Mental Health in the Formative Years
As daunting as mental health can be, psychologist Dr Joel Low says you can modify your thinking for a more positive outcome
What is normal behaviour and one that signals a mental health struggle? We speak to psychologist Dr Joel Low on mental health matters
Between the countless tantrums, crying, shouting, all-out meltdown and teenage angst, parents often have a hard time deciphering their children’ mental and emotional state. As adults who have been through the pains of growing up, often alone or mitigated by time with friends and no awareness of such a thing as mental health, it’s natural for parents to see their kids’ apparent struggles as a part of growing up. Still, there may a nagging feeling that something doesn’t seem quite right with your child, perhaps because you don’t remember having this many meltdowns in your time. So, what is normal behaviour and one that signals a mental health struggle?
Tatler Malaysia speaks to clinical psychologist Dr Joel Low of The Mind on mental health matters:
How do you define good and bad mental health?
Joel Low (JL): If you collapse it to those broad categories, the best way to look at it would be one’s ability to function. From a clinical perspective, for example in the case of depression, there’s disruption in one’s ability to function either socially, occupationally or both.
Broadly speaking, someone with good mental health is able to function quite well in these two parameters. They can socialise, go to school, study, get decent grades and so on while someone with bad mental health will have some dysfunctions, they can be more reclusive, struggle with their studies or there’ll be a sharp decline in both areas.
What are some of the signs that parents can look out for that may indicate their child is struggling with depression or anxiety?
JL: For the older kids, in the late teens like 17- to 19-year-olds, the signs are similar to adults.
If it’s depression, there’ll be excessive sadness, hopelessness and inactivity. For anxiety it can be constant fear, their thoughts are quite negative, they are always thinking about worst-case scenarios. The types of ideas and thought patterns that they share will be pretty good indications.
For younger kids, we are looking at more typically significant behavioural changes. For example, if they were always super outgoing and sociable and all of a sudden they just become reclusive, they don’t want to go to school and so on, chances are there’s something going on and you need to get them some help if it doesn’t go away. The other one is if there are significant changes in their relationship with you, for example if they were generally quite close and open with you and suddenly there’s a massive change, they’re closed off and don’t want to spend time with you. This needs to be taken with a pinch of salt though, because there is the whole teenage angst period. The best way to determine if that is the case is to look at the consistency. If it is teenage angst, chances are it’s going to be quite consistent for a year or two. If it comes in bursts—couple of months your kid is ok, couple of months they aren’t—there is a possibility that there is something else going on.
Some children can hide their
mental health struggles too. By and large, 99 per cent of young kids wear their hearts on their sleeves so it’s easier to read them. The 1 per cent are those who are forced into situations where they need to grow up quickly and they learn to cover up any signs of weaknesses.
Teenagers and young adults have a stronger capacity to hide it because they have the ability to be one person outside in the world and another when they are alone. It’s not a clinical term but it’s popularly called highfunctioning depression. Basically, if a therapist did an assessment, they will mark every single criteria for being depressed. But largely speaking, they are still sociable, able to function in school but as soon as they are home, as soon as they turn on the shower, when they are completely alone, they collapse.
Is there a distinction between the ‘natural’ mental or emotional outcomes of challenges that come with growing up and mental health?
JL: There is no good way for us to judge or to determine whether what our kids are going through is mental health condition inducing or not. As parents, we get into the trap of extrapolating our experience on what our kids are going through. Don’t try and determine or ascertain from your perspective how bad the situation is for them. Instead it’s more helpful for your child and a more reliable gauge if you try and get down to their level and understand from their perspective how bad it was for them. It may not be easy to do especially with older kids but you can prep them from young. For example, I always tell my kids, “look, I don’t always know what you’re going through and I can’t because I’m not you but if you ever want to talk about things, come to me, we can talk about it and try to find solutions.” So even though they get more ‘angsty’, they know they have a safe harbour with their parents and someone to go to when they hit a wall.
If you haven’t done that, it’s not the end of the world. You can try to engage them but if that doesn’t work, look up resources for them and tell them: “look, if you don’t want to speak to me, that’s fair but these are some literature or websites you can read up on or I can bring you to chat with a professional if you want.” At least that way they don’t only have their friends as the only source they can rely on, which is unreliable at best.
Why do some children resort to drastic measures like self-harm or suicide?
JL: There is no real conclusive reason. Anecdotally, this is not based on research but I think one of the key reasons we see a lot more middle to late teen children struggling a lot harder is because they have never been allowed to fail. You see the typical reactions in malls—if a child falls down, everyone runs to pick him up, put a Band-aid on the cut and give him an ice cream. It’s almost like feeling bad, crying or getting hurt is taboo. But allowing them to fall, feel the pain and to get back on their feet on their own—knowing that “ok, it hurts but I can walk”—it’s not a bad thing. If they are not allowed to have these kinds of experiences or to fail
while growing up, they won’t know how to handle it when it happens, as it becomes too overwhelming for them and they will freak out. I think that’s probably what’s resulting in a lot more older age kids or teenagers going through really rough patches because they never experienced ‘challenges’ and learned how to handle them when they were younger.
What are some other practices that parents can do at home?
JL: One thing parents can do is, model the behaviour you want in your kids. So if you want your kids to be expressive or open with you, if your kids want to tell you something, don’t shut them down or tell them ‘not now, later’. Allow them the space to speak. Nurture that from a young age. The idea here or hope is that as they grow up, it will keep the lines of communication open.
The second one may be controversial because as a parent, we feel we need to be at a different level from our kids but I think there’s a lot of value in expressing your emotions in front of them, not just anger but also happiness, fear, sadness and loss. If you’re able to express it in a healthy or processed way, they are going to learn that this is the range of emotions that they can feel because their parents are also feeling them. It takes away that uncertainty, shame or fear about feeling jealous or sad. We often have cases where an elder sibling will say, “you know what, I actually don’t like my brother or sister because they get a lot more attention” but they cannot say this because it’s not right. So what we tell them is “hey, it’s ok to feel that way, we’re humans, we feel things.” Essentially, we’re not who we feel, we’re who we choose to be. So you can hate your brother or sister, that’s fine. But what do you choose to do? And that’s important for them. So if parents can be honest with their kids about what they feel when they are sad or fearful and tell them after, this is what I choose to do in spite of it, it’s actually a very powerful teaching tool for your kids.
What role does a school play in mental health?
JL: A big one because the kids spend so much time in school and so schools have a lot of opportunity to help shape the kids. Again, with 200–300 kids, it’s not going to be an easy task but I think if there are good policies in place, for example inclusiveness and encouraging conversations about depression and anxiety to show that it is a common thing—which it is by the way, as 1 in 4 people have depression and anxiety—that’ll be a really good start. Just taking the taboo/fear out of it, will be great. I think schools also play a role by providing a counsellor in some way, shape and form so kids have a safe harbour to get help if they are depressed.
What is your advice to a child that’s going through a rough time?
JL: I’d say don’t ever feel that what you’re going through is invalid or wrong. What is causing you to be depressed or anxious is not as important as the fact that you are feeling that way. So your feelings and what you’re going through is valid. Once you can acknowledge that, that this thing is happening, you’re not feeling ok, then we can do something about it.
What do you want to say to parents?
JL: Parenting is hard. Just fundamental parenting like feeding, getting them ready or ferrying kids to school can be a challenge, what more mental health! But, I think what we need to remember is that what we try to do for our kids today, the impact is going to be very long-lasting. There is no right way or perfect way to do it, we can only do it to the best of our ability and knowledge but the important thing is we try. And don’t ever stop trying to connect with your kids, communicating with them and giving them that safe harbour.
Also, try to shift your perspective on work-life balance. It’s idealistic in a perfect world but not very realistic nowadays with the smartphones and laptops. Instead, adopt the idea of a work-life integration where you don’t see life as two separate entities. If it’s working hours and your kid is crying on the side, attend to your kid but tell them to hang on, I’ll do my work first and we’ll process this later. Then go back to work and be ok with that, understanding that if you lose your job, you can’t feed them. And the opposite is true as well; say it’s 8 o’clock at night and you’re trying to feed your kids and you get an urgent email from your boss saying to get something done. Being able to say, “ok boss, got it, but let me put my kids to sleep first and then I will get it done” is not deprioritising anything but we’re saying let’s do it together.