Divorce, Teenagers, and Mood Disorders/ Dr. Mark Banschick

Posted on July 14, 2010

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Divorce can create a range of conflicting emotions for teenagers, and their moods can swing many times during the day. (There are no definitive statistics as to the rate of Jewish divorce, but it is likely not dissimilar from the national rate of approximately 50%.  Divorce in Orthodox Jewish homes has been estimated to be between 15-20%).  After all, your son may be angry at his Dad, or not want to take direction from his Mom or he may simply be frustrated with a Gemara assignment. Given that emotions can run high, parents want to know if their child is having a normal reaction to the divorce.

Here are a few thoughts.
Mood disorders¬–whether depression, bipolarity, or some variation of the two–are more common in teenagers than we generally think. Tackling the issue from a diagnostic point of view can be tricky. By default, teenagers are inconsistent, moody, and they often test limits. In divorce situations, many teenagers struggle with many destabilizing issues. Aside from general moodiness, they can be angry, despondent or undisciplined as a consequence of their family situation.

When should you become proactive?
What you are looking for is evidence of extreme moodiness. You should take careful note if your child stays in bed an excessive amount, or goes for long periods of time without showering or changing clothes, seemingly losing interest in personal appearance and grooming. On the flipside, be on the lookout for flights of manic energy, sleeplessness and grandiosity. In these instances, you might be up against a bigger problem than mere teenage moodiness. Mood disorders are often hereditary, so educate yourself as to your family’s history of mental health. Inquire about your ex’s side of the family as well. If your child is adopted, you will have to dig further–did the biological parents have these issues?

Mood disorders, indeed any disorder, are defined not just by what one experiences but also how it impacts basic functionality. If you notice your son acting depressed, but he isn’t suicidal, he does well in school, he has good friends, is interested in shul life (assuming this was important to him prior to the divorce) and he generally gives off an attitude of contentment, you are most likely dealing with the normal combination of teenage angst. If he occasionally complains about the divorce or your parenting, but lives life well, he is probably okay. If, on the other hand, your daughter protests constantly that she’s “fine”, but you clearly witness her having trouble getting out of bed in the morning, her friends are no longer calling, and she has lost interest in what used to give her pleasure, this well may be an actual depression. Some teens going through divorce may actually become more compliant when depressed. They don’t want to rock the boat.

Depression and other mood disorders are treatable, and very effectively so, but you must be proactive and vigilant about getting the child seen by a mental health professional if you suspect there is a problem. I generally recommend that parents tell their children that they’re coming in for an assessment – there’s no obligation that they continue to see me or to get treatment. This reasurance generally lightens the load off them, allows them to feel less trapped, and paradoxically, lets them open up.

Once a depression, bipolar disorder, or their less severe cousins, dysthymia and cyclothymia, have been diagnosed, treatment often includes a combination of supportive psychotherapy, cognitive behavior therapy (CBT) or prescribed medications.

Different types of therapy all have one thing in common: the therapeutic alliance. The child or adolescent must feel understood by their helping professional. Whether the therapist is a social worker, a psychologist, or a psychiatrist the development of trust in that relationship is critical. Psychotherapy looks at how a child is doing and offers him or her ways to improve.

Treatment is not only focused on alleviating and coping with a youngster’s unhappiness or instability, but also about understanding and dealing with the problems that trigger their mood swings in the first place. Common triggers include a breakup, a move, the death of a grandparent or a pet, and of course, a divorce.

Therapy alone sometimes does the job, but at times, the mood problem is so severe or longstanding that medication should be considered.

People often put off the decision of medicating a teenager, but many psychiatrists, including myself, will tell them that medication can be very effective–sometimes the most effective of all treatments. And when it is effective, it’s a blessing. When it is indicated, we medicate children in order to give them the strength to overcome the obstacles that are affecting them, so that in the future they can get back on track and fare well.

Mood disorders are real. Like anything else in life, they are best handled in a straightforward way. During the tumult of divorce, your teen may be upset, but that upset can sometimes be a sign of deeper suffering. Keep your eyes open. Simple anger and disappointment may well be just simple anger and disappointment. But if you think your child has a mood disorder, get a consultation.

As a child, adolescent and adult psychiatrist, Dr. Mark Banschick has been working with children and their parents for over twenty years.  He is the author of The Intelligent Divorce: Taking Care of Your Children (2010) and an online course for divorcing parents. His goal is to make divorce a better experience for children.
Contact Information:
Mark R Banschick, MD
215 Katonah Avenue
Katonah, New York 10536
914-232-9000/www.TheIntelligentDivorce.com

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