1. It May Not Look Like Mental Illness I was a teenager who wore black, slept a lot and cried often. I ate too much or too little, couldn’t concentrate on my homework and wasn’t interested in a social life. I had no idea that these symptoms, if they last more than a couple of weeks, can signal serious depression.  I  simply thought this was what being a teenager was like. It wasn’t until I was 26 that I had my first “nervous breakdown” and was diagnosed with chronic depression. I was lucky. If I’d turned to drugs or alcohol as a way to solve my problems, I might have been another teenage drug addict or alcoholic, and never have gotten the help I needed. Even so, I didn’t recognize the symptoms in my son until it was too late. He was already doing drugs every day. He wasn’t diagnosed until he was 33.

2. Look for Mental Illness in the Family
Was there an aunt in your family who had a “nervous breakdown” when you were growing up? A grandparent who never spoke to anyone?  A relative who ‘burned out’ at work? A cousin who had to leave college because the stress was too much? A brother who was in trouble because of drinking or partying? These may pointer to underlying mental health issues. Many mental illnesses run in families. If there’s mental illness in yours, then your child’s drug activities may be an attempt to self-medicate the family disease.

3. Get Informed
When I was dealing with my own depression and then my son’s there wasn’t the vast amount of information around that there is today. I had to look for books in the self-help section of the library or bookstore. I felt ashamed that I needed the books, and sure other people were judging me. These days, there is almost too much information around — so pick your sources carefully. The best information on drug addiction and mental health comes from reputable sites like The Partnership at Drugfree.org and the National Alliance on Mental Illness. Parents’ blogs can be helpful too, mainly because they tell you about other parents’ experiences, and may help you realize that you’re not alone in dealing with this.

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We live in a society of excess, where street drugs are readily available, so it is not surprising that many teens experiment with drugs. However, more is known now about teenagers who are not only experimenting, but who are self-medicating because they have other disorders, such as depression or anxiety. Dealing with a child who has co-occurring disorders is of course even more difficult. If you are reading this blog, this already means your eyes are open and you’re taking steps to be fully informed.

For me the most challenging part of parenting has been that in my family, substance abuse has been intensified by co-occurring mental illness and a family history of genetic vulnerability. So much more is known now about the brain and chemical imbalances than when my husband and I and our children first began to experience the ravages of both in the early 1960s. Truly, we hadn’t a clue.

Months before my wedding, the man I was to marry, the star athlete and class president I had fallen in love with five years earlier in high school, climbed out onto the ledge of my mother’s fifth-floor New York City apartment, and in a state of drunken bravado, threatened to jump.

Off and on over our fourteen years together and the parenting of two children, he continued to go through episodic periods of binge drinking accompanied by wild behavior and threats of suicide. In 1977, when my children were eleven and thirteen, he did kill himself.

All through these episodes, we always thought of it as a problem with alcohol. It was not until his death, and when I finally sought professional help, that I realized that of course he had a mental illness, most likely a bipolar disorder.

And even though I was now much better informed, I still did not fully understand how vulnerable my children were. It was not until they reached their 20s that one of my children became willing to see his problems in terms of co-occurring disorders. The other son never sought help and ended his life at the age of 28.

When mental illness and suicide are part of a family’s history, the whole question of when to hang on and when to let go becomes much more complicated. Drawing the line when someone is in the midst of a psychotic break is more than a tough call.

Though it is important not to rush into labeling a difficult teenager, not to rush into medication as the answer, parents are wise to become informed about symptoms and seek counsel with highly qualified professionals who can keep an eye on what’s going on, especially if there is some family history of depression or manic behavior.

My husband’s father, a man who majored in psychology in college and was the director of a children’s home in a large city for many years — and who himself carefully monitored bouts of acute anxiety — revealed to me after my husband’s death that when he himself was a boy, he would come home from school hoping his mother had not stuck her head in the oven, as she had threatened to do before he and his sister had set out that morning.

I do not want to end on such a bleak note. Though I am reluctant to steal any more secrets from family members, I do want to say that my son has gone through a long period of recovery and is now, day by day, leading a productive, creative life.