Q. I am very concerned about a friend of my 15-year-old son. To my untrained eye, he seems to be displaying some symptoms of depression – mood swings, withdrawal, etc. I mentioned it to his parents, but they chalked it up to his being overtired. I am certain it’s more. Is there anything I can do? I’m worried something serious will happen to this kid.
A. You have brought up a very difficult situation. Even in my position, as a psychiatrist, I have parents who are not ready to – or do not want to – hear any feedback about their child that may be perceived as being negative or as a criticism. It is important to remember that the parents may be attributing the changes in their child to his or her being “overtired” because they are scared and not sure what to do. People who feel like that may become defensive.
Often, things have to go bad before people are able to say that there is indeed a problem and seek the help that is needed. With that in mind, you are clearly concerned enough to write in and ask for advice and therefore it is probably a good observation you are making and it would be helpful for this child to be evaluated. There are different ways to approach this and you will have to use your own judgment and comfort level at how you would do it.
One approach is to take is the indirect approach. Instead of saying that you notice mood swings, etc., in their child, you may say something like, “Gosh, Billy was over the other day and he did not seem as happy as I’ve seen him before.” Or, “It seems to me that Billy has been quiet and sad looking lately.”
You may also talk to the child him or herself if you have a close enough relationship. At the age of 15, this child can consent for treatment. If he or she wants to talk to somebody, you can encourage the child to approach the parents and ask them to set up an evaluation.
Another approach would be to side with the parents. “I can see why you would feel Billy was overtired. I can’t believe how hard kids are worked these days. Can you imagine how much pressure Billy must be feeling if he is this overtired?”
Finally, you can use empathy. “I would hate to hear what I am about to say and I would possibly be upset or defensive if somebody told me this, but I am concerned. Billy has not seemed like himself. He looks sad and moody and he simply is not as happy and engaging as he used to be. Have you considered having him evaluated for depression?”
There is no easy way to deal with people’s resistance to ask for or receive help and there are many reasons for this. It is important to remember that you can only do so much because they are the parents of their child and they have their own beliefs and philosophies on raising children, on mental health, etc., that need to be respected.