My child psychiatry rotation opened my eyes into the daily struggles of children and adolescents in the midwest. My previous post shares some of my experience and insight into mental illness. While I expected to learn more about what crosses a child’s mind, I was never expecting to gain an understanding of how parents view their children and vice versa. Sitting in on psychiatric evaluations of kids and their families gave me a lot of perspective on the disconnect between them. Hearing their hugely different takes on situations gave me some insight on where the discord arises from. I wrote some notes to myself for future reference that I’m hoping will help someone here.
Disclaimer: I have no children of my own and am years away from realistically considering having kids. Please take any advice in that context.
1. Inconsistent parenting often leads to impulsive kids.
Divorce is an incredibly difficult thing for families to go through. Often times they both want the best for their children, but have different styles of parenting. One house may have a certain set of more rules while another may offer children more independence. This creates a sense of disrespect towards rules and authority. There were many kids that I saw that felt as though they did not know how to control their angry, impulsive behavior because it was tolerated at one household. Even in families with parents that had good communication, children often acted out if rewards and punishments were poorly enforced. I noticed that kids that had good impulse control and respect towards others came from households with consistent rules that were enforced in all environments. The key in treating patients with oppositional defiant disorder was providing a structured environment and giving them a chance to prove themselves with some responsibility.
2. Rewards are more powerful motivators than punishments.
As mentioned above, kids think in extremes. So when their punishment lasts any period of time longer than 2-3 days, they feel as though they’re *never* getting rid of their punishment. They lose focus quickly and go back to acting out and repeating the behaviors that got them in trouble in the first place. I’ve noticed that it is much more effective to reward kids for positive actions. It is crucial remind them that their possessions are earned rewards and not necessities. That way when they break a household rule, they feel that they no longer earn their reward of independence or having a cell phone. Keeping them on a short timeline and providing details about how they can earn back their rewards seemed highly effective for most kids.
3. Kids have an “all or nothing” mentality about most things.
I found it amazing how quickly kids could change from hating their moms back to loving them after she returned their phones to them. Kids love using extremes like always, never, love, and hate. I’m not quite sure when they start to understand the spectrum of emotions, but for a vast majority of childhood everyone is simply “good” or “bad”. So when they say they hate you, try not to take it personally. They often don’t realize the gravity of the words they use and think the point of arguments is to be as insulting as possible. They’re just kids and they’ll go back to loving you before you know it. Kids have incredibly large egos and it often takes adults to be the first to show affection and open doors of communication.
4. Electronics give kids unlimited access to the world.
Nowadays kids are influenced by all sorts of things. It is so easy for a kid to ignore everything a parent says and subscribe to one quote that they read online written by a complete stranger. In a world where cell phones and iPods are being given to kids younger and younger, this makes for a dangerous combination. While on child psychiatry, I noticed that a lot of kids had extensive communication with strangers online to whom they confided in. Much of this was without their parent’s knowledge. Between sneaking downstairs when they thought their parents were sleeping and telling their parents their iPods didn’t have texting, kids find a way to get online. My advice to parents is to educate them about the danger of what they find online and to try to keep as close of an eye on their electronic and social media use as possible. I noticed that some parents had their kids turn in all of their electronic devices before bedtime and had conversations with their kids about the websites they were allowed to visit. These families had far less incidents of kids finding things online not intended for their eyes.
5. Peer pressure is a strong motivator.
Depression is an isolating disease, yet many kids find that when depressed they want to relate with their peers that feel the same way. In relating to other kids, they get inspired to self-treat their depression or anxiety.There are many groups on the internet where adolescents take pride in cutting themselves. It is not uncommon to see kids running into another kid who self-harms and being inspired. Similarly, adolescents commonly normalize their thoughts of suicide and harming themselves. They confide in other peers going through similar emotions and don’t turn to adults for help. This creates an environment in which kids don’t realize their depression is getting the best of them and don’t reach out for help.
My biggest advice to parents suspecting that their kids may be depressed: ask them if they’ve thought of harming themselves and if yes, get them to a hospital ASAP.