I received an interesting question yesterday: What is the best way to share your mental health diagnosis with your child?
There is no simple answer to that question. It will depend on your child—the age of your child and your child’s level of maturity. It will also depend on your child's current circumstances. We never want children to adopt the role of “parent” to their moms and dads, and we never want children to feel like they are somehow to blame for how their parents are feeling.
Sometimes though, the circumstance would require your child to have some understanding of what is happening for the parent. This would be especially true if a child needed to stay with an extended family member for a while during their parents’ treatment.
If a parent is struggling with mental health challenges, it is incredibly important—I would say critically important—that they get help. Getting help is not only necessary for the parent’s health but also for the health of the family as a whole. An important part of this help will be talk therapy and the therapist involved can help a parent navigate the “disclosure” process with the child. The therapist may even encourage the parent to bring the child into a session to discuss the diagnosis during a family therapy session.
Parents sometimes find it helpful to keep a parenting journal where they write to their child about what is happening for them and how they are feeling, but that they save this journal to share with their grown up children.
If parents are ever in doubt about how their mental health is affecting the wellbeing of their child, they should reach out to a child psychologist or therapist. Getting your child help, while you are receiving help, would be an excellent idea.
A word of wisdom: when you are struggling with mental health challenges, this is not the time to economize. The first step is always to talk to your family doctor to see if there is any help available that would be covered by the medical services plan. There are often long wait times for this help, and so if you do not have extended medical that covers psychotherapy, this is the time to reach into savings (or ask for help from others) to pay for the treatment you need! (A note of advocacy from myself to Prime Minister Trudeau: if you really want to make a difference in the lives of Canadians—include the services of registered psychologists under the MSP programs in each province. This care will undoubtedly pay for itself over time, as prevention and early intervention are truly the keys to successful mental health treatment!)
With all these things in mind, here are some general guidelines for how to disclose your mental illness to your child, broken into broad age groups:
Preschool and younger:
Children this young would not often need to know the diagnosis. This is a time to shelter stress, as much as is possible, from your child. Parents must seek treatment and surround themselves with as much support as they possibly can. This is the time to ask family and friends to come in and help you with the children as much as possible.
Early elementary school:
Children this young would be similar to preschool children, except they could likely handle you explaining that you are “not feeling well.” It is important to reassure children and tell them not to worry about you. Explain that you are getting help and will be better soon. The key here is to not transfer your stress onto your child.
Middle elementary school:
Children at this age could manage a little more. You could explain that you do not “feel well in your mind” or “in your heart.” It will still be very important to reassure your children, stress that this is not their faulty in any what whatsoever, and explain that you are getting the best help available. Leave them with a feeling of hope that things will be better soon.
Older elementary school and middle years:
Older kids could handle a name. You could say something like, “I have an illness called depression. It means that I have deep feelings of sadness inside me that I cannot shake off. It drains me of my energy and makes me want to sleep all the time. It is nobody’s fault. It is not my fault, and it is certainly not your fault!” Share with your child everything that you are doing to feel better and give them hope that things will be better soon.
Adolescents and young adults:
This is the time to have the kind of conversation you have been probably wanting to have with your child for a long while. Young people at this age could handle more detailed information. This would be a good time to explain the medical basis for the mental illness. You can talk about genetic factors and environmental factors. You could explain in more depth the treatment you are receiving. You can give your children updates on how your doing and what your doctors (etc) are suggesting. You can also ask your child of this age for a little help. Ask them to help around the house. Ask them to go for walks with you. Allow them a sense of agency and give them a way to participate in the family’s goal of getting you better. This is also the time to talk to your adolescent children about any genetic risk factors they may have inherited and what to be on the lookout for in their own lives. Talk about what it means to practice good mental health care. Perhaps, you could even bring advocacy into these discussion. How can your family raise awareness about mental health and spread the message that the world needs to LOSE the stigma (finally!) and focus on getting help to those who need it?
If you have any other ideas or suggestions, please send them in! I am continually learning and growing by sharing ideas with others. To me, this blog is a community of sharing!