How to talk to kids about mental illness in the family

Parents are constantly explaining things to their children.

However, it is not always easy, especially if a family member suffers from a mental illness.

It is one thing to make it clear to them what a broken arm is; depression, an anxiety disorder, or post-traumatic stress disorder (PTSD) is quite another.

“Many parents avoid it,” says pediatric psychotherapist Anja Lorenz, because “there is no standard procedure” for how to do it.

So they have to use their imagination.

Children, even very young ones, can often sense when Mom, Dad, an uncle or grandmother is not well, she says, adding that “parents are often surprised by how much children notice.”

They notice, for example, that mom or dad does not react when they are spoken to, they become quickly irritated or often sad, says pediatric psychotherapist Julia Ebhardt.

What’s more, they worry, they take many things personally “and they feel guilty because their only explanation is that they did something that bothered mom or dad,” he says.

That is why it is important for parents to give clarity and explain to their children, even the youngest ones, that an illness is to blame and that it has nothing to do with the child, and that they should not feel in any way responsible.

Make it relatable

Who should talk to the child: the person with the mental illness or someone else?

This depends on the quality of the relationship, according to Lorenz, who says children usually have a clear preference.

“Simply say, ‘I’d like to talk to you about something that has to do with me.’ That’s ok? Just you and me, or would you like someone else to be there?’”

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The child’s age should largely determine the content of the talk and its level of detail.

“Younger children need less information than older children,” says Ebhardt.

Parents should explain the disease and its consequences in simple, age-appropriate language.

“It’s good to incorporate the child’s current interests, for example, a certain character or theme such as knights, monsters, dinosaurs, football or fairies,” she says.

If a gentleman is depressed, it doesn’t show, you might say.

But it’s like he’s no longer wearing armor.

“Or a fairy who has lost her magical powers and her interest in being with other fairies,” suggests Ebhardt, who encourages being creative and playing with the child’s mental world.

In the case of an anxiety disorder, the image of a monster often arises, he says.

It jumps out suddenly and it’s very scary.

Viewing an anxiety disorder as a creature helps children understand and cope with it.

Be sincere

While creative, child-friendly explanations are desirable, parents should be careful that they are not too complicated.

“And please don’t make up stories about why mom or dad aren’t there,” says Lorenz, for example in the case of a parent being admitted to a psychiatric clinic.

“The child will realize that something doesn’t add up, which will cause additional stress and confusion.

“The main goal is to give the child a sense of security,” he says.

“You must emphasize that mom or dad is addressing the problem and is already receiving help.

“Otherwise, the child may think that he or she must do something on his or her own.

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“This can ease the child’s worry about losing a parent,” he says.

For children around three years old and older, parents can also use books as an explanatory aid.

Naturally, the books must be adapted to the age and level of development of the child so as not to aggravate any discomfort.

“And you should look at them and read them together so you can answer any questions,” Ebhardt says.

What if you have the feeling that mental illness in the family is seriously distressing the child and he or she needs outside help?

You can then go to a family counseling center, some of which offer special counseling for children whose parents have a mental illness.

In extreme cases, it may be advisable to take the child to a pediatric psychotherapist. – By Angelika Mayr/dpa

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