ParentingTeensOnline™ asks Lisa Machoian Ph.D., Michael Schwartzman, Ph.D., and Donna Secor Pennington, LMSW, for answers on teen depression and anxiety.
Lisa Machoian, Ph.D. is the author of "The Disappearing Girl: Learning the Language of Teenage Depression," and a national expert on teenagers, their mental health, psychosocial development, and self-esteem.
Michael Schwartzman, Ph.D. s a psychologist and child psychoanalyst in Manhattan and Larchmont, New York. Currently, he is the Consulting Psychologist at The Allen-Stevenson School for boys in New York and serves as Clinical Supervisor at City University of New York, Adjunct Assistant Professor at Teacher's College, Columbia University, and Clinical Instructor at the Mount Sinai School of Medicine.
Donna Secor Pennington, LMSW, has been a school social worker at the high school level for twenty years and has been an advocate for programs and services for teens and parents.
Q: At the beginning of the school year we moved to a different state with our three teenagers. The oldest had just graduated from high school, our middle daughter was entering the 11th grade, and our son beginning the 9th grade.
Immediately, our 11th grader determined she didn't want to go to the new school. She refused to get out of bed. She missed several weeks, we talked to the school staff, and ultimately got her into school. Things were fine... that is until after the Christmas break.
Now she once again refuses to go to school, will not even speak with us, locks herself in her room, and won't get out of bed. When we try to talk to her, she just covers her head and refuses to talk. We have talked about getting her to go to the doctor, but can't get any response from her. We are at our wits end.
Do we physically pick her up, put her in the car and take her to a doctor? I know if we do, there will be a big fight, crying, yelling, etc. It will be a physical fight to get her out of the house, in the car, and into the doctor.
However, I don't really know of an alternative. Are their therapists that make house calls? Even so, I'm sure she will lock the door and refuse to speak or cooperate.
She has no problems with drugs; her grades, while not great, were average. The only comments we got from her during the first semester was that she "couldn't make friends." She doesn't have any physical problems or issues such as problems with weight, other health problems, etc. She is an extremely attractive young lady, but we cannot and do not know how to deal with her depression. Please help! Thanks.
Lisa Machoian answers: Friends are the world to teenagers, and it sounds like not having friends, combined with the move, have made her life feel unbearable and precipitated depression. She endured a huge and significant loss at a critical developmental time. I think you need to get her to a psychotherapist that works with teenagers. I don't know if there are some in your area that come to the house--that could be rare. However, there might be some who could start by speaking with her on the phone. You may want to find a few names and let her see who she feels comfortable with, but she needs to go. Moreover, a teen group, (group psychotherapy for teens,) would also help because she could make friends and not feel so alone. She is contending with issues of belonging and acceptance. Are there extracurricular activities or sports or dance or anything she did before that she could enroll in now? Church or temple groups? Validate her feelings about how hard it is, but do get her to therapy as it sounds like her depression is really spiraling. And help her to find friends. Kids are not too welcoming and often have pre-formed groups and cliques, so this is extremely hard for her. If she is alone all day and sits in the cafeteria alone, she is going to be depressed. Ask the guidance counselors at her school if there are any other girls or boys her age in a similar transition, contending with loss and making new friends. Remind her of her strength, and make sure she can keep in touch with her old friends. You may want to look into other schools in the area if that is feasible, so she can get a new start.
Q: My soon to be 14 year old daughter struggles with depression and anxiety and is receiving treatment (medication and therapy). She has recently expressed a desire to have a baby with an older boy whom we didn't even know about. We've since kept her at home, allowing her to only go to school, or with a friend if I know the parent and the parent will be there the entire time. I hate to revert to treating her like a toddler, but there's obviously no way she's ready for all that goes with sexual relationships, not to mention a baby. I know this is a desire for unconditional love on her part, and we're working on ways to help her find fulfillment and build self esteem. In the meantime, Would I be totally off-base in speaking with a physician about long term, reversible birth control (such as an implant that she cannot remove or "forget" to take)? I can't keep her "locked away" forever, and want to make sure that at least she wouldn't have a pregnancy on top of everything else.
Lisa Machoian answers: It is good that you are aware of some of the needs she has that are spurring her to want to have a baby; it is important to try fulfill those needs. I understand as her mother you are concerned and protective and have the foresight to see what having a baby would mean for her. I think you will need to talk with your daughter about long-term birth control both yourself and with her physician/gynecologist. If she is forced to comply she could resist even more and try even harder to have a baby. I think communication will be very important.
Q: My daughter exhibits almost all of your warning signs. She is going to a Christian therapist and has been on a very low dosage of Prozac---haven't seen a lot of difference. The therapy---yes, i agree it helps. Some changes, but not a lot. She's been going to a therapist since around Thanksgiving. What do you suggest?
Michael Schwartzman answers: Your question raises, for all of us, the issue of how to tell if your child is getting better while in psychotherapy. And, how do you know whether it is the medication or the talk that is making the difference? The most straightforward way of figuring out the answer to these questions is to ask for a meeting with your child's therapist. If your child is below 18 and you are raising your child in your home, you have a right to direct information from your child's therapist just as you do from their pediatrician, teacher, dentist etc. Although the therapist will keep confidential what your child says, they should give you a sense of what the issues are and how you child is doing with them. Certainly the therapist will be able to offer you guidance on issues that you bring up, and you should feel free to bring up issues that you are aware of in your child's life. Similarly, you should be able to ask specifically about the Prozac and the pros and cons of it for your daughter. You are also entitled to know about your child's goals in therapy and the therapist's opinions about how and when your child will achieve those goals, or what impedes that process. Prognosis is something you can ask about. It is also a good time to ask the therapist for ideas on how you may be encouraging or interfering with her growth, and changes you might make to support your child's efforts.