To Explain My Mental Health Issues To My Kids, I Got Expert Advice
It’s sunny and 80-degrees in early December (thanks, Florida), and I’m standing outside my idling car in a Target parking lot. My toddler is screaming in his carseat, because he didn’t want to leave the store without seeing the Let’s Dance Elmo toy. My tween is sitting in the back seat, scrolling through music on his iPhone.
I’m breathing deep. Four-count in, four-count out. My toddler screams on in the backseat, staring at me through the window.
I walk in circles a bit, hands on my hips and head down, waiting for my heart to slow. About five minutes later, I open the driver’s side door and climb into my seat behind the wheel.
My little one’s wails have subsided into a quiet whimper. My 12-year-old is still on his phone. He looks up for a second.
“You OK, Mom?”
“Yeah,” I respond. “It’s just my anxiety.” Then it occurs to me that my son and I have never formally spoken about my mental health issues.
I look in the rearview mirror and ask him, “Um… do you know what anxiety is?” Without looking up from his phone, he shrugs.
“I guess,” he says. “I don’t know.”
I’ve only been diagnosed with generalized anxiety disorder (GAD) within the last couple of years — a mental health issue that I’ve likely dealt with since I was a child. I can remember what I now know were panic attacks starting at age six, shortly after my parents separated.
We didn’t talk about mental health in my family, and coming to terms with my own mental health issues has been difficult. The one thing I didn’t realize in the middle of my own reckoning with my crippling anxiety is that I needed to be able to articulate what I was going through to my children. Doing so had never been modeled for me, so I wasn’t sure where to start.
My children are 12 and almost-3, making it all the more difficult to figure out how to talk to each of them, since they’re in such different spaces developmentally. On top of that, mental health has long been seen as a character flaw in my family, which is an ideology I’ve been learning how to dismantle. Unfortunately, this sentiment is all too common, even today.
I was afraid that my children would be damaged because they had a mother with anxiety.
One in five adults experience mental illness in a given year, per CDC information, as Lisa Savage, a licensed mental health counselor and the owner of The Center for Childhood Development in Newark, Delaware, points out. “We don’t realize the prevalence because we tend to suffer in silence.”
So when it came to discussing my GAD with my kids, I was a bit lost on where to start.
“First,” explains Savage, “Learn as much as you can about your diagnosis. Your mental health provider should share with you what your diagnosis is and give you additional resources.”
Yes, mental health needs to be discussed, but “mental health” in itself is a blanket term. There are several different kinds of mental health diagnoses, and they all have unique characteristics. Depression doesn’t look like anxiety, and anxiety doesn’t look like bipolar disorder, so being able to talk about the specifics is important.
At this point in my journey, I’m familiar with what GAD looks like and how it’s different from other diagnoses. I know how it manifests in my life, which makes it easier to talk about to, say, my husband, but with my children, there are several considerations to make.
“You want to consider the developmental stage of the child,” explains Dr. Ashwini Nadkarni, associate psychiatrist at Brigham and Women's Hospital and an instructor at Harvard Medical School.
Given the age difference between my boys, figuring out how to talk to each of them meant catering the conversation to their level of understanding.
“Children under the age of 7 can understand things symbolically,” says Nadkarni.
My toddler, like most other toddlers, is perceptive. He knows when I’m feeling down. He knows what tired looks like. He knows what mad sounds like. He’s starting to articulate his own feelings, so I know I can talk to him in simple terms about these things.
"One good way to convey mental health to younger children,” said Nadkarni, “is to act it out. Consider their world and create that comparison.”
I can use my youngest son’s favorite stuffed animal to explain to him what fear or angst (typical ways that my anxiety can manifest on any given day) look like for his stuffed animal, and then I can explain that Mommy feels the way his toy feels.
For my oldest son, helping him understand when I’m having a hard time with my GAD is a little easier. “First, just talk about the brain,” said Dr. Nadkarni. My 12-year-old has studied the brain in biology classes, so he knows the basics on how it works, which means I can talk to him about how my brain works a little differently because of my mental-health issues. Using examples, said Nadkarni, are also useful for this age group.
“Compare it to something the child has experienced.”
When we first started going to theme parks, my son was excited, but it took him a good deal of walking around before he garnered the courage to ride a roller coaster. I used this as an example of how my anxiety feels when we gear up for an event or an outing.
Nadkarni also recommends using movies like Inside Out to understand how emotions work and resources like The National Alliance on Mental Illness’ “Ending the Silence” video to help kids understand how mental illness works. “These resources are great ways to illustrate complex concepts to kids.”
For parents like me — just beginning to understand their own mental health diagnoses — discussing these things with our children might feel daunting. I know I was afraid that my children would be damaged because they had a mother with anxiety, which made me afraid to talk to them openly. But, as Savage explains, these conversations are not just important, but necessary.
Kids also need to know that their parents are getting help and that it’s not the job of the child to take care of them.
“Children are particularly intuitive when it comes to their interactions with their parents,” said Savage. “In early development, children see themselves as extensions of their parents. As they tune into their parents, they become acutely aware that something might not be right and in turn, perceive it has to do with them or that something isn’t right with them. If this goes unaddressed, a child becomes confused and either feel flawed or responsible for a parent's difficulties.”
Dr. Nadkarni says that providing children with assurance that their parents’ mental health struggles are not their fault is important. “It’s kind of like explaining divorce. Parents typically talk about the issues between the two of them, and simultaneously reassure the kids that the divorce isn’t their fault. The same goes for mental health,” she says. “Kids also need to know that their parents are getting help and that it’s not the job of the child to take care of them.”
Savage agrees. “Using words and reassurance helps children to feel in control, not take responsibility for their parents and feel confident that the parent is being proactive in taking care of themselves.”
So talking with my kids in an open, honest, and age-appropriate way helps them understand that they are safe, despite my mental health struggles, and that my GAD is not their fault. When I tell them that I see a therapist to help me understand my GAD and that I’m exploring whether or not to try medication, they know they aren’t responsible for fixing me, because I’m taking care of that part on my own.
And talking to my kids about mental health also helps break down the stigma for myself and for my children.
“As a society, we must transition from seeing mental illness as a flaw,” says Savage. “Your child isn’t stuck with a parent who has a mental health issue. Rather than feeling guilty about having a condition, see this as an opportunity to teach your child about acceptance for differently abled people. This includes people who have mental health conditions. As you practice self-compassion and acceptance, you’ll find that your family will thrive in spite of challenges.”
If you or someone you know is seeking help for mental health concerns, visit the National Alliance on Mental Health (NAMI) website, or call 1-800-950-NAMI(6264). For confidential treatment referrals, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website, or call the National Helpline at 1-800-662-HELP(4357). In an emergency, contact the National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or call 911.