QUESTION: I would like to ask for your help or advice in relation to a major problem that we have with our youngest child. He is just 15 and due to sit his Junior Cert this June. He is a quiet child by nature and never had a lot, if any, self-confidence, no matter how well he excelled at anything. In the past year or so he has lost all interest in sport, does no homework, has no close friends, and seems to have withdrawn into himself and I would say has become mildly depressed . . . he is just like a lost child now, with no focus or direction, and there is no talking or reasoning with him.
We have three older children, two girls and one boy and all of them would have suffered from lack of self-confidence and self-esteem. This is especially true of my eldest daughter, who is in her 20s, suffering from depression and has been on medication for some years now. We are worried that the 15 year old is beginning to show similar traits. Could you recommend somebody we could go to see to get our son assessed and see if we can get some help for him before it is too late?
During adolescence it is much more common for children to experience feelings of low mood or to become depressed at times. This is partly due to the turmoil of adolescence which, along with hormones and physical changes, brings a rollercoaster of intense emotions and moods.
In addition, adolescents experience many more stresses and strains, whether it is the increased pressure to study or do well in exams, learning how to fit in with peers, or working out big questions of their own self- identity, etc.
Adolescents naturally question the values of the adult world and what really matters in life and this can lead some to become a bit alienated or rebellious. While such issues are relatively common in adolescence, a small number of young people can become depressed and, in serious cases, this can affect their motivation and disrupt their participation in ordinary life.
Young people who lack confidence or who have fewer friends or who live in families where there is a history of depression are particularly at risk. For these reasons you are right to be concerned about your son and to be thinking about how best to help him.
Professional help may be of benefit and you could consider taking your son to your local Child and Adolescent Mental Health Service (you should be able to get a referral from your GP or via your son’s school). Such a service should be able to provide you with an assessment of your son’s needs and a recommended treatment plan. Different treatments can be of benefit including individual or group counselling, family therapy, medication, as well as parent support.
You may also be able to access support through your son’s school, where there might be an attached counsellor or psychologist or, alternatively, you may be able to access a private therapist from an organisation such as the Psychological Society of Ireland, Irish Association for Counselling and Psychotherapy and Irish Council of Psychotherapy (all of which can easily be found online). Make sure to seek a therapist who is experienced in working with young people and their families.
The type of therapy that is most often recommended for depression is cognitive behavioural therapy, which would focus on helping your son identify and challenge negative patterns of thinking, and on planning constructive behaviours.
However, the truth is that the approach that will work best is the one that most appeals to your son and the one he will most engage in. The key is finding a therapist or approach that clicks with your son and gets him engaged and motivated to make positive changes.
There is also a lot you can do as parents to help your son and in studies it is parental support that is most highly rated in getting young people through difficult times.
The key is getting the balance right between listening to and supporting your son as well as challenging him and putting gentle pressure on him to get out and do things.
This means that at times it is important to encourage him to open up and talk about how he is feeling and at other times to gently encourage him to take action to make changes.
The ideal is to get your son on board and to work together on small achievable goals. For example, you might start by focusing on doing some study, picking a favourite or easy subject, or you might make a plan for your son to go out on a trip to meet a friend or to make a small step to restarting a sport or other helpful interest. Even simple things like helping your son prepare or enjoy a family dinner can make a difference. Being patient and making small goals is crucial.
It is also important that you maintain your relationship with your son. Try not to be on his back all the time and make sure there are other times of lighter or even “neutral” conversation when you can chat with him about ordinary things (like the TV programmes or a football match, etc).
The ideal is to try to do some enjoyable daily activities together, whether this is taking a walk together, driving your son somewhere or preparing lunch together. A good connection with you as his parent will make a big difference to his wellbeing in the long term.
Living with someone who is down or depressed can be difficult enough for the family. As well as the worry as to how your son is doing, it can be hard work trying to motivate him and to make strides to get things done.
In addition, although depression can mainly present as low mood, it can also be expressed by the young person as irritation, boredom or even anger and this can be hard to manage. As a result, it is important as parents to seek support yourselves, both for your own wellbeing and so you can be energised to help your son.
You might find some more information in a book I have written with Prof Carol Fitzpatrick, Coping with Depression in Young People – A Guide for Parents.