms of depression, including lingering sadness and mood swings. But she didn’t know she had depression, a treatable condition closely tied to genetics.

“We were a private family,” she says. “It was more about pulling yourself out of feeling bad and pulling yourself up by your bootstraps.”

So, Mott tried pulling herself out of her depression, self-medicating with alcohol and pills by age 13. After a decade struggling with addiction and depression, she swallowed hundreds of pills in a suicide attempt that resulted in a month-long coma, persistent respiratory distress and severe muscle atrophy.

Her long recovery from the suicide attempt was a bleak, dark period in her life, Mott says. Even with care from the region’s top specialists at Overlake Medical Center and Clinics and other local hospitals, she struggled to breathe and walk independently.

“At one point after the coma, I was on a ventilator and using a wheelchair, and I remember crying watching someone walk up the stairs because I didn’t know if I’d ever be able to do that,” she says.

As Mott’s body healed, she eventually found the right combination of treatments for her depression, which included a brain stimulation therapy called electroconvulsive therapy, or ECT. Stronger and healthier, she decided to become a resource for others experiencing the pain and isolation of depression.

Now 35, Mott is a licensed mental health counselor in private practice in Seattle, working primarily with people experiencing mental illness. Her volunteer work with the National Alliance on Mental Health (NAMI) involves talking to local youth about mental health and depression. “It’s so important to keep lines of communication open with kids and teenagers, so they know how to reach out for help when they need it,” she says.

Overlake psychiatrist Dr. Antonio Avila agrees. Depression touches nearly every family at some point — recent statistics show eight to nine percent of adults and youth experience depression, and rates for children and teens are climbing — but the topic isn’t openly discussed in many homes.

If a family member has, say, diabetes or cancer, we’d call the condition by its name and answer kids’ questions more openly, he says. But mental health conditions aren’t handled with the same frankness.

The unintended result of that silence: Symptoms of depression can go unreported and unrecognized, leaving youth vulnerable to substance abuse, self-harm and even suicide. Although more youth and families have health insurance these days, some 76 percent of youth with severe depression don’t get adequate help.

Breaking the silence

Talking about depression as a family can at first seem strange or stilted, especially for adults whose own parents stayed quiet on the topic. But breaking the silence around mental health has profound benefits for children, says Dr. Avila. First, talking openly about depression helps kids depersonalize the behavior of a family member experiencing it.

When a depressed parent withdraws, cries without warning and sleeps at odd hours without explanation, many kids blame themselves, he says. Only when the condition is labeled as depression, a treatable, often temporary state, can kids begin to understand that the behaviors aren’t about them.

Discussing depression has another important benefit for children, Dr. Avila notes. Because depression has a strong genetic component, kids with a depressed parent have a much higher risk of developing depression themselves, he says.

“So developing a dialogue around mental health helps share with kids an important part of their own health history, one that could affect their own risk for mental illness down the road.”

When is the right time to start talking?

There’s no right age to begin a conversation about mental health, says Dr. Avila. “But kids are pretty smart, and they’ll get it, as long as we talk about it in an age-appropriate way.”

This means approaching the topic differently with a 7-year-old than with a 17-year-old. With younger children, parents might say something like, “Dad loves spending time with you, but right now he has something called depression, which happens to people sometimes. He’s working to get better, but right now he’s feeling sad.”

Teens and young adults are probably ready for a more factual conversation about depression, including risk factors, symptoms and therapies that can help. “Parents should talk to teens about what to do when they’re not feeling like themselves, and also what they can do if they notice that their friends are struggling,” says Mott.

When a child shows signs of depression, which can start as early as age 5, parents shouldn’t wait to intervene, says Dr. Avila.

“With kids experiencing depression, we see a lot of the same symptoms as adults, but kids are more likely to show a lot of anger,” he says. Symptoms like persistent sadness and irritability warrant a prompt visit to a child’s pediatrician; for threats of suicide, call 911 or take your child to the nearest emergency room. 

Developing a dialogue

Talking about mental health isn’t a onetime thing, says Mott; raising kids with mental health savvy takes many conversations over many years. But starting even a single conversation lets kids know that they can bring up questions later on.

“Having discussions about a parent’s or grandparent’s experience with mental illness can let kids know they’re not alone if they’re experiencing these things too, and ways they can seek help,” Mott says.

The goal is to build kids’ “health literacy” regarding mental health — healthcare-speak for the ability to recognize health problems, speak up and get needed help.

When kids know that severe mood swings and crying jags aren’t character flaws or normal teen angst, but symptoms of depression, they’ll be more likely to get help before symptoms spiral out of control, says Mott. They’ll also be less likely to fall prey to depression’s most dangerous and seductive symptoms: isolation, fear and silence.

Editor's note: This article was sponsored by Overlake Medical Center and Clinics.

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