Stepping out of my home office for lunch break, the first thing I hear is a familiar whooshing noise coming from her bedroom. The sound that marks every telehealth appointment, serious conversation with her boyfriend, and bedtime (day or night) for daughter.
It’s a sound that I’ve grown to resent, as if the white noise machine is taunting me. Because it’s often a subtle reminder of the pervasiveness of my daughter’s illness. Sometimes it signals that she is sleeping while her peers go to class or jobs. Sometimes it sounds when she isolates in her room. As grateful as I am for her treatment team, the machine is a reminder of the numerous appointments that she needs to stay grounded.
Signs of Mental Health Issues
Over the past three years of parenting a teen with mental health challenges, I’ve noticed certain markers of both illness and recovery.
My car keys remind me that I am still driving my daughter, almost three years after she reached the legal age to get a license. After weeks of classroom education and countless turns around the neighborhood with her dad, my daughter’s anxiety brought driving lessons to abrupt halt.
Often the kitchen brings markers of eating disorder health and relapse. In her darkest days of bulimia, my daughter would bake and binge, bake and binge, then purge and restrict, leaving the kitchen in chaos to collapse on the couch. She left glass mixing bowls, spatulas, whisks, and spoons piled in the sink, while flour, like a fresh snowfall, covered my kitchen counters. Her bedroom hid empty foil packages of laxatives, bowls crusted with dried ice cream, and garbage bags that she vomited into. Today, she makes healthier choices, supported by her nutritionist. But her obsession with cooking, even in recovery, still dominates the kitchen.
A final symbol: my daughter’s school backpack by the back door. Although we packed our minivan to the brim in August and drove seven hours to the prestigious college of her dreams, we stumbled onto the painful truth that our daughter was flailing on her own. Due to a combination of physical and mental health conditions, our 18-year-old withdrew from college after two months and moved back home to regroup and connect with a medical team.
The Many Faces of Denial
Parenting a teen with mental health challenges invites a level of acceptance that most of us don’t want to embrace. The truth is that mental health issues show up in ways that are sometimes unwelcome, uncomfortable, or awkward. Rather than facing our child’s limitations and the manifestations of their mental health challenges, we may try to fix, control, or deny that they have a problem.
What might that look like? Here’s some glimpses into my life:
Straight-up Denial: “My daughter isn’t depressed. She’s just a teenager who likes to sleep. She’s not isolating, she’s just an introvert. She doesn’t have an eating disorder, she just doesn’t feel well at dinner. We’ve been good parents so it’s not possible that she could be struggling that much… right?”
In this stage, parents like me are too scared to step back and see what might be going on underneath the surface.
Control: “Hey, Ellie, I’ll lift you out of bed and wash your face. You’re not too tired, I’m getting you to school. Why don’t I invite that friend over, don’t you like her? Hey, only two brownies, remember? Don’t eat this, eat that. Let’s do your homework together so you can get it done…”
In this stage, I was determined to keep my child afloat by doing everything for her and directing her life according to my rule book. But I was also avoiding the reality of her sickness as my efforts made it appear, at least on the outside, that she was healthy.
Fix: “Hey, Ellie, do this to get well. Therapist, how do I help my daughter get well? What can I buy or do or learn or master so that my kid isn’t sick anymore?”
Of course, we work as hard as we can to help our child heal. We take advantage of every resource we can find, from support groups to mental health professionals to treatment centers to medication to faith communities. But I’ve noticed a fine line here: often, I have gotten so frantically, manically caught up in trying to fix my daughter because deep down, I believe that if I can work hard enough, she won’t be sick anymore. I can’t sit with the reality that she has an illness, one beyond my ability to heal, one that may accompany her for years, if not a lifetime.
What is Acceptance?
Acceptance doesn’t arrive on its own, like a peaceful meditating guru or a stroke of enlightenment. It takes effort to slow down and notice what is true, without judgment or automatic protest. To be clear, acceptance is not approval or agreement. It’s not about giving up or embracing defeat. It’s about noticing what is. In Acceptance Commitment Therapy (which I learned alongside my daughter), we acknowledge and embrace our thoughts and feelings, even the most painful ones. Instead of trying to change our loved one’s reality or even our feelings about it, we step back to recognize what is there. We take a breath and admit the truth to ourselves and others.
Al-Anon talks about three A’s: Awareness, Acceptance, Action, to slow down those of us who love to rescue sick people. Before we do anything, we need to become aware of our challenges and gradually accept, this is what is, even though we hate it. Acceptance lays a foundation for our own growth. Then we take action to care for ourselves first (so hard!) and our loved one.
Acceptance Leads to Grief
True acceptance carries a painful but necessary companion: grief. We may not even realize how desperately we are fighting against grief until we collapse. After all, ever since we birthed or adopted our children and held their small bodies close, we dreamed of hopeful, happy futures for them. We invested our hearts, our best energy and time, and our financial resources to help them to flourish. To face that they are sick with a debilitating, life-threatening illness is agonizing. We may grieve the loss of the child we knew, the uncertainty of our child’s future, and the loss of our family’s way of functioning.
For me, grief has meant realizing that my firstborn child, whose poems I’ve marveled over, whose humor tickles my tummy, whose kindness to small children fills my heart, has a sickness that causes her unmitigated suffering. And while there are many methods of treatment, there are no guarantees. Our family therapist described eating disorders as the sneakiest, darkest, meanest illness she knows. Even though my daughter’s eating disorder is in remission and her depression is manageable, the tentacles of mental illness still show up in her daily life.
When I’ve paused long enough to accept my daughter’s challenges, I’m often overcome by sorrow. This isn’t what I want for her! I cry out to God, my therapist, my husband. She is a shadow of the young woman that I know. Her illness handicaps her functioning and saps her potential. Everything we dreamed for her is slipping away. And the future, the “what-if’s” send me into a fear spiral.
Expressing my broken heartedness feels messy. Sometimes I yell and scream and use up half the tissue box. Sometimes I worry that my friends are sick of hearing me. But as I move through grief, I believe I’m embracing healing. As I lean into acceptance, I can start to envision our new reality. Ironically, as much as I’ve tried to avoid accepting my child’s mental health challenges, I’ve found that it leads to hope.
I’d love to hear your story. Feel free to comment or reply back to share your stories of denial, acceptance, grief, and hope. We are in this together.
I have a family member whose child had to leave their dream college two months into freshman year due to mental health, and is still living at home and struggling. I can’t imagine going through this as a parent. But I know how lucky your daughter is to have a mom who cares; who seeks to understand and help. My mental health struggles growing up were always swept under the rug, so I learned to hide them well until I collapsed in my 30s. I wish I’d had an advocate to help me navigate the system and get me the care I needed much sooner. So give yourself a pat on the back! Your daughter is lucky to have you. ❤️