Talking With Kids & Teens About PMDD
Whether one considers Premenstrual Dysphoric Disorder a mental illness or hormonal one, mood lability is one of the if not the most difficult symptoms of PMDD. Sadly, it is those closest to the woman affected by PMDD will also suffer the most.
Mood lability refers to frequent or intense mood changes or shifts. It is more than the occasional emotional ups-and-down. It is characterized by very strong mood changes that are outside of normal experience (for example, going from feeling completely elated to very depressed). Children often wonder why “mommy is sad” or angry or can’t get out of bed. It is difficult for children and other family members to grasp that the woman they know and love still exists even when PMDD is present. It is important to speak honestly with children and young adults about what PMDD is on an age appropriate level that can be easily understood and non-threatening. They need to be reassured that mommy is and will be ok. Family members must also learn to respect her need for treatment and time to heal just as if she had the flu or a really bad stomach bug.
Kids are naturally curious and have questions about mental illnesses. Understanding mental illnesses can be challenging for adults as well as for children. Myths, confusion, and misinformation about mental illnesses cause anxiety, create stereotypes, and promote stigma. During the past 50 years, great advances have been made in the areas of diagnosis and treatment of mental illnesses. Parents can help children understand that these are real illnesses that can be treated.
In order for parents to talk with a child about mental illnesses, they must be knowledgeable and reasonably comfortable with the subject. Parents should have a basic understanding and answers to questions such as, what are mental illnesses, who can get them, what causes them, how are diagnoses made, and what treatments are available. Some parents may have to do a little homework to be better informed.
When explaining to a child about how a mental illness affects a person, it may be helpful to make a comparison to a physical illness. For example, many people get sick with a cold or the flu, but only a few get really sick with something serious like pneumonia. People who have a cold are usually able to do their normal activities. However, if they get pneumonia, they will have to take medicine and may have to go to the hospital. Similarly, feelings of sadness, anxiety, worry, irritability, or sleep problems are common for most people. However, when these feelings get very intense, last for a long period of time and begin to interfere with school, work, and relationships, it may be a sign of a mental illness that requires treatment.
Parents should be aware of their child’s needs, concerns, knowledge, and experience with mental illnesses. When talking about mental illnesses, parents should:
- communicate in a straightforward manner
- communicate at a level that is appropriate to a child’s age and development level
- have the discussion when the child feels safe and comfortable
- watch their child’s reaction during the discussion
- slow down or back up if the child becomes confused or looks upset
Considering these points will help any child to be more relaxed and understand more of the conversation.
Pre-School Age Children
Young children need less information and fewer details because of their more limited ability to understand. Preschool children focus primarily on things they can see, for example, they may have questions about a person who has an unusual physical appearance, or is behaving strangely. They would also be very aware of people who are crying and obviously sad, or yelling and angry.
Older children may want more specifics. They may ask more questions, especially about friends or family with emotional or behavioral problems. Their concerns and questions are usually very straightforward. “Why is that person crying? Why does Daddy drink and get so mad? Why is that person talking to herself?” They may worry about their safety or the safety of their family and friends. It is important to answer their questions directly and honestly and to reassure them about their concerns and feelings.
Teenagers are generally capable of handling much more information and asking more specific and difficult questions. Teenagers often talk more openly with their friends and peers than with their parents. As a result, some teens may have already have misinformation about mental illnesses. Teenagers respond more positively to an open dialogue which includes give and take. They are not as open or responsive when a conversation feels one-sided or like a lecture.
Talking to children about mental illnesses can be an opportunity for parents to provide their children with information, support, and guidance. Learning about mental illnesses can lead to improved recognition, earlier treatment, greater understanding, compassion, as well as decreased stigma.
Information adapted from Talking To Kids About Mental Illnesses by The American Academy of Child and Adolescent Psychiatry (AACAP)