Orthopedagogue Carine Kielstra sees it every time when she starts a new course for parents with a depressed child. Panic. Despair. Parents who enter the training room restlessly.
“Is it me?”
(“No,” Kielstra then says.)
“Isn't my son just lazy?”
(“No,” is also her answer.)
“What should I do to help my daughter?”
(“Keep a close eye on her, but also on yourself”).
It's sometimes maddening for parents. Their child in the bedroom, that ever closed door, and that messy bed, their child in that messy bed, and those blankets over it, 'go away', 'leave me alone'. “Anyone who is depressed loses connection,” says Kielstra's colleague Bernet Elzinga, psychologist and professor of stress-related psychopathology at Leiden University. “Especially when things are going badly, especially when that bedroom door no longer opens, you have to keep entering that bedroom.”
But how?
In 2017, Kielstra and Elzinga set up the Strong Together course at the Rivierduinen mental health institution for these parents. Existing courses, they had noticed, mainly focus on parents of children with behavioral problems, which did not work for parents of children with depressive complaints. Kielstra: “Children with behavioral problems sometimes do not want to go to school or to the sports club for various reasons. Children with depression cannot do it.” Parents and educators need support. “In mental health care it is almost always about the child,” says Elzinga. Kielstra, nodding: “It is shocking. Parents are not told much about what they can do to support their child, while they are longing for guidance and hope.”
For the course they worked closely with system therapist Marjanke Ruys-Zonnenberg and orthopedagogue Romke van den Nouweland-van Baars. This collaboration was followed by the book of the same name for parents, which has just been published.
It had to be a book that – all four agreed – would contain 'not a word too many'. Kielstra: “Parents with a depressed child have their heads full. They don't have the time or energy to sift through woolly language in their search for answers.” It is not a self-help book – the subject is too complex for generalities, because one child and family is not the same, and one depression is not the same as the other. Strong together is actually more of a help-your-child book. It contains practical tips and information: what to do in case of self-harm or unhealthy social media behavior, what therapies are available for a child with depressive complaints? The book also contains questions with blank lines underneath, to be completed by parents in the hope that they will gain insight into their own situation. And they will find factual information about their child's condition: what is depression, what are the symptoms, what do we know from research?
Guilt
The authors hope that this knowledge will help parents get rid of persistent feelings of guilt. Depression can be caused by many different factors, social, biological, psychological, but many parents still look at themselves (and each other). “We think it is important to say to them: focus on what you can do,” says Elzinga. The psychologist and professor admits that she once also suffered from that blaming side and blamed the parents. At the time, she conducted research among adults with depressive complaints, half of whom indicated that they had suffered from critical or neglectful parents. “But we now also know from research that depressed young people view their parents and home situation much more negatively than young people without depressive complaints. That does not necessarily say anything about what it is really like at home.”
For a study yet to be published, Elzinga and colleagues from Leiden University recorded conversations between depressed children and their parents in 2018 and 2022, and conversations between children without depression and their parents. “We are still writing up the findings, but overall we see that young people with depression experienced the conversations as more negative than young people without depression, while independent raters saw no differences in how warm, loving and understanding these parents were.”
The researchers also saw that as time went on, depressed young people looked back on their parents' behavior more and more negatively. Just to indicate: that's how black those glasses that teenagers peer through can be.
But how do you recognize those black glasses? The answer: talk, talk, talk. An open door, but one that still too few parents go through, according to the authors. Parents try to help. Over and over again. Kielstra chuckles: “A father confessed that he wanted to pull his daughter out of bed by the feet, go-to-school-hool. He was a cat in a corner, wasn't he? But at that moment he also realized what research has been confirming for a long time: forcing is counterproductive.”
Define borders
Elzinga much prefers to use the word 'seduce'. “You have to make it attractive for teenagers to get out of bed. For example, by crushing it as soon as they are down. Cup of tea together.” Kielstra knows a mother who played poker with her child. She heard from another parent that he was going to play games with his son. The orthopedagogue also always advises parents against saying judgmental things such as: 'Are you still in bed?' Instead, say: 'It's good that you got out.' Even if it is 4 o'clock in the afternoon.
Independence, both authors say several times, is essential. Because puberty is inherent in developing yourself. “That urge is in a teenager,” says Kielstra. “And then it is up to the parent to show the child: just go ahead, try it yourself, we will stand by your side.”
This does not mean that you can let your child choose whether he or she stays at home. Elzinga: “You have to set boundaries.” Kielstra: “Because ultimately lying in bed is not helpful.” She talks about the father who sat down next to his son on the bed. To work. Coffee, laptop, but still: on that bed. Next to his child. For hours. “At one point that boy felt: hmm, this is actually not very relaxing. And he stood up.”
The book contains many such middle paths, often based on the experiences of other parents. For example, the agreement that if a child cannot go to school full days, it is best to agree that it will only go half days. Or: gym can be skipped. Or: a license to tune out every now and then, to sit in a chill room (“They have more and more schools”). Elzinga: “What was that moving anecdote like again, with that caretaker…” Kielstra, perking up: “Oh! One boy was always late because it was such a struggle to get up every morning. Instead of giving him a tardy note, the janitor welcomed him and walked him into the classroom – there's nothing worse than entering the classroom alone when you're already feeling bad.”
“But,” Kielstra continues, “let's face it: a child doesn't think of this. The school is needed for this. And a father, mother, educator.”
To do fun things
Kielstra and Elzinga are often asked by parents: will this ever be okay?
Of course they are aware of the relatively high, increased suicide rates among young people in the Netherlands. In 2023, Statistics Netherlands (CBS) reported that of all teenagers who died in 2022, 1 in 5 died by suicide. “That is more common than traffic accidents or cancer,” according to the CBS researchers. And suicide was also the main cause among people in their twenties (1 in 3). “That is very, very bad,” says Kielstra, “but we keep telling parents: the vast majority of young people get out. We also know from research: the more hopeful people enter a process, the more likely they are that the treatment will be successful.” Kielstra and Elzinga invariably answer that will-it-be-okay question with: 'Yes, but keep a close eye on your child.' And also: keep an eye on yourself. It is not without reason that the title of the fifth chapter in the book is 'Staying afloat yourself'. “The world of parents is getting smaller,” says Elzinga. “Depression has a pull effect. If you're not careful, it will swallow you up.”
'I can't break up with my child,' a mother once said during a course evening, 'but sometimes I wish I could'. That's why the authors insist: book that massage, go to the movies, don't skip your sports evening. Elzinga: “We once spoke to the mother of a depressed daughter. She found it difficult to go to a cabaret performance while her child sat somberly in her room. Felt selfish.” But later, when things got better, her daughter indicated that she liked that her mother had continued to do fun things. The mother compared herself, she wrote in the book, to a lighthouse: she had shone light in a period that was dark for her daughter.
You can talk about suicide on the national helpline 113 Suicide Prevention. Telephone 0800-0113 or www.113.nl.
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