DS1 collecting MH labels and I'm not sure counselling is helping

[teawamutu]

I'm hoping this won't sound horrible but I'm genuinely worried.

DS1 is 16. Had a fairly difficult time over GCSEs including being ostracised by his friends over a fallout. Was expressing anxiety and claiming mild self-harm and panic attacks so we spoke with the school and booked him some private counselling.

He's been going for a couple of months and says it helps and is progressing. But...

Yesterday he was 'having massive panic attack' in his room before school. Said had no control over his thoughts or limbs (we noticed nothing). Said he has 'muscle dysphoria' and is obsessively checking his body in the mirror. Has time out from lessons if he feels he needs it.

I have longstanding anxiety and depression issues myself (well controlled by meds) so there's no way I'd dismiss out of hand, but it seems to me a lot of what he describes is JUST BEING A TEENAGER.

But if I gently question whether A Label is really helpful, he clearly thinks I'm just denying the whole thing. Which I'm not, I know how horrible being a teen can be. I just question whether pathologising to this extent is healthy.

I'm not going to stop the counselling just in case, but I don't know whether I should be trying to speak to the counsellor or what.

Any MN wisdom would be much appreciated.

As a long term anxious person, also well controlled with drugs, I tend to agree. I'm not sure that having had my anxiety pathologised beyond "anxiety" would have done much good for me at that age and may well have made me feel unable to do some things/take part in some areas/study like I did. I'm a SENCO so
see this a lot; I'd say 75% of the population suffer from some kind of debilitating anxiety: giving it fancy names isn't very helpful in my experience, learning methods to cope with it is.

Yes - that point about having a diagnosis and therefore not being able to do certain things is exactly what worries me.

Would you try to have a word with the counsellor (obviously not about what they're discussing)? She seemed a sensible woman.

I'd rather have a name for something "normal" than no idea why I'm feeling this way, like when I was younger. I love finding out the specific word for something. If you don't know what something is, you can't get help for it. Awareness is awesome.

I think you're being sensible OP.
There is having anxiety in the true meaning of a mental health diagnosis and there is feelings of anxiousness that is normal...life situations can make us feel anxious..it doesn't mean we have anxiety.

Agree with you. It is good that we have better awareness of mental health now but I do think that DC will happily stick labels on just "normal" teenage feelings. DD says she has anxiety and OCD when I see nothing in her behaviour which would suggest either of these. So yes I agree that we pathologise these things much too quickly and that it's almost like you can't feel down without "being" depressed etc.

Teenagers seem more hung up on identities and labels nowadays, and there’s a huge competitive element to it all.

Dd is now an adult but is similar. I found there had to be a balance to how it was all dealt with - if she felt fobbed off she switched off and stopped discussing stuff with me, so there was a level of affirmation mixed in with more pragmatic practical how to deal with it conversations. When the moment was right we could have discussions about how most teenagers feel like this and that it does pass.

It’s not an easy time for teens right now, but I suspect that a large part is that there are too many adults around indulging every hurt feeling and bad mood, rather than allowing them to get on with it.

SchoolGlue that's a good way to put it - DS clearly does feel fobbed off when I just say what I think.

I can't seem to find a way of saying 'I'm concerned about labels because being nervous in a social situation is something to get over; having social anxiety is a reason not to try' without him thinking I'm totally dismissing his feelings.

I need to find a way of keeping the lines of communication open. Maybe Whatsapp, harder to flounce out of the room rolling his eyes.

I think I would have a good talk about what he is spending his time doing, TikTok and similar are rife at providing content that makes young people feel they have X, Y, Z condition when most are just experiencing normal angsty teenager experiences

I would also look at getting him outside, experiencing life away from his phone and school to develop more of an identity of his own. Conservation groups and some green gym work would be great, litter picking a local forest or beach or something similar. You could do it together or him alone. Our local Wildlife trust have different aged groups of young wardens where they do some bushcraft, first aid and project work for the nature reserve they are based at.

My DD is autistic, low support needs is likely to lead a very independent life. I have always made it clear to her that her autism is not a reason not to do things. It might be a reason to do things differently though so we work to identify where her struggles lie, discuss possible coping strategies and then practise using them at home and then applying them in the big outdoors.

For his panic attacks look at what happened that day at the event and before to cause it if that is indeed what it is. Go to the GP to rule out any nutrient deficiencies. Then get him to learn some coping techniques. Normally for DD her autistic traits trouble her more when she is stressed or under the weather much like irritability in the rest of us.

If your dc was suffering from a physical illness, something complex with many symptoms, would you tell him that it’s not worth looking fir all ‘those labels’, that he just needs to learn how to cope with his illness and that most if us have ‘symptoms’ like this anyway??

It’s a very serious question too because I’m suffering from ME and POTS. Having two labels, even though they are for very different illnesses, has lead to comments from medics on how I’m chasing labels for very similar symptoms.
Same with a few other conditions that are often linked with those (like MCAS).
The issue fir me: I need to pace for ME, be treated with medication for POTS and avoid some foods with MCAS. Despite all of those giving me very similar symptoms (huge overlaps).

I feel the same is true with MH. And having different labels might be easier for him to find ways to deal with his anxiety and panic attacks.

I agree with the OP

I think you missed the part in my op where I specifically said I have personal experience in this area and value appropriate medical treatment.

Questioning - based on my specific knowledge of this kid - is not at all the same as what you're suggesting.

By the sounds of it he’s not on medication? I suppose he might feel something like how you would feel if you were no longer on medication.

You can suffer a panic attack with no outwardly signs, l had them when l was younger, and got very good at masking them. I think it's good young people talk more about MH, my Mum was absolutely useless, when l told her she just said "l don't know much about them" and never spoke about it again, even 30 years later.

I was a teen in the 80s/90s. And even back then we would spend our lunchtimes diagnosing ourselves with depression, having read the symptoms in Cosmopolitan or More. Thank goodness things like 'muscle dysphoria' didn't exist then.

Looking back, mostly we were just being teens. Some of us could have done with some extra help - but mainly we were just normal teens.

I've worked my way through at least 4 mental health diagnoses in my time, the label isn't always the most helpful thing.

Who's diagnosed all these? Is the counsellor even qualified to make diagnoses? What are her credentials?

Also, ideally I would expect a therapeutic intervention to include psychoeducation so that he can recognise the difference between normal difficult emotions (eg nerves before an exam) and mental disorder.

It is important that he understands the difference and isn't pathologising normal albeit difficult emotions.

DS has, not the counsellor. And I obviously can't tell if he's talked about them with her, or what she'd say if he did.

To PP's point about meds; I'd be the last person to rule them out if necessary.

What I'm seeing at the moment, though, is a lad very similar to the shy kid I was. My worst issues came on later, in response to very specific circumstances.

All I want to do is be sure the intervention is at the right level for the problem: sure, you may have social anxiety, but you're also shy and out of practice. So will we try practicing and getting out and about a bit first?

What you describe is precisely what I'm trying to say! Thank you. Are there any books or anything you could recommend for teenagers?

I think what I would do is skip past the labels he is giving himself and just engage at the feelings level with him. So he says "I have muscle dysphoria" you ask what he feels about his body, how do these feelings affect him, is he comparing himself to impossible online airbrushed standards or whatever.
If you dismiss the label out of hand, then it may mean he becomes more entrenched in insisting on the label.
I'd just ignore the label side of it and just offer what support you can. His issues/feelings are true for him whether they meet the criteria for a particular label or not.
I think it is good that he is engaging in counselling as many teenagers refuse to. As he is still a minor, I don't think you would be totally out of order to talk to his therapist but make it clear that you don't want her to break any confidentiality contract she has with your son, just that you could do with some advice on how to deal with certain things.

That's brilliant advice, thank you. Engaging with the feelings not the label - will definitely take that approach.

And I’m sure you can appreciate that your way to experience things might be vastly different from your dc. That whatever worked fir you might not work for him. And that what worked fir him might never work fir you.
Especially when it comes down to MH!

But feel free to shot down a different pov because you don’t like it…. 🤷‍♀️🤷‍♀️
It was merely a suggestion coming from experience too….. (because you’re not the only one to have experience MH issues…..)

It's not that I didn't like it - it just didn't quite describe the situation I'm dealing with. Partly because other posters on this thread have articulated my concern better than I did in my OP.

I have considered, of course, DS genuinely having these diagnoses, and the GP will be my next step if I see anything deteriorate. My concern is that the labels he's talking about seem to make things feel more serious for him/stop him dealing with it, not empower him.

We will have better conversations now, I hope, and maybe do better at identifying what he does need. And whatever that is, I'll make sure he gets it.

Just to add, @TheGhostOfTheOpera, that I do appreciate your taking the time to offer the perspective. I read your post as being accusatory and it caught me on the 'you're being a Bad Mother nerve', and that might have coloured my reaction. So I didn't mean to shoot you down, but it obvs came across that way and I'm sorry.

I find the current MH system very dangerous for lots of teens. My DD has adhd (which was obvious from early years but due to CAMHS messing up etc only got diagnosed at 16). As it took years before her getting assessed by the time she had read all about different MH conditions and over identified with loads, Not helped by friends who also tried to label her. This extended to a point that psychologists/ MH professionals would be fooled by her presentation as she would act to meet certain labels and would do so extremely convincingly. However this would not be consistent over time and could switch from one condition to other sometimes in matter of minutes.

Needless to say this was extremely distressing for all, not lest to herself. As a parent for the first few months I was completely dismissed and my concerns ignored re label searching. There was awful lot of parent blaming and MH professionals who had NO qualifications/ training to diagnose would be labelling her as she would ask them what they thought was wrong with her. On a initial meeting with CAMHS the staff member tried to fit multiple labels and suggested starting various medications even though not within her competency. They even wanted her to be placed on MH unit which would have been the worts ever place allowing opportunity to fixate even more on diagnoses. If anything this made DD feel there must be something really wrong with her as professionals straight away want her on meds/ in unit (which I refused). in a way I get MH professionals as her behaviour at times was unusual, but if they listened to parents would know her emotional control had ALWAYS been extremely poor resulting on various issues, hence we had been help for long to get adhd diagnoses. Suddenly we went from having no support ever to various professionals wanting to med her/ label/ place in MH ward. it was horrible time and only made things worst than what they were before and totally broke my trust in services.

Luckily after months of hell one psychologist finally listened to my concerns (rather than dismissing all I said) and realised the patterns. After than she was also assigned a MH nurse who would not go into panic mode everytime my daughter said/ did something impulsive and avoided any diagnoses apart from adhd. They worked well together for a while and my daughter is now finally much more stable and relatively happy nearly 18 years old. She still has some difficulties and is on adhd medication that does help. She is now also aware of dangers of social media mental health post and has cut out “friends” who were feeding this bs to her. She is extremely sorry for all that happened and thankful I did not trust the professionals or allow for labels, meds, MH ward placements.

It would be interesting to read but by many professionals I was labelled as difficult mother. All I can say is that I wish I had never gone to CAMHS. The experience was extremely traumatising for all of us. All I would say to others is trust your gut instinct.