Talking With Kids & Teens About PMDD
For many, one of the most difficult symptoms of PMDD/PME is mood lability, which refers to frequent or intense mood changes or shifts. Those closest to us - our partners, children, close friends, etc - often suffer alongside us as we all ride the waves of PMDD together.
Mood lability is more than the occasional emotional ups-and-downs of life that everyone experiences. It is characterized by very strong mood changes that are outside of the normal range of 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 can be difficult for children and other family members to grasp that the person 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/PME is, on an age appropriate level that can be easily understood and is non-threatening. (It’s also important that we use language that is self-empowering rather than self-deprecating when describing our experience of PMDD/PME to loved ones). Family members need to be reassured that you are, and will be, okay. They must also learn to respect your need to engage in ongoing mental health and/or medical treatment, to practice self care, and time for rest and healing just as if you had the flu or a really bad stomach bug.
Kids are naturally curious and have questions about what their parents are experiencing. Understanding mental health conditions can be challenging for adults as well as for children. During the past 50 years, great advances have been made in the areas of diagnosis and treatment of mental health conditions. Parents can help their children understand that illnesses such as PMDD and PME are real and treatment is available.
In order for parents to talk with a child about a mental health issue, 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 suffer from mental health conditions?
What causes them?
How are diagnoses made?
And the types of treatments that are available
Some parents may have to do a little homework to be better informed before speaking about the topic with their children.
When explaining to a child about how a mental illness affects a person, it can 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 health issue that requires treatment.
Parents need to be aware of their child’s needs, concerns, knowledge, and experience with mental health conditions. When engaging children in conversations on this topic, it is important that parents:
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
Engage in the conversation when the parent is feeling well enough to focus on the child’s needs and stay present
Communicate in ways that are empowering and compassionate towards the individual living with PMDD/PME. For example, when explaining to your child that you have PMDD, make note of your strengths while acknowledging the challenges that come with PMDD. This, importantly, shows kindness to ourselves, but also breaks down stigma and fosters empowerment and ease in our children regarding mental health issues. Someday they may need to reach out for support for their own challenges, and we want to model that while some people live with mental health conditions, that does not mean that they are less good or worthy than someone without a condition like PMDD, anxiety, or depression.
Preschool Age Children
Young children need less information and fewer details when talking about mental health issues. Preschool children focus primarily on things that they can see. For example, they may have questions about a person who has an unusual physical appearance or is behaving differently than normal. They would also be very aware of people who are crying and obviously sad, or yelling and angry.
It can be helpful to say something like, “Mommy is crying and feeling sad right now. Sometimes you feel sad and sometimes I feel sad and that’s okay. Mommy just needs a little time to rest and cry.” Or, “I kinda shut that door loudly. It’s because I’m feeling a little angry, but not because of anything you did. Sometimes we feel angry, and that’s okay. I just need a minute to take care of myself.”
Older children may want more specifics and may ask more questions. Their concerns and questions are usually very straightforward, such as:
Why are you crying?
Are you mad at me?
Why have you been sleeping so much?
Are you okay?
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 been given misinformation about mental health conditions. Teenagers respond more positively to an open dialogue that includes give and take. They are not as open or responsive when a conversation feels one-sided or like a lecture.
It can be helpful to ask your teen open-ended questions such as, “I know I haven’t seemed like myself lately, how has that been for you?” Or “I get that all of this can feel confusing, what questions do you have about PMDD/PME? I’ll answer as best I can.”
Talking to children about mental health conditions can be an opportunity for parents to provide their children with information, support, and guidance. Making sure that children and adolescents have good information about mental health conditions can lead to improved recognition, earlier treatment, greater understanding, compassion, and decreased stigma.