What to Do If Your College Kid is Having Psych Symptoms

A college student, now a freshman at a large state university, called my office in distress last week. He’s not sure he can make it through his first year. He was receiving care before he headed off to start his life away from parents. His diagnoses include anxiety and Autism Spectrum Disorder. I think he can be successful in college, even though he needs medication and psychotherapy. He’s bright and responsible, motivated and ambitious. But when kids struggle in college, sometimes it’s hard for families to know whether to bring them home, or encourage them to tough it out.

What would you do?

Your daughter came home during the break, and informed you that she is not doing well in college. In fact, she may not receive any credits for this semester at all. She hasn’t been attending most of her classes. She stays up half the night and then oversleeps in the mornings. She has been trying all semester to get her act together, but she is failing. Does this mean she’s depressed?

Your son came home during the holiday and spent every night out with his friends. He didn’t make curfew a single night. In the mornings, he wreaked of the previous night’s drinking and cigarette smoking. Does this mean he’s destined for the life of an alcoholic?

Your twenty year old has completed three semester of college and has made pretty good grades. She broke down over the holiday break and told you she doesn’t want to go back to college. She wants to drop out. She says she feels completely overwhelmed all of the time, and she doesn’t think she can continue on. She wants to take a leave of absence, or maybe drop out all together.

Your twenty-year-old son says he needs to drop out of college. He says he spends almost all of his time worrying that something terrible is going to happen to you at home. He sees vivid images of car crashes, brutal assaults, and kidnappings. He can’t stop worrying about the family. He says he needs to come home so he can personally observe that you’re okay. Otherwise, he will spend the rest of his time in college feeling preoccupied with his fears.

Which of these students needs to leave school and come home?

Reflect a moment. Are these individuals suffering from mental illnesses? Is it difficult to say with certainty? Where does a parent begin when trying to assess situations like the ones above?

Whether you’re the parent or a trusted advisor, consider how the stage of young adulthood might complicate the picture for any of the young adults described above. Rather than reaching for the withdrawal forms, it’s vital to consider how a college student, away from home for the first time, may plummet functionally from mild mental health or behavioral health symptoms. Many students can benefit from learning simple coping skills like time management or self-soothing. The presence of mental health symptoms does not imply disability, not for most of the people who have them.

Steps for parents with symptomatic college kids:

1.     Start by asking the advice of a professional.

2.     Look for a professional who is NOT a prescriber to offer the first opinion. Prescribers usually prescribe. If you’re uncertain whether medication is necessary, start with someone who can provide guidance, but wont necessarily take a narrow view of the situation.

3.     Keep him or her functional if that’s possible. If school withdrawal in unavoidable, push for another type of functioning as soon as possible- perhaps a part time job or a volunteer role.

4.     Think about the situation in terms of “problem,” not diagnosis. Mental health symptoms are often transient and stress induced. Young adults are in the process of defining their identities. Be cautious about adding “mentally ill” to their identities, unless you’re absolutely certain.

5.     Accept the uncertainty of young adulthood. While you have known your child his or her entre life, s/he has never been in this stage of life before. Many things are changing, including his or her coping skills and emotions.

6.     Resist the urge to compare your young adult to:

a.     An earlier stage of his or her life.

b.     Other young adults. Each young adult forges a unique path.

c.      Fully functional adults who have successfully navigated through young adulthood.

7.     Define your expectations. Do you want her to finish the semester? Should he see a counselor on campus right away?

8.     Expect to understand the symptoms more clearly with time. Don’t panic. Listen and be supportive.


Posted on December 1, 2014 .

14 Creative Ways for Family and Guests to Express Gratitude This Thanksgiving

Give Thanks! 


Thanksgiving is coming, and it’s time to give thanks! Many of us will sit around the dinner table on the holiday and share our “thankfuls.” Gratitude is a wonderful tradition for families and friends to share.

14 creative ways for your family and guests to express gratitude this Thanksgiving:

1.     Ask each Thanksgiving guest to write something they are thankful for on a small card and place it in a box. Draw cards one by one and let guests and family members guess who authored each gratitude.

2.     Invite family members and guests to share something for which they are thankful as they take their seats at the table one at a time.

3.     Have each person describe what s/he is thankful for during the meal. Start with the youngest person in attendance and work your way to the oldest.

4.     Ask the group to vote on one thing the entire group is most grateful for as a whole. Take suggestions, then pick a winner by show of hands.

5.     Have everyone guess what each member might be most grateful for. Then ask every person to share their biggest gratitude and see how the guesses match up!

6.     Before or after the meal, have every person draw a picture that represents what s/he is most grateful for. Display the pictures for everyone to view and discuss.

7.     Ask each person to say what s/he is most grateful for in exchange for a serving of turkey.

8.     Invite guests to think back and share what they were most grateful for during Thanksgiving dinners past. See how times change (or don’t change).

9.     Ask each family member or guest to say something they are grateful for about the guest sitting immediately to their right. Go around the table until everyone has had a turn.

10. Ask each interested guest to write a story about what it means to feel gratitude. Assign judges to read the stories and award a prize for the best one.

11. Have family members and guests act out their gratitudes in a game of charades.

12. Have each person list everything under the sun s/he can find to be grateful for. See how the lists compare and which list is most impressive.

13. Invite each person to choose a song that best embodies their gratitude. Play each song for the group.

14. Ask guests to list their gratitudes in advance. Seat guests who share similar gratitudes together and encourage them to discuss.

How ever you choose to express your gratitude this holiday, join in and be grateful. It’s a wonderful way to spend time together and remind yourselves why you go to all the trouble to gather together and share the Thanksgiving festivities.


Posted on November 24, 2014 .

Think You're Ready for Kids to Come Home for the Holidays?


Your kids are coming home for the holidays. Do you really know what to expect?

Sure, you raised your kid until adulthood. So you think you know what to expect when s/he heads home for the holidays this year, right? You’re a family. You know one another intimately. You’re aware of each other’s habits and living style.

But if your child has been living away from home, you may be in for a big surprise. Kids change rapidly when they live away from parents. Habits and expectations change.

With the holidays coming and your adult child heading home, are you prepared?

Do you expect it to be like it was when your child lived at home full time?
    When your child lived at home, you probably had a comfortable rhythm with one another. Your daily routines involved checking in, or maybe planning dinner together. But since your child moved out, he has begun to arrange his time around his individual needs, not those of a family. He may not be thinking about the family’s routines. He may expect to sleep in, go grab dinner alone in a restaurant, or order a pizza. How has he been handling things while he lived away? He might want to do his own thing.

Do you think s/he will want to spend some time with old friends? How much time? 
    When adult children come home for the holidays, parents are often looking forward to spending lots of time with them. During the days home, you may imagine that you and your adult daughter will sit and talk for hours, prepare meals together, or maybe even sort through the old boxes in her closet. But have you considered that she may be planning to spend much of her time with her friends? Many young adult children come home excited to see family and friends alike. Holiday trips home can span from a couple of days to a couple of weeks. If your adult child had friends to visit, those plans can cut into your family plans heavily. Its important to communicate about how much time you or child plans to spend with the family and how much she wants to go off with friends.

Have you thought about curfew during the visit? Has your adult child?
    When your kid lived at home, he probably had a curfew. But when he transitioned away from your home and out on his own, he probably started staying out as long as he liked. During the holiday stay, are you imagining he will come home by midnight like he used to, or do you think he might plan to stay out later? If you’re uncertain, its probably best to have a discussion about what time you want to lock your doors for the night.

Do plan to serve alcohol with your holiday dinner?
    Many families include alcohol as part of the family meal during the holidays. If your child is an adult, she may be accustomed to enjoying a beer or a glass of wine with her friends. She may even decide to bring a bottle of wine to the table herself. Have you considered whether you are comfortable serving her alcohol during the holidays? If you are not, or if you want to ask her to limit her intake of alcohol in some way, it might be an important talk to have before she sits down at the table and pours herself a drink.

Posted on November 17, 2014 .

Do’s and Don’ts of Empowering Emerging Adult Children

We all want our kids to ultimately take over the running of their daily lives. We want them to soar out on their own and thrive as adults whom we trust and respect. We hope they evolve into responsible adults, capable of solving their own life problems without constant parental supervision. But all too often, parents are inadvertently undermining the confidence and opportunity to gain experience that lead to autonomy in adult children. Parents “helicopter.” Parents control. Parents criticize and thus dishearten teens and young adults instead of encourage and empower them.

When parents undermine, it occurs accidentally, born out of attempts to teach, guide, and support. But what’s the difference between useful guidance and clipping your young adult’s wings? Consider the following Do’s and Don’ts for empowering your young adult to soar independently. 

Don’t: Say, “You’re doing it wrong.”
Parents often want to share their experience with budding young adult children. You may watch and observe your child making obvious mistakes, However, saying, “You’re doing it wrong,” is likely to crush your adult child’s confidence and stop her dead in her tracks. Or worse, if you hurt her feelings, she might shut you out and refuse to listen to your advice in the future.
Do: Say, “Can I tell you what has worked for me?”
Instead of pointing out that your adult daughter is “wrong,” try telling her about your experiences. Say, “Can I tell you what I have experienced and what I learned?” Explain what your situation was, how you made mistakes (or succeeded) and then why her current situation made you decide to share the personal history. And then step back and allow her to make decisions on her own.

Don’t: Criticize
You might feel tempted to offer your emerging adult child feedback, but tread lightly. Giving your opinion is only helpful when the listener is open to hearing it. Because you’re the parent, your opinions carry an emotional heft that is likely absent when the feedback comes from a third party. As the parent, your comments have a higher likelihood of resulting in hurt feelings and thus proving counterproductive. Maybe you’re just not the right person to offer a critique.
Do: Praise and give constructive feedback
Instead of pointing out your criticisms, try focusing on praise. Tell your emerging adult what he does well. Doing so helps encourage him to do more of his best. If you can’t keep quiet when you see an area in need of improvement, take care to give your criticism the kindest, most constructive fashion. Your emerging adult wants your approval. So make sure your admiration and affection show. 

Don’t: Offer unsolicited advice
Your emerging adult needs mentors and parents, but those roles are often divided into multiple relationships. Because you are Mom or Dad, you may not also be the best person to provide sage advice. Why? Your child knows you have a vested interest in the outcome, so you’re not objective. 
Do: Ask permission to share your opinion
When it’s time to give advice, shift into advisor and student roles by explicitly requesting permission. Doing so will increase the likelihood your adult child will listen to the wisdom you offer with an open mind rather than dismiss you as a biased family member with an emotional agenda.

Don’t: Take over
Sometimes emerging adults children seek out the help of their parents. When they come to you, make sure you help in just the right way. You probably spent years running your adult child’s life. Remember, now it’s his turn. Let him drive. Taking the wheel and controlling the situation robs your adult child of the opportunity to learn and practice under your wise tutelage. 
Do: Support and offer to share your experienced opinion and guidance
If you’re fortunate enough to function as an advisor to your adult child, be a teacher instead of a controlling boss. Instead of usurping power, give the power to your budding adult. Let him steer and position yourself squarely in the passenger seat. Remember, you know how to run your life. Let him learn how to run his.

Don’t: Threaten punishments if your emerging adult child refuses to cooperate.
Teaching your kids through the use of punishments should be a thing of the past by the time you reach the young adult years. Your young adult child must function in the world of adults day to day. She has to accept the natural consequences as her teachers, not worry about whether Mom and Dad will ground her when she gets home.
Do: Explain the rules and how you can (or cannot) support his or her choices.
Instead of punishments, parents of adult children help best when they make offers of support that come with clear expectations and rules. Say, “I can give you a loan for $700, but I expect to be paid back in 6 months. If that’s not enough money to meet your need, I can’t give you any more.” Making rules and allowing your adult child to operate within the rules or deal with the consequences of non-compliance will make things work more like the real world and prepare them to succeed..

Dr. Deuter is a psychiatrist who specializes in the care of emerging adults.

Posted on November 10, 2014 .