Questions and Answers

Q: My son is 10 years old. He was diagnosed with Depression and Anxiety Disorder when he was 8. He struggles in school. It is hard for me to sort through the problems and possible solutions because I don't get a lot of information from the school. How can I get more communication from the school so I know what is happening there?

A: You are right on target. Your son spends much of his waking day in school. How he manages through his day is vital information. At this moment in time mental illnesses are chronic illnesses that are managed over a lifetime, like asthma. They are not resolved or cured as would an episode of the flu. It is common for people of any age with a diagnosis of depression or anxiety to have "break through" episodes of their illnesses. This means that during treatment they have periods of stability but then an episode of new illness "breaks through" the treatment and they find themselves dealing with a recurrence of the illness despite active, previously successful treatment for their condition.

Because of this tendency it is critical that anyone with a mental illness learn their early warning signs: the things that typically signal early on that they heading into a new episode. These earliest signs tend to vary from person to person but are typically fairly consistent for a particular person. For instance, your son might notice that when a new episode of depression is emerging that he notices he forgets where he puts things or perhaps he becomes easily overwhelmed.

The University of Michigan School of Nursing did some research on early warning signs. You can view their findings at http://www.umich.edu/~urecord/9697/Jul30_97/Depress.htm. They found that although most the actual early signs themselves vary, most people move through several consistent stages:

1. "Something's Not Right"
2. "Something's Really Wrong"
3. "The Crash"
4. "Getting Connected"

This is where it is critical to have good information flowing to/from school. Your son spends considerable time there. It is important to collect ongoing observations of his functioning level during those hours. Teachers and other school staff have many demands on their time so it is essential that you develop a communication system with the school that is convenient and quick.

Click here to take a look at some of the communication tools on this website. There are several forms on the site.

Symptom Reports: Two of the forms relate to ongoing communication about symptoms. The forms are formatted the same for both Symptom Reports. One however uses positive language to identify the observations (i.e., alert, calm, respectful) the other uses Negative language (i.e., impulsive, irritable).

Medication Change Form: It is important for safety reason for the school to have accurate and timely information about the medications your child takes. This form is designed to quickly and easily update the school with each medication change.

Logs: The child's day is fluid and moves between home and school. They carry their challenges among their various settings. It is therefore important for the school to know about what is happening at home, and it is important for the family to know what is happening at school. Daily logs are quick and easy tools that help keep the communication flowing because a consistent system is used every day. A note is made in a log book each day by the teacher or assistant as well as the family. The notes keep both sides up to date. A note from home might mention that your son slept poorly last night, thus giving the school the head's up that your son might have less ability to pay attention or participate today. A note from school might inform the family that a big project was assigned today, detailed printed instructions stapled to the log, not only letting the family know the details of the assignment but also giving the family the head's up that the child might be overwhelmed by the day's assignment. Often the child's homework assignment notebook is used dually for assignments and as the daily log. Other times a separate blank notebook is used. The key is to use the system daily so everyone knows where to look for information. If the child is having issues on the bus an additional log can be used to communicate between the bus driver and family in a similar fashion. E-mail can also be used for these purposes.

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