Tag: troubled teenager

Is my teen ‘normal’ crazy or seriously troubled?

Is my teen ‘normal’ crazy or seriously troubled?

photo8A high percentage of teenagers go through a rebellious or crazy phase that is normal for their age and brain development.  The difference between normal teen crazy and truly troubled behavior is when the teenager falls behind his or her peers in multiple key areas.  At a bare minimum, a normal teen should be able to do the following:

  • Attend school and do most school work if they want to;
  • Have and keep a friend or friends their own age who also attend school;
  • Have a maturity level roughly the same as his or her peers;
  • Exercise self-control when he or she wants to;
  • Have basic survival instincts and avoid doing serious harm to themselves, others, or property.

photo5It is normal for teens to be inconsistent, irrational, insensitive to others, self-centered, and childish.  Screaming or swearing is normal–regard this the same as a toddler temper tantrum.  It is a phase that crazy teens grow out of unless something else is holding them back.

This is your challenge:  even teens with mental disorders have challenging  teenage behaviors like those listed above.  How do you tell which is which so you can get help?  Look for pervasive patterns of social and behavioral problems that stand out against their peers, are persistent, and occur most settings.  The patterns repeat and you fear they will become increasingly worse.  It is clear the troubled teen cannot control themselves if they wanted to.

photo2

Some signs of abnormal unsafe* behavior

*Unsafe” means:  there’s a danger of harm to themselves or others, property loss or damage, running away, seeking experiences with significant risk (or easily lured into them), abusing substances, and physical or emotional abuse of others.

  • If a troubled teenager does something unsafe to themselves or others, it is not an experiment, but is impulsive, intentional, and planned.
  • They have a history of intentional unsafe activities.
  • They have or seek the means to do unsafe activities.
  • They talk about or threaten unsafe behavior.
  • There are others who believe there is something abnormal or unsafe about your child.  (e.g., your child’s friend comes forward, their teacher calls, other parents keep their children from your child, or someone checks to see if you’re aware of the nature of his or her behaviors).


photo7How psychologists measure the severity of a child’s behavior 

“Normal” is defined with textual descriptions of behaviors, and these are placed on a spectrum from normal to abnormal (“severe emotional disturbance”).  Below are a few examples of a range of behaviors in different settings.  These descriptions are generalizations and should not be used to predict your child’s treatment needs, but they do offer insight into severity and the need for mental health treatment.

School behaviors

Not serious – This child has occasional problems with a teacher or classmate that are eventually worked out, and usually don’t happen again.

Mildly serious – This child often disobeys school rules but doesn’t harm anyone or property.  Compared to their classmates, they are troublesome or concerning, but not unusually badly behaved.  They are intelligent, but don’t work hard enough to have better grades.

Serious – This child disobeys rules repeatedly, or skips school, or is known to disobey rules outside of school.  They stand out in the crowd as having chronic behavior problems compared to other students and their grades are always poor.

Very serious – This child cannot be in school or they are dangerous in school.  They cannot follow rules or function, even in a special classroom, or they may threaten or hurt others or damage property.  It is feared they will have a difficult future, perhaps ending up in jail or having lifetime problems.

photo6Home behaviors

Not serious – This child is well-behaved most of the time but has occasional problems, which are usually worked out.

Mildly serious – This child has to be watched and reminded often, and needs pushing to follow rules or do chores or homework.  They don’t seem to learn their lessons and are endlessly frustrating.  They can be defiant or manipulative, but their actions aren’t serious enough to merit a strong response.

Serious – This child does not want to follow rules, even reasonable rules.  They take no responsibility for their behavior, which can damage to the home or property, or cause harm to themselves or others.  They bring everyone down.

Very serious – The stress caused by this child means the family cannot manage normally at home even if they work together.  Running away, damaging property, threats of suicide or violence to others, and other behaviors require daily sacrifices from all.  Police are commonly called.

photo9Relationship behaviors

Not serious – The child has and keeps friends their own age, and has healthy friendships with people of different ages, such as with a grandparent or younger neighbor.

Mildly serious – This immature child will argue, tease, bully or harass others, and most schoolmates avoid them. They are quick to have temper tantrums and childish responses to stress that make them “high maintenance.”

Serious – The child has no friends their age, or risky friends, and is manipulative or threatening. They can have violent tendencies, poor judgment, and take dangerous risks with themselves and others.  They don’t care about others’ feelings., and take anger out on others.

Very serious – The child’s behavior is so aggressive verbally or physically that they are almost always overwhelming to be around.  The behaviors are repeated and deliberate, and can lead to verbal or physical violence against others or themselves.

photo1If your child’s behavior falls along the spectrum encompassing Serious to Very Serious behavior, get good mental health treatment for them now and spare them a difficult future.

Pay attention to your gut feelings.

If you’ve been searching for answers and selected this article to read, your suspicions are probably true.  Most parents have good intuition about their child.  If you’re looking for ways to “fix” or change your child… all I can say is that this approach will probably not work.  You may need to work on yourself; you may need to change how you relate to your child or picture your situation.  Regardless, seek help.

photo4Early treatment, while your troubled teenager is young, can prevent a lifetime of problems.  Find a professional who will take time to get to know your child and you and the situation, and who will listen to what you have to say–a teacher, doctor, therapist, or psychiatrist.

–Margaret

Your comments are welcome.

 

–Margaret

Life with a schizoaffective teen

Life with a schizoaffective teen

I have first-hand experience raising a child with schizoaffective disorder.  Up until my child’s onset of the disorder in the ‘tweens’, I never thought I had much patience or backbone.   But one’s character strengthens with trials, and I learned I was patient and stronger inside than I thought.  Parenting my child entirely changed my life’s direction.

Farther down this post are practical tips and advice for raising your child.

My Story:  Schizoaffective teens have both schizophrenic symptoms (thoughts disconnected from reality) and affective symptoms (unstable emotions and moods).  What an unfair combination of experiences to sabotage one’s brain.   My child had to persevere through intense feelings, excruciating anxiety, and thoughts that rarely touched on facts.  How could anyone maintain any semblance of normalcy during this?   The mental effort of holding oneself together was exhausting.

My child was often exasperated with me, as other teens are with their parents:  “Mom, you don’t understand me, it’s like the TV’s on, the radio’s on, the stereo’s on, you’re talking to me, and I’m trying to read a book, and I can’t not think about every single thing.”  Right, I couldn’t relate.  I could not imagine processing 10,000 inputs at once without going crazy.

Hallucinations feel normal when you’re in them

My child had a slow early onset of hallucinatory experiences beginning about 11 or 12, and was able to hide it until 14.  She considered the hallucinations and voices normal, and became accustomed to them.  Eventually, she noticed that others didn’t see or hear the same things:  the rhinoceros walking by; the sky turning green; words writing themselves on a blackboard.  To my child, here was proof of being special, magical, a traveler on the metaphysical plane.  Because there was proof, she felt superior to others and that she had special powers.

I have never had hallucinations, but imagine they are like dreaming wide awake.  My child’s audio hallucinations included something out of Monty Python:  two loudly arguing British ladies, with thick Cockney accents, relentlessly criticizing each other’s cooking and husbands.  She complained it was impossible to hear what the teacher said in class.  (Even today, during summers when she is happy, the stand-up comic voice visits and tells jokes throughout the day.  Our family witnessed many outbursts of laughter and giggling for no apparent reason, then started laughing contagiously.

My child’s visual hallucinations took fascinating forms:  stairs looked like a cascading waterfall; a living room chair continually rotated in space instead of standing still; moving objects left trails in space, like a series of images seen with a strobe light.

She awoke one morning with stories of her life as a queen for 1000 years, and talked about it in extraordinary detail.

My child is the bipolar type of schizoaffective person.  While depressive types don’t have the highs or excessive agitation,  they still suffer with anxiety and paranoia.  When she was in a down cycle, she darkened her room and slept in a pile of bed-clothes on the floor.  She avoided things with negative symbolic meaning, such as certain people, certain streets, or certain names.   For some reason, sunflowers and Christmas were upsetting.  During depressive phases, she talked about suicide, or “caught” other disorders such as anorexia and PTSD.  I was often accused of abuse and endured many hurtful words.

Haunted by anxiety and paranoia

Anxiety and panic are torturous, and I wished I could have spared her from the pain.  She would obsess on a past emotional hurt and become horribly upset for hours, days, weeks at a time. (In my stress and ignorance back then, I yelled at my child unaware of how hard this impacted emotional memory.)  I had to apologize a zillion times.

My child continues to obsess on ancient hurts, now well into adulthood.  Any traumatizing experience can become a theme in the life story of a schizoaffective person.   They will refer to it and make connections to it for the rest of their lives.   Big issues with my child are about money (having money, people stealing money, having no control over money).   It’s common for her to interpret any event as the turning point when everything started to go downhill, “That’s when you took all my money, “That’s when you ruined my life.”

It may not be preventable.  It’s the very nature of schizophrenia spectrum disorders to find something to be paranoid about.  The point is for a parent to learn to avoid triggering the traumatic memories, and avoid reasoning or explaining what really happened.  Our children cannot reason once upset.  I had to learn to “de-escalate” my child, don a quiet and patient demeanor, affirm feelings, show empathy, and change the subject (“redirect”) etc.

Stalkers of famous people often have schizoaffective disorder

She did some reading and told me that people with schizoaffective disorder often believe they are connected to a celebrity’s life as lovers or confidantes, and some will stalk that person.  John Hinkley is a famous case.  He believed he was the boyfriend of actress Jodie Foster.  In her film, “Taxi Driver,” her would-be boyfriend attempted to assassinate the president to impress her.  Hinckley did the same, and attempted to assassinate then-President Ronald Reagan.  In prison, Hinkley was diagnosed with schizoaffective disorder.  The Beatles musician, John Lennon, was killed by Mark David Chapman, who believed he was the rock star and John Lennon was impersonating him–Chapman is another person with schizoaffective disorder.  I was amused that she realized, only then, that her ever-present (invisible) boyfriend was a famous rock star.

Partial complex seizures can simulate symptoms of schizoaffective disorder

Partial complex seizures of the left temporal lobe (temporal lobe epilepsy) cause, enhance, or simulate symptoms of schizoaffective disorder.  If your child has not had an EEG, request one.  If there is seizure activity, it can be treated by anticonvulsants such as Tegretol (carbamazepine).  This helped to reduce many of my child’s symptoms, such as intermittent bouts of terror, seeing auras around people, and color changes in the sky.  (See an abbreviated article with an explanation at the end of this post.)

Lessons I learned

  • Don’t challenge your child’s beliefs about their experiences, even if you think they are strange, focus instead on keeping your child functional: taking meds, attending school, engaging in safe activities, and managing personal care.  You will be better able to correct/redirect their thinking once they feel comfortable speaking openly with you.
  • Believe and act on any references to suicide or destructive ideas—this may be manipulation, but don’t take the chance.   If you believe your child is being manipulative or overly dramatic, ask them respectfully to stop.  Yes, just ask.
  • Allow your child to talk comfortably about their hallucinatory experiences.  You want to know what they are witnessing or monitoring in their head.  You want to know if a voice is verbally abusing your child, or telling them to hurt themselves or others.
  • “Inoculate” your child from cruel voices or messages–teach them to deny the power of the voice or not take it seriously.  Example:  “I know you can’t stop [this voice] from pestering you, but it’s OK to resist [him] or ignore [him].  [He] has no power over you.”  She was very upset once because her rock star boyfriend/ghost yelled at her.  I told her to tell him, “Stop it and leave me alone! Don’t talk to me that way!”  She did (somehow), and it worked!  The rock star guy stopped talking to her for a couple of days (as if he was sulking), and returned and was nice to her again.

Things you can do

  • Low stress is a priority. Create a low-key environment in the home, limit sensory input, use quiet or soft voices as much as possible.
  • Allow your child to avoid over-stimulation–crowds or energized spaces with too many things happening (parties, malls, sports events or activities, slumber parties, or whatever they say it is).
  • Don’t argue with them if something they say doesn’t make sense to you.  Listen attentively and avoid offering your opinions.  Let me repeat, don’t reason with someone who is inherently irrational.  Ensure they are safe, comfortable, and appropriate, and spend quality time listening like you would any other child.
  • Help them avoid anxiety-causing things or places.  Go out of your way.  Make a point of driving down a different road, or bringing them home from an event early, even if it’s inconvenient.  This is respectful and humane because they are  agonizing about something that you don’t experience.  You need their trust in you to protect them from their own mind.
  • Ask your child what they need to calm down or settle.  If they want to be in a dark room with the windows covered with foil, fine.  If they want to listen to loud ghastly music through headphones, fine.  Just watch.  It will be obvious if it settles them, or helps them focus and relax.
  • Allow your child to be weird at home as long as they adhere to basic rules.  “I respect your freedom to be who you want to be, but you must take showers and wear clean clothes.  Hygiene is the family policy.  This rule won’t change, but I am happy to help you with this if you want.”  No reasoning or justification, just a simple statement of the rules everyone follows.

You can ask for, and expect, respectful behavior

It is possible to ask your schizoaffective teen to stop disrespectful or harmful, inappropriate behavior, and it is possible to set a boundary if done in a respectful straightforward manner without justifying yourself.

Example of something I said to my daughter during a particularly dark period:  “I’m leaving the house and I’ll be gone about 2 hours.  Do not try to commit suicide, stay right here in your room and be calm.  I’ll bring you a snack when I get home.”  Note that this gave her a reason to wait until I came home.

Outcomes are poor with schizoaffective people, but statistics say they have a better long-term prognosis than those experiencing schizophrenia (see “Outlook for schizoaffective disorder and schizophrenia”).  Perhaps it’s because their emotional awareness gives them the ability to form friendships and relationships, and talk about feelings (unlike those suffering with ‘pure’ schizophrenia).  See article at the end of this post, “Social Interaction Increases Survival by 50%.”

You are in this for the long haul.  You will experience a roller coaster ride of emotions.  Pace yourself as if in a marathon.  There may be multiple crises  and hospitalizations, but these may space farther apart over time with treatment and family support, and you’ll have respite.  Your child will settle into stable, repeated patterns unique to them, and you’ll learn which triggers to avoid, and to ignore what isn’t important.  You’ll also learn how to bring them back into positive states of mind, and set up a healthy environment where they choose to stay.  Have hope.  I lived this, and can attest to it.

 

–Margaret

How am I doing?  Please rate this article at the top, thanks.

Please add a comment about your experiences.  Your observations help others. 

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Complex Partial Seizures Present Diagnostic Challenge  (summary)
Richard Restak, M.D. | Psychiatric Times, September 1, 1995

Temporal lobe epilepsy (TLE), is now more commonly called complex partial seizure disorder. It may involve gross disorders of thought and emotion, and patients with temporal lobe epilepsy frequently come to the attention of psychiatrists.

A Dr. Jackson observed in the late 1800’s that seizures originating in the medial temporal lobe often result in a “dreamy state” involving vivid memory-like hallucinations sometimes accompanied by déjà vu or jamais vu (interpreting frequently encountered people, places or events as unfamiliar). Jackson wrote of “highly elaborated mental states, sometimes called intellectual aura,” involving “dreams mixing up with present thoughts,” a “double consciousness” and a “feeling of being somewhere else.” While the “dreamy state” can occur in isolation, it is often accompanied by fear and a peculiar form of abdominal discomfort associated with loss of contact with surroundings, and automatisms involving the mouth and GI tract (licking, lip-smacking, grunting and other sounds).

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Social Interaction Increases Survival by 50%

Psychiatric Times. July 30, 2010

Theoretical models have suggested that social relationships influence health through stress reduction and by more direct protective effects that promote healthy behavior. A recent study confirms this concept.  Findings from a meta-analysis published in PLoS Medicine indicate that social interaction is a key to living longer. Julianne Holt-Lunstadt, PhD of Brigham Young University and colleagues analyzed data from 148 published studies (1979 through 2006) that comprised more than 300,000 individuals who had been followed for an average of 7.5 years. Not all the interactions in the reports were positive, yet the researchers found that the benefits of social contact are comparable to quitting smoking, and exceed those of losing weight or increasing physical activity.

Results of studies that showed increased rates of mortality in infants in custodial care who lacked human contact were the impetus for changes in social and medical practice and policy. Once the changes were in place, there was a significant decrease in mortality rates. Holt-Lundstadt and colleagues conclude that similar benefits would be seen in the health outcomes of adults: “Social relationship-based interventions represent a major opportunity to enhance not only the quality of life but also of survival.”

When is it OK to search a teen’s room?

When is it OK to search a teen’s room?

This is a paraphrase of a question that was posed a few years ago in a support group I facilitated.  It’s a question I had to face more than once.  Now that years have gone by, I still believe this is a good approach when you have a troubled teenager, but some parents may struggle with the issue of trust.

Q: My son is always in his room and gets extremely upset if I go in there.  He says he has a right to privacy.  But I suspect something bad is going on, and want to search his room when he’s not there.  Yet it bothers me that I’d be violating his trust.  Is it OK to search his room?

A:  I advocate searching a troubled child’s room or reading “private” information like email if there is any concern whatsoever that something potentially dangerous is being hidden from a parent.  Since he gets very upset, he may not want you to find something because he knows you’ll disapprove.  Practically speaking, is there a way you can search his room or read email without him (or anyone else) ever finding out?

If he finds out you’ve searched his room, yes, you will lose his trust, and he may go to greater lengths to keep secrets.  But as the responsible adult in the household, you must think not only about your son, yourself, and your family, but about others who may be at risk if your son has really dangerous plans.  The need for safety should include those in contact with your son.  Who else is at risk of violence? criminal changes? substance abuse?

If you find nothing unusual or dangerous on a search, you’ve at least satisfied your rightful need to know.  The first issue is his need for privacy and his fear of losing it.  The second issue is your need for mutual trust.  He will need you someday when he’s in trouble, and his trust is critical.  It’s OK not to tell him if you’ve searched his room.

In dire circumstances, a parent may need put some values aside.

If you find something dangerous, act on it immediately and do not defend your decision or try to talk him into taking responsibility for his actions.  A troubled teen can’t or won’t.  He will either be remorseful and embarrassed, or enraged and threatening.  Regardless, take dangerous materials or actions very seriously because someone’s life could literally be at risk.  Since it’s clear that trust is important to you (as it should be), expect that it may be very long time before your son trusts you if he finds out.  But also remember that, under these serious circumstances, his trust of you may be less important than your trust of him.

Parent to Parent Guidance

Parent to Parent Guidance

Margaret Puckette is a Certified Parent Support Provider, and helps parents with tailored advice for raising their troubled child, teen, or young adult. She is a parent who understands that parents and families need realistic practical guidance for maintaining their lives without stress. Margaret has coached and mentored families for over 20 years. She is an author & speaker, and believes parent & family support is essential. Mentally healthy parents with the right skills raise mentally healthy children.

You Can Handle This.

You Can Handle This.

You are not alone. Your situation is no one's fault. Behavior disorders are disabilities!
Troubled children need a very different parenting approach than 'normal' kids.

Care for yourself first, then set new goals:
1. Physical and emotional safety for all
2. Acceptance of the way things are
3. Family balance, meet the needs of all
4. One step at a time, one day at a time

Practical Guide for Parents

Practical Guide for Parents

A guide with practical steps for reducing stress at home and successfully raising a troubled child. You use the same proven techniques as mental health and other professionals. It starts by taking care of your wellbeing first, then taking an entirely different approach to parenting.
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