How to Support Adult Children Struggling With Mental Health

The New York Times

By Julie Halpert

July 7, 2021

Expert advice on how to gently offer help and compassion.

Katie Bradeen of Colorado Springs, Colo., began to worry about her 20-year-old son, Ryan, when he came home for Christmas break of 2020. She said he had a “gray demeanor” and “he seemed to be in slow motion.”

Though Mr. Bradeen was on campus for his sophomore year of college, the social distancing and virtual classes during the pandemic were challenging, especially for him as a theater major. The winter of 2021 “was even more difficult and excruciating than the fall 2020 semester,” he said.

His mother didn’t think he’d be open to a face-to face conversation, so she left a note on his pillow, written on pink heart stationery. She said she wouldn’t pry, but was “available to listen anytime he wants.” Mr. Bradeen said that he had been wanting to get counseling for a while but his mom’s raising the issue made him feel he had the “thumbs up.” He started therapy early in 2021, and his mother said she can already see the difference; there’s “more laughter and jokes, less grumpiness.”

Many parents like Ms. Bradeen were navigating the sticky territory of how to help young adults with mental health issues long before Covid-19. But the pandemic brought greater challenges, taxing already-vulnerable young adults even more.

Data from May 26 to June 7 from the Centers for Diseases Control and Prevention’s Household Pulse Survey shows that 43.6 percent of adults 18 to 29 experienced symptoms of an anxiety or depressive disorder in the previous seven days. The National Center for Health Statistics partnered with the Census Bureau on the survey questions, which are based on self-reporting and are not a clinical diagnosis; the data are weighted to be nationally representative.

The American Psychological Association’s 2020 Stress in America survey found that 34 percent of those 18 to 23 said their mental health has worsened compared with before the pandemic, a number higher than any other generation. Risa Garon, a licensed clinical social worker in Silver Spring, Md., and executive director of the National Family Resiliency Center, has seen in her practice that the pandemic has caused many young adults to lose “the rhythm of living,” she said.

Even before the pandemic, many young people struggled with major student loan debt, overall economic uncertainties and unrealistic expectations of success from social media, Ms. Garon said. Then Covid-19 hit, with its mandated isolation disrupting friendships and romantic relationships. It doesn’t always go as well as it did for Ms. Bradeen and her son. Ms. Garon said it can be common for adult children in her practice to brush off a parent’s suggestion that they need help.

David Palmiter, a professor at Marywood University with a private practice in Clarks Summit, Pa., and author of the book “Working Parents, Thriving Families: 10 Strategies That Make a Difference,” said that if a parent tries to intervene the wrong way, it could “drive a wedge in the relationship with the child.”

But there are effective strategies that can at least open the door to a young adult receiving help if parents see signs that their child is struggling.

If children aren’t local, Dr. Palmiter said, parents could arrange a weekly phone call or FaceTime and wait to establish that connection before broaching the subject of getting help.

Ms. Garon said that if parents fear that a young adult may be suicidal or likely to harm others, it would be appropriate to act immediately and call 9-1-1.

Show empathy.

Parents should avoid the temptation to lecture, which comes across as criticism and may shut down communication, Dr. Palmiter said. Instead, he suggested a sequence he called “pain, empathy, question.” Start by asking questions that help parents understand how the young adult is hurting, with language like: “How’s your mood these days? You’re doing so much.”

The next step, empathy, can promote more open sharing. If a child complains that their boss is yelling at them all the time, don’t step in and try to problem solve. Instead, say, “It’s terrible to go into work and be yelled at when you’re working as hard as you are. I’m sorry you’re experiencing that.” Then the parent can raise the issue of getting support.

If this does not lead to a child being more open to help, he said don’t fight it. Instead say, “If you ever change your mind, I’d be happy to partner with you in thinking about possible solutions.”

Laura Dollinger, of Beaver, Pa., tried this approach. She began to worry about the mental state of her daughter Emily after two distressing events: the breakup with her boyfriend in November of 2018 and the loss of one of her best friends in a car accident in February 2019. A straight-A student, Emily, now 19, said that she began to push “people away, slept a lot, skipped classes, and made friends with people who filled their own voids with unhealthy things.” Concerned about her daughter, Ms. Dollinger got a recommendation for a good therapist.

“My mom presented it in a nonthreatening way; I knew she cared about me and loved me,” Emily Dollinger said. She took the recommendation and said her counselor helped her to develop healthy coping skills, which she used in dealing with a recent breakup. The difference therapy made “was night and day,” Laura Dollinger said.

Mirean Coleman, a clinical manager for the National Association of Social Workers with a private practice in Washington, D.C., agrees that normalizing the situation is key; tell your child that many people struggle with their mental health and that it often helps to talk to someone about how they’re feeling. “Let them know that you will be with them every step of the way” and help them get to a better place, she said.

Ms. Garon encourages her young adult patients to approach treatment of mental health just as they would a physical ailment. Conveying the message that mental health issues are similarly treatable provides a “sense of hope.”

Offer help gently.

If a young adult is willing to seek treatment and can’t afford it, Ms. Garon said parents who can afford to help should offer to pay with sensitivity. Ms. Garon suggests saying something like: “We want to help. We know payment may be an issue. We don’t want that to be an obstacle.” She said it’s also important to respect young adults’ choice of treatment and medications.

Dr. Palmiter said for most circumstances with young adults, “Parents would do well to realize that they may ultimately have limited control.”

That was something Kelly Kerlin of Greenwood, Minn., came to understand. When her daughter Hayley, now 25, began to lose a significant amount of weight in 2015, she felt it was a way for her to have control in her life. “I was in an abusive relationship, so I felt like food and my body were two things I had control over when everything else felt chaotic and overwhelming,” Hayley Kerlin said.

When her mother realized it was an eating disorder and suggested she get treatment, the younger Ms. Kerlin initially balked. A year later, when she was so exhausted that she couldn’t fulfill her duties working at a restaurant, she checked herself into a residential eating disorder treatment center. Her mother recalled her saying, “I’m too thin. I don’t like what I look like and I don’t want to die.”

Even though she didn’t immediately follow her mother’s advice, Hayley Kerlin said that when she sought treatment, “I do feel like it helped to have my mom’s support.”

Seeking treatment is a huge step, she said, so parents should continue to be encouraging, be respectful and “give your young adult space to work through their experiences on their own terms.” Hayley Kerlin also suggests parents consider seeking therapy for themselves to help navigate these complex situations.

Ms. Kerlin completed treatment just over three years ago and said she’s doing well and will be starting a program to earn her master’s degree in education in the fall.

Even though seeking help as a young adult can be scary, she said it’s important to not be afraid to reach out to friends or family members so you don’t go through it alone. “Mental illness tends to thrive in secret,” she said. So telling somebody “can take a huge weight off your shoulders.” Though she was initially scared to seek help, “it ended up being one of the best decisions I’ve ever made.”