How to explain depression/PTSD to young children

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Hi! I am currently working with a pt who is suffering from depression NOS and PTSD. He has two young children (6 y/o) and has told them he is in hospital because he hurt his back and not because of his mental health issues. He has expressed to me that he would like to tell his kids the real reason why he is in hospital, but is unsure of what to tell them/how much. Has anyone else ever encountered a situation like this, or know what they would tell their own young children if it were them?

Specializes in Nephrology, Cardiology, ER, ICU.

Hmm - is it military-related? I know the VA has family support groups for vets with PTSD.

Specializes in psych, addictions, hospice, education.

He could tell them that he has an illness that makes him very sad and nervous, and that he went to the hospital so he could get better...

He could tell them that he has an illness that makes him very sad and nervous, and that he went to the hospital so he could get better...

yes, this...

keeping it as simple as possible.

and that the hospital will make sure he is on the right medicine so he can come home.

leslie

Specializes in Community, OB, Nursery.

My son is 7 and adores his uncle, who also has PTSD from time spent in Afghanistan.

I've explained it to him like this: A while back we had tornados rip through our area - very scary. For a long time afterward our son was terrified of storms and got nervous whenever he heard the news say a storm was coming. I explained that something similar is happening inside Uncle's brain from all the bad things he saw and did during the war, and it scares Uncle just as much as the tornado scared DS. I've explained that sometimes loud noises make him jump, and sometimes it might look like he's staring at us without hearing what we're saying. Those things don't mean he doesn't like us, but that he's got some things happening inside his brain that can change his behavior sometimes.

I also reminded him that even if he's playing he absolutely cannot sneak up behind his uncle, and he can't do the stare-at-him-up-close-while-he's-sleeping-until-he-wakes-up thing. (DS likes to do both to his dad and me.)

Hmm - is it military-related? I know the VA has family support groups for vets with PTSD.

It is; however, I live in Canada. Also, my pt has not liked going to support groups in the past because he feels like he cannot relate to the other people in attendance. Another problem he has is that a lot of military related things trigger him so he is not very open to the idea of looking into any military mental health services we have available here.

Specializes in ICU, Telemetry.

I was a child during the Vietnam war -- we had a lot of dads on base with undiagnosed PTSD. What our 1st grade teacher said really stuck with me. She said that some of the Dads were stationed in a bad place, and bad things happened there, and it gives them nightmares at night. And sometimes they can have nightmares when they are awake. And just like we're scared and upset and sometimes cry after a nightmare, so do the dads when they have their nightmares. Don't scare them, don't be mad at them, and don't think they're mad at you. They're just having a nightmare.

Most kids can identify with a nightmare. It really worked for us.

Specializes in Medical Surgical-Oncology.

I was diagnosed with depression and PTSD in college and it wasn't easy to share with others. For the reason being that I didn't want people to think that I was abnormal. He should definitely tell his children the truth but he has to keep it simple so that he doesn't confuse them. They are young and don't understand complex information. He can tell them that he is sick and needs help that only the hospital can provide for him. That it will take some time for him to get better and that the nurses and doctors are taking care of him. Also, that he is still the same person and still loves his children very much. That's all they need to know for now until they get older and understand the dimensions of human behavior.

I was diagnosed with depression and PTSD in college and it wasn't easy to share with others. For the reason being that I didn't want people to think that I was abnormal. He should definitely tell his children the truth but he has to keep it simple so that he doesn't confuse them. They are young and don't understand complex information. He can tell them that he is sick and needs help that only the hospital can provide for him. That it will take some time for him to get better and that the nurses and doctors are taking care of him. Also, that he is still the same person and still loves his children very much. That's all they need to know for now until they get older and understand the dimensions of human behavior.

i agree with your entire post.

i also think it's important though, that his kids understand (to extent possible) that daddy isn't 'all better' when he comes home from the hospital...

that he is better, but not completely.

leslie

I worked with quite a few kids who have parents with mental illness so here are a few suggestions from my experience that you would need to tailor to the specific situation...

I completely agree with telling. Kids are intuitive and get a feel that something isn't right. Some of how you tell is going to depend on the cause of the depression and PTSD. If it is war or a car crash or something the child is aware of then that is different from sexual abuse or something the child doesn't know about.

Keep it simple...at 6, no matter what you say the focus should be on making sure the kids...

  • - Feel safe,
  • - Know that is isn't their fault, they didn't cause it
  • - Know its okay to be sad / worried that dad is sick, and want to help (and can help) but that they can't fix it - can't cheer dad up. Up to adults and doctors to try and fix it.
  • - Know that dad still loves them the same
  • - Know that dad is working with doctors to get better and this isn't forever.
  • - Feel comfortable to ask questions

I would give it a name - either depression or PTSD but not both. Go with whatever one is most prominent. Ask if they have noticed if dad is any different, what is daddy like at home...then let them know that sometimes daddy gets sad/mad/needs to be alone because he has something called depression. Or sometimes dad has nightmares during the day / night when he remembers something scary (tell the event if appropriate) because he has something called PTSD.

You can say something like "I know you worry sometimes because I don't feel good. Sometimes I get cranky, or get really quiet, and I can't help it. I know that this can worry you. I don't want you to be worried about me. I'm OK, and I'm getting better, and I'm going to take care of you no matter what happens. Even if I'm not feeling good, I'm still your dad and I love you and I want you ask me any questions you have anytime."

You can compare it to an illness the kids know...even a cold, how other people can't make it better, even dad can't help it or make it better by himself and that dad will have to check in with the doctor / take medication to make sure he is getting better. I wouldn't go into detail about the symptoms of depression / PTSD. Instead focus on what the presenting behaviour is...to get better daddy is getting help to sleep better, to get more energy, to get help calming down, to help with his nightmares, to stop crying so much, to not want to be by himself as much etc...

Talk about how hard it is to see someone different and that's its okay to miss the things they used to do with daddy when he was well. Also really important for dad to keep as much of depression / PTSD from kids as possible. Kids an be very irritating when you are struggling with mental health as they are loud, active, etc... so it is important to have times when dad has quiet..maybe someone takes kids to the park.

Let kids lead conversation to some degree. Don't give more detail than they want to know beyond the basics. Check in periodically with them to see how they are finding spending time with dad and if they have questions.

If it is war related there is a book that is available online called Daddy's Home - http://www.carolinanadel.com/PTSD/

And let the kids know that no matter how dad is feeling or acting, it's nothing THEY did... even if something happens that may appear that way. That dad can be very confused about what he is feeling, and he's getting help.

As a VA nurse and wife of a husband with PTSD (military related), I would suggest keeping it very simple. I tell my son (7 y.o.) that "Daddy feels very sad sometimes because....". As he gets older we explain a little more.

All the advice given here has been great. I feel for anyone who suffers from PTSD and MST. :-(

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