As a psychologist who works in a school, one of my priorities is to minimize the stigma there is in talking to someone like me. I do not want children to feel that there must be something “wrong” with them if they are speaking with me. As I introduce myself to the students and their parents for the first time in 6th grade, I stress to them that I meet with ALL the students simply to check in, see how they are doing and to get a pulse on how the students perceive different aspects of school-life. I also purposefully involve myself in activities that have nothing to do with my official role in the school. For example, this past week, I coordinated the Yom Yerushalayim program in the Middle School. These sort of activities give me the chance to “hang” with students. I have also in the past taught Judaic Studies as well. These activities provide the opportunity for the students to see me as someone who doesn't only meet with “crazy” kids.
Fortunately, I think my efforts are mostly successful. (As successful as they can be with teenagers who typically are wary around adults!) However, unfortunately, this stigma still exists when it comes to teenagers seeking private counseling help outside of school. As I often share with parents, in my fifteen years of working in schools, I can think of only a handful of students who asked to have private counseling. Most teenagers feel that it means they are “crazy” and that their parents have labelled them as “mental.”
A few weeks ago, I attended a conference sponsored by Ohel on the topic of Understanding Teen Depression and Suicidality. Grace Carricarte, the presenter was from an organization called the Ganley Foundation. Their mission is to educate teenagers, their teachers and their parents about depression, its warning signs and that depression is not just for the the “mentally ill.” The founders of this organization – parents from Bergen county- lost their son at the age of 22 to suicide. They did not even know he was depressed. He was a “perfect” child- life of the party, always successful in academics and sports, and even presented to them a picture of perfect happiness. In his good-bye letter he said that he presented that way to them purposefully because he did not want them to feel guilty that they did something wrong as parents. The Ganleys were overwhelmed with anger that no one had ever told them this could happen. Children get yearly check-ups to check for all sorts of maladies. Depression is an illness- like cancer, or diabetes. It is treatable. Why didn't anyone tell them to look out for it? And, so their mission became to speak about the warning signs so that teens could self-refer and refer their friends for help. Teens don't generally come forward to ask for help. Why not?
According to a 2009 Rand study, the stigma of depression and the potentially negative reactions of their family and parents to admitting needing help are the main reasons why teens do not seek help. The message from this study is obvious. As parents, we need to minimize the stigma of getting help. We need to make it clear to our children that there are many “normal” difficulties in life, and sometimes we need help from an expert in working them through. Those who enter therapy have life challenges or stessors that are affecting their ability to cope- for now. Seeking help is not a sign of weakness. They should NEVER be afraid to tell us anything. We will always support them and get them the help they need.
In addition, many teens do not even realize they are suffering from depression, as they think it might be a phase through which they are going. And, oftentimes, when they do report to adults, the adults chalk it up to a “phase” as well. That is where the education piece comes in. They need to understand what the illness of depression is- what physiologically happens in the brain, and how it is treated.
Teens also often have many misconceptions about how therapy works. They think it means lying on a couch spilling their secrets with a therapist who just nods his/her head and then later reveals all to the parents. Clearly, that is therapy on TV. Therapy today is education and directed activities to achieve a goal. Therapists who work with teenagers are careful about confidentiality issues. Teens are also used to concealing problems as they may not want to admit that there are difficulties. Those suffering with depression also often feel unworthy. They feel worthless so they feel they are not worth the help. Overall, the fear, embarrassment and even at times, defiance, stand in the way of their getting help. As the adults, we need to make sure that just like if our child, G-d forbid, had cancer we would not allow him to suffer, so too we must make sure that he gets the treatment he needs. (The stigma tends to be even greater in boys and men who are not “supposed to” emot like girls do).
The stigma is magnified in the Jewish community. No one will admit in public that they are suffering. Rabbi Nathaniel Helfgot spoke about this issue at length in his 2001 article in Jewish Action Magazine “Dimensions- A Young Man's Story of Torment- Surviving Depression.” As parents, we need to stress to our children that it's not a “shanda” to feel depressed.
And, so, I have added another “Talk” to our list of “talks” we need to have with our children. (You thought the puberty talk was bad enough!) The details of these talks may be different, but the underlying message is the same. No matter what you tell me, I will always love you and take you seriously. Nothing you ever tell me will make me ashamed of you.