How to Talk to Kids About a Parent's Brain Injury or Illness

When when a parent comes home with a brain injury or mental illness like PTSD or depression, it can be much more confusing for children. The injury is invisible, and the ways in which dad or mom has changed are much less predictable. That's why it's important for kids to get help understanding how their parent has been affected, and what to expect.

But being clear about these challenges is part of being the best parent you can be. Kids are going to notice changes in their mom or dad whether or not they know what's going on. Therefore, it's a good idea to try to talk to them about what's going on. Otherwise, they're left to fill in the blanks themselves, and may come up with other ways of explaining the changes in the parent, like "Mommy must be mad at me because I didn't write her" or "Daddy is happier without me around."

To help children understand a brain injury or psychiatric disorder, it may be helpful with younger children to talk about "invisible injuries." Even though you can't see the hurt, it's there, like a stomachache. Give examples of some of the changes the child may notice, like anger and frustration, forgetfulness, or sleepiness.

Gear your conversation about Mom or Dad's injuries to each child's developmental level. For instance:

• PTSD: For a younger child, you might say that as a serviceman, Dad had to function in a dangerous, high stress situation. He had to be very alert and cautious to stay safe. He got used to being in combat mode. Now he's having a hard time turning that off. 
  
  
• Depression: You might tell a child that depression makes Mom feel sad and blue, not just for a couple of hours, but for whole days, and not just when something sad has happened. Depression may mean that she doesn't feel like doing things she really likes to do, like play with you, or go to school events. She's having trouble having fun.
  
  
• TBI: To describe a brain injury you might say that Dad's brain is having trouble remembering things, or figuring things out the way he used to. Or his personality might change, so if he was a big talker before, he might be quieter now

Here are some other tips for talking to kids about TBI &  mental health changes. These tips could be applied to any situation where a parent has an ongoing struggle with a mental health condition:

• Do some research. Make sure that you understand the diagnosis so that you'll be more confident answering questions that come up. It's also okay to be honest with children about things you may not know the answers to, for example, "How long will it take you to get better?" It's okay to tell them you don't know.
  
  
• Work as a team. Another adult in the conversation can provide added support and track the kids' emotions during the conversation.
  
  
• Pick a good time and place. Make sure that children are not hungry or sleepy or having a bad day. Choose a time that doesn't conflict with favorite activities. Choose a location away from distractions in order to facilitate conversation. 
  
  
• Don't go into too much detail. Don't talk about the traumatic event or how the TBI was acquired.
  
  
• Check-in with children frequently for questions. It's important that kids feel that this is a two-way street. No question is too silly. Children will often wonder if they can "catch" the mental health condition or whether it was caused by something they did. 
  
  
• Be attentive to children's emotions. Older kids may be able to express emotions, so you can ask them how they're feeling. Younger children may have a harder time with their emotions. If you start to notice the child becoming quiet, fearful, or tearful, you can end the conversation and try for another time. Hopefully, this will be an ongoing discussion for the family, so there will be many other opportunities. 
  
  
• Tell them it's not their fault. Children have a way of personalizing things that happen in their lives. Even if they don't ask, make sure you say this to them, maybe more than once!
  
  
• Tell them they are loved. Explain that even though Daddy gets frustrated sometimes, or Mommy doesn't smile as much, they are loved just as much as before.

Matthew Rouse, PhD, MSW (2015)