Davids Lupus Awareness Blog

It is not uncommon for parents to wonder whether their child is acting like a normal teenager or behaving differently due to mental illness, drug use or behavioural difficulties. Normal teenagers are often moody due to hormonal and physical changes that happen during puberty. However, when mental illness is involved, it may be difficult to differentiate “normal teenage behaviour” from the symptoms of depression, anxiety and other emotional difficulties.

Teenagers may be short-tempered and get angry easily, especially when they begin to naturally separate from the family and feel they do not have enough distance or privacy. The natural process of separation begins in early adolescence; this is when parents see that their child begins to be embarrassed by them and spends increasing amounts of time with friends and very little time with the family. You may be worried that your teenager spends hours on end on the computer or locked in his or her room chatting on the phone and gets defensive when asked what he or she is doing or who he or she is talking to. This type of behaviour is normal. Teenagers need to naturally separate in order to gain their independence in early adulthood and often react defensively in order to attain this goal. During this time, you should be able to see that even though your teenager may cringe at spending quality time with the family, he or she is still able to enjoy time with friends and engage in healthy social and extracurricular activities outside of the home. If you see that your teen is not engaging in other activities or with friends and is chronically disconnected, angry and sad, this is when the behaviour becomes abnormal and requires intervention. Les

Along with the teenage years comes drama. This is a phase of new experiences, and what may seem like a small affair to an adult may be a big deal for a teenager experiencing it for the first time. Teens may be distraught when they are having difficulty with girlfriends/boyfriends or when fighting with a friend, when they do not do well on a test or even for not having the right thing to wear to school one day. Teenagers are often oversensitive and self-conscious and have not developed adequate coping tools to appropriately deal with events such as these. Therefore you may notice that your teenager experiences episodes of sadness, anxiety, frustration and feelings of being overwhelmed. These episodes should not last more than a few days at most; if these feelings are continual and your teen is chronically anxious or sad, then you should speak to him or her about your concerns and consult your family doctor to see if there may be a more serious problem than normal teenage angst.
It can be difficult to tell the difference between symptoms of mental illness and normal problems that all teenagers experience from time to time. If you begin to worry that your teenager may be suffering in silence or acting in a way that is concerning, but not enough to call the doctor, you may want to talk to other parents or organizations to compare your teen’s behaviour to those of his or her peers.
Often as adults we compare our teen’s behaviour to that of our own at that age. This can be anxiety provoking for many parents due to the changes in today’s social norms. Teens these days are engaging in sex, drugs and alcohol at a much earlier age. Parents often panic when they find out that their 15-year-old is already having sex or has started drinking socially. If all of your teen’s friends, classmates and colleagues are engaging in this behaviour then you have a good sense that although you do not approve or support it, this behaviour is “normal” and there is less of a possibility that mental illness is present. If you find that your son or daughter is out of the norm, then you may have reason for concern and should contact your family doctor. Here are some things that you may observe in your teen that will help to decipher the difference between mental illness and normal teenage behaviour.

Some concerning behaviours
• Decrease in enjoyment and time spent with friends and family
• Significant decrease in school performance
• Strong resistance to attending school or absenteeism
• Problems with memory, attention or concentration
• Big changes in energy levels, eating or sleeping patterns
• Physical symptoms (stomach aches, headaches, backaches)
• Feelings of hopelessness, sadness, anxiety, crying often
• Frequent aggression, disobedience or lashing out verbally
• Excessive neglect of personal appearance or hygiene
• Substance abuse
• Dangerous or illegal thrill-seeking behaviour
• Is overly suspicious of others
• Sees or hears things that others do not

*It’s important to remember that no one sign means that there is a problem. It’s important to examine the: nature, intensity, severity and duration of a problem.
Know who your teenager is
Although your child is growing up and changing rapidly, as his or her parent you are in the best position to know who your child is. You have raised your child with values, beliefs and a set of guidelines to work from; you know when your child is acting out of character and when he or she is having difficulty. Trust your instincts and don’t be afraid to act on them. Even though your teenager may give you attitude when you ask him or her what’s wrong, asking on occasion lets him or her know that you care and that if he or she wants to talk, you are open to it.
Pride and denial can often get in our way of accepting that there is a problem with our child. As parents we have dreams and hopes for our children and we begin to see them come together in the teenage years as the adult personality emerges. Often teens who are intelligent, talented and creative become ill just as they are becoming mature enough to use these skills in a productive way. This can be earth-shattering for parents and makes it very easy to deny that a problem exists. Ignoring the problem does not make it go away and can contrarily make the problem worse. As with any illness, not getting the appropriate treatment prolongs the symptoms, which will likely get worse with time. Being open, honest and non-judgmental with your teenager about his or her difficulties will help you to be more in tune with his or her needs and facilitate a trusting relationship between the two of you.
Talking to your teen about your concerns
If you have major concerns about your teen’s behaviour and moods, it is very important to have a conversation with him or her about it. Try to identify specific concerns, i.e., “I’ve noticed that you haven’t really been going out much lately and you don’t answer the phone when your friends call.” Or “I can’t help but notice that you haven’t been eating much at dinner and your stomach aches have been getting worse.” Your teen will most likely not want to talk about it, but give him or her enough space and time to respond. Let him or her know that you are there to help and that you can work out the difficulties together. Seek help from a family doctor or local CLSC, who can evaluate your child and offer the appropriate services.
It is never easy to start a conversation with someone about mental illness, but the following tips offer a way to lessen tension during the discussion.
• Speak in a calm voice.
• Say what you mean and be prepared to listen.
• Try not to interrupt the other person.
• Avoid sarcasm, whining, threats and yelling.
• Don’t make personal attacks or be demeaning.
• Don’t assume your answer is the only answer.
• Try not to use words such as “always” or “never.”
• Deal with the now, not the past.
• Don’t try to get the last word.
• If things get too heated, take a break and come back to the discussion later.
• Make allowances for the other person.
• Parents: Remember what it was like to be a teen.
• Teen: Remember that parents frequently react strongly because they know the stakes are high.
• Acknowledge that you are in this together.
The teenage years can be the most difficult for a parent. During this time, there are many changes that make it difficult to know how and when to intervene with your teen. It may even be difficult to identify when there is a problem and when your teen is just being a teen. Listen to your instincts and get involved. Ask questions and take action if you feel that your teen is not doing well. Early intervention is the key to success; prolonging the problem may lead to more difficulties.

Major mental illnesses such as schizophrenia or bipolar disorder rarely appear “out of the blue.” Most often family, friends, teachers or individuals themselves begin to recognize small changes or a feeling that “something is not quite right” about their thinking, feelings or behavior before one of these illnesses appears in its full-blown form.

Learning about developing symptoms, or early warning signs, and taking action can help. Early intervention can help reduce the severity of an illness. It may even be possible to delay or prevent a major mental illness altogether.

If several of the following are occurring, it may useful to follow up with a mental health professional.

One or two of these symptoms alone can’t predict a mental illness. But if a person is experiencing several at one time and the symptoms are causing serious problems in the ability to study, work or relate to others, he/she should be seen by a mental health professional. People with suicidal thoughts or intent, or thoughts of harming others, need immediate attention.

As well as the health impact, using any type of recreational drug – be it nicotine, alcohol or a street drug – will be a problem if it changes the way you act (less motivated, irritable, anxious, aggressive), the way you live your life (not getting on with people, not having enough money, finding it hard to keep living in the same house, getting in trouble with the law) or even the way you look (losing or gaining weight, for example).

It can be hard to tell which problem came first – the drugs or the mental illness.

Having a mental illness can make a person more likely to abuse drugs, to make their symptoms feel better in the short-term. Other people have drug problems that may trigger the first symptoms of mental illness. Some drugs cause a condition called drug-induced Psychosis, which usually passes after a few days. However, if someone has a predisposition to a psychotic illness such as Schizophrenia, these drugs may trigger the first episode in what can be a lifelong mental illness. Using drugs can also make the symptoms of mental illnesses worse and make treatment less effective.

Anyone who has, or is vulnerable to, mental illness is therefore strongly discouraged from using drugs.

People with a mental illness experience drug problems at far higher rates than the general community. Studies suggest that around 50% also have a drug or alcohol problem. It is important, then, that both conditions are correctly diagnosed and receive the appropriate treatment.

There are a number of ways that you can go about getting help for your drug problem.

These include:

Research shows that people who have some kind of supportive relationship generally find it easier to tackle their drug problem. Having someone around to encourage you is important because there is someone to talk to if times get tough, and to help you learn new ways of dealing with old problems, see ‘Guide to Drugs’ for further information.

Mental illness is a serious concern. According to recent statistics, about 1 out of 5 American adults suffer from mental illness in a given year. The numbers are similar in Canada, with 20% of Canadians developing a mental illness in their lifetime. More concerning still, all Canadians will be indirectly affected by mental illness at some point in their lives, whether through contact with a friend, family member, or coworker. With these odds, you’ll likely find yourself dating someone with a mental illness at one point or another. Maybe you’re dating someone with mental illness now, or maybe you’ve dated someone with mental illness in the past. Either way, you probably have questions that you’d like answered.

It isn’t easy navigating the waters of mental illness. You have to be vigilant at all times, careful not to trigger a relapse or a fit of illness. Mental illness will try your patience at times. There’s a good chance that it’ll negatively impact your own well-being. Before you know it, you’ll be seeking therapy for yourself. Movies and TV shows can glamourize relationships with the mentally ill, but in reality, there’s nothing glamorous about them. Many people in relationships with a sufferer of mental illness would choose differently if they had known what they were signing up for. So if you’re thinking about dating someone with mental illness, here are a few things that you should know.

Mental illness isn’t a “one size fits all” kind of deal. Variation exists between mental illnesses and between people with the same mental illness. Symptom presentations differ, and so does degree of impairment. Some mental illnesses are acute; others chronic. Some mental illnesses are heritable; others are more influenced by environmental factors. Some mental illnesses are highly treatable; others aren’t. You’ll have to get to know the person with mental illness first before you can get a clear picture of what life would be like as their romantic partner. He or she might end up being the perfect date, or he or she might turn out to be your worst nightmare.

If you’re going to date someone with mental illness, then you should probably know what the chances are of that mental illness being passed on to your kids. Some mental illnesses have a high likelihood of being inherited by children. Bipolar Disorder, for example, is 90% heritable, which means that developing Bipolar Disorder has a lot to do with genetic factors. Other mental illnesses have a low chance of being passed on, like PTSD. Personality disorders are somewhere in the middle with 50% heritability. This means that having children with someone who has a personality disorder may or may not lead to your children developing a personality disorder of their own.

Warning: dating someone with mental illness might turn your life into an episode of 13 Reasons Why. Several mental illnesses list suicidal ideation as a symptom. If your romantic partner is contemplating suicide, then Major Depressive Disorder is the most likely culprit. There’s a high chance that a person suffering from MDD will attempt to commit suicide. Then there’s Borderline Personality Disorder. People with BPD use threats of suicide to keep romantic partners from abandoning them. They’ll occasionally attempt suicide, carefully planning out their attempt so that someone catches them in the act just in time to save them. As you might have guessed, their suicide attempts are sometimes accidentally successful. People suffering from PTSD are also at increased risk of committing suicide.

If you’re going to date someone with a personality disorder, then you should know that personality disorders don’t just go away. They’re present from childhood to old age. For as long as you have a personality, you have a personality disorder. They’re notorious for being one of the most difficult classes of disorder to treat. People with personality disorders don’t realize that they have a disorder, meaning that they don’t seek treatment. Even if they do end up in therapy, it won’t be successful as long as the person doesn’t recognize that he or she has a problem. I speak from experience when I say that personality disorders aren’t worth the hassle. In the end, you’ll suffer more than the person with the actual disorder.

Many mental illnesses require medication to be treated successfully. Bipolar Disorder is a prime example. Look at Charlie Sheen. He says he’s “bi-winning,” but his erratic behaviour stems from Bipolar Disorder untreated. People with Bipolar Disorder feel better on medication such as lithium, persuading them that they no longer need to take it. As soon as they stop, however, they risk triggering another manic episode. You can’t let your romantic partner go off of their medication without a medical consultation first. You’ll need to become aware of your romantic partner’s medication regimen and encourage him or her to follow it. Other mental illnesses that may require medication include OCD, Schizophrenia, and ADHD.

Dating someone with mental illness will keep you up at night, and not in a good way. Sleep disturbance is a symptom common to many mental illnesses. If you’re sleeping next to someone with this symptom, then your sleep will be disturbed too. People with Bipolar Disorder who are having a manic episode often get up in the middle of the night to carry out a spontaneous plan. Some people with Major Depressive Disorder have trouble sleeping. People with PTSD experience traumatic nightmares that have them waking up screaming. We all need sleep. Think about that when deciding to swipe right on a mentally ill person’s Tinder profile.

People don’t always realize how much mental illness impacts loved ones. Family members and friends of people with personality disorders have a particularly difficult time, given the chronic nature of the disorder. To illustrate, allow me to tell you a story about a family member with a personality disorder. Let’s call the person with the personality disorder Alice. Alice’s family tries to warn several of Alice’s boyfriends about Alice’s disordered behaviour. Alice’s boyfriends, not believing her family, tell Alice what’s being said about her. Alice threatens several family members and spreads vicious lies about them in their community. Still think it’s worth it to add a personality disorder to your family?

You can’t argue with a mentally ill person like you would with a mentally healthy person. People suffering from mental illness aren’t always in a position to respond to rational argument. It’s futile to try. Take Schizophrenia, for example. A person with Schizophrenia won’t be able to listen to reason in the middle of a terrifying hallucination. The demon standing behind the sofa is there, no matter how many times you tell that person otherwise. The hallucination is real to that person, and until he or she takes medication to stop the hallucinations, you won’t be able to persuade him or her that he or she is imagining things.

No, it won’t pass. Mental illness isn’t something that a person just gets over. It’s not just going to go away. It requires treatment of some kind, whether pharmacological or behavioural. If you’re going to date someone with mental illness, then you have to understand that it’s a lifelong struggle. Are you ready to make that commitment? If not, then extricate yourself from the situation before you get in too deep. You’ll only hurt the person with mental illness more if you pretend that you can cope with their illness when you can’t. There’s no shame in walking away. Just do it before you cause the person with mental illness further damage.

Dating someone with mental illness might convince you that there’s something wrong with you. I’m here to tell you that that’s probably not the case. Mental illness is often synonymous with relationship dysfunction. You will experience problems with communication and trust in your relationship no matter what you do. While your behaviour may exacerbate the problems, chances are you didn’t create them in the first place. Some people with a substance use problem try to persuade their romantic partners that they drove them to abuse substances. Understand this: nobody causes another person to become an addict. Using substances is a choice; you can’t make it for them. The same goes for suicide, and many other behaviours characterizing mental illness.

Novels like Fifty Shades of Grey have fed into the false assumption that sexual preferences such as BDSM are normative and desirable. In reality, Sexual Masochism and Sexual Sadism are paraphilic disorders. Don’t allow yourself to be convinced otherwise. You’re completely in the right to find these sexual acts disturbing. Would society fawn over a romantic hero who had a thing for Voyeurism? Oh wait, they have: Edward Cullen from the Twilight series. Society certainly doesn’t condone Pedophilia, which shares common traits with BDSM, in that it’s a paraphilia. Think about that for a minute.

Mental illness often leads to occupational impairment. It’s an unfortunate consequence of many disorders. People suffering from mental illness miss a lot of work days. People with anxiety disorders might feel too anxious to go to work. People with Major Depressive Disorder struggle to feel motivated enough to get out of bed. People with OCD might show up late to work because they had to perform lengthy rituals before leaving the house. People with certain personality disorders, like Histrionic Personality Disorder, cause drama in the workplace, causing them to be fired. If you date someone with mental illness, then you have to be prepared to be the primary breadwinner in the relationship.

When it comes to mental illness, social problems come with the territory. Impairment in social functioning is actually a required condition in order to be diagnosed with a mental illness. Some disorders, like Autism Spectrum Disorder, come with a social skills deficit. Social gatherings might be made awkward by including a person suffering from one of these disorders. Other disorders, like Borderline Personality Disorder, create problems in your social circle through lies, threats, and inappropriate sexual behaviour. Not everyone is understanding when it comes to mental illness, and some mentally ill behaviours are very difficult to understand. You need to have a thick skin to date someone with mental illness.

If you’re going to date someone with mental illness, then you’ll need insurance. Therapy isn’t cheap, especially if you’re seeing a private psychologist. You’ll have to ask yourself as you consider dating someone with mental illness: can you afford it? Assume that your romantic partner needs regular therapy for life. Can you afford it? Assume that you might need couples therapy to deal with your romantic partner’s mental illness. Can you afford it? Therapy is often necessary in successfully treating mental illness, and no, there are no coupons. Unless you’re a trained psychologist, don’t try therapy at home.

Ah, stress; the silent killer. Its effects are insidious, leading to your demise before you can even detect them. Stress can kill us in a number of ways by wreaking havoc on a number of physiological systems. Dating someone with mental illness means inviting a constant stressor into your life. Are you prepared for that? Is your body prepared for that? Is your mind? Mental illness introduces you to social problems, relationship problems, and professional problems that you never even knew existed. It takes a gladiator to make it through exposure to mental illness unscathed. My advice to you: don your armour, or get out of the arena.