Should I Talk with My Teens About My Own Mental Health Challenges?

The Ask Lisa Podcast does not constitute medical advice and is not a substitute for professional mental health advice, diagnosis or treatment. If you have concerns about your child’s well-being, consult a physician or mental health professional.

The following transcript has been automatically generated by an AI system and should be used for informational purposes only. We cannot guarantee the accuracy, completeness, or timeliness of the information provided.

Reena Ninan:

Episode 193. Should I Talk With My Teens About My Own Mental Health Challenges?

So how are you doing?

Dr. Lisa Damour:

Oh. How about you?

Reena Ninan:

I feel like I’m on this hamster wheel. I never get off, but I keep telling myself, oh, it’s just five more minutes and you’re going to get a nice long break. And that break never comes.

Dr. Lisa Damour:

No, it really the to-do list never ends, Reena. And I don’t know how, I have not figured this out yet. I keep thinking that somewhere, somewhere there is an end to the to-do list and I really am trying to be like I step in and out of it. I’m just not in it all the time, but I kind of feel like I’m in it all the time anyway.

Reena Ninan:

I wonder what studies say about this. We always think that we’re going to be done and we’re not done.

Dr. Lisa Damour:

Well, actually, it’s funny you should mention that because there actually is one of my favorite research studies shows…

Reena Ninan:

Of course you have a study on this.

Dr. Lisa Damour:

…I have a favorite, of course, a favorite. I live for these. We have a study that shows that if you ask people about how busy they are now and how busy they’ll be in the future, they reliably say, oh, I’m very, very busy now, but I won’t be busy in six months. They think somehow out there is leisure.

Reena Ninan:

And we have to believe that or we’re going to self combust.

Dr. Lisa Damour:

Well, it’s true, but this is also how we do ourselves in because we agree to things in the future because we think, well, I’m busy now, but I won’t be busy then. So yes, let’s put it on the calendar. And that’s how we end up with these over full calendars is this distorted belief that the future is somehow full of leisure and extra time.

Reena Ninan:

We’ve got to learn to say no. That’s a hard thing. That’s a very hard thing.

I love this letter that came into our inbox about a parent who’s dealing with their own history of mental health challenges. I want to get right to it.

Dear Dr. Lisa, I’m a mom of three teenagers as most parents with children of this age. My husband and I are having lots of conversations about mental health. I come from a family with mental health issues including alcoholism, depression, anxiety and eating disorders. I myself had anorexia during college. I’ve not shared this part of my story with my children and I think it is important that I do. So they understand their family history and how important it is for them to build healthy skills. I’m not sure how to start this conversation and how much to share with them at this point in their adolescence. What do you think is the best way to talk to my children about my past? Thank you.

Do you think a lot of families are dealing with this?

Dr. Lisa Damour:

I think more families are dealing with this than not. I would say that it’s probably the rule, not the exception that families have things in their past, either the parents of their own past or even family history that they are trying to figure out how and when to bring up with their kids. I think about in my clinical practice how not rare it has been that I will sit with families who maybe I’m caring for their teenager and they will say, oh, by the way, also her grandfather who died before she was born actually died by suicide. We’ve never mentioned it, our kid is kind of depressed. Should we tell her, do we bring this up, do we not? I would say this is having things that families are trying to figure out how and when to bring up with their teenager is more the rule than the exception.

Reena Ninan:

But I worry if I bring it up that they’re going to think, okay, I’m going to have suicidal thoughts. I’m going to be this person. So as a parent, I don’t want to mention it or bring it up.

Dr. Lisa Damour:

I think that’s exactly right. I mean, we all feel so loving and worried about our kids that you don’t want to do anything that’s going to rock the boat. And so this letter writer, and I think lots of parents sit in this tension of it feels like this is important information for my kid to have, but what’s going to be the impact of sharing this information and is it going to have unintended consequences?

Reena Ninan:

I want to pick up where she talks about, I think what really stood out of the issue she talked about was the eating disorder, right? This is your expertise. I mean, what do you think the mom should do in regard to knowing that she had a history of an eating disorder?

Dr. Lisa Damour:

So I think this helps us kind of start to tease apart some principles that can be useful as families are thinking about if and when they’re going to say something to their teenager. And I would say as a generic rule, you should have this, whatever the issue is, it’s probably best if it’s pretty well metabolized on your end.

One thing that would be really, really helpful in these conversations is if any parent who is suffering with something or has suffered with something, so this parent with an eating disorder really feels like it’s behind them, really feels like it’s something that they have worked their way through. They understand in retrospect what occurred. They can offer insight into it. I would want that would be the ideal condition.

Reena Ninan:

And if they’re not, Lisa?

Dr. Lisa Damour:

Well exactly. I mean of course we have parents who of course suffer while parenting. So let’s come back to that. I think that’s a really important question. What if a parent is actually working their way through depression? How do we talk with kids about it? But for something that’s in the past minimally, I would want it to be something that the parent feels like they’ve got their hands around and it doesn’t feel uncontrolled to them when it comes up. 

I think another principle that we really want to bring to bear here is how we bring up delicate conversations about anything with teenagers. Even if you have no drug history in your family, you’re going to need to have a conversation with your teenager about fentanyl, right? I mean, so this is a constant challenge in parenting teenagers is that we have important and delicate things we need to say, and it’s not always easy to get those across to teenagers.

One way to think about this is to remember teenagers have a lot going on. Their minds are very busy. They’re thinking about 40 different things. We may be aware of two of them, but there’s 38 more happening. And so when we just suddenly bring up something big and important out of the blue, it tends not to go that well because they didn’t see it coming. They weren’t really ready. They don’t know why we’re talking about this. So I think that part of what we want to look for here are openings. So I think especially with teenagers, you’re going to get these openings. They’re going to talk about the classmate who is losing weight rapidly. They’re going to talk about the classmate who’s getting into way too much booze. So your chances of having a successful conversation go way up. If you’re actually stepping into a conversational line, the teenager has already started as opposed to being like, “Hey, I’ve got a big thing. Sit down, let’s have this conversation.”

So I would wait. I think I would wait until, and it’s very high guarantee at some point the teenager is going to bring up something in the vein of what the parent wants to talk about. And then I think the parent can say something like, actually, I have more experience with eating disorders than I wish I did. I actually had one in college. Do you want to hear a little bit more? I think giving teenagers a little control about how much they hear or how much they hear all at once is probably a third thing I would strongly recommend.

Reena Ninan:

But do you think it could be a little bit jarring if this comes up casually in conversation like, whoa, whoa, whoa, what? You had an eating disorder and there were maybe no signs or maybe suffering from alcoholism. Maybe there are no signs.

Dr. Lisa Damour:

I think it can be very jarring. There are parents who are sober and their kids may be very aware of it because the parent doesn’t drink. So it may have come up more naturally than something like an eating disorder will. But I really do think Reena, there’s value when you have to share some pretty heavy stuff about your own history. I think that part of how we signal to teenagers that we have it in hand is to say, I have more experience with this than I wish I did. How much do you want to hear? There are things I want to tell you, but you let me know how much you want to hear right now. I think that that makes it far more bearable. But I’ll tell you, Reena, you are right. Teenagers want us to be boring. Kids need us to be boring. I think that in many ways it’s ideal for them if we can give them a pretty not a lot going on over here, just available to support you as needed. And so when we bring up truths about the fact that we’re whole and real people with long complicated histories, sometimes we have to account for the fact that that’s not exactly what they are always counting on or wanting.

Reena Ninan:

Lisa, you were saying a little bit about this will come up organically in a way that you can enter the conversation and discuss it, but what about, I want to go back to eating disorders. I don’t know. That just stood out to me in the letter. We talk about it a lot. You have flagged so many times that this is not just a “white girl problem”, that it affects, affects boys and girls from all different races. So talk to me about that?

Dr. Lisa Damour:

It does. It affects people of all races, ethnicities, sizes. I mean, eating disorders are very equal opportunity and they’re very dangerous. And so we want to be really thoughtful about how we talk about them. So for sure if a teenager brings it up, I think that that creates an opening to start to have a conversation. It also may be that a teenager “brings it up” using finger quotes by going on a diet that you can imagine. Can you imagine as a parent who has suffered with an eating disorder, knows how harrowing they are, how scary it would be to see your kid suddenly get weirdly serious about fitness or weirdly restrictive in what they eat. And I think here again, is an opening, an opportunity, and I think if the parent themselves suffered from an eating disorder, there also may be a genetic loading that the kid needs to know about.

Reena Ninan:

Well, talk to me about that. I was wondering if you have gone through these mental health issues, are your children higher probability that they will be susceptible or will definitely have these?

Dr. Lisa Damour:

There’s no “definitely you will have”. We know that for sure. There’s never a one-to-one correspondence, but is there a vulnerability? And the answer is like, yeah, truly. And we do know that there’s a genetic component to eating disorders. This doesn’t mean your kid’s going to have an eating disorder, but it does mean that you probably need to flag to them that they need to be careful that they may be more vulnerable. And then this is the same as true for alcoholism. We know that this can run in families, not just from what we would call environmental effects of kids seeing adults drinking more, that there can be a biological vulnerability. And so if there’s a family history of alcoholism, I think we need to let kids know. And I think that it can be very helpful to actually drill down on exactly what it is maybe getting transmitted genetically. And this is stuff we pretty much know, but we’re always learning. So for eating disorders, some of what we know can get shared or can be a biological vulnerability is a very high tolerance for hunger.

Not everybody can tolerate hunger. I cannot tolerate hunger. As soon as I’m hungry, I’ve got to eat. There are people though who can just ignore their hunger and we think this may have a genetic loading and we know that it can make it easier to have an eating disorder if you can just not mind being hungry.

For alcoholism, the way we think about where the genetic loading comes through, there’s a few different features. So fundamentally, alcohol is a biological agent that acts on our biologies and everybody’s biology interacts differently with biological agents. Some people don’t like Advil. It’s just different for different bodies. So for alcoholism, we think there’s a few mechanisms in play. One is how pleasurable you find alcohol to be. Some people don’t really like the feeling of being buzzed.

Other people love the feeling of being buzzed, and this can be true for other substances as well. We think that is genetically conferred in part. Another thing is how much it takes you to feel an effect. Some people are born with just a very high tolerance, they drink a lot and it just doesn’t really have much impact. They are at higher risk for alcoholism and substance concerns. And then the last is how bad the after effects are. So people, most people, if they get really drunk, they’re going to feel really terrible the next day. There are people who have a biology where they actually shake it off real fast and it doesn’t have that much of a negative consequence for them. That is also biologically based, and that makes us worried. So telling kids it’s not just random genetic, just having them know what the risk really looks like is important.

Reena Ninan:

I still have to tell you if I have mental health issues as a parent, I don’t feel comfortable discussing them. It makes me anxious and I just don’t want to have, and I know we’ve got to have these uncomfortable conversations, but what’s your advice when you have that talk, even if you’re entering it in a natural, organic way, what should I keep in mind if I have mental health issues and I’m talking to my kids about this?

Dr. Lisa Damour:

Well, it’s funny, Reena, I’m actually going to think about something that Tovah said last week in our conversation about what’s this about for me?

Reena Ninan:

Tovah Klein who was talking to us about building resilience in kids.

Dr. Lisa Damour:

Yeah.

That question of I feel like I need to talk with my kid about my history of and then fill in the blank, and yet I am coming up against a lot of internal resistance. I think that is such a good signal to actually unpack that resistance a little bit. Like what’s my worry? What’s my worry in telling my kid? Because say you smoked a ton of weed in high school, say you smoked a ton of weed in high school, that you totally regret it. You wish you hadn’t, and you feel like, okay, I’ve got this life lesson. I want to keep my kid from making the same mistakes. I want to say something to them, but also I don’t want to say anything to them. So interrogating the what’s the worry.

Reena Ninan:

And I’ve, I’ve got shame. I’ve got shame about it. I don’t want them to know. So maybe they’ll think it’s okay because I did it. Maybe they have an impression of me that I think will change.

Dr. Lisa Damour:

Those are wonderful reasons. I think you just rattled off a lot of the top concerns, which is I don’t want them to think less than me. I don’t want them to take it as permission. What was the last one you said? It was so right on.

Reena Ninan:

The shame? I think the shame of it.

Dr. Lisa Damour:

Right. Okay. I feel ashamed about this.

I think that one of the beautiful things about teenagers is that you can have meta conversations, you can have conversations about the conversation you’re about to have. So say a parent comes to the place where they are ready to talk with their teenager about having smoked a lot of pot in high school and yet they are anxious that their kid is going to take this as permission for the kid to do as they please around cannabis.

Past age 14, you can say to most teenagers, listen, I want to talk with you about my own pot smoking in high school and what I learned, and I want to try to spare you lessons that I learned the hard way. But let me just say at the outset, this is not me giving you permission to do it.

Reena Ninan:

So just tell them. Just say, I’m sharing this. I want you to know I’m sparing you. I love that language. You said, I’m sparing you.

Dr. Lisa Damour:

Yeah, I want to spare you. I learned the hard way. I’d rather you not have to learn this lesson. You can do the same. Say there’s something I feel like I need to share with you about my own struggle with an eating disorder in high school or college, but I got to tell you, I feel kind of ashamed. There’s a part of me that still feels shame about it and I just want to play my card’s face up.

Teenagers are generous, interested, and very tender around their adults’ vulnerabilities. I’ve learned that. They know and they don’t know that we’re whole and real people with histories. They don’t like to think about it all the time. But if we have it under good enough control and can just talk about it in a pretty straightforward way, in my experience, teenagers can take that in stride and leave with whatever message it was that you were hoping that they would take from it.

Reena Ninan:

When you look at healthy coping, Lisa, I’m just curious because I want to also talk about what makes for good healthy coping.

Dr. Lisa Damour:

Well, it’s interesting when you’re reading that letter, Reena, the writer, said something about how do I help them move towards healthy coping? And as soon as those words came out, I was like, oh, this lady has this totally under control. Because what she has fully metabolized is that her eating disorder, whatever else it was about, was about unhealthy coping, right? That’s what all of these behaviors that we worry about fundamentally at bottom have in common.

Abusing substances is unhealthy coping, eating disorders are unhealthy coping. You’re trying to get your hands around something you’ve landed on an unproductive self-destructive strategy. So I think that when we need to talk with teenagers about past events, past history, family life, the all time opening that’s going to come is somehow around coping, right? Kids have to cope. They have their ups and downs, they have good days and bad days, and so we’re watching their coping and we’re reflecting on their coping. And so when your kid’s like, oh my gosh, I had the worst day ever. I’m going to go for a run without being too corny about it, you can be like, you know what? That is such beautiful coping. That is exactly how we handle hard things.

Reena Ninan:

It sounds so corny, but you’re getting them to be aware that what they’re doing is taking the pressure off, like going to go play basketball. I’m going to go listen to really loud music in my room.

Dr. Lisa Damour:

Exactly. And so I think every relationship between parent and child is its own universe and its own unique thing, and you can’t really tell people how to do it. But I think that the fundamental is if a parent knows they’re in a good place with their kid to say, you know what? That is such healthy coping and it’s not the kind of coping I was using when I was in high school, and I’m so proud and happy as your parent that you’ve already found your way to such healthy strategies. Or the flip, right? Say the kid is doing destructive things. Say, look, you get to be upset. You get to have hard things. Unhealthy coping is not an option. The strategy you’re using is unhealthy. I have a lot of sympathy for this. I chose unhealthy strategies when I was in high school, but I love you too much. I’m not letting you do it this way.

Reena Ninan:

Just tell me, what do you see in teens that are like, you’re like, yes, that’s really great coping skills. What is healthy coping that you would love to see in teens?

Dr. Lisa Damour:

I get such a smile on my face around this question because healthy coping in teens can look so different from healthy coping in adults, right? Healthy coping in adults. It’s like you call a friend, you go out to dinner, you take a long shower. Healthy coping in teens, honest to God can be your super hairy 17-year-old son rereading, captain underpants, teens sometimes go back to little kid stuff as part of healthy coping. 

Reena Ninan:

Oh, really? I didn’t know that. 

Dr. Lisa Damour:

They love video games as part of healthy coping and within limits, a distracting video game that just connects ’em with friends or changes what they’re thinking about. That’s healthy coping. Teens love music. They love listening to music for healthy coping. Teens will go do physical stuff. Teens love to eat comfort foods for healthy coping, and again, within limits everything at moderation. That’s totally fine. Reena, we’ve talked about this, the skincare over the top skincare stuff. Can be healthy coping. So I think that when we’re trying to see that our kids are engaged in healthy coping, it’s really imperative that adults kind of widen the lens and not just look for a meditation practice as evidence that their kid is using healthy coping.

Reena Ninan:

For some people, it’s like shopping on Amazon or…

Dr. Lisa Damour:

Exactly.

Reena Ninan:

I want to ask you, as we’re wrapping it up here, what do you want parents to really keep in mind when it comes to dealing with this topic of telling your children, here are my mental health issues that I’ve struggled with?

Dr. Lisa Damour:

You know, Reena, when you ask it that way, it really helps me hone in on the key thing, which is it has to be about the teenager. You are sharing this information because of something that you really care about in your teenager, whether they’re starting to exhibit behaviors that you’re worried about or they have a friend who they’re concerned about, or you’re sending them off to college and somehow these conversations have never come up and that college can involve a lot of new stresses. And so you want to make sure that they know your worries about biological vulnerabilities to unhealthy coping. The kid has to be at the center.

I would say don’t bring it up if it’s just, let me just tell you about my life and a really upsetting and disturbing to my child part of my life. That’s not really how we want to approach this as parents. We always want to approach this from the standpoint of what does my kid need and how can I use my experience to try to help meet those needs, not I have this really painful story and the time has come for you to hear it.

Reena Ninan:

Cause that’s how I would approach it. I would be so dramatic and be like, this is just, I’m so embarrassed by this and dah, dah, dah, dah. But you’re also saying pay attention to the tone in which you’re delivering this.

Dr. Lisa Damour:

It’s got to be about the kid and what the kid needs. And Reena, I think what you’re describing a lot of parents would feel and warranted. Of course, these are, our pasts can be hard. People go through terrible things. Everyone deserves support around that. That needs to be, I keep using the word metabolized, it needs to be metabolized. It’s not your teenager’s job to metabolize it for you or to help you metabolize it. And I think that that’s the distinction we want to make.

Reena Ninan:

So Lisa, tell me what if you’re currently suffering with this issue, it’s not one and done in the sense of like you’ve put it in the past, it’s deep in the closet. What advice do you have for parents who are still struggling?

Dr. Lisa Damour:

There are parents who suffer from clinical depression. There are parents who have anxiety disorders that are not under control. It is not by any means a basic expectation that we are somehow parenting in full mental health. I mean, that is just not what is realistic. It’s not what a lot of people’s lives are.

I think here there needs to be honesty with kids. I mean, kids can see it, especially teenagers. And I think, again, and this is so hard when a parent themselves is suffering, there has to be a focus on the kid and the kid’s needs. And so I think a parent needs to try to get to a place where they can say, I am suffering from clinical depression. I am working with my doctors on trying to get it under control and get it to a place where I am really feeling better and able to do more. I know this cannot be easy for you, and I want you to know that your needs matter tremendously to me, and I’m going to make sure they get met even as I find my way through this. I think that anything that a parent is suffering with that stands to interfere with their ability to be the parent they want to be, should be addressed from a standpoint like that.

Reena Ninan:

A lot to think about here, but you giving us these tips of what to look out for, how to say it and to keep the kid really at the focus can help with these conversations.

Dr. Lisa Damour:

I think that’s right, and I’m so grateful for this letter because I think this parent speaks to so many parents’ experiences of having lived through something, having a knowledge base that they earned the hard way, loving their kid, wanting to spare their kid pain, wanting to use their own experience to spare their kid pain, and running up against the reality that to even try to coordinate with your teenager about pickup from soccer.

Reena Ninan:

Yeah, exactly.

Dr. Lisa Damour:

Next to impossible. So how do you have conversations like this?

Reena Ninan:

Yeah.

Dr. Lisa Damour:

I think that that is really, that just comes across so clearly in the letter, this parent understanding those tensions of things I want to share, and sometimes the extraordinary challenges of having even everyday conversations with teenagers.

Reena Ninan:

This isn’t always easy. In fact, especially at a certain age, it becomes really harder, I think. So Lisa, what do you have for us for Parenting To Go?

Dr. Lisa Damour:

On this topic of needing to have an important conversation with a teenager? If you get an opening, take it. I think that’s my number one advice. You don’t always get those openings, and I think that there are times in parenting where you feel like, okay, this conversation has to happen. No opening has arrived. I think then we need to be thoughtful about how we approach it, and my advice is get on your kid’s calendar. Say to your teenager, there’s a conversation I need to have with you about, and then fill in the blank and make it clear that it’s not because of something the kid did. This has been on my mind and the opportunity has not arisen. Are you available for that conversation now? Is there a time in the next few days where we could sit down? I don’t think it’ll take us more than 10 minutes, but we’ll see. Engage them in when the conversation happens a little bit about how the conversation happens. Do not do a sneak attack. Sneak attacks don’t go well.

Reena Ninan:

Great advice, Lisa. Thank you. Thank you for walking us through this and thank you to the parent who wrote this letter because it just makes you realize that you can have these conversations and the right way to do it. I want to thank you so much, Lisa.

Dr. Lisa Damour:

You bet.

Reena Ninan:

And so next week we’re going to talk about what do you do when kids at school are spreading ugly rumors about your kid? We’ll have that next week. I’ll see you then.

Dr. Lisa Damour:

I’ll see you next week.