Q My 22-year-old daughter is graduating from college, but has shown signs of mild depression for several years. I convinced her to visit her school's counseling center, where she was told she should continue seeing a therapist, but she felt the experience was too traumatic to continue. She is an intensely private person who has never been able to talk about her feelings. I have managed to "enable" her to at least keep up a fairly normal life by talking to her for hours on the phone and talking her through her occasional panic/anxiety attacks. I just don't know if there is anything else I can do, and I am afraid that entering into adult life will put her over the edge. How do you get your child who is living independently to get the help she needs?
One of the most difficult challenges a parent can face is getting a child, an adolescent, or especially a young adult who does not think that she has a problem to accept the psychiatric help she appears to need. Many psychiatric illnesses like depression are perceived quite differently than physical ailments, both by those suffering with them and by those around them.
When children have cancer, they know it is killing them and that they must fight it. Headaches cause significant pain; rashes cause uncomfortable itching. These illnesses are seen as separate from the person who struggles to overcome them. But psychiatric disorders can actually affect thinking and cognition, so much so that patients can be on the side of the illness — can think of it as part of them, as something that cannot or does not need to be treated. This feeling could be part of the reason your daughter found therapy “traumatic.”
In my opinion, one of the contributors to this difficult situation is the stigma that surrounds mental illness—it puts a psychological barrier between a person and the acceptance that she has a real problem, a barrier of shame and fear. Your daughter may be unable to break through that barrier alone, but there are real ways you can try to get through to her and help.
First, assure her that just because one experience with a therapist was bad it does not mean that mental health professionals can’t help — or that diagnosis, evaluation, and treatment will be anything like the previous experience. Without knowing what method her previous therapist used, I can tell you that many good doctors have moved away from psychoanalysis and towards evidence-based approaches like cognitive behavioral therapy and interpersonal therapy, and that the medications we have now are effective in about 80% of cases. You should also go with her to a new doctor — your love and companionship can be as important as your tenacity and concern to help your daughter begin to put these tough times behind her.
You can also level with her about the future and the risks of continuing to ignore her impairing feelings. She has graduated from college, which is a fantastic achievement for someone dealing with emotional problems, but at the same time she has likely missed key parts of development — making friends, finding love, having fun. To catch up on those things she needs to reach out for help, or allow you to reach out for her. If you’re still helping support her — or even letting her do her laundry at your house — you can use these privileges as leverage to get her into treatment, if necessary. If she truly is depressed, then she has a problem that’s as important to kick as a young person who’s addicted to drugs.
Sometimes, and this is the hardest thing to do, waiting is the only thing that works. When psychiatric illness progresses into adulthood, it becomes harder to treat and more dangerous. But sometimes it takes a scare for someone to come around and accept help.
Most of all the message I want to leave you with is, don’t give up on your daughter. And the message I want to give your daughter is, don’t give up on yourself. It can get better. You are not your depression.