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.
I was able to leisurely take a wog (walk/jog) this morning before work since offspring are enjoying their favorite time of the year at sleep-away camp. As I huffed and puffed along the quiet streets of Fairfax County in early August, I realized that this stillness is short lived. The vacationers are gone, the office is quiet and I haven't cooked a meal in weeks!
There are hints that IT is coming; the weather had a moment of coolness, soccer and dance registration are here and we just had no-tax weekend (I always feel that it is TOO early to hit up the school supplies aisle in early August, but clearly, I am in the minority here).
As I revel in this peace, I am aware that it will end with a bang (literally when the kids land in the garage with pounds of dirty laundry) and do wish the transition was more gradual. I go from moments of boredom when my house is too quiet and actually clean to practice/orthodontists/carpools etc.
So, my dear readers, enjoy the tranquility, the long days with sunlit evenings and LACK OF HOMEWORK. Good things are upon us although they involve alarm clocks and packing lunches; sometimes it is nice to take a moment and enjoy what is right here in front of us.
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:
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.
Last Tuesday I had a client spend a good part of her session talking about, none other than, mashed potatoes. She had been rushing all morning preparing for her Thanksgiving meal; she created a schedule down to the minute which allowed for one hour to slip into a therapy appointment. These in-laws are coming, those siblings are bringing this and that and she was trying to get things in order. She had a faint memory of her mother telling her that one type of potato was better than another for the perfect mash, but she didn't remember which was that "right" potato. She had boiled them, drained them and begun to mash them as her husband entered the kitchen to see why she was uttering profanity at the potatoes.
As we dissected the stress, the emotions, and the mashed potatoes it became clear that the whirlwind of anxiety was not really about the potatoes, but about her relationship with her mother, perceptions of family expectations and feelings of inadequacy. As she finished the session, my client's parting words were "I am so glad I didn't skip this week. I didn't think I'd have time to come in, but this was a well-spent hour."
So often we project our inner inadequacies and stress onto the minutiae of our day. I can't imagine that road rage during the 5:00 rush hour doesn't have something to do with a lousy day at the office or a nasty boss. I think about all the craziness at the mall over the next few weeks and wonder about people searching for the perfect gift to heal a relationship or calm a turbulent family situation.
The holidays have arrived. The Salvation Army folks have been ringing their bells for weeks at the Giant, wreaths are up and the endless soundtrack of Christmas music is on every radio station. Chanukah, Christmas, Kwanzaa and New Years are upon us. If you are feeling overly stressed; pause. Take a deep breath. Think about your last interaction or thought. Was it the phone call from your spouse or the nastygram from you teenager? We are so accustomed to swallowing our emotions and having them erupt at the dinner table or the pot of mashed potatoes that we often don't even realize we are upset until it is too late.
As my client said "it was an hour well spent". If you are thinking that your own potatoes are about to boil over, consider giving yourself the gift of "an hour well spent". I don't think you will regret it.
I am a psychotherapist in Herndon, VA. I work primarily with adolescents, women and adoptive families who may be struggling with depression, anxiety or low self-esteem. Join me here for my thoughts about my practice, therapy or whatever is tickling my mind at the moment.