How to help your troubled teen after they turn 18

Your job as parent is far from over.  Parenting an 18 to 25+ year-old may feel the same as when they were 13 – 17 years old.  They’ve been behind their peers for a long time–emotionally or socially or academically. You’ve done everything possible to get them ready for adulthood but they simply aren’t!  For troubled young people, the teen years may last well beyond 18 into the mid-20’s to early 30’s.  It’s a period of setbacks and stress, when suicides and suicide attempts are higher.

The stakes are high for many years to come.

Over the past 24 years, I’ve asked a question of people with mental disorders and addictions; I’ve asked their parents, siblings, children, or their friends.  “At what age did you or your loved one make the conscious choice to take responsibility for treatment?  When did you/they get a stable job or live on their own, and associate with healthy people?  I asked dozens of people. Their answer? Every single one tells me they or their loved one didn’t turn things around until they were about the age of 30.  In my personal experience, the late 20’s is when they start to realize something is wrong and that they have to do something about it.  This is when many make their first attempts to get well.

True story: a co-worker told me about his bipolar disorder and years of addiction.  I would never had guessed that this pleasant, stable person had had such a troubled past.  Never in a million years.  I asked when he turned his life around; it was 30.  I asked what motivated him.  He said, “I couldn’t avoid it anymore.  I ran out of excuses.  I just hit rock bottom too many times.”

Why does recovery take so long?

1. You’re child literally isn’t aware they have a problem because they have anosognosia “a deficit of self-awareness” caused by mental disorders.  They can’t tell they are different from other people, and many resist being told that they are and resist treatment.
2. They get good at coping.  They squeak by, or use others, give up, or depend on others to rescue them.  Many delay the inevitable scary thought that there really is something wrong with them and only they can change their life.
3. Emotional development falls behind for young people with disorders or addictions. They may need an extra 10 years to go through the final brain maturation phase into an adult brain.

Because of their challenges, the adult child needs better life management skills than their normal peers–better self-discipline and self-monitoring, continual assessment of their state of mind.  It’s like a diabetic who must continually assess their blood sugar levels.  Your adult child need to remember to take meds, get enough sleep, and avoid situations that impact their wellbeing.  Your child must avoid excesses that their peers can get away with, e.g. risky liaisons, parties, junk food, marijuana and alcohol, anxiety-ridden situations, paranoia, despair.  They must stick with a healthy diet, exercise, sleep, and invest in supportive friendships.  You know your child, all of this may be hard for them!

How much to sacrifice and how much to let go?

Parents need to let go eventually.  Make a plan for pulling back a step at a time.  You may need to watch your child struggle, so plan to be encouraging and supportive and to avoid rescuing as much as possible. Parents are often tempted to rescue their adult son or daughter when a crisis occurs because it’s so hard for their child to recover from set-backs. But rescuing too much may make them more dependent as well as resentful.  On the other hand, pressuring a troubled young person act like an “adult” when they are not ready can push them to dependence on others who might make their life worse, or addictions, isolation, resignation, or self-harm.  Strive for balance, but be strategic when and how you hand your child off to the world,

True story:  I met a couple in their 70’s who’d rescued their demanding 34-year-old daughter her entire life, and couldn’t afford her financially or emotionally anymore. They were terrified she’d become homeless or suicidal, and deeply regretted that they may have unwittingly undermined her capacity for independence.  It was heartbreaking for them not to answer her calls.

It’s time to back away from direct support as a “parent,” and become a case manager, therapist, and mentor.

• Case manager – This is the busy work.  You fill out forms, make appointments and perhaps provide transportation to appointments; ensure prescriptions are refilled; check-in that your child has taken them.  You might follow-up on calls and emails regarding: banking, waivers, police reports, insurance, self-care, etc.
• Therapist – Just listen to your child’s demands or complaints; acknowledge and validate their feelings; but in your head, determine how much you’ll help without rescuing them or smoothing over issues.  Be supportive and caring but hold to boundaries.  What should they struggle with on their own so they can learn how to be a responsible adult.  Think about how and when you should rescue just a little bit.
• Mentor – Build trust by listening strategically for legitimate needs of any young adult.  When they trust you they’ll listen to you, and when they listen, you teach them all the things they need to know.