It can be extremely challenging to get a depressed or distressed teenager to do basic things that are essential for wellbeing, such as getting enough sleep, eating regular meals, and staying in contact with peers, but even small steps can make a difference, the experts say, and will improve the effectiveness of specialist therapy.
The experts offered this advice for parents:
Self-compassion: Parenting is hard at the best of times. Parenting with significant mental health concerns present for your children is really hard. Make time to look after yourself, your relationships, and your health so you can be there for your young person.
Time: Spending time with your young person engaging in positive interactions is still incredibly important, more so when they are struggling. This can be challenging with teenagers, and with job and life pressures, but persist.
Validation: The actions or behaviours that result from a young person's overpowering emotions don't always make sense. But when young people hide those emotions, it leads to bigger issues. So let your child know that their feelings make sense. This can be simply by listening to them, letting them know that you heard them, and by trying to put yourself in their shoes. This doesn't mean you agree with the behaviours, or that consequences don't apply; it just means that you are helping them feel like they're being heard.
Do the basics: Eat, sleep, and move. This isn't always easy but it's important to persist. Without good nutrition, sleep, and movement in our days we become vulnerable to bigger emotions, and they make coping with any challenges harder.
Reinforcement: Parenting is often reactionary, particularly when it gets tough, and focused on reducing unwanted behaviour. Building effective behaviour is more helpful. We can do this through simple reinforcement: When you see behaviour that you want to see more of, reinforce it, even by describing what they did and acknowledging that you appreciate it.
Crisis support: There isn't one right answer for dealing with young people in acute distress. Most often, if they're not in medical danger and the family can cope, the best place for them to be is at home surrounded by people who care about them. This doesn't mean you shouldn't reach out for professional support: Contact a crisis line or 111 if the child is at risk. Remove things from the home that they could use to hurt themselves and keep a close eye on them. Listen, and don't try to solve the problem. Parents often want to jump in and solve what is causing their child to feel overwhelmed; that is rarely easy or even possible. Validate, validate, validate. It can't be overemphasised how important it is for the young person to know that someone genuinely accepts their emotions (not necessarily their actions or urges to hurt themselves). Engage, don't withdraw. If possible, keep up routines, activities, social engagements, and responsibilities. In the long run, this should help to improve their mood.
Don't give up. Knock on every door. Professional support can be hard to find and inconsistent, but there are plenty of people in the system who want to help. There are some numbers to call at the bottom of this article.
Digital tools
Thabrew, Woodfield, and Bekker pulled together a list of resources which are designed to supplement a package of support for children, young people, and their families:
Improving well-being and resilience
Whitu – seven ways in seven days is a NZ app designed to teach young people aged 13+ evidence-based skills for recognising and managing emotions via seven bite-sized modules. Developed at the start of the COVID-19 pandemic, Whitu was found to improve well-being, mood and self-compassion. It is now being adapted for use in high schools.
Aroha is a NZ-developed chatbot designed to help young people deal with stress related to the COVID-19 pandemic. It is free to download.
Manaaki Ora is an NZ developed app that helps young people and whanau recognise emotions, manage low mood and get support from friends and whanau. It is free to download.
DNA-V is a youth-friendly adaptation of Acceptance and Commitment Therapy (ideal when thoughts are troubling or intrusive). The Australian authors of several books for young people have a page of free downloads including a therapeutic game for children under 12, and worksheets for teens.
Anxiety
Fear-Less Triple P is an evidence-based online programme for parents of anxious children. It is currently free of charge, funded by the Ministry of Health.
Camp Cope-A-Lot is a US adaptation of the Cognitive Behaviour Therapy (CBT)-based Coping Cat program. Multiple parent and child-focused modules are available to anyone for a fee via the developer's website.
Sparklers at Home is a toolkit of fun wellbeing activities for children, including managing emotions. It was developed after the Christchurch earthquakes and provides a fun way to start important conversations.
This list of 25 practical tips for parents of young children who are anxious was created by Professor Carolyn Webster-Stratton
"Helping Your Anxious Child: A step-by-step guide for parents" by Professor Ron Rapee and colleagues from Macquarie University is available as an e-book, audiobook or library book. It has sound evidence-based advice for parents of children experiencing anxiety.
Depression
SPARX is a NZ-developed game and CBT-based app for young people aged 12-17 years. It is free of charge, and studies have shown that it improves symptoms of mild to moderate depression and anxiety in young people.
The Lowdown is a NZ website that provides excellent, youth-friendly information about depression and anxiety (it is not designed as a treatment programme).
Youthline is another NZ website with youth-friendly information about depression and anxiety (again, not designed as a treatment programme).
Aunty Dee is a NZ-developed app that coaches young people to solve problems that might be related to stressful life experiences. It is free to download.
Suicidality and self-harm
Village is a NZ-developed communication app that helps young people experiencing low mood, self-harm and suicidal ideation more easily communicate with, and receive effective support from a network of up to five trusted individuals (buddies). It can be used while waiting for, or alongside, face-to-face counselling or therapy.
Getting through a tough moment
Sometimes we need to just get through a moment without making it worse and apps that can help us wind the emotion back a bit can be helpful. Many smart phones have similar functions built in and a simple app web app that can help with this is Breathe.
Or if you need a few different ways to relax, distract or soothe, Virtual Hope Box has some useful resources.
Disordered eating
FEAST is a global support and education community for parents of those with eating disorders. The service aims to help children get appropriate treatment and provide information to help them recover. It features the FEAST 30 Days programme, which provides a lesson a day over the course of 30 days.
Anorexia Family offers help for parents of children and teens suffering from anorexia and other eating disorders.
The Eating Disorders Association of New Zealand is a non-profit organisation dedicated to supporting people caring for a person with an eating disorder. EDANZ provides support, information and education as well as awareness raising and advocacy for better access to quality care.
Challenging behaviour
Triple P Online is an evidence-based Australian programme for parents of children with challenging behaviour. There are different versions for parents of children under 12 and teens. It is currently free of charge, funded by the Ministry of Health.
The Incredible Years is an evidence-based programme for parents of primary-aged children (2-8 years) with challenging behaviour (including ADHD). In-person groups are run throughout New Zealand, but if it's not possible to attend one of these, then the e-book or audiobook outlining effective techniques may be of value.
Advice for Parents
Whāraurau has a series of videos to help young people and their families navigate their way through child and adolescent mental health services, including the roles of different professionals, and the role of medications.
"How to Talk so Kids will Listen, and Listen so Kids will Talk" (and "How to Talk so Teens will Listen…") by Adele Faber and Elaine Mazlish are books that were written decades ago, but remain incredibly relevant for parents who are trying to communicate with their child, and finding it hard going. Filled with comics and cartoons, they're an easy read, with lots of practical ideas. Available from public libraries, or as audiobooks.
This specialist library has hundreds of audiobooks, books, DVDs, and all sorts of resources relating to anxiety, depression, Autism, ADHD, social skills, and parenting children with complex needs. It's free to become a member and borrow resources, and the only cost is to courier or post the resource back to the Wellington-based library when you're finished.
The UK's Anna Freud Centre has very sensible advice for parents and carers.
Whāraurau also has downloadable books and games for children of parents who are experiencing a mental illness or addiction difficulty.
Where to get help
If it is an emergency and you or someone else is at risk, call 111.
For counselling and support
Lifeline: Call 0800 543 354 or text 4357 (HELP)
Suicide Crisis Helpline: Call 0508 828 865 (0508 TAUTOKO)
Need to talk? Call or text 1737
Depression helpline: Call 0800 111 757 or text 4202
For children and young people
Youthline: Call 0800 376 633 or text 234
What's Up: Call 0800 942 8787 (11am to 11pm) or webchat (11am to 10.30pm)
For help with specific issues
Alcohol and Drug Helpline: Call 0800 787 797
Anxiety Helpline: Call 0800 269 4389 (0800 ANXIETY)
OutLine: Call 0800 688 5463 (0800 OUTLINE) (6pm-9pm)
Safe to talk (sexual harm): Call 0800 044 334 or text 4334
All services are free and available 24/7 unless otherwise specified.
For more information and support, talk to your local doctor, hauora, community mental health team, or counselling service. The Mental Health Foundation has more helplines and service contacts on its website.
