Married With (Sick) Kids

Parenting Teens with Health Challenges

Oct 13, 2024

Not quite twenty-four hours into a romantic getaway for me and my husband, our daughter hit a crisis point.

“I’m so dizzy, I can’t stand up for more than two minutes. I’m so nauseous, I can barely eat. I might need to get IV fluids,” she texted.

Instinctively, I paused our hike through the woods and dialed Ellie’s number. It didn’t matter that my husband Peter and I were finally on the 25th anniversary trip that took months of planning and childcare arranging. It didn’t matter that we were in the middle of a beautiful forest, alone on a weekday, besides skittering voles and the occasional swooping bird. What mattered was our kid was in crisis. Except that this teen lives in a constant state of almost-crisis, between her chronic physical health challenges1 and anxiety. In this instance, Ellie was fighting off a bad virus, which worsened her chronic health issues to a desperate place. Plus, she was alone in her college dorm room.

On and off throughout that “date” day, Peter and I talked to Ellie on the phone, soothing her tears, validating her pain, suggesting short-term solutions. Then we talked with each other about our daughter. At one point, as we sat on the beach watching the sunset, I said to Peter, “I don’t know if I can stay here. It’s hard to be on this trip with you when she’s struggling so much.”

Peter nodded sadly, adjusting his tripod. He put his arms around me and kissed my cheek. In silence, we watched the blazing yellow sun creep down the horizon, shots of yellow, orange and pink announcing its departure. When it finally disappeared, we watched streaks of tangerine trace its journey, colors dancing off the water.

One of Peter’s best photos from our trip

That’s when I realized that what was happening in that moment was a microcosm of the past four years, ever since our daughter’s mental health (and later physical health) decline began dominating our marriage.

Why it’s Hard

When our teen is struggling with mental health challenges or chronic physical health conditions, it’s often hard to find space to invest in a marriage, but it’s vitally important. Marriages are vulnerable during those times. Our relationship with our spouse can make our parenting challenges easier to bear or much more difficult. Studies show that many couples whose child has chronic health issues experience increased marital strain. There are several reasons.2

back view photography of two person under umbrella on snowy day

Exhaustion and Isolation

The weight of dealing with a teen’s emotional outbursts, angry withdrawal, or demanding treatment can feel crippling. When Ellie confessed her suicidal thoughts, my body felt like an electrified wire, always on alert. Two months later, after she declined even further into depression and admitted her eating disorder, my mind was consumed with saving her life. At the same time, Peter’s job required crazy hours; he oversaw safety during the height of the pandemic for an essential business. As Ellie entered treatment, her need for parental support increased even more. I took on the role of sole caregiver for Ellie (and her siblings) while Peter barely held down his job. This arrangement was a setup for resentment, exhaustion, and confusion. But we couldn’t see any other way.

My friend Jessie sent her daughter Brittany to an out-of-state eating disorder residential treatment center. That meant that when Brittany healed enough to step down to the partial hospitalization program, Jessie temporarily relocated to this city, without her husband, to support her daughter. In her daughter’s most volatile moments, Jessie found herself desperate and alone. As Jessie’s husband had little interest in joining family therapy sessions, Jessie felt even more frustrated.

Parenting Disagreements

Sometimes, couples struggle because they disagree on treatment options or parenting strategies for their child. This can be especially difficult if one parent functions as primary caregiver and therefore has access to more information while also carrying more of the weight of their child’s illness.

Tina and her husband Zane argue about their son’s psychiatric medications, as Tina is aligned with the psychiatrist and Zane prefers a less medicated approach. Tina grew up in the suburbs, where access to therapy felt normal, while Zane grew up on a farm, where personal problems were kept private. When their son acts out, they have different reactions; while Tina might feel ashamed and determined to rescue their son, Zane feels angry. Even though these tensions make sense, they lead to pain and distance, rather than mutual support.

Guilt and blame

Some couples sink under the guilt of what they might have done to prevent an illness; some beat themselves up when their teen’s recovery seems slow. Some spouses might blame the other for not doing enough to help the teen heal, or for doing too much, that it seems like enabling rather than empowering.

When we learned the severity of Ellie’s depression, I couldn’t stop looking for a culprit. I blamed myself or Peter for not being a “good enough parent.” Perhaps blame gives us a false sense of control, as if we can play God and fantasize about preventing the outcome we dread. In any case, I quickly found that blame only made both of us feel worse.

Unavailable for Intimacy

Logistically, it might feel impossible to spend alone time as a couple when we have a sick kid. Our kid might require frequent medical care or dedicated supervision. Their anxiety might mean that they can’t be alone. For months, Ellie’s therapist trained us to keep her under constant supervision. I could barely figure out when to go to the bathroom, let alone consider a date night with Peter. I used to joke that even though we could hire a babysitter for small children, there were no “BHCs” (behavioral health counselors) who hired themselves out to supervise a teen recovering from an eating disorder.

Some of us might not carry these types of caregiving responsibilities, but we may feel so exhausted that we are emotionally unavailable. One friend said that she just wanted to sleep when she was alone. Perhaps if we do have time alone with a spouse, we can’t stop talking about our teen’s needs. Or maybe we feel so depleted that we cannot support our equally depleted spouse.

In all of these difficult scenarios (and many more), it can be so hard to focus on “us” in a positive way.

Hope for Couples

There are ways that couples can come together during their teen’s health crises. After four years of navigating multiple health crises for our daughter and innumerable hard moments, Peter and I have found ways to strengthen our marriage. None of this came easily or quickly. We don’t feel like we have arrived, and we are not experts. But our marriage has moved from a place of spiraling to one of healthy partnership.

Here’s what I’ve learned from our experience and from our friends.

Become Allies

In the face of their teen’s darkness, some couples become allies, rather than enemies. Maybe their marriages were already strong; maybe they made a conscious shift.

I loved hearing about how Esther and James chose to be a team when their son had “Level Ten Meltdowns.” Even in their son’s most difficult times, they found ways to laugh together.

Cameron and Roy resisted the urge to blame each other, even when it might have been tempting. When a therapist pointed the finger at Cameron as a catalyst for Rachel’s bulimia, Roy refused to accept that narrative. When Roy felt responsible for Rachel’s genetic propensity towards mental health challenges because of his biological mother’s similarities, Cameron offered him grace and love.

As Peter and I found ways to even out our parenting arrangement (which was aided by his job change), we became a stronger team. I needed to get better at asking for my needs, such as time for self-care, rather than trying to be Supermom. Peter needed to find ways to incorporate “Ellie care” into his busy schedule, while also learning new ways to care for Ellie, such as monitoring her meals under her nutritionist’s guidance or accompanying her to doctor’s appointments. These changes felt uncomfortable for both of us at first, but they have led to greater mutual appreciation and partnership.

Along the way, Peter and I try to celebrate the small wins and affirm each other for our efforts. “Thanks for taking Ellie to that appointment,” Peter might say. “Way to go in staying calm in that fight with our kid,” I might say. Recognizing our shared purpose in helping our daughter heal has brought us closer together, as we pray and work towards solutions.

Find Support

Creating a support network, whatever it looks like, is essential for parents. Peter and I have found that it’s important for both of us to find ways to invest in our own self-care in order to be available to our daughter and each other. Often that has included having our own support network, a mix of friends, therapists, and pastors, who help us work through our challenges.

We’ve also relied on professional help for ourselves as a parenting team. For three years, we’ve prioritized family therapy with Ellie, because it provides guidance for us as parents and a safe place to work through conflict with our daughter. Having this therapist’s support helps us stay aligned and minimizes conflict.

At times, we’ve also joined parent support groups which have provided community and guidance that we needed.

Make Time

When our teens need a lot of us, it can be extra challenging to find time as a couple. But sometimes creative options emerge, like holding hands in hard moments, grabbing fifteen minutes to connect, or sending a meaningful text. Peter and I used to have “dates” in a sunroom where we could watch Ellie through a glass door to ensure her safety with some level of privacy. Kind friends offered to take our younger two kids when Ellie was hospitalized, so we could have a few quiet hours together. In some seasons, couples counseling provided a place to work on “us” when it felt hard to find each other.

Sometimes we also need to set boundaries with our children. On that beach, I prayed for Ellie, asked for guidance, and tried to trust that she would be okay as I focused on my marriage (spoiler alert: she got better the next day). I let go of the anxiety about letting my younger daughter down because we were missing her last tennis match, along with my concerns about our son’s progress on his college applications. Even though I carried worries about each of them, I knew that my actions would communicate something important: our marriage comes first.

When our children have needed much of our attention for a season, it’s normal to feel out of practice in making time for our relationship. It takes intentionality to make time to be together again. But it is worth it. Our partner can be our best ally in navigating the heart wrenching journey of teen health challenges. A strong partnership between parents isn’t just good for our teen - it is good for our weary hearts.