For many parents, bringing up the subject of alcohol and other drugs is no easy matter. Your teen may try to dodge the discussion, and you yourself may feel unsure about how to proceed. To make the most of your conversation, take some time to think about the issues you want to discuss before you talk with your child. Consider too how your child might react and ways you might respond to their questions and feelings. Then choose a time to talk when both you and your child have some “down time” and are feeling relaxed.
You don’t need to cover everything at once. In fact, you’re likely to have a greater impact on your child’s decisions about drinking and using drugs by having a number of talks throughout his or her adolescence. Think of this talk with your child as the first part of an ongoing conversation.
And remember, do make it a conversation, not a lecture!
One half of mental illnesses appear by the age of 14 and two thirds by the age of 24. These are the years when youth leave home for college. In other words, mental illnesses, including alcohol and drug abuse, are the conditions that arise and may affect your child as he takes on the developmental steps of leaving home to go off to school. In fact, an important study of the mental health of college students by Dr. Carlos Blanco of Columbia University reported that almost 1 in 2 college aged individuals had a mental disorder in the past year.
The most common conditions are alcohol and drug problems with 25% of college youth (18-24) impacted. Remarkably, this is greater than the presence of a mood disorder (depressive or bipolar disorders) which was 11% and anxiety disorders (panic, social anxiety, phobic and generalized anxiety disorders) which were 12%. Importantly, less than 25% of those youth with a mental disorder sought treatment in the year prior to their identification in this survey; far more youth with mood and anxiety disorders in college sought treatment (34% and 16% respectively) than those with alcohol or drug disorders (only 5%).
As your child heads off to school, there are a set of questions you may have and would like answered.
Q: What are the more common mental health conditions that strike when students go off to school? Why is that?
A: Mood and anxiety disorders are the most common. These conditions come on in adolescents and those in the college years. Social anxiety disorder is particularly prominent, and not a condition many think about.
Co-morbidity (the presence of more than one disorder at the same time) is highly prevalent - especially depression and anxiety. Some 60% of those youth with a social anxiety disorder will develop depression by the time they are in their 20s.
Depression is very common, and associated with suicidal thinking and behavior. Often youth come to college with a depressive condition that may or may not have been detected or treated. So, often they arrive at school already ill with this condition or develop a first depressive episode at the college. Alcohol abuse and drug taking are unfortunately quite common challenges at colleges and universities. But many students do not see it as a problem, and don’t seek help for these behaviors.
“Why now”? First, there is the biology of mental health disorders, which are common and emerge in this age group. A family history will often reveal which students are especially at risk for mental and substance use disorders. But there is something about going off to school that may be less about separation and more about a natural desire of youth to be independent. Those already with mental health problems, like depression or anxiety, often envision going to college as a “new phase of life”. If they were on medications they often think “I can stop the mess, I can do it”. Sometimes they tell their doctor at home and sometimes they don’t. They have a good summer, go off to school, stop taking medications and by mid-semester they relapse. That’s when they appear for help.
An underlying vulnerability combined with the stress of leaving home and facing the developmental challenges of living on one’s own. These are heightened by the academic and social demands of school. Sexual exploration and the emotionally destabilizing effects of alcohol and drugs add to the risk for youth in college. In other words, quite a cauldron of ingredients for developing or worsening mental health problems.
Q: How can parents know a child is in trouble? What would they look for? How should they behave?
A: First, be attentive but don’t be hovering.
What a parent should do starts before the child goes off to school. This is a conversation, that doesn’t happen nearly often enough, where a parent finds the moment to talk about both the academic and health aspects of going to school. A parent needs to say “I care about your health, not only your grades.” The conversation ought to cover the main health areas of significant concern for students, which are sexually transmitted diseases (STDs), alcohol and drugs, and depression. You child may say or think “...mom/dad, you’ll never understand” (or look at you like you are suddenly speaking Latin - but don’t be put off. A parent can say “...I have read that 55-60% of students report stress, and that it affects their lives and their grades.” And add “...Going to school can be wonderful but I know things happen to lots of kids, so I want you to know not only that I know these are common problems but that I am here for you if they occur.”
The three things that tell you your child is having trouble are: academic difficulties, her reporting she is “not fitting in”, and any call or contact from the school.
Q: What about when a child returns home on school break? What should a parent know or look for?
A: These are unique moments where a child may let down his defenses. In an unguarded moment, feeling the need to communicate, a child may turn to a parent and cue that they are having trouble. Alternately, if your child is especially withdrawn or reclusive, different from how she was, that is important to recognize. If your child goes from being a talker to someone who doesn’t hardly say a word that is also something to note.
Significant weight loss can also suggest a mood or eating disorder. In other words, any significant change in your child may be a signal that you need to find out more, and perhaps do something about.
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