Talking to children about a parent's depression as a non-family caregiver.

May 27, 2009 7:54 PM

How do you talk to young children about a parent's depression?

I began providing childcare this week for the five-year-old son of a woman I know through one of my local drop-in centres. She is suffering from severe depression and is unable to care for her son. Dad works long days and isn't entirely equipped to step in as primary caregiver, which is why I am helping out.

I am uncertain how much the boy knows/has been told about his mom's illness. He knows that mommy is sad, he knows that she's been in the hospital. This morning when I was getting him ready for school, he asked why his mom wasn't there to say goodbye (the previous two mornings, she got up to give him a hug and kiss before he left). I explained that she needed to spend a little time with her doctors so they could help her feel better (this is her second hospitalization in a little more than a week). He accepted this and moved on to another subject without any questions, which worries me more than if he asked about it.

I know that the kid is scared and confused about what's happening. His behaviour is changed (he's not acting out, rather, he's on his best behaviour, which is unusual since he generally has a healthy amount of the naughty). Since he's spending the majority of his waking hours with me, I'd like to know how I should talk to him about what's going on. Should I encourage discussion or wait until he brings it up? How much information should I give him? What do I tell him when he asks when his mom will be back?

The facilitator of the drop-in centre is arranging for a school social-worker to help out, but I don't know how long that will take to get in place. In the meantime, I'd like to know what I can do to help the boy understand and adjust to this situation.

(Any advice on how to help support the mother as she goes through this is also appreciated.)

posted by Felicity Rilke to human relations (6 answers total)

Definitely, mommy is sad - in your shoes I'd be most concerned about reiterating the message that she's really not just "sad," which is something that to a kid has a cause and a solution, but she's sick and that's what makes her feel sad, and that it's not the kid's fault. It doesn't surprise me that he's on his best behavior because he might link his actions to her sadness. So I'd also try shifting the focus to him...how does he feel? Give him opportunities to talk about whether he's worried about his mom, or alternatively about other things in his life and how they make him feel. Sometimes when someone in the home is sick and all the attention is on that person, kids tamp themselves down so as not to rock the boat and start to feel invisible and like there isn't any room for them and their emotions.

I'm not a therapist, but used to be a primary grades teacher, FWIW. I'm no expert but those are my immediate thoughts.
posted by Miko at 8:02 PM on May 27, 2009

Depression ≠ sadness.

Depression = illness.

The child's mother is ill, and any discussion of what's going on with mommy ought to be framed in those terms. That way, emotions and behavior --- whether hers or the child's --- aren't the focus at all.

I would not be concerned about the child's accepting your answers matter-of-factly and going off to play. He's just little, and doesn't need to know all the nuanced details of things yet.
posted by headnsouth at 8:17 PM on May 27, 2009

I'm not sure that you should step in as the person to explain this to the kid. I understand that you want to help him to understand it, and you have, by answering his questions. You can be a great person to help him build a place in his life that is safe and comfortable, and you can answer his questions when he has them--as you have been saying, mommy is sick and is with her doctors so that they can help her, etc. But I don't think you need to do anything beyond answering his questions when he has them; it could be too overwhelming for him to fully comprehend if you sit him down and try to tell him about everything, and it may confuse him and make the situation a lot worse, if not handled properly.

Considering his age and developmental level, you are already doing a great job helping him with what he needs right now! I would leave the further detail and work on mom's depression to the social worker.
posted by so_gracefully at 9:09 PM on May 27, 2009

There's some great advice in this thread.

The kid's probably on his best behaviour because he thinks his mom is sad about something he's done. It's a reasonable assumption for a 5-year-old, because pretty much any other time that he sees his mom happy, sad or angry, it's because he's done something cute, embarrassing, or diabolically destructive. Kids that age are naturally self-centred - they haven't yet learnt that the world isn't All About Them.

So make sure he knows that mom is feeling sad because her brain is sick, not because he's done something wrong. Liken it to something he's familiar with: "Hey, do you remember the last time you had a cold? Remember how it made you cough and sneeze and make a lot of snot, even though you didn't mean to? Well, right now mom has a different kind of sickness, one that makes her brain feel a bit funny. She loves you very much and seeing you still makes her very happy, but the kind of sickness she has is making her cry a lot, even though she doesn't mean to. It happens to lots of grownups, but doctors are pretty good at making it go away. Remember how you went to the doctor and she made your cold go away? Well, mom's gone to hospital so the doctors can help her feel better too."

I'd be wary of actually naming his mom's condition without getting her permission first. He needs to know that she's sick, but when she gets well enough to care for him again, she might not want him blurting out "My mommy had DEPRESSION!" to strangers on the bus. Also, make sure he knows that his mom really is going to get better. If he's ever lost a relative, he might believe that being really sick and sleeping a lot means a person is going to die soon.

Finally, try not to give him the impression that what's happening to his mom is something to be ashamed of. Don't whisper to other adults in his presence, or shoo him out of the room while you discuss it. Be discreet but matter of fact about the fact that his mom's unwell. Remember that as the child of someone with depression, he faces a higher-than-average risk of suffering it himself when he's older. By being honest now, you'll be giving him the tools to recognise the condition and to seek treatment if he needs it, without feeling ashamed or embarrassed. Ask anyone who's had depression and they'll say they wish someone had bothered to teach them that lesson at age 5.

Good on you for taking care of this kid. I hope his mom feels better soon.
posted by embrangled at 11:33 PM on May 27, 2009 [6 favorites]

I forwarded this to my wife, who's an early childhood expert/preschool consultant. This is right up her alley. She said:

"I think it's important to frame it as the child's mother is ill. 'Your mom was too sick to say goodbye this morning.' I would avoid offering any more explanation than what's asked for, but if there are further questions, I would tell him that Mom is working with doctors to get better. If further pressed, say that she will get better.

"It's important to make the distinction between 'sad' and 'sick,' because five-year-olds understand 'sad' and see it as very temporary and not debilitating, which doesn't describe depression at all. 'Sad' to a child who's five means something that lasts from a few minutes to perhaps a day. More importantly, children see sadness as a direct result of displeasure with something, which could lead to questioning the cause of her sadness and implicating himself.

"If he comes to focus on 'sad,' I would explain that Mom is sad because she is sick, which gives a simple cause-and-effect that children his age look for and should be enough explanation for him."

Hope that helps!
posted by Mayor Curley at 8:21 AM on May 28, 2009

Most of the things I wanted to say have already been covered. You might also find this website helpful. It says that you should cover three main areas:

1. The parent or family member behaves this way because he or she is sick.
2. Reassure the child that he or she did not make the parent or family member sad and depressed.
3. Reassure the child that the adults in the family and other people, such as doctors, are trying to help the depressed person. Looking after the depressed person is an adult responsibility, and not something the child should worry about.

When I once had to explain to a little child why I am taking antidepressants, I said that there is something wrong with my head and I need to take the meds to fix this like they have to take meds when they have a cold or something else. I think it is important that a child can relate what you say to his/her own world.

About the mother. There is not really anything you can do beyond what you already do.
posted by jfricke at 11:05 AM on May 28, 2009