It is great that the theme for this year’s Mental Health Awareness Week – sponsored by the Mental Health Foundation – is stress; because it’s so universal isn’t it ? Or is it and has the word become so overused and hackneyed that it has almost lost its meaning ? After all we all have stress don’t we ? Business men have stressful lives – even the super-rich do. It is stressful to travel on the underground in rush hour. We have all had stress at work, with little children, with adolescents and so on.

But as Dympna Cunnane, the CEO of the Kidstime Foundation, has pointed out there are some meaningful definitions of stress which really do matter – such as Sir Michael Marmot’s who has identified the holy trinity of severe stress as high demands, low control, and low support.

So consider this overused and abused word. It is often used in 3 different ways; as a verb ‘to stress someone ‘ or to be ‘stressed’ , as a noun ‘ my stress gave me anxiety attacks’, or even as the end product ‘ I’ve got an attack of stress’. Funny that it was originally an engineering word; metals or other material are ‘stressed’, meaning they are under tension – and at some point they will either bend too much or break. Actually it may not be so bad as an analogy – the things which stress us leave us in a state of tension. It can be mild and short lived or intense and continuous, and there’s an important difference. We all know that the feeling of tension means that one cant relax, cant enjoy things, have to stay too alert, and often cant think too clearly and may be distracted in ways that can be dangerous – for example if you are driving.

I – and we in the Kidstime Foundation – work to support children and young people who describe often constant tension when their parents suffer a mental illness. So when I heard about this year’s mental health awareness week’s theme I thought I must find out some more about how these children and young people experience and think about stress. So on May 2nd in preparation I met with 4 young people aged between 13 and 20 + years old, all of whom had experienced stress as a result of the impact of growing up with a parent with mental illness. We addressed three questions: Firstly what did they think stress meant: secondly was there a kind of stress from living with a parent who suffered from mental illness, and thirdly was there something different about that stress or specific to the effects of a parent’s mental illness on themselves ?

The discussion took off a pace. They all agreed that the effect was to be constantly worrying about something, that there could even be positive and negative kinds of stress and that stress meant different things to different people. The older young people pointed out that what mattered was how ‘you relate to the problems you are facing’, as that could be with physical symptoms, extreme emotions, or extreme behaviour. They then worked hard to identify ways of coping with stress that were less harmful to them and others. But they all agreed that a parent’s mental illness was a special kind of stress and that it was worse – worse because of the sense of responsibility they felt, because they were confused by what their parents did and said, and because they were told little or nothing by professionals, and also a specific aspect : because ‘ it (the parent’s state ) is constantly changing, and you are always having to adapt’. In addition they all agreed that the impact of a parent having mental illness meant that most often they had not had anyone who could model for them and show them positive ways to manage stress. The youngest there felt that ‘ Cos my mum has looked after me for all these years, I felt that I must give something back. I didn’t feel that I could let anyone else care for her as that would be letting her down’.

But one young person – Georgia (now aged 18, and her real name by her choice) – described the experience most poignantly. She said ‘ For me I have a lot of physical symptoms, headaches and my periods totally out of whack. I am quite a stiff person. I don’t like it when people touch me because of how stressed I am constantly, and I don’t like unexpected things. When you are as stressed as I am for as long as I have been your whole manner changes. Its never ending for me the stress about her mental illness, as I am having to constantly adapt. It was a small part – no actually a big part  – of why I gave up my A levels. I had no backup plan if it failed, so I needed to get a job so I could support my mum financially as well as emotionally’. 

What these young people had both told me and shown me was very clear, but still I wanted to know what really was the critical and different stress. I knew that a parent’s mental illness could mean that life was intensely insecure – emotionally and financially – that they all felt guilt and responsibility, and believed that their own lives must take second place to caring for their parent, but I also learnt something that was knew and not talked about in professional and media discussions. That is that they feel they must subjugate their own thoughts and at times beliefs because they are so desperate to maintain emotional contact with their ill parent – that is join the ‘ill’ thinking. As Georgia put it ‘My Mum’s view – partly as a result of her bad life experiences – is that everything is dangerous; friends are dangerous, the internet is dangerous, everything is. And I cant always argue with her or she just says ‘ You’re disagreeing with me cos you think its my Bipolar; you think I’m stupid because I’m Bipolar’. ‘When I was younger all those ideas did seep into my mind. Now I’m beginning to learn to trust people and to try to always see the other side before I jump to a conclusion’.

All these young people have found ways to manage stress, and increasingly more positive ways so that they are making a success of their lives, but there is a message for all of us. They need friends and supporters – not necessarily therapists – to help them think, to re-discover their own minds so that their stress can become positive.

Author(s)

  • Alan Cooklin FRCPsych

    Psychiatrist, campaigner for the children whose parents have mental illness, Founder of Our Time

    Consultant family psychiatrist, Founder and Academic Lead of Our Time as well as a private family psychiatrist. Developed and was Director of the Marlborough Family Service 1975-1995. Paediatric Liaison lead for UCLH and Consultant to the Camden and Islington Family Project for Major mental Illness, where I developed developed the ‘KidsTime’ workshops for families in which a parent suffers from mental illness. Retired from the NHS in 2015. Founding Chair of the Association for Family Therapy, founding Director and then Chair of the Institute of Family Therapy. Worked with families for some 45 years. Set up three University courses, and has taught throughout Europe, North and South America, Australasia, India, Singapore, and China. Regular expert witness in the District and High Courts in relation to Child Protection until 2015 Set up Kidstime Foundation in 2012 which became Our Time in 2018.