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Archive for Tuesday, February 18, 2014

Double Take: Why can’t I take a ‘mental health’ day off?

February 18, 2014

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Dear Dr. Wes & Kendra: Why is it that we can say we're going to throw up and not go to school, but if we say we're too sad or feel like dying, we have to go. Aren't mental health issues just as important as physical ones?

Kendra: While in my eyes the equivalence of a sick day and a mental health day seem obvious, uninformed individuals often struggle to see a condition of the brain in the same way as other illnesses.

A parent can easily diagnose a red nose or a high fever, but may not understand the chemical imbalance that causes depression. And although I’m not a doctor of the body or the mind, I completely understand how to exhaust both.

Especially this time of year, anyone is susceptible to seasonal affective disorder, a winter depression resulting from lack of sunlight. And while I’m not among the 10 percent to 20 percent of people who suffer from S.A.D., I’ve certainly taken mental health days for other reasons.

As trivial as my problems may seem to others, stressful days packed with Showtime rehearsals, newspaper work night, and piles of homework can launch me into a panic. I know exactly what it’s like to look “healthy” on the outside, but feel ill in my brain.

Sometimes all I need is a good workout, meditation or a relaxing bath, but without time to do so, my stress doesn’t end. Although on some days missing school would only make me more stressed, taking the necessary day off to go on a run and then get ahead in reading for a class is the only way to alleviate my distress.

However, while I can simply stay home for a day or two to recuperate from a cold or even stress and exhaustion, others who suffer from serious depression or anxiety should seek professional help.

So while I understand parents not allowing kids to skip a day of school when facing a tough math test, allowing a day of recuperation is sometimes essential. And when these students get back in school and out of their heads, they’re far more ready to learn.

Wes: You may be surprised that, as a psychologist, I’m a bit torn on this issue. Mental health issues aren’t “all in your head.” They create very real symptoms and impairments. On the other hand, Woody Allen famously said, “Showing up is 80 percent of life. Sometimes it’s easier to hide home in bed. I’ve done both.” When one is feeling down and out, it’s really easy to make a bad situation worse by taking yourself out of the game. Moreover, when one is depressed, the standard therapy recommendation is to get up and do something, not hide in bed.

That said, I have written letters for teens asking that they be excused for mental health days, and I’ve rarely found schools willing to argue the issue, as long as the privilege isn’t abused. In fact, the entire purpose of that intervention isn’t to avoid school, but to increase the chances of attendance by allowing a safety valve to go off periodically. I usually fold that into a larger intervention where you go snowboarding or rock climbing or kickboxing — anything active that will improve your brain chemistry. Playing video games does not count in this regard, nor does lying around watching TV. A movie, museum, shopping, mini golf or go-carts all make for better mental health days than does lying around considering the pain and disillusionment of our modern world.

Kendra alludes to the other problem with mental health days in school. As parents and psychologists we rely on you to tell us about your psychology, and how much pain it may be causing you. Just as with physical pain, some folks are more resilient than others — they can bear more suffering. Our fundamental job in advising you is to know how much to push you and how much to hold you. That’s tough to judge and easy to mess up, meaning that we may at times not be sensitive enough to those needs. At other times we may give in too easily. Either error only adds to your impairment.

Thanks for raising an interesting question.

— Wes Crenshaw, Ph.D., ABPP, is author of “Dear Dr. Wes: Real Life Advice for Teens” and “Real Life Advice for Parents of Teens.” Learn about his practice Family Psychological Services at dr-wes.com. Kendra Schwartz is a Lawrence High School senior. Send your confidential 200-word question on adolescence and parenting to ask@dr-wes.com. Double Take opinions and advice are not a substitute for psychological services.

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