Dear Dr. Michelle:
This past year, my oldest daughter has struggled mentally while our younger daughter has been thriving and adjusting well to change. I feel like we need to talk about mental health as a family so we can support each other, but I don’t know how to talk about it without making it feel like an attack on my oldest daughter?
It is good you are in tune with your oldest daughter’s feelings and potential reaction. Unfortunately, there is still stigma related to mental health. Hats off to you, as it seems you are being sensitive to not replicate that stigma in your household. Not knowing specifically what mental health issues your daughter may have, I’ll refer to them as her “struggles.”
If your family is not used to talking openly about your oldest daughter’s struggles, then it is best to start by talking to each child individually, beginning with the oldest daughter. Discuss her symptoms. Ask her if she is aware the rest of the family notices her difficulties, how it may affect them, and how the family could support her.
The goal of this conversation is to start making it comfortable for your oldest daughter to have open discussions with the family about her struggles and to name them. It is always best to be specific when talking about mental health and not couch the conversation in general terms. Children and teens can see through this approach and it can affect self-esteem and create even more sensitivity about their struggles.
Help your daughter identify how she wants to refer to her symptoms with the rest of the family and the external world. For example, if it is depression, does she want to call it her “depression.” Or does she prefer calling it “the blues” or “being down.” This normalizes it and give her some control about how people refer to her experience.
How To Navigate the Conversation
Discuss who needs to be in the know about her struggles. Have her identify who she is comfortable talking to about her struggles and if family members have her permission to talk to others. Be clear about the rules around discussing her mental health and let her have some control over this point. She has the right to privacy so long as the family can still support her in the ways that she needs.
Although your oldest daughter has some control over who needs to know, help her understand that it is not an option to exclude her younger sister in the conversation. However, your oldest daughter can be involved in how her sister is engaged. If you need to explain why it is necessary to engage her younger sister, emphasize that it is important to normalize these struggles. Not only will this help others respect and support her needs, but at some point, her sister may experience mental health symptoms herself. It is important for her sister to know that it is safe and okay to talk about these things in the family.
After you gain understanding and agreement from your oldest daughter, then talk with your younger daughter either alone, or with your oldest daughter (whichever the oldest daughter prefers) about sister’s mental health. Be open with each other about how the whole family can support your oldest daughter and the role each member can take.
Mental Health Topics
It will become much more natural from this point forward for your family to talk generally about mental health. Discussions on mental health can include a variety of topics including:
- Symptoms of common mental health issues, like depression or anxiety
- How to ask for help if struggling
- Activities that can help with our mental health
- How to give each other space
- How to recognize when to support others
Dear Dr. Michelle blog posts are informational in nature. The posts are not meant to take the place of consulting your physician, mental health professional, or other qualified health providers regarding your well-being or the well-being of others. Submitting a question does not establish a client/therapist relationship.
Submit Your Question on mental health and/or family relations to Dr. Michelle K. Murray.