Explaining depression to children

Depressive Illness: An Information Guide

Explaining mental illness or depression to children can be awkward and difficult. To protect their children, the depressed parent and the well parent (if present) may choose to say nothing and try to continue with family routines as if nothing were wrong. While this may provide a short-term solution, over the long term it can leave children confused and worried about the changes in behaviour that they have inevitably noticed.

Children are sensitive and intuitive, and quickly notice when someone in the family has changed. If the atmosphere in the family suggests that the subject should not be discussed, children will draw their own, often incorrect, conclusions. Young children, especially those of pre-school or school age, often see the world as revolving around themselves. If something negative or difficult happens, they assume they did something to cause it. For example, if a child disobeys a parent and gets into trouble, and the next morning the parent is depressed, the child may assume he or she caused the parent’s depression.

To explain mental illness and depression to children, you provide them with as much information as they are mature enough to understand. Toddlers and preschool children are able to understand simple, short sentences, without much technical information. School-age children can process more information, but may be overwhelmed by details about medications and therapies. Finally, teenagers are generally able to manage most information, and often need to talk about their impressions and feelings. They may have questions about how open they should be about the situation, and concerns about the stigma of mental illness. Sharing information with them provides an opening for further discussion.

It is helpful to cover three main areas:

1. The parent or family member behaves this way because he or she is sick. It is important to tell children that the family member is ill with a sickness called depression. Depression makes people sad, sometimes for no reason. They might cry a lot, sleep all day and have trouble eating or talking to people. Sometimes depression takes a long time to get better, and our efforts to cheer the person up do not work.

2. Reassure the child that he or she did not make the parent or family member sad and depressed. Children need to be reassured that they did not cause their loved one to be sad and unhappy because of something they did or did not do. This is a frequent assumption children will feel guilty about. Depression needs to be explained as an illness, just like having the chicken pox or a bad cold.

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. Children need the non-depressed parent, or other trusted adults, to serve as a buffer against the effects of a parent’s depression. Talking about their feelings with someone who empathizes with how hard it is to see their mother, father or relative suffering is very helpful. Many children are frightened by the changes in their parent. They miss the time previously spent with this parent. Participation in activities outside the home is helpful because it exposes children to other healthy relationships. As the ill parent recovers, gradually resuming family activities can help restore the relationship between the children and the ill parent.

Both the ill and the well parent should talk with the children about explaining the illness to people outside the family. Support from friends is important for everyone; however, depression can be difficult to explain, and some families are concerned about the stigma attached to mental illness. The level of openness you and your children are comfortable with is a very individual choice.

Finally, some parents struggling with depression find that their symptoms of irritability, impatience and disorganization make it difficult to tolerate the boisterous activities and noise that are part of children’s everyday play and routines. It may be necessary to take special measures to protect against events that could trigger irritability in the ill parent and cause him or her to be abrupt or short with your children. You may need to plan time for the children to play outside the home, or arrange for the ill parent to rest for part of the day in a quiet area of the house.

Once recovered, it is helpful for the parent who was ill to explain his or her behaviour to the children. The recovered parent may need to plan some special times with the children, to re-establish the relationship and to reassure the children that he or she is again available and interested in them.

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