The Boomerang Teen Part 2

AirDancer

I said I would return with suggestions to avoid having your teen flop back into the house for an extended stay in the middle of a semester.  I make no guarantees, sometimes a one-way ticket home is inevitable and necessary, but here are some thoughts on how to prepare for a successful flight out of the nest.

I love the idea of sleep away camp. Any reader that has spotted one of my summer posts is aware of my proclivity towards all things camp.  I have promoted camp for infinite reasons (friendship, bonding, summer structure etc.) and one of the biggest reasons is for kids to get a taste of  being away from home.  There are many kinds of  camps that can meet this objective;   sports camps, Scout camps, academic camps and arts camps and they vary in length from a few days to an entire summer.

Camps provide a sense of independence for kids with the safety net of responsible adults who are not their parents to guide them.  At camp kids learn to manage their own clothes, toiletries and meals without mom and dad micromanaging all the details. If they miss a night of teeth brushing or lose a sock (or hundreds), it is all part of the process of learning to have some independence.  I have found that the kids that have spent time away from home for a period of time during their middle and high school years have had the easiest transition to college and have had  less risk for the boomerang swing.

When a teen has increased responsibility throughout high school, he will have an easier transition to college.  Freshmen start slowly, perhaps getting  more opportunities to socialize with peers in groups before they are juniors and driving independently. Many juniors and seniors obtain part-time jobs which teach them responsibility, time management and a bit about finances.   Extra-curricula activities also help a teen with independence; there are clubs with responsibilities, teams with obligations and bands and theater with commitments that the teen must learn to balance with academic and other expectations.

One of my biggest selling points with my clients and their parents is for the kids to become responsible for their own academics.  A freshman in high school should manage her own schedule by knowing when she has an exam, when papers are due and the status of her grades.  I encourage parents to be supportive and helpful WHEN ASKED, but to allow the student to manage his own work load.  The more autonomy a high school student has, the more success will occur in college.

Parents often tell me that their teen will fail if the parent lets go of the academic reins.  The best advice I ever got was at a back-to-school night when my oldest child’s teacher said “Parents, you have already completed second grade, it is their turn.”  Yes, it is their turn; their turn to learn,  their turn to succeed and their turn to fail.  I constantly stress to these parents that the fall is easier when they fail junior year before they are legal adults and still in high school than when they are half a state or country away, paying thousands of dollars for tuition and suddenly realizing that they don’t know how to manage their work load without mom leading the way. (Students with learning disabilities or attention challenges do require more parental supervision.  It is important to strike a balance between over-doing and supporting the student; not an easy task for many families).

My last thought is to address mental health issues if and when they present themselves.  If a child is predisposed to anxiety or depression and has struggled throughout her adolescence with symptoms of sadness, feeling overwhelmed or anger management issues, please GET HER HELP.   Sending a child off to college who is struggling emotionally can be a set-up for failure.  College is inherently stressful with its huge life transitions and rigorous academics.  If your teen seems to be struggling, getting him the help he needs before he leaves home can arm him with the extra tools he may need to have a successful college experience.

Again, sometimes things happen.  Unplanned trauma, anxiety or homesickness can occur; kids come home and it is okay.  There is always another path and other options, so don’t fret.

One last thought, have your kids learn to do their own laundry……if nothing else it will make for a more pleasant aromatic experience for the roommate.


The Boomerang Teen

AirDancer

I am dedicating this to all the parents who have kids home tomorrow either due to snow, teacher workdays or other various reasons.  Find yourself a few free moments and read a post or two. Laurie

As has been previously mentioned, I work with many adolescents.  I work with them both in high school and beyond. One population that I have had nice success with is the college kid who, for a variety of reasons, has returned home for a semester (or more).  I have worked with several kids who have become very depressed and/or anxious while away at college which has necessitated a medical leave of absence.  The schools’ counseling centers have been very supportive in such a scenario and huge advocates of the student taking the time off to heal.

Bringing your child home from college for mental health reasons is terrifying.  Many parents have shared their fearful trip of driving to the college to pick up the pieces of their child’s lost semester; kids so depressed they haven’t left their room in weeks, have fallen behind on all of their school work  and become so anxious about academic failure that the cycle becomes a virtual tornado whirling inside the poor kid’s soul.  After being dismissed from the mental health center and packing up the dorm,  the families find themselves in uncharted territory.  Our child is home, our child is really struggling, our child won’t get out of bed, our child has no peers around.  How can we make it right?

Enter Laurie Levine. When I  get the frantic call, I schedule the assessment for as soon as possible.  Usually the parents come in for the first session and I never see them again (they are left to pay the bill, contain the worry and get a vague update every few months).  That is good, that is how it should be; the teen establishes a nice rapport with me and begins to delve into his presenting problems in an independent and adult-like manner.

What went wrong at college? How is it that so many students are able to make it work in what appears to be a seamless manner when others find themselves back in their childhood beds struggling with mental health issues, legal charges or or sometimes somatic symptoms brought on by stress?

Each kid has his unique story.  Be it a predisposition to depression, an uncomfortable roommate scenario  triggering despondency or an over arduous academic load.  Sometimes college or this specific college is not a good fit for a specific student.  That is okay, it saddens me though, that to find the right fit there are often periods of despair and worry both for the student and the family.

I work with the teen on the initial complaints until she is feeling stabilized. Sometimes a referral to a psychiatrist is necessary when medication is indicated, other times weekly therapy isn’t enough and we bump up the intensity for a short time.  Usually, the crisis period is short lived (weeks to a  month) and then the task becomes identifying and processing deeper core issues to avoid a relapse back to the  malfunctioning  behaviors.

Meanwhile, there are many hours per week that the client is not in therapy.  Lying in bed should not be tolerated for more than a day and  half.  Family discussions about employment, local schooling and household chores can cause conflict especially when the teen is still feeling low.  I always encourage structure in one’s day, especially in the case of depression, he needs to get up, shower and have a reason to leave the house.

I am happy to say that the kids that I have worked with have  had good outcomes.  One student took a semester and a half off and then returned to his original school.  We did Skype sessions upon his return to school and then terminated after his first semester back because he was doing so well.  Another student struggled with such depression that after coming home, it was a struggle to just get her in for her session. After a year of good therapy and the proper medication regime, she found her calling in another field and attended a certification program. She is now working in her chosen career  and has not received therapy in over a year.  I’ve worked with several students that have settled in to some classes at Northern Virginia Community College during their time at home.  Most of them have had very positive experiences which has afforded them the time to work on their mental health challenges while also continuing with their education.

You are probably thinking: “Thanks Laurie for sharing your professional experiences with us, but what can we do to avoid being the next boomerang family on your caseload?”  I will fully oblige with such recommendations in a Part 2 to this post.  Give me a few days to collect my thoughts and I will be back here with brilliant (?) suggestions.


High School Reunions

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source

Let’s talk about high school reunions. My 30th reunion was this past weekend and I was unable to fly North to attend due to a much too heavy Fall travel schedule here in the not-so-South South.  Several of my friends attended and based on the pictures, texts and phone calls I have received in  the post-reunion de-briefing everyone seemed to have a good time.

I sit with high school kids every day, in my office, who share their pain about  feeling left out, being different and believing  that they are alone in suffering through this hell we call adolescence.

I have two thoughts running through my head as I re-read those last two paragraphs:

1. Why would anyone choose to go to a high school reunion after swimming in that pool of  hormones and insecurities for four entire years?

2. By the time we are 48, isn’t it nice to realize that everyone has joys and worries, emotional maturity does happen and no one is supposed to weigh at 48 what they did at 18?

I was looking at a photo of my son and his tenth grade buddies and commented to my husband, “this picture will be  priceless in 30 years”.  Simultaneously, my son saw the hair loss and belly expansion in his future and wonders “how can I make it stop?”

Would I really make it stop if I could?   There has been so much living and learning over the past thirty years.

When I sit with distraught, angry and sad teenagers, I know my “I’ve been there” mentality is not what can help them. I can listen and validate, sometimes I can throw in a story or advice (my favorite to share is that I skipped class once;  Mr. McKerron’s 11th grade Honor’s English class because  I hadn’t finished the reading for a quiz.  As I left the cafeteria  that day, I walked head-on into Mr. McKerron). That was my story and my shame having to explain to Mr. McKerron ( who spared me from any harsh detentions), but my telling it does not help these kids learn their life lessons.  They need to experience their own  “bustings” and consequences to develop their own personal morals and values.

When I want to shake my clients and explain that the “popular people” have insecurities and worries just like they do,  they roll their eyes at me as if I am clueless.  I get that it feels miserable at this moment in this teen’s life and I know that she doesn’t know that the pain will subside and heal in thirty years time. In the meanwhile, I give her the tools she needs to believe that she is as wonderful as the next girl; what are her strengths, what makes her feel good, how can she fill herself up with joy when she is feeling so low?

Everyone has suffered in some way – insecurities are universal.  I didn’t know that then and I know these kids don’t know it yet.   As I looked at the beautiful photos of my high school classmates I know that they each have happiness, troubles, insecurities and great laughs. Some have more money than me and less BMI than I, but at 48, I know that we all have bad days, silly annoyances and big challenges, even the popular ones!


Our own game of Life

Game-of-Life

One day a few weeks ago I was finishing up a 3 mile “wog”.  Wogging consists of some walking and some jogging (my son who ran cross country and track says I “bunny hop”; I guess a long legged teenager might see that in me).  As I was wogging down the home stretch, my neighbor called out “hello”.  She is a tall, long legged, athletic young thing (not to be confused with the bunny hopper hopping down the street).   We have had many a bus stop conversation about my various attempts at athleticism; there have been 5k’s, sprint triathlons, a half marathon and, of course, the Avon Walks. (This bunny hopper is SLOW and steady, no awards even in the advanced aged category, but it has been fun interesting to plod along throughout the  years).

My lovely  neighbor asked me if I am “training for anything?”  I thoughtfully answered “no, just LIFE”.  The truth is, I have paid for an event in July, and that is probably what is motivating me to get out there and move, but I am not sure I am  going to participate, both due to scheduling and my hesitancy about my readiness for this event.  So, I thought my answer was more accurate because, I am training for LIFE; we all are every.single.day.

On a daily basis we are trying to do our best as humans:  parenting, nutrition, kindness, healthy bodies, school, work, volunteering, community, environment.  Goodness, I am tired from just reading that list.  And, yet every morning, we get up and begin the training again.

There are those mornings when just getting out of bed is considered success.  I have worked with  many who are depressed or grieving and putting those two feet on the floor can feel like a marathon at times. Some days are harder than others, and I truly empathize with their struggles. I’ve had people say that if they are able to just keep breathing, they are doing okay.

Depression and grief can be very heavy.  I’ve spoken to many whose friends and family don’t understand the heaviness, “my dad says if I just go out and get some fresh air I will be fine”.  When you live with someone that has never experienced the  “downs” it can be complicated.  A stranger to depression really can not appreciate the weight of the grief/depression, they can not put themselves in your shoes and realize how hard it is to accomplish the simplest things.

In family meetings, I do my  best to help both parties begin to understand how the other is feeling.  Mom/husband/anyone is pushing  you to exercise, work or even shower and you just can’t summon the energy to move forward.  There is an education piece for the non-depressed person where they need to learn what depression looks like, why their loved one is so dormant and how they can be helpful rather than an additional pressure.

I see these therapy sessions as part of the training for LIFE.  It is in the sessions when we build our muscles via repetition.  “I can’t tell my parents ___________” .  What are you most afraid of? What is the worst that could happen? Can you tell them a  piece of the story?  Week after week we break down the issues (depression, anxiety or anger) and do the training necessary to move forward;  sometimes it is a 5k, maybe even a full marathon, but often the training is just helping to put one foot in front of the other and show up for that game of LIFE.

Be it healthy physical choices, emotional goals or concrete work challenges, each of  us is participating in our own training program.  What we bring to the table will impact the outcome; I know the harder I wog, the better I feel in my muscles and in my mind.  Please, keep in mind, that sometimes we all struggle to tie up our running shoes, sometimes getting to the training is just that difficult.  Have patience with yourself and those around you, tomorrow is a new opportunity to train for LIFE.


Teenage Depression and Suicide Presentation

borken-flower-sad-blurred

How many of you loyal readers remember this post about a presentation that I was being trained to give about teen suicide and depression? The presentation was last week at my synagogue and it went really well.

There were about sixteen high school kids ranging from ninth to eleventh grades that met with the Religious School Director and another volunteer therapist from our congregation.  Ivy Weitzner, our liaison from Jewish Social Services of Northern Virginia and I met with their parents, about 19 in all (some of the kids had both parents present).

Ivy and I met with the parents in the sanctuary. It was a calm and serene setting for our presentation and discussion.  We shared some scary statistics about teenage suicide such that suicide is the third leading cause of death for those ages 10-24,  children and particularly adolescents who suffer from depression are at much greater risk of dying by suicide than are children without depression (U.S. Department of Health and Human Services, 1999), and children who first become depressed before puberty are at risk for some form of mental disorder in adulthood. Five years ago, 1 in 25 teenagers were making suicidal attempts, today 1 in 12 teens are attempting suicide.

We talked about some common risk factors for teenage suicide:

  • previous suicide attempt(s)
  • History of mental disorders, particularly depression
  • History of alcohol and substance abuse
  • Family history of suicide or child abuse
  • Feelings of hopelessness or isolation
  • Loss or interpersonal conflict (problems with school or the law)
  • Physical illness

and some of the warning signs that demand immediate attention:

  • Talking or writing about suicide or death
  • Giving direct verbal cues “I wish I were dead” or less direct verbal cues “You will be better off without me”
  • Expressing that life is meaningless and/or isolating from family and friends
  • Giving away prized possessions
  • Neglecting appearance or  hygiene
  • Dropping out of school or other activities or groups
  • Obtaining weapons (gun, knives, sharp objects) or prescription medication
  • Exhibiting a sudden and unexplained improvement in mood after being depressed or withdrawn (this often signifies that the person has made the decision to end their life. Once the decision is made, the weight is lifted and the person feels a sense of relief which can translate into an unexpected euphoria)

We then talked about indicators that could help prevent suicidal behavior such as supportive family relationships, good social skills and knowing where to seek help when difficulties arise. Additional protective features are connection to extra curricula activities and having good relationships with ‘other’ adults that were not necessarily the teen’s parent.

The DVD that I talked about in detail in the original post was viewed (I tactically suggested we cut out the cheesy dramatizations and instead focus on the people that shared their real life experiences.  I was even thanked by one of the parent participants for sparing her the cheese factor).

The discussion that ensued was beautiful.   There were tears and fear and honesty.  Parents shared about their personal experiences, their experiences with their kids and various stories about what their kids had endured be it depression, the loss of a friend or exposure to cutting (an important note that cutting is not necessarily a suicidal attempt, it can be, but it can also be an unhealthy way that one deals with emotional pain).

It was lovely to see how the group respected one another and offered compassion, or in some cases a tissue.  One parent shared that he and his daughter had read the book, Willow by Julia Hoban  about a girl who coped with a tragedy via cutting. Others (myself included) copied down the book information as a resource for our kids.  The group felt safe, they asked amazing questions and allowed for a rich and thoughtful dialogue about such a scary and poignant topic.

The review from the teen group was that it went equally as well.  I polled a couple of teens on their way out and they gave me a thumb’s up.  The leaders of the teens were impressed with their maturity with this difficult subject and with much of the discussion and candid responses that were shared.

One of the parents shared with me in an email that “the best part (for me) was the discussion it provoked in the car on the way home with my 16 year old daughter.  Having had separate but similar sessions we were able to compare them, and this led to us talking without awkwardness.  I shared about my post-natal depression, and she discussed her stress at school (nothing rising to the level of depression, thank goodness), but we both felt reassured that the door was always open between us, and that is a very valuable outcome”

We will be repeating this program at another synagogue at the end of the month.  I feel honored to have the opportunity to spread such a powerful message and hopefully make a difference for those that are struggling with these mental health challenges.

As always, if there is EVER a question about someone’s safety or risk of suicide the National Suicide Hotlines are available 24 hours/day 7 days/week.

1-800-SUICIDE (1-800-784-2433)


Bouncing Back from the Darkness

I wrote this last week before the tragedy in Newtown, CT.  I have struggled to write or post anything unrelated to to the horrors that occurred because I don’t want to detract from their experience. Sadly, as I re-read this post, I saw that it could be applicable. I do hope that if anyone is feeling stuck in the depths of darkness or struggling with any thoughts of suicide that they will reach out to me, another practitioner or use the resources listed below.  Warmly, Laurie

A few weeks ago my son was rejected from a college. This was the first he had heard from any college and it was a lousy way to begin the process.  He was devastated, as was I.  It wasn’t his first choice school, but that “rejection” be it in your mailbox, or these days on your computer, is one loaded word.  My son is a sensitive kid with a sick sense of humor.  I share this because in the midst of his anger/fury/sadness/fear he announced that he was going to “drink a bottle of bleach”.  Although he was kidding, the therapist in me NEVER takes any suicidal talk lightly.

Twenty-four hours later, he was  notified that he was accepted into his safety school.  Ahhh….relief! He would not be spending the next 4 years in my basement, he has somewhere to go.  He was elated, proud and just darn happy.

A week later, he was then notified that he was accepted to the first school, yes, the one that originally rejected him.  What? It turns out that he had accidentally made two accounts when filling out his application online. He had called the school and asked them to delete the first account which, unbeknownst to us, they failed to do.  His first account with incomplete application was rejected, his second and proper account was accepted.  Relief and sanity ensued.

And, yesterday, he was accepted to his first choice school! Joy, joy and all joy! (except for enormous tuition payments).

Back to the bleach.  In our lowest moments, some of us resort to “all or nothing thinking”.  A devastation occurs, a heartbreak, a financial crisis or something equally as traumatic and many teens and/or adults contemplate suicide, some attempt it and tragically, others succeed.

I have tried to make the “bleach” conversation a teachable moment. In one’s darkest hours  it is sometimes impossible to see that something positive could happen, in my son’s case within twenty-four hours.   I saw a client a few weeks ago for her first appointment.  She was very depressed and felt lost and “stuck”.  She shared her story with me and I tried to give her some relief from the heaviness that she carried.  Later that day on a whim I sent her an email.  She responded very positively and said that she had wanted to email me, but hadn’t wanted to seem to “needy”.  We had a few more exchanges and I sent her an exercise to practice until we next met.   I kid you not, for her second session the following week, she bounced into my office. She said that she was feeling “motivated” and had taken several concrete steps with her renewed energy to help lift her spirits.

What a gift to be able to witness such a transformation.  Not all clients experience change as quickly, but many do get their bounce back  and find joy and calm after doing the necessary work to address the heaviness and move forward.

Tigger's bounce

Tigger’s bounce

I beg you to know that joy can be had.  If you or someone you know is in that very dark place, please get help.  Twenty-four hours, a week or a few months can feel like eternity, but the darkness can lift and joy is attainable.

See these resources for immediate help:

Suicide Hotline

Kristin Brooks Hope Center


An uncomfortable topic: Depression and Suicide

I have been asked to help my synagogue with a program that educates teenagers about depression and suicide.  I met with the Religious School Director, a professional from Jewish Social Services of Northern Virginia and another volunteer mental health worker  to learn about the program.  The curriculum has been written by an outside agency; our task is to be trained and discuss how we want to present it to the teenagers that attend our religious school. The structure is such that we will meet one evening during religious school for 90 minutes with the teenagers (9th-12th grades) and their parents.  Two of us will meet with the parents and two with the teens.

I found the curriculum to be interesting, thought provoking and important. I noted that during our training discussion, there was concern as to whether some of the material was too harsh, or would the parents be taken aback.   The other mental health provider and I were adamant that these serious and scary subjects need to be addressed, there was to be no beating around the bush.  It made sense that those more involved with the politics of both the synagogue and the community would be sensitive to the tone of the the program, a.k.a. complaining calls and emails about such touchy subject material.

We have to be candid with these kids.  We want it to be safe for them to talk about times that they feel sad, anxious, depressed or  even suicidal.  There is a lot of pressure for teens to be  happy and perky. I have many clients tell me that they “fake” it around their friends and at school because they don’t want people to know that they are really sad and struggling inside. I hope we can create a space where the teens can not only  gather some information, but also realize that they are not alone with these “taboo” feelings.  I hope that they will be able to reach out to either their peers or the adults and share what may be on their hearts.

 The curriculum includes  handouts, written material and a DVD.  The DVD  has three vignettes of teens acting: a girl that has broken up with her boyfriend who is feeling hopeless, a boy stressed about grades and college and feels life isn’t worth living and a boy that is being bullied in school. Interspersed with the somewhat “cheesy” dramatizations are real life people sharing their stories which are powerful and emotional (compensating for, in my opinion,  the “cheese” factor of the dramatizations).  One boy talks about jumping out of a window and both his physical and emotional recovery.  A girl talks about her struggle with her parents divorce,  drug addiction and a suicide attempt and how she has pulled her life together and now feels very hopeful.  The story that was most difficult to watch was that of a girl’s family and friends following her death from suicide.  The friends talked repeatedly about missing the warning signs, ignoring her cries for help and not doing enough to help her.

The program has a strong focus on what to do if a friend shares that s/he is feeling hopeless or suicidal and requests that you not tell anyone.  I have had many of my teenage clients share this exact predicament with me in their therapy sessions.  Their initial concern is that they want to be a loyal friend. I emphasize the importance of safety with these teenage clients. I inform them that being a loyal friend is telling a trusted adult like their parent, teacher or guidance counselor to keep their friend safe.  I tell my clients that it is better to have their friend mad at them and alive than have their friend die.

The parent group will be separate from their sons and daughters.  The teens are more apt to open up if they are not with their parents.  The parents will also view the DVD and be instructed on warning signs of teen depression and suicide.  I hope to create a dialogue with the parents around issues such as supporting their teens, when it is necessary to get professional help and also helping them tap into their own feelings of depression, anxiety or other mental health concerns.

This is a troubling and scary issue, one that we don’t  want to have to think about, and yet we must.  I am including some links if you want to read more about this issue, and as always, I am here to help.

Laurie

Teen Depression

Warning Signs of Suicide

American Association of Suicidology