San Antonio psychiatrist Melissa Stennett Deuter noticed a common theme in many of the patients who were coming to see her. They were all young adults who had done fine or better than fine in high school. They went off to college and then they came home. They were given a diagnosis of anxiety or depression.
Their parents gave them space and time. Then months passed. They weren’t back in school. Often, they weren’t working or leaving the house. Everyone was frustrated, and they came to see her.
“If the plan is: this person is depressed and wait (until they are ready), more than half don’t get up,” she says.
San Antonio psychiatrist Melissa Stennett Deuter wrote “Stuck in the Sick Role: How Illness Becomes an Identity” about what happens to kids when they fail as young adults.
“They came to a set point and do the least amount that they had to do,” Deuter says. If someone else is willing to take care of you, wouldn’t you let them and not do for yourself?, she asks.
Her book, “Stuck in the Sick Role: How Illness Becomes an Identity,” tries to explain why this is happening and gives parents a guide to getting their now-adult kids on the path to being productive again.
“I see a lot of young people who are not seriously ill, not in the way they are afraid they are,” she says.
Instead, she says, “The reason he’s not getting a job is because he’s afraid and doesn’t know how. He’s never gotten a job.”
The world for these young adults has changed. We have emphasized academics. We have limited their unsupervised time. We have not given them life skills.
“We have kids who reach adulthood, and they really have no confidence in themselves; … they have limited skills,” she says.
“Stuck in the Sick Role: How Illness Becomes an Identity,” by Melissa Stennett Deuter
They go off to college because they are told everyone has to go to college, even if they are not ready. It’s much different than they think it’s going to be. They look depressed, but they’re not incapacitated, Deuter says.
“The problem is that their life plan isn’t working out,” she says.
They are stressed and they are exhausted. They probably aren’t clinically depressed, she says.
Yet, they are given a diagnosis and given medication. The medication they are being given, she says, can’t solve the fact that they need help building skills and regaining their confidence.
There’s a danger in taking medications that you don’t really need, she says, because the risks outweigh the benefits.
One of those risks is that you begin to believe that depression is your problem. “Now the story you’re telling yourself is that you’re sick, very, very sick, when in fact that the reason why the medication isn’t working is because you’re not sick enough for the medication to work,” she says.
It changes the young adult’s whole identity. Instead of being that successful person they saw themselves in high school, they see themselves as a sick person.
We can prevent this by preparing kids for life better, not just for academics. That means in those high school years, we don’t give their busy academic or extracurricular schedule as the reason why they can’t do the adult things such as being able to feed themselves, do their own laundry, handle a budget, do chores around the house, and maybe have a job.
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“If I’m raising a teenager who is going off to college in a couple of years, if he can’t get out of bed on his own and can’t prepare a meal, where’s that going to go in a couple of years?” she asks.
That adult life stuff is all things they can be doing under their parents’ watchful eyes but without parents doing it for them. It’s better to let them fail when they are still high-schoolers living at home, than in college far from home, Deuter says.
For parents who have that kid who has come home and now doesn’t seem to be making any progress getting a job or even getting out of bed, Deuter recommends parents set limits as soon as they get home (or now, if they already are stuck).
- Set a time by which they have to either be re-enrolled in college or have a job.
- If the choice is to have a job, but stay at home, make them pay rent.
- Expect them to have chores around the house.
- Require that they go to sleep when normal people go to sleep and be up during normal waking hours.
- Stop doing everything for them.
Little by little they will have success at a job or having some form of responsibility. They will want to leave the house again, though it might not be back to school. College isn’t for everyone,and it isn’t for everyone at age 18.
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