How do I discipline my depressed child?

Disciplining a child is a common concern for most parents. They worry how they can do it appropriately, whether a child’s infraction seems minor or serious. But what should a parent do if a child is depressed or has suicidal thoughts? Is discipline during these times advised — or even effective?

Dr. Kelsey Bradshaw, a clinical psychologist with the Child and Adolescent Inpatient Program at Sharp Mesa Vista Hospital, answers parents’ top questions about discipline.

What is discipline?

Many people may think of disciplining children as ordering obedience or using punishment. But a more helpful way to consider discipline is by examining what your expectations are as a parent and how they are enforced for your child. When we see discipline as expecting our child to be perfectly obedient, this can set a problematic standard, as it can increase conflict within the parent-child dynamic.

What is a helpful way to discipline my child?

We typically recommend parents work with their child to identify some core expectations and continue to adjust those expectations based on their child’s development and temperament (i.e., biologically based differences in behavior that are mostly independent of learning). This helps set the stage for consistent expectations that can be modeled and reinforced through acknowledgement, praise and use of contingencies. These can be things like rewards and privileges that are dependent on the child engaging in a specific action.

How do I discipline my child when they're depressed or having suicidal thoughts?

It is important to understand your child’s temperament and circumstances. You want to strike a balance between having expectations while also being compassionate. Sometimes you must consider whether your child is able to meet current expectations. However, you don’t want to potentially enable harmful behaviors by not having any expectations or by doing too much for your child.

What are some signs that may indicate that my child is depressed or having suicidal thoughts?

Signs of depression include:

• Decreased time doing things they enjoy or spent with friends and family

• Significant decrease in school performance

• Absenteeism or strong resistance to attending school

• Significant problems with memory, attention or concentration

• Noticeable changes in energy levels, eating or sleeping patterns

• Frequent physical symptoms, such as stomachaches, headaches or backaches

• Expressed hopelessness or crying often

• Frequent aggression, disobedience or lashing out verbally

• Excessive neglect of personal appearance or hygiene

• Statements such as “I want to die” or “I don’t want to be here anymore”

How do I support my child when they’re depressed or having suicidal thoughts?

It's important to first check in with yourself and be aware of your own emotions. It can also be helpful to turn to others for support to help manage your emotions. Additional suggestions include:

• Try to remain calm. Do not raise your voice, talk too fast or threaten your child.

• Speak slowly and confidently with a gentle, caring tone of voice.

• Do not argue or challenge your child even if what they are saying seems unreasonable or outrageous to you.

• Empathize, actively listen and try to give positive support and reassurance. But avoid jumping into problem-solving mode or engaging in toxic positivity.

• Ask simple questions and repeat them if necessary.

• In a genuine way, say something along the lines of, “I’m here, I care and I want to help. How can I help you?”

• Try not to take your child’s actions or comments personally.

• Do not handle any crisis alone — reach out to your support system.

• If you have concerns that your child is contemplating suicide, stay with them, but try not to physically restrict their movement.

What resources can help my depressed child?

If appropriate, consider participating in family therapy. You can also reach out to your child’s school for support. Additionally, the San Diego Access and Crisis Line can be contacted at 1-888-724-7240 or you can text or call 988 for the 988 Suicide & Crisis Lifeline.

Another option for youth experiencing a severe behavioral health challenge is receiving care at Sharp Mesa Vista. Our hospital offers both structured inpatient and outpatient services to support the emotional and social well-being of children and teenagers. A child’s parent or provider, such as a primary care doctor or therapist, can call our hospital at 858-836-8434 for more information. We also accept outside referrals for outpatient treatment.

Ultimately, it’s just as important for parents to remember to help themselves when helping their child with challenges. Keep in mind the analogy of what you’re instructed to do if there’s an emergency when flying with your child — you have to put on your own oxygen mask first. We must be doing OK ourselves if we want to be able to help those we care about.

If your child is experiencing a severe mental health condition, learn how Sharp Mesa Vista can help.

For the news media: To talk with Dr. Bradshaw about this story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.